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I keep them open, but don't stare into the eyes or face of the hygienist. There are plenty of things to look at in the room. There's a cool aquarium screen saver on the computer they use for the charts. It's right in my line of view. Probably on purpose. Also, the fluorescent ceiling lights are covered with light diffusers that have transparent pictures of a blue sky with puffy white clouds. They have a huge picture frame on the wall, filled with old dental related advertisements from magazines like 50 - 100 years ago.
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