Euphemisms: it’s not what we say, it’s what we do - Michael Sultan

We all use euphemisms for many different reasons. We may choose to simplify our language when talking to adults, so that we don’t come across as arrogant and full of technological jargon, or when talking to children to not appear too scientific and intimidating. We therefore use euphemistic language that our patients are more likely to understand as a way of overcoming communication barriers.

Euphemisms are also used within the industry to put a positive shine or spin on something. You may be familiar with the term ‘technique sensitive’. When we first began using composites for instance, we were told by the manufacturers that these materials were very good, but ‘technique sensitive’. What this implied was that if not used exactly as instructed, the material was likely to fail and it would be the dentist’s fault.

‘Technique sensitive’ can therefore be seen as an excuse that shifts the blame to the practitioner rather than the product. It is a euphemism that glosses over the fact that the materials didn't always do the job they were meant to do.

These examples begin to highlight the use of euphemisms from two distinct perspectives. Firstly as a way of communicating and being kind to our patients, limiting anxiety and stress; and secondly highlighting how poor or insufficient our materials and treatments can be.

The major use of euphemisms in dentistry covers both of these viewpoints and significantly relates to discussions of pain. 9 times out of 10 this is in reference to injections.

We rarely say to our patients ‘I’m now going to give you an injection”, instead we’re more likely to say, “I’m just going to numb you up”, or “you’re going to feel a little pinch”, and this is really a way of avoiding the truth. What we need to say is “this will hurt”; but we don't want to induce fear.

Ideally we should be using injections that don’t sting, or rather anaesthetics without the needle. Some kinder ways of providing anaesthetics to patients do exist, but these still tend to be needle techniques, and there are also some needle-free options, but these are by no means perfected. Ultimately it seems that we are in the dark ages with our local anaesthetics and still thrusting surgical steel through human tissue.

Naturally for our patients dentistry can be particularly unpleasant, and our job should be to negate this as much as possible. So we avoid the words ‘pain’, ‘injection’ and ‘discomfort’, and we gloss over them with our euphemisms. The problem is that we shouldn‘t have to do this. We shouldn’t need to gloss over such aspects; we should be striving to improve them.

The point of a euphemism is to make people less fearful or anxious, or to replace the offensive terms making things seem innocuous, but really what it does is mark our failure to do better. We are all too happy to hide behind these euphemisms, but at the end of the day all this does is gloss over the fact that we are doing something unpleasant, and our research should be geared towards not having to come out with a euphemism, and being able to tell the truth when we say, “this wont hurt a bit”.

For further information please call EndoCare on 020 7224 0999

Or visit www.endocare.co.uk

Dr Michael Sultan BDS MSc DFO FICD is a Specialist in Endodontics and the Clinical Director of EndoCare. Michael qualified at Bristol University in 1986. He worked as a general dental practitioner for 5 years before commencing specialist studies at Guy’s hospital, London. He completed his MSc in Endodontics in 1993 and worked as an in-house Endodontist in various practices before setting up in Harley St, London in 2000. He was admitted onto the specialist register in Endodontics in 1999 and has lectured extensively to postgraduate dental groups as well as lecturing on Endodontic courses at Eastman CPD, University of London. He has been involved with numerous dental groups