What a dental appointment taught me about physiotherapy

I went to the dentist today, and unexpectedly, it taught me a lot about physiotherapy.

Not because anything catastrophic happened, the appointment was clinically probably fine. The dentist seemed competent, polite enough, and technically skilled, but I left the clinic feeling unsettled, tense, and strangely small and as I reflected on that experience afterwards, I realised it had exposed some blind spots in my own practice.

It reminded me how easy it is, as healthcare professionals, to normalise experiences that may feel deeply uncomfortable from the other side of the treatment table.

The strange thing is that this reflection actually started the night before the appointment. I woke up around 3am after a vivid dream. In it, the dentist approached my face with a needle without warning or explanation. I remember physically grabbing their arm to stop them. In the dream they became irritated and defensive, telling me it was “standard procedure” and that I should not interfere because it was dangerous. I woke up with my heart racing.

It surprised me. I have been to the dentist before. I would not describe myself as particularly fearful of dental care. Yet clearly, somewhere in my mind, there was anxiety around vulnerability, consent, and loss of control.

That feeling stayed with me the next morning until my appointment.

The appointment began routinely enough. I filled out the intake forms, although I noticed myself becoming uncomfortable with how intrusive some of the questions of the form felt and how little information there was regarding how my data would be handled. Then I met the dentist. He introduced himself warmly, guided me into the room, and asked briefly why I had come in. Then came the first moment where I felt uneasy.

“Let’s do some X-rays.” He said.

There was no real discussion beforehand. No explanation of why they were needed specifically for me. No conversation about risks, benefits, alternatives, or whether I was comfortable proceeding. I found myself having to interrupt and ask questions about the necessity of the procedure. As a healthcare provider, I am very aware of issues surrounding unnecessary imaging and radiation exposure. I also had to ask about the cost, because ultimately these decisions involve my money and my healthcare.

To be fair, the dentist did explain things when I asked, but the explanations remained broad and generic. At that stage, he had barely asked me anything about my oral hygiene habits, symptoms, or history, so I found myself wondering what clinical reasoning had actually led to the decision. Perhaps the X-rays were entirely appropriate. They probably were, but appropriateness alone is not the same thing as shared decision-making and I was not part of the conversation.

That distinction matters.

The cleaning itself was technically well done. Yet throughout the appointment I was extremely tense. At one point I noticed that I was literally shaking while lying in the chair. Nothing catastrophic was happening, but internally I felt unsafe and hypervigilant. Interestingly, nobody acknowledged it, nobody checked in emotionally. The interaction remained focused almost entirely on the clinical tasks.

At the end of the appointment, I was told I would need two small procedures. Again, the explanation was medically detailed and technically clear, but there was no real discussion of alternatives despite these issues having been present for years and despite the dentist having very little information about my previous history. No “wait and see” option was offered. No conversation about urgency. No balanced discussion of risks and benefits of intervening versus monitoring. I left having to research much of this information myself afterwards.

Then came the billing. What I thought would use half of my yearly private health allocation actually consumed closer to three-quarters due to these unexpected imaging. A quote for future procedures was presented, but again it felt less like a collaborative discussion and more like a predetermined pathway. When the receptionist told me they would call me if I had not booked within a week, I felt an unexpected sense of pressure. Rationally, I understand this may simply be standard administrative procedure. Emotionally, it felt difficult to separate the healthcare advice from the business model surrounding it.

This is where the experience became genuinely valuable for me as a physiotherapist. Because the biggest lesson had very little to do with dentistry itself. What stayed with me most was not whether the scaling was perfectly performed or whether the clinical recommendations were evidence-based. What stayed with me was how I felt for those forty minutes.

Small.
Tense.
Uncertain.
Rushed.
Not fully involved.

It made me realise something uncomfortable: I have probably made some of my own patients feel similarly at times, despite caring deeply about person-centredness.

This reflection humbled me.

Over the years I have spent a lot of time reading, thinking, writing, and talking about person-centredness. I genuinely value informed consent, shared decision-making, therapeutic alliance, and patient autonomy. But there is a subtle danger in becoming intellectually comfortable with concepts we identify strongly with. We can start assuming we are already “good” at them. We stop noticing the smaller relational details that shape another person’s experience.

Being the patient again shook me out of that comfort zone.

It reminded me that consent is not a one-time checkbox. It is relational and ongoing. It reminded me that what feels routine to us may feel intimidating, confusing, or vulnerable to someone else. It reminded me that simply explaining a procedure is not the same thing as creating genuine choice.

Most importantly, it reminded me that technical quality is only one part of healthcare.

I think, if I am honest with myself, I have often prioritised providing the “best” clinical care in a technical sense. Precision. Optimisation. Evidence. Thoroughness. These things matter deeply to me and they still do, but this experience made me realise that warmth, emotional safety, pacing, and human connection may matter just as much, and sometimes more, in how care is actually experienced.

A technically excellent intervention delivered in a way that leaves someone feeling powerless may not feel like good care at all.

The experience also reminded me how little we truly know about what patients bring into the room with them. The clinician I saw had no idea I had spent the previous night anxious after a vivid nightmare about them. Just as I often have no idea what invisible fears, past experiences, stresses, or vulnerabilities my own patients may be carrying when they arrive at the clinic.

Sometimes we interpret silence as comfort. It is not.

Sometimes patients comply while internally distressed.

Sometimes they nod despite not understanding.

Sometimes they disappear from care not because they are “non-compliant,” but because something in the interaction did not feel safe enough for them to return.

One particularly confronting thought I had afterwards was that I do not feel comfortable giving this dentist feedback directly. Not because he was malicious or incompetent (quite the opposite, he was probably skilled, well-intentioned, and convinced he was providing excellent care) but because the interaction did not create enough relational safety for openness and that made me reflect on my own drop-outs in physiotherapy. How many patients quietly disengage without ever telling us why?

Probably more than I would like to think.

I do not write this to criticise an individual clinician. In many ways, the appointment reflected very normal healthcare interactions. That is precisely the point. So many aspects of paternalism in healthcare are subtle, normalised, and often well-intentioned. Most clinicians are trying to help. Most are busy. Most are working within systems that reward efficiency and throughput.

But good intentions do not erase the patient experience.

This appointment reminded me that reflexivity, (the ability to critically reflect on ourselves, our habits, our assumptions, and the unintended effects of our behaviours) is not something we “complete” once we become experienced clinicians. It is an ongoing process. Perhaps one of the most important processes in healthcare.

I left the dentist thinking less about my teeth and more about the kind of physiotherapist I want to continue becoming.