Visualising the problem

When explaining the patient's condition to them you must remember that they have very low capacity to visualise what you are talking about. When discussing the prognosis of teeth you must communicate:
-Tooth location
-Tooth surface
-Tooth condition
-Prognosis of treatment

Patients can sometimes visualise the location of the tooth and surface if there is obvious markers such as cavitated caries or a missing tooth as a reference point however they do not have the dental anatomy knowledge or experience that you do. Patient's can't understand how a small cavity can open up into a much larger one or how far under the gum the decay has progressed. Their ability to see into their own mouths is limited to one very narrow angle and insufficient lighting with no magnification. You must be able to use alternative methods to communicate with them.

-Put a mirror in their hand and shine a light in their eyes. You can point out the location and surface of the tooth in question with a probe. This saves the guesswork.
-Take photos: Full arch photos are a great way of showing the condition of teeth with reference to other teeth. Patients can actually see what you see and this is great for case acceptance. Intraoral photos have poorer range of view, focus and quality but can be useful for quick communications of a localised problem
-Take models: Actually holding their dentition in their hands can be a powerful way for the patients to understand their issues. They can check their occlusion and wear as well as the actual 3D size of cavities and see how weak the remaining tooth structure is.
-Show them their radiographs: So many of the patients that pass through my chair have not seen the OPG  taken by the previous dentist. This means that they were returning for further treatment based on the trust of their dentist and they didnot have an appreciation for the condition of their teeth and periodontium. Often times when I show them the OPG they are surprised at how bad the condition is. Remember mcaries will always feel smaller than it actualyl is when it initially cavitates. The patient may be under the impression that their decay has formed very quickly as it has only broken through recently but they have to be made aware this is not the case and that there are many issues that will come to light if not dealt with promptly.
-Use descriptive terms: When communicating which teeth are to be treated I will use terms of condition "the broken tooth" or "the one in front of the broken tooth" or "the one behind/in front of the gap" to allow patients to feel the location of their problem with their tongue. This is also best done while they are looking into the mirror.