Never underestimate the value of good communication skills when providing patients with information about dental procedures and oral health care. Stephanie Osfield reports
What’s your communication style when talking to your patients? Do you adopt a fairly formal approach and point out the technical aspects of procedures? Or do you take a conversational tone and invite your patients to ask plenty of questions?
Though most dentists are extremely proficient in clinical skills and knowledge, the important ‘soft’ skill of communication is often given far less attention. This can be unhelpful for repeat business and also open up other risks. “Poor communication prevents the development of a trusting dental partnership between patient and dentist, and can lead to an incomplete understanding of patients’ wishes, treatment preferences, medical and dental histories,” says Dr Michael Foley, deputy chair of the Australian Dental Association Oral Health Committee.
“It can be a dental/medical/legal accident about to happen. By contrast, good communication ensures that patients have realistic expectations of dental procedures, which boost patient satisfaction and trust while reducing misinformation and patient complaints.”
The following issues can all combine to reduce the level of communication between a dentist and their patient:
Physical barriers: These include dentists wearing masks or speaking while leaning over the patient in the dental chair. “This is okay if you’re asking your patient to open their mouth wider, but not okay for giving information about a procedure,” says Dr Foley. “Instead, take your mask off, sit your patient up in the chair, and talk to them at their level.
“If the information is complex or involves serious pathology, request that the patient has a family member or friend present to listen with them. No patient will remember everything you say, particularly if they’re feeling anxious.”
Time constraints: Pushed for time when discussing an upcoming treatment? Then offer to answer any questions or provide further information at a later date if needed.
“Provide your professional opinion and suggestions, but don’t pressure patients,” says Dr Foley. “Treat patients with the respect you would give a friend or family member. Also speak in a friendly, but professional manner with practice staff and any accompanying people in the surgery, as that sets a relaxed atmosphere that makes patients feel more free to ask questions or express concerns.”
Poor verbal skills: To improve communication with patients, it is important for dentists to:
1. Note their manner of speaking.
“Mumbling or not speaking clearly can contribute to loss of communication between dentist and patient,” says Dr Foley. “Asking patients to repeat back what you said can help to clarify their understanding. You can then also paraphrase what they have said to you.” If there are language barriers, Dr Foley suggests using an interpreter service or a friend or family member who can translate.
2. Minimise dental jargon.
Using plenty of technical terms when talking to patients may increase the risk that the information is not well grasped or understood. “Instead, speak in plain language, using words that your patient understands,” advises Brett Churnin, general manager of Client Relationships at Prime Practice, which trains dentists in all aspects of dental management. “Photographs can be helpful, so can metaphors.”
For example, when discussing:
• Missing teeth: “Point out that teeth are a little like books on a book shelf and that when the books are together they hold each other in place, but when one is missing from the shelf the other books may start moving (and teeth may start rotating),” Churnin suggests.
• Periodontal care: “Explain that gums can be a little like a boat that may be nice and clean above the waterline, but below the waterline they may have barnacles eating away at the hull,” says Churnin. “Similarly, gums may appear fine when you look at them, but may have issues going on below the gumline.”
3. Verbally address patient anxiety.
“If your patient is clearly anxious about dental visits, make statements that show empathy, such as, ‘I can understand that this might be confusing or overwhelming’,” says Churnin.
Patients may not always state how anxious they feel about visiting the dentist, so enquire whether they have any specific fears or concerns about upcoming procedures or dental visits in general. “Ask leading questions to identify what specifically triggers their anxiety,” Churnin suggests. “Once you are clear about whether your patient is fearful of pain or needles, lying on their back for a long period of time or a past bad dental experience, you are able to address that specific concern.”
Patients want and need their thoughts and opinions to be valued, so it is important that dentists listen to them. Optimal communication involves more than simply a brief outline of what will occur during a dental procedure.
“A key point is to find out what your patient knows and what they understand about what is going on in their mouth,” says Churning. “That means creating conversations rather than telling patients what to do. This can help patients feel they have more control over decision-making.”
Churning suggests you ask plenty of clarifying questions, such as, ‘Can you describe to me what you think this will involve?’ or ‘Can you tell me what you understand the risks of this procedure to be?’
In order for good communication to occur, your patient’s needs to feel that you have a relationship. To build this ‘dental partnership’, Dr Foley recommends that you get to know your patient’s background, medical and dental history, priorities and treatment preferences and take a minute to refresh your memory before their appointment begins.
“Note important information, even children, family histories and so forth, on the treatment record, so that you can continue a conversation at the next recall appointment,” Foley says. “Patients will appreciate that you’ve gone to the effort of remembering them.”
Four handy tips
1. Repeat what you have said: Patients don’t recall as much of the advice and agreed actions about future dental care as dentists believe they have discussed.
2. Supply written information: Patients can then take this home to read about their upcoming procedure. Additional advice or discussion points can be noted in bullet points on a notepad, to help jog your patient’s memory when they leave the dental surgery.
3. Verbally ask patients about forms. “Don’t presume that patients have always understood what forms say or that they have filled them out correctly,” says Dr Foley. “Clarify what they have written and ask them to update you on any medical conditions or health issues since their last visit.”
4. Address Dr Google: “Many patients will go home and google their condition,” says Dr Foley. “So give them links to one or two reputable websites from professional authorities and document this on their patient record. That way you can be assured they are getting good quality information.”