COMMUNICATION SKILLS IN THE DENTAL PRACTICE: A REVIEW
subsequent treatment. 13 This requires improving the methods and the amount of information that dentists share with the patient. But, to do that, the physician must be trained. The results of their third survey entitled“ Optimized orthodontist- patient communication” came out in 1996. They show that asking questions, providing explanations, engaging in careful listening and encouragement are important for successful communication. The authors come to the conclusion that the dentists’ communication skills of dentists should not be taken for granted, but be integrated in their university training. 14 Patients are increasingly willing to participate in the decision-making process and expect more information from their dentists to make an informed choice. They want to ask questions and talk about their oral health and at the same time they expect more concern. The dentist should ask the right questions, listen carefully and provide clear information without medical terms. 15 This was confirmed in a study conducted by Gürdal et al.; according to him, the factors that determine patient satisfaction are: personal relationships, good organization, the skills and knowledge of the treating dentist. 16 The patients’ desire to become informed regarding the duration and type of treatment, their expectation of compassion from the dentist, who refers to their fear, indicates the presence of a strong emotional component in the process of communication between the dentist and the patient. According to Enkling et al. patients assess the quality of the dentist mostly according to his interpersonal skills. 17 This is because during treatment, the patient cannot realize what professional skills the dentist has. This will come up later – for example durability of the completed restoration or denture. During treatment the patient evaluates the dentist according to his pain and how he communicates. In dental practice, pain is associated with anxiety, fear and dental phobia. Studies show that about 70 % of the population experiences certain discomfort before visiting a dentist, 20 % are very anxious, and 5 % avoid such visits. 18 The most common reason for dental phobia is a previous traumatic experience in the dental office, followed by dissatisfaction and lack of trust. 19 Anxiety, fear and dental phobia are experiences that require specific knowledge demonstrated by the dentist to determine the right approach to such patients. The assessment of the patient ´ s condition stays before setting the correct approach. 19 A special scale has been developed to assess such conditions. To assess the mental condition of the patient before treatment, one can use the scale created by Corah, Gale and Illig- Dental Anxiety Scale( DAS). It consists of 4 questions that measure the anxiety of the dental treatment. 20 Another similar tool is the Dental Fear Survey( DFS). With it, the authors measure the level of fear of the treatment. 21
About two-thirds of dentists believe that treating patients experiencing fear is a major challenge. 22 Choosing the right approach stimulates the patient ´ s trust and satisfaction. Janke and other writers conducted a study with their own questionnaire and with a standardized questionnaire-( STAI and DFS). 23 The results show that 36 % of patients describe themselves as very fearful, while only 23 % of them are identified as such by the dentist. The main reasons for their fears that patients point out are the uncertainty of what will happen and bad memories of previous visits to the dentist. 24 A number of authors have shown that fear elimination is an important success factor for dental treatment and must be taken into consideration. If the dentist is calm and friendly, if he provides moral support to the patient, if the patient does not feel pain during the treatment, fear can be overcome. 23, 24, 25, 26 Only if the patient does not feel fear, can there be satisfaction with the treatment. Corah et al. have developed an assessment tool for the cognitive, emotional and behavioral patient satisfaction- Dental Visit Satisfaction Scale. 27 According to them, the patients evaluated the professional skills of the dentist based on their satisfaction with interpersonal factors such as communication and concern. This once again confirms the importance of the dentist having good communication skills. The need of good communication in the medical practice has led to the development of a manual for teaching communication and social skills in medical universities in the German-speaking countries entitled“ Basel Consensus Statement”. 28 Its aim is to help teachers improve the educational programs in the field of communication and social skills. The main competences, which every graduate student in medicine and dentistry must possess, are: 28- Respect for the patient;- Recognizing the own strengths and weaknesses;- Recognizing the needs of the patient;- Catching the non-verbal aspects of communication( gestures, facial expressions, posture, etc.).- Respect the individuality of the patient and his personal views;- Stick to their own values and norms of behavior;- Intent to work in a team. In addition to the better outcome and the satisfaction with the treat ment, communication is also important for the patient’ s motivation. Sgan- Cohen explains that any health intervention, including oral hygiene instruction, should be based on scientific evidence and contains two components- inform about the risks and motivate the patient. 29 To motivate someone is to make him do something or change his behavior. According to Geisler the following statements are valid in medicine and dentistry:- Successful treatment without motivation is unthinkable;- Work with patients is based on motivation;- Conversation is the number one tool while
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