Good dentistry from the patient's perspective

Dr. Andrew Wong is a recent graduate of the University of Sydney and is on the Young Dentist Committee in Australia. He is currently working in public and private practice in Sydney.

During our many years at University we are assessed on our level of clinical skill and theoretical knowledge. We all know that our crown preparations should end on solid tooth structure with 2mm of ferrule and that our endodontic root fillings should be within 1mm of the apex with a good apical seat. However, what does all this jargon (and dare I say gibberish) mean to the person sitting in our chair? Absolutely nothing. What they do judge us on is based on parameters that they can relate to.

In my short career as a dental practitioner I have learned what these are and realised the huge part they play in whether the patient will return. You can be a great dentist clinically and have the perfect cavity preparations but if you don't tick these boxes your patients aren't likely to come back.

Here's how to improve your patient relationships and become a great dentist in their eyes.

1. Pain

• Your patient will assess your ability as a dentist based on this very important parameter. Often, the expectation of pain is the obstacle that prevents patients from coming, so if you can master delivering pain-free dentistry, you will have a very satisfied patient.
• Learn how to give a pain-free injection (this is possible!) and allow time for the anaesthetic to work. If you ask the majority of patients with dental anxiety it is often the "dread of the jab" that frightens them the most. Master this, and you have a great confidence-building tool, give a bad needle and you could lose the patient.
• Read the patient's non-verbal cues. Often the patient will be in discomfort but will put up with it because they think it is part and parcel with dentistry. Small and simple things like adjusting the headrest and applying Vaseline to dry lips help improve the patient's experience and leave them impressed with your level of care.
• Handle the patient's soft tissues with care and respect. Mirrors can hurt!
• Always warn the patient about any possible pain or discomfort and follow it up with a recommendation on how to relieve that pain. This can save you chair time as the patient will know exactly what to expect and how to remedy it. Remember that forewarning is seen as being meticulous but an explanation afterwards may be viewed as an excuse.

2. Punctuality and time-management

Nothing irritates patients more than a dentist running unreasonably late. Feelings of anxiety and frustration added with the fact that they don't really want to be there, culminates into a bad experience. Running late is inevitable from time to time, but if you can foresee yourself being unreasonably late, ask your receptionist to inform the next patient to arrive a little later or apologise on your behalf.

You should always inform the patient on how long you will need for a procedure before the appointment. This will give them time to arrange their day or inform work/home that they will be running late. Nothing is worse than when you are forty minutes into a surgical extraction and the patient is asking you how much longer you need as they need to pick up the kids. Again this boils down to good communication and your patients will thank you for it. Remember patients have plans too and their time is just as valuable as yours and should be respected.

3. Chairside manner

When describing a good dentist patients often use adjectives like "friendly"," gentle" and "nice". Let's face it, some patients know very little about teeth. Therefore one of the few ways they can distinguish one dentist from another is through how they are treated. Even if you are an excellent clinician, your books will never be full if you are lacking in the communication and rapport department. At the end of the day, the patient has to like you enough to trust you, and whether we like it or not, most patients measure our competency as a dentist based more on our interpersonal skills than clinical skills.

Here are some tips on improving your chair side manner:

• Use the patient's name, particularly at the start of a sentence.
• Walk your patient in and out from the waiting room; this shows that you are friendly, approachable and down-to-earth.
• After the patient leaves, type your clinical notes, but also note down any conversation starters for their next visit such as upcoming holidays, weddings or milestones in their lives. This really impresses a patient, and they are often surprised at how good your memory is.

4. Fees

At the end of the day, dentistry is a business and I have had appointments that have gone extremely well up until the point where the patient is paying at the reception only for them to turn sour. Patients can be driven to look elsewhere if they cannot justify the costs of your services. It is our responsibility as practitioners to highlight the value of our treatment and effectively communicate this to the patient so that they understand why they are paying so much.

• Always give a quote before doing anything major especially for new patients and print this out in an itemised treatment plan. If there are situations where there is a possibility of more expensive treatment down the track e.g. a very deep filling that might turn into a RCT, it is better to list this in the treatment plan from the outset so that the patient has an idea of the possible costs.

• Never change your quotes halfway through carrying out a treatment plan. A quote should be treated like your word and you will lose integrity if you change the price.
• Show value in the treatment carried out by spending a few minutes at the end of each appointment providing a summary and the benefits of what you have done.
• Favour multiple short appointments over single long appointments for patients who may have difficulty paying for all of their work in one go.

All the best young dentists and remember to treat every patient as though they are your only patient.

Dr. Andrew Wong