The Oxford English Dictionary defines a euphemism as, “a mild or indirect word or expression substituted for one considered to be too harsh or blunt when referring to something unpleasant or embarrassing”.
We all use euphemisms in our daily practice in a number of scenarios and settings. For instance when we have to communicate with small children there is little point using words they might not comprehend. So instead we say, “We’re just putting a small raincoat over your tooth and then we’re going to use our little vacuum cleaner.” These
euphemisms help to communicate what is about to happen, whilst attempting to make the situation less fearful.
We may also choose to simplify our language when talking to adults, so that we don’t come across as too scientific
and intimidating, or as arrogant and full of technological jargon. Thus we use terms 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. One particular time that
this happens is when referring to certain materials as being ‘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. Years later, having experienced many different generations of materials, it is clear that what this term really means is that the product is not robust enough.
‘Technique sensitive’ is therefore 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.
With these examples you can begin to see the use of euphemisms from two distinct perspectives. Firstly as a way of being kind to our patients, limiting anxiety and stress; and secondly actually highlighting how poor or insufficient our materials and treatments can be.
The real euphemism
The major use of euphemisms in dentistry comes from both of these viewpoints and of course relates to discussions of pain, and nine times out of 10 this is in reference to injections.
We rarely say to our patient ‘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”, or “a little scratch”, 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.
What is more, the names of the materials we use often don’t help. We are forced to use other words to replace the sometimes harsh sounding products: “can you pass the local”, or “can we have a bit of topical”, for instance.
Indeed if you think about what is involved in an injection, it is essentially thrusting two inches of cold steel through the gum. If we were to put it in these straightforward terms, I certainly don’t think many people would choose to sit in our chairs.
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. 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 unnecessarily 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 more 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”.
There is a French saying: “mentir comme un arracheur de dents”, which means: to lie like somebody pulling out your teeth. It would seem that there is certainly more truth in this than you might initially think, and perhaps we are doing our patients a disservice, hiding our shortcomings behind these euphemisms.