Floss or Get Lost
Dr. Pearly White—often called Dr. W. by his patients—is a world-renowned general dentist. Everyone who has ever attended Dr. W.’s clinic has had all of their oral hygiene concerns assuaged and treated. When it comes to flossing, Dr. W. is passionate about the habit, to say the least. When patients come to Dr. W.’s and lie about or admit their less-than-ideal flossing habits, Dr. W. cannot help but frown. Oftentimes, patients report that Dr. W. does not shy away from scolding them about how “idiotic” one has to be to not practice what is, in Dr. W.’s eyes, the simplest habit one can adopt for a myriad of health benefits. He insists that flossing each night can aid in removing plaque and food stuck between teeth, reduce the chance of gum disease, and get rid of bad breath. Dr. W. is quick to burst into lectures to the point that patients regret going to the dentist in the first place, as they report feeling “attacked,” “shamed,” and ultimately discouraged about the idea of coming to see a dentist regularly.
In Dr. W.’s eyes, flossing is simple and effective. As a dental professional, it is unimaginable how one could avoid flossing when there are so many benefits. Dr. W. feels that if lecturing and making his patients feel bad for this one moment leads to a change in behavior, then any harm is minimized. Dr. W. assumes patients do not know nearly as much as he does about the health benefits in question. If patients cannot adhere to this simple advice, Dr. W. reasons, then he has no time to waste on what he calls “flosstrophobia.” Dr. W. aims to help patients to look at the bigger picture of their health, and feels this is the best way to share concerns with patients—to truly make them understand the gravity of their decision not to floss.
Several patients who were on the receiving end of Dr. W.’s lectures have reported the opposite of what he hoped. By being ostracized by their dentist, they felt anxious and unwilling to listen to what Dr. W. had to say. According to a 2018 study, 61% of respondents avoided going to the dentist because of anxiety and fear about dental visits, and about 4% reported never having gone to a dentist in their life for the same reasons [1]. Patients have shared that going to the dentist is stressful, as they feel their mouths are one of the intimate parts of their bodies. They also share that they sometimes fear going to the dentist because of what might be said about their overall oral health. Former patients tell Dr. W. that if he had informed them of the benefits of flossing in a more approachable way, then they might have reconsidered their decision to leave his care. Often, after a bad experience, patients avoid going to the dentist altogether as they see no point if they are just going to feel ashamed.
DISCUSSION QUESTIONS
Has Dr. W. done anything wrong?
Is it ever morally permissible for a dentist, or any healthcare professional, to use shame tactics to entice patients into changing their behavior?
Do the risks of not flossing outweigh patients' feelings?
References
[1] Dental Products Report, “Study finds more than 60 percent of people suffer from dental fear”
