Sir, we read, with interest, the article ‘"It's their mouth at the end of the day": dental professionals' reactions to oral health education outcomes'.1 It highlights an important issue and verifies the results of our research exploring dental stressors, where some dentists volunteered that they became frustrated or irritated (anger group emotions) by ‘patients' [failure to] take responsibility for their own oral health: “after [you keep] giving them oral hygiene advice … and they just don't really care”' (pp 405).2

Such frustration may be driven by underlying anxiety about future claims of supervised neglect as well as a genuine desire to do the best for the patient. Dentists may experience a perceived loss of situational control, particularly if the patient wants treatment that is inappropriate to their current oral hygiene state.

Assuming you can or should change other people's behaviour is a cognitive error3 or thinking trap,4 as we highlighted in the training package that was evaluated as part of our research.5 As stated in that training, ‘you can never make other people change their behaviour - it is their right and responsibility to do so... You have a professional responsibility to diagnose, treat, inform and transfer skills. It is up to the individual to choose to apply that knowledge and to put those skills into place' (unpublished manuscript, reference available from the authors).

Respect for autonomy is central to shared decision-making, a process facilitating integration of patient preferences with the evidence- and experience-based advice and recommendations of the practitioner, thus allowing mutually agreeable treatment decisions.6 These decisions may appear unwise to the practitioner but should be respected.

As Barnes and colleagues discovered, appropriate coping strategies for this situation are acceptance and reappraisal1 which, again, confirms our findings.5 These coping skills are associated with reduced vulnerability to burnout, depression, anxiety and stress.