Shaking the Cheek

This is another in our series of previews of the material inside our knowledge base. We have mindset material to help owners, managers and mentors understand key concepts and communicate them effectively to their Teams; Team-facing training material that directly shares important knowledge and expectations; and hands-on tools like conversation scripts, meeting agendas, decision trees, worksheets, and other methods to help you organize information and triage your ongoing process toward change and growth. 

Dr. MacInnis always practiced under the assumption that if you weren’t getting unsolicited compliments on your needle technique, you weren’t doing it right. The cheek-shaking technique was how he earned those unsolicited compliments. He counted it among the items the success of his practice was built on. In the Growth Platform, we’ve enshrined it as an Effective Action in Dentist’s 4Blocks. We include a video to show not only the technique with the needle, but the the right kind of patter or banter to help achieve the maximum effect: 

Just as many feel that they either invented or discovered it for themselves, or were let in on it like a secret by a mentor or colleague. I have heard successful senior dentists say very sincerely, with a reverence usually reserved for departed dogs, that they are sure that it is the secret their success, that it was the key thing they did that the dentist across the street didn’t care enough about, that they built their practice on the cheek-shaking technique.    

 Patients really do love it. Here are (one and two) random Yelp samples just chosen randomly off the top of a search for cheek shaking. 

"Cheek shaking" seems to be the accepted term for it, and the search results for the phrase make it clear that it’s one more place where machines have been invented to do an easy but somehow impoverished version of something a human being can do with great warmth, and to greater effect. The machines miss the point, though.

The mechanism behind the physical effect of the shake is explained by gate control theory, which states that non-painful input closes the "gates" to painful input, which prevents pain sensation from traveling to the central nervous system. Therefore, stimulation by non-noxious input is able to suppress pain. 

But the pain gate is only the explanation of the effect on the nerves. The overall effect on the individual patient is dictated by how the dentist performs it, and the purpose of delivering a painless injection is about more than just avoiding pain. It's about building trust. 

The “Bob Shake,” as they called it at his practice, was all about making a connection, and building trust through a powerful demonstration of skill in evading pain and discomfort, which so many of us have been led to believe is just a necessary element of dentistry. When the machine does it, it’s expected. When a person does it, it means something.   

 
No matter what you call it, the cheek-shaking technique for injections is something that many dentists swear by. The point here is not just to share the trick, but to discuss its unique place in a dentist’s bag of tricks, and to use it as a prime example of the mindset that separates a dentist who wants to be great from a dentist who just wants to finish. 

 It seems like cheek-shaking has become a standard now, so it may not be a romantic thing to the many younger dentists out there, who seem to be learning it in school or on the internet as something that “everybody knows.”

But there was a time when it was a secret, passed dentist to dentist, or, like so many practical inventions, discovered by many different people in different places working independently on the same problem—how to poke people with needles and still have them want to see you again—thrilling at the feeling that they knew something that made a huge difference. 
Cheek shaking doesn’t just solve a problem, it jiu-jitsus it, flipping a strong negative into a strong positive, as the ponderous mass of the negative—the fear and previous experience of needles causing pain—is miraculously transmogrified into delight once the patient realizes that they have been given an injection they couldn’t even detect, much less feel pain from.

 
Sounds like magic, doesn’t it?

 
When you do it right, patients look at you as though the rules of physics—of cause and effect, even!—do not apply to your magic hands. This is a very good thing for them to think when they look at you.

 
By performing a painless injection, you put lie to the supposed equation that dentist=pain. Everything you can do to erase that equation in the mind of an individual contributes to the improvement of the public's impression of the importance of oral health, and the standing of the dental profession 

 
Without this level of demonstration, even the most charitable, empathic patient you could ask for has to tell themselves, hey, dentistry is like life according to the Buddha: it’s about suffering. But once you turn pain into pleasure, all bets are off. You’re not the average bear.

Even if you use the machines, (here's one and here's another) there is no way to pay for this result. It can only be earned. It is the secret to credibility and trust and loyalty, and that is magic. Sit down with each patient caring that they will have a positive experience. Know you must earn their trust, and listen and watch to learn what you must do to earn it. Not only will you be more successful in caring for your patients, but your days will feel more meaningful.