When a simple email becomes a complaint: Why communication truly counts

Yvonne Shaw, Underwriting Policy Lead at Dental Protection, shares a case that shows how thoughtful, sincere communication can prevent patient concerns from escalating into formal complaints.

How routine care can lead to unexpected complaints

This case involving a dental hygienist shows how your interactions with patients can often escalate unexpectedly, especially with online communications.

Managing patient expectations after hygiene treatment

Ms P was a patient at a general dental practice, though she was a somewhat irregular attender, and she had not been in for her regular dental care for some time. Ms P was referred by her treating dentist to the practice’s self‑employed in‑house hygienist, Ms L.

When Ms P arrived at her hygiene appointment, Ms L conducted a thorough clinical assessment to discuss ways to improve Ms P’s oral hygiene, which included Professional Mechanical Plaque Removal (PMPR).Subsequent to this appointment, Ms P began to notice changes to the shape of her teeth and, troubled by this, proceeded to email a complaint to the practice regarding her concerns, forming the opinion that her teeth had been “damaged”, having been left with the appearance of “black triangles” by the scaling treatment that she received. This was all despite Ms L explaining to Ms P at the outset that areas of calculus would be removed from her dentition, which may alter the way her teeth may appear or feel.

When email responses escalate rather than reassure

The practice received Ms P’s complaint and forwarded this on to Ms L for her to review and respond. Ms L was somewhat surprised by the receipt of this complaint considering the discussions that had taken place. Feeling somewhat hurt in what she perceived as a slight on her clinical skills, Ms L responded to Ms P’s complaint with a somewhat brusque email with equal parts “I told you about this already” and “if only you came regularly this may not have happened”.

This response did not achieve the de‑escalation that Ms L had anticipated, with further upset emails arriving from Ms P. Consequently, Ms L decided to get some advice on how to proceed and called Dental Protection to discuss her concerns.

Seeking dentolegal advice before matters worsen

Dental Protection assisted Ms L with a further response to Ms P. In this email, Ms L took the time to explain the situation in a non‑defensive way and in terms that Ms P understood. Ms L also took the time to convey her genuine concern for the distress she had experienced and offered a heartfelt apology.

Ms L was genuinely surprised by Ms P’s response to this letter, which acknowledged the time Ms L had taken to respond a second time, which Ms P was not anticipating, and politely accepted her explanations and apologies. Ms P advised that what had meant the most to her was that Ms L had not just ‘fobbed off’ her concerns and had taken the time to explain the situation in an open and honest way. Ms P continued to attend the practice, along with her husband and children.

Practical lessons for handling challenging conversations

Learning points

• Communication matters – not only the content of our communication but also the tone. Though at times difficult, communication with our patients should be genuine, sincere and heartfelt. This lends itself to a more open and meaningful experience that is more inclined to address the heart of the matter and prevent unnecessary escalation.

• Research has shown patients rate “black triangles” as the third most disliked aesthetic concern and therefore demonstrates the importance of discussing interdental “black triangles” prior to commencing supra and subgingival PMPR.

• Dental Protection can offer advice and support on effective communication with patients. Members can access helpful resources and training modules about ensuring effective communication on Dental Protection's online learning platform.

Why this matters

Dental Protection exists to protect, support and advocate for dental professionals throughout their careers. As the world’s leading member‑owned defence organisation, we combine decades of dentolegal expertise with practical support, education and professional indemnity designed around the realities of dental practice. By sharing insight drawn from real cases and investing in initiatives that support wellbeing from the very start of a career, we help reduce risk before it leads to complaints, claims or harm to patients. Our aim is not only to respond when things go wrong, but to provide the reassurance, knowledge and protection dental professionals need to practise with confidence.