“Please don’t give me a lecture on flossing today.”
I am sure that you have heard this countless times from patients before. You knew that it was coming as the same patient has asked you the same request during the visit before, and the visit before that. When I first started practicing dental hygiene, I found dealing with patients who did not want the flossing lecture very frustrating. So instead, I decided to change my mindset on approaching patient education. Rather than pointing out what they have been doing wrong from the get-go, I decided to think like a personal trainer instead of an oral health police officer.
The hygiene appointment: A personal training session
Perhaps you have an hour with a patient, or maybe it is their first visit to your dental practice. Regardless, treat it like a one-on-one session with the coach (you!). Assess their individual oral health condition, goals, strengths and weaknesses. Instead of generic advice, focus on what you’re seeing in their mouth.
One of my favourite tools for this is the intra-oral camera. I like to take before and after photos when I’m scaling, especially of the calculus behind their mandibular anteriors. A good visual is impactful and often enough to encourage them to change status quo. I also find using disclosing solution prior to debridement helpful as it gives a good visual of where the patient should be focusing their homecare routine.
Just as a personal trainer documents progress with measurements and pictures, we can create a visual journey of oral health improvement that motivates patients to stay on track.
Read: Insights from an RDH: How to foster lasting patient relationships
Progression over perfection
As dental professionals, we are quick to judge patients and roll our eyes behind our loupes when a patient makes excuses as to why they haven’t been keeping up with their brushing and flossing at home. Instead of critiquing them on what they have done wrong, perhaps we can encourage them and tell them what they have done right.
“Your gums are definitely bleeding less since you started using the electric toothbrush!” or “I’m seeing great improvement in the pocket depths in this area… I can tell that you’ve been paying more attention here since our last visit.” Recognizing any improvement no matter how small validates their efforts and encourages them to continue regular appointments.
This positive reinforcement approach creates a supportive environment where patients feel motivated rather than judged, making them more likely to share their real challenges and work collaboratively toward solutions.
Finding connections to things that matter
Just like how a motivational trainer would relate working out to their client’s personal goals, I’ve also learned to connect oral health to things that the patient cares about. For example: if I have a patient going on holidays, I talk about how important it is not to delay restorative treatment to prevent any dental emergencies potentially ruining their vacation. In another instance, if I have a mother who is expecting, I talk about the importance of maintaining good oral health in relation to the health of their unborn baby.
It might seem trivial but connecting the importance of oral health to circumstances that your patients value most creates a larger incentive for them to be proactive about taking good care of their teeth and overall oral health.
Taking one step at a time
Good trainers don’t encourage a beginner to deadlift two-hundred pounds on their first session. Instead, they focus on starting with light weights and using good form to achieve results. As an oral health coach, focus on one thing at a time: this might be in the form of introducing a different tool, a short-term timeline, or a change in a technique they’re already doing at home.
For example, I have encouraged patients who have never used an electric toothbrush to try a battery-operated one before they commit to investing in a plug-in power toothbrush. I’ve also suggested things like adding an alarm on their phone to remind them to floss at 8PM every Monday evening in hopes of creating a consistent habit. It’s amazing how small, bite-size changes can pump up a patient to tackle on a new challenge once they’ve mastered the previous one.
Coaching through setbacks
Any personal trainer knows that clients can sometimes have off days: sickness, travel or unforeseen family commitments can derail gains that have been made in the gym. A good dental hygienist should also be empathetic of their patient’s life circumstances.
When a patient returns with more tartar buildup after a stressful period at work or a family crisis, I acknowledge their situation first: “It sounds like you’ve had a really challenging few months. Let’s talk about what’s realistic for you right now.” Then we adjust our goals temporarily—maybe focusing on just maintaining twice-daily brushing during tough times, with the understanding that we’ll add back flossing when life settles down.
I’ve found that patients are far more honest about their struggles when they know they won’t be scolded by their dental hygienist. One patient confided that she completely stopped her oral care routine after a close family member suddenly passed away. Instead of lecturing, we created a “bare minimum” plan she could manage even on her worst days. At her next hygiene appointment six months later, she was back to a full routine and thanked me for not giving up on her when she’d given up on herself.
Taking a collaborative approach to dental fitness
The shift from lecturer to coach transforms the entire dynamic of patient care. Instead of us versus them, it becomes a partnership working toward shared goals. I now start appointments by asking, “Let’s figure this out together. What’s working for you?” and “What challenges are you facing?” rather than immediately pointing out problems.
This coaching approach has radically changed my practice. Patients who once dreaded appointments now come in eager to show their progress. They excitedly show me the new tools they’ve purchased or e-mail questions about different techniques between visits. Most importantly, they’ve stopped asking me not to lecture them about flossing—because they know that’s not what I do anymore.
We’re not the oral health police writing tickets for poor brushing. We’re personal trainers for oral health fitness: celebrating victories, working through setbacks, and helping our patients build sustainable habits that last a lifetime. And just like the best personal trainers, our success isn’t measured by perfect compliance, but by consistent progress and patients who feel empowered to take charge of their oral health journey.
So, the next time a patient says, “Please don’t give me a lecture on flossing today,” try responding with, “No lectures here—let’s talk about what’s working for you and what we can change to make your routine easier.” You might be surprised at how quickly the conversation transforms from defensive to collaborative. After all, the best coaches know that lasting change comes not from perfect performance, but from building confidence… one small victory at a time.
About the author
Marguerite Maslo, DipDH, BSc, RDH, has over a decade of clinical experience and currently practices in a general practice office in Edmonton, Alberta, Canada. She has taught the local anesthesia module for dental hygienists at the University of Alberta and graduated with a Diploma of Dental Hygiene in 2011 and a Bachelor of Science in Dental Hygiene from the University of Alberta in 2012. Outside of her professional work, Marguerite is passionate about traveling and volunteering. In 2018, she participated in a dental mission to Cotacachi, Ecuador, with a local charitable organization.