TranslatorsUsing interpreters and translators

Background.—Dental hygiene care requires clear com-munication with the patient, so what do you do when thepatient does not speak English and you do not speak hisor her language? This can happen in any dental practice,but is especially common in practices that serve communi-ties of diverse ethnic groups and inmissions to underservedareas or overseas. Some hygienists have added languageskills, but often translators or interpreters are needed.Translators convert written material from one language toanother, whereas interpreters translate spoken languageinto another spoken language or into sign language. Work-ing with interpreters and translators differs depending onthe situation and the individuals involved. It can be chal-lenging for translators and interpreters to handle oralhealth issues, which is quite different from engaging in sim-ple conversation. Interviews with a number of dental hy-gienists displayed several situations that may arise whereinterpreters and/or translators were needed.

Working Abroad.—When working abroad, it is impor-tant to have interpreters to facilitate the patient–hygienistrelationship. Being briefed on how to work with an inter-preter before jumping into oral care delivery will diminishthe dental hygienist’s anxiety and contribute to a more suc-cessful experience. Often by the end of the mission, the in-terpreter has become adept at teaching oral health careprinciples or explaining the steps needed in delivering den-tal hygiene. The interpreter also puts the patient at ease, en-suring that he or she will be able to understand what thedental hygienist is saying about oral health care, which im-proves compliance with instructions.

Dental hygienists should be aware that the beginning en-countersmay requiremore time and effort than normal com-munication, since thehygienistwill have to learn to speakandthenwait for the interpreter to convey themessage. This canmake it difficult tomaintain a train of thought. Having visualsprepared to enhance the process can be invaluable.

Working with Diverse US Communities.—Some hospi-tal or government systems provide certified medical inter-preters and translators. These may be especially helpfulwhen the care being provided includesmessages that cannotbe readily translated between languages. These interpretersmay also be able to ask questions of the dental hygienist to becertain that they understand what is to be conveyed.

The dental hygienist may also become aware of culturaldifferences with respect to understanding the importance

of proper oral health care and its relationship to overallhealth status. Once the significance is explained in a waythat patients understand, many patients become commit-ted to learning all they can during these health care inter-ventions so that they can maintain a healthy dentition andexperience better health overall.

In US communities it may be possible to use apps onsmartphones to facilitate communication between the den-tal hygienist and the patient. With these apps, the personspeaks into the phone and it translates the words into theselected language. The iPhone Google Translate app actu-ally speaks back what is said as well as spells it out. Thismethod of communication can be reassuring to the patientand build his or her confidence in the dental hygienist. Bothpatient and practitioner tend to feel more comfortablewhen they need to express their thoughts, give instruc-tions, ask questions, or supply answers.

Recommendations.—The dental hygienists inter-viewed offered tips for working with interpreters:

1. Speak clearly and slowly.2. Ask the interpreter to use your words as precisely as

possible rather than paraphrasing or interpreting.3. Introduce yourself to the patient.4. Position the interpreter beside you and facing the

patient.5. Maintain eye contact with the patient and address your

remarks to the patient rather than the interpreter.6. Pause about a minute after completing a thought or

making major points.7. Watch the interpreter to ensure he or she is keeping

pace with you.8. Don’t use long, complex sentences, slang, jargon, or

colloquial expressions. Use basic words that the inter-preter understands.

9. Don’t interject jokes or humor; what is funny in En-glish may not be humorous in another language.

10. Encourage patients to ask questions throughout theprocess.

11. Become familiar with the culture of persons withwhom you will be speaking.

Discussion.—In previous times, when a dental staff wasfaced with the situation of a non-English-speaking patient,he or she often spoke very loudly or extremely slowly orcombined dramatic facial expressions and hand gesturesto get the message across. None of these methods are

Volume 58 � Issue 5 � 2013 e27

especially helpful, since drastically increased sound or di-minished speed and charade-like movements do not reallyaddress the language issue. Using interpreters and transla-tors helps both the patient and the dental hygienist to com-municate clearly and effectively. It also teaches both partiessome key words or phrases and enhances their mutual re-lationship. The interpreter or translator can contribute sig-nificantly to the process. Ideally he or she will help to builda relationship between the patient and practitioner that willproduce better oral health care in the future.

e2

Clinical Significance.—Language barriers canhinder dental care delivery and prove frustrat-ing to both patient and health care provider.

8 Dental Abstracts

Taking the time to practice with an interpreterbefore seeing patients is important, as are themeasures suggested by the dental hygienistswho were interviewed for this article. All ofthem expressed great appreciation for the inter-preter and found the experience beneficial notjust for the patients but for themselves.

Pera M: Working with translators and interpreters. Access 26:22-25,April 2012

Reprints not available