Blood Thinners and Toothbrushing

Communication.  Most gets lost somewhere between the one speaking and the other hearing.  Statiscially, only 10% is understood, so I guess we must make up the other 90% in our heads as to what the speaker is telling us. It happens everyday. I guess because the hearer thinks what the speaker is saying and doesn't ask clarifying questions. In our dental office, clarifying questions are encouraged so that both the speaker and the listener have a better understanding of the communication taking place.

Recently, during the course of reviewing his health history, a patient informed me he had been put on a blood thinner due to a heart issue. During the dental hygiene exam, I noticed heavy amounts of plaque all along his gum line and (once the plaque was scraped away) several areas of white, chalky enamel. I proceeded to ask him how his daily plaque control was going.  He informed me it was going very well.  His doctor had told him to use a very soft toothbrush, and don't brush the gums because it might make them bleed.....oh boy.....

Whelp, I'm sure his gums didn't bleed, because he didn't even get close with the toothbrush.  Now he has gingivitis AND three cavities at the gum line.  I'm thinking something got lost in communication!

Probably the MD said something like, "With this blood thinner, you may experience more bleeding.  When you brush your teeth make sure you have a soft bristle toothbrush and brush gently." What the patient heard was, "Don't brush your gums, because they will bleed." To go one step further to clarify, the doctor may or may not have (or should have) said, "Now it is important to brush throughly, because if you don't clean the bacterial off, especially at the gum line, MORE bleeding will occur because the body has to fight off the bacteria that is left there." If the patient can say back to the speaker in their own words what was said, then both parties will have a better understanding of its meaning.

Now this patient has generalized gingivitis and cavities, and he has to be reappointed to have restorations in the teeth with cavities.  Hopefully, words were communicated in a way that he is better educated with his condition so that problems like this can be avoided in the future.  While it is up to the speaker to communicate the message to the listener, the listener also has to ask questions to clarify communications.

Health-bites: brush plaque away from gums to avoid disease AND ask clarifying questions