Many complex care patients have lost hope that dental health is possible for them. 

Restoring hope is the fourth step in building emotional momentum. 

I learned about restoring hope early in my career. I practiced as an associate in a small community called Spruce Pine in western North Carolina in the heart of the Blue Ridge Mountains. Most of my patients drank water from wells on their land. There were no community fluoridated water supplies. On top of that were strong cultural attachments to soft drinks, cigarettes, and alcohol. Consequently, many of my new patients had severe dental conditions. After my exams, I’d reveal to patients all their conditions and my treatment recommendations which included most of their teeth. 

What surprised me was their indifference to it all. 

I’d hear, “Well, doc, both my parents wear dentures. I guess I’ve got soft teeth. What’s the use in fixing them when I’m gonna end up losing them anyway?” I’d push back on their indifference and told them modern dentistry could do amazing things. I felt I had to defend dentistry to those who lost faith in it. 

After a short while, I began to realize patient education can have unintended consequences. It discouraged patients.

Many were already in a negative mindset about their “soft teeth,” and my new patient experience confirmed it for them. It was this realization that became my turning point. This shifted my emphasis during my post-exam discussion from negative framing (here’s everything wrong with your dental health) to positive framing (here’s everything I see that’s good about your dental health). For every condition outside of normal limits, I described the ones within it. 

Immediately I began to see a change in patients’ responses, and I’d hear things like, “Doc, no one ever told me about the good things; just the bad things.” My team and I got really good at positive framing and gave patients hope. 

Positive framing doesn’t mean sugar-coating patients’ conditions. It’s about presenting a balanced appraisal of their dental health, citing the healthy and unhealthy conditions. 

At times, patients need more hope than education. Patients will appreciate and remember and how well you made them feel. Inspiring hope as the emotional outcome during patients’ post-examination discussion is critical for complex care patients.