Dentists know that giving patients bad news or having difficult conversations can be a part of their job. Informing a client he or she needs a root canal or crown is never easy. The procedure is unpleasant and costly. At the end of the day, however, an hour or two in the chair and some ibuprofen will likely cure the problem. The patient fares well and has little need of extensive follow-up.
Telling patients they need an oral cancer screening is a whole other ballgame. Just uttering the "C" word strikes fear in anyone. Outcomes are much less certain. Dentists can't use amalgam or porcelain to fix a tongue or jaw that's cancerous. They also leave their patients with a great deal of anxiety because suspecting cancer based on a visual exam is not the same as confirming it with a biopsy or other reliable test.
It's best for dentists to have a formal plan for breaking news of this sort. The following strategies can help give clients the help they need:
- Seeing a specialist is generally required to confirm oral cancer, so patients should be given a list of referrals to qualified oral surgeons. Dentists can also offer the assistance of their office staff in setting up the appointment.
- As soon as the patient hears the word cancer, he or she will likely shut down and be unable to process more information. Clients should be given written materials which talk about the screening tests, and possible treatments.
- A hygienist or dental assistant should be present when the patient is told. This individual serves as a witness and can help calm upset patients.
- While a visual exam is insufficient to make a diagnosis, patients should be counseled that many sores and lesions are not cancerous. If a routine screening uncovers a suspicious area, dentists should stress getting it tested without worrying the patient too much. They should also go over risk factors as patient history can sway the need to get a screening.
The key to discussing oral cancer screenings with patients is to impart their importance without causing unnecessary fear. It's a balance that takes finesse and a good deal of compassion.