Sir, each year in late December the same patient presents with the same bruxism-induced symptoms. Over the past few years tooth wear has become increasingly evident on the cusps of the occlusal surface on the patient's posterior teeth and he reports suffering from tired jaw muscles which has even resulted in sleep disruption.

I struggled to treat the patient as he refused follow-up appointments, stating they were too expensive. I have also repeatedly urged the patient to use fluoride toothpaste, but he refuses, claiming that this is also overpriced. I have told the man to come in and get to know me better – I firmly believe in developing friendly dentist-patient relationships – but it did not seem to be in his nature. Personally, after taking his history and learning a little about him, I have come to the conclusion that the patient's bruxism is a symptom of his bitterness. He dislikes everyone, detests charity and the mere mention of Christmas considerably worsens his mood and causes him to grind his teeth. This year I went to great lengths to help: showing him both past and a present radiographs to highlight the deterioration of his teeth. However, I saw no improvement in his attitude until I showed him another patient's radiograph demonstrating how his teeth will suffer in future years yet to come if he continues to decline treatment.

I was shocked at the immediacy of his change. He booked a follow-up appointment there and then, and tipped me on his way out of the practice.

Important note to readers

This content has been created for the entertainment of readers in the spirit of seasonal good humour and, on the whole, possesses not an ounce of truth. All persons, products, URLs and email addresses mentioned have been invented by the BDJ Editorial Team.

Figure 1
figure 1

The bitter bruxism patient

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