Words matter vitally

Research output: Contribution to journalLetter


Sir, I read with interest the letter 'Every word matters' by Dr Adali regarding how language affects patients’ interpretation of what clinicians say and influences their treatment choices.
I agree that language is extremely important. This applies to clinicians as words, and particularly diagnostic terms, affect dentists’ decision-making about treatment. We asked dentists to choose their preferred treatment for cases after we supplied the diagnosis and radiographs. When ‘chronic’ was used instead of ‘asymptomatic’ (eg chronic apical periodontitis versus asymptomatic apical periodontitis), there were highly significant differences for all conditions regarding whether the dentists would treat the tooth or not. When ‘acute’ was used instead of ‘symptomatic’, there were significant differences for most conditions. This indicated that dentists were more likely to base treatment decisions on the presence/absence of symptoms rather than on the disease itself which is a serious concern. Hence, terms used for diagnosis are important as they influence dentists’ decision-making. Similar findings were reported in the medical literature, where practitioners were more likely to treat ‘chronic malaria’ than ‘asymptomatic malaria’. These studies demonstrate ‘words do matter’.
There are many other words that have crept into the ‘common vocabulary’ of dentists, yet they are inappropriate. Two examples are ‘leakage’ and ‘vitality tests’.
‘Leakage’ presumably means something is getting into the tooth but the public are likely to think something is escaping from the tooth. Hence, ‘restoration breakdown’ and ‘bacterial penetration’ – which describe the process occurring – are more appropriate.
‘Vitality test’ implies assessment of the pulp’s blood supply, but thermal and electric pulp tests can only assess the ability of the pulp to respond to a stimulus (ie ‘sensibility’). The term ‘vitality’ leads to use of ‘vital’ and ‘non-vital’ for the diagnosis – but both are completely inadequate to indicate the various stages of the pulp/root canal disease process with a blood supply and stages without a blood supply. Use of inappropriate terms should be avoided. They also suggest a poor understanding of what is happening in the tooth.
Dentists should consult their dictionaries from time to time because words do matter!
Original languageEnglish
Pages (from-to)315
Number of pages1
JournalBritish Dental Journal
Issue number6
Publication statusPublished - 24 Sept 2021


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