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DENTIST-PATIENT INTERACTION D M.Wael. The aim of continuous dental care is for dentists to be able to make contact with patients in an easy and acceptable manner.
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The aim of continuous dental care is for dentists to be able to make contact with patients in an easy and acceptable manner. For patients who may be described as ‘regular attender's dentists have been able to form and maintain a ‘treatment’ relationship. This enables patients to accept the care which has been negotiated and offered. INTRODUCTION
From a psychodynamic viewpoint dental healthcare is a 2-person Endeavour There are three aspects of the psychodynamic model which must be considered in this regard. These are ,first the real relationship, secondly, the treatment alliance and thirdly, the transference. Psychodynamic explanation of dentist-patient interaction
The real relationship is an equal and unique relationship between two adults This is a genuine interaction in which the uniqueness of the dentist is complemented by the uniqueness of the patient. Within the adult-to-adult equality of the relationship the dentist will have been chosen by the patient because of his clinical attributes and skills. The real relationship, in this regard, will remain unaffected by any anxieties or concerns the patient may have about dental treatment. The real relationship
The treatment alliance is an equal relationship between two adults. However, while it possesses the same status equality of the real relationship, it differs. It is not only a development of the real relationship but is affected by the patient's anxieties and concerns with regard to accepting dental treatment. For the first time in the dentist–patient relationship the patient's concerns and anxiety about dental treatment seem to merge with the dentist's clinical and patient management skills. The treatment alliance
Like the treatment alliance the transference develops with time but unlike the real relationship or the treatment alliance this is not an interaction between adults. The transference represents the past. as the transference represents the past, it sometimes becomes intrinsically associated with regression. The interaction is no longer one of equality between adults but one between the dentist as 'parent' and patient as 'child' The transference
Dentist patient relationship have been described by various authors in different ways. A. SZASZ and HOLLANDER have described 3 basic type of doctor patient relationship. • ACTIVE PASSIVE • GUIDANCE-COOPERATION • MUTUAL PARTICIPATION TYPES OF DENTIST PATIENT INTERACTION
ACTIVE –PASSIVE • In this type dentist is active and patient is passive. • Whatever dentist does to patient, patient remain helpless. • Mostly, dentist is concerned with operatory part and has nothing to do with prevention of disease. • The treatment session: an example of the activity–passivity model
Patient is expected to follow dentist direction. • Dentist tell his patient ,what is good for him and expect full cooperation from him. • Patient cooperation is prerequisite in this type of relationship. • The dental check-up visit: an example of the guidance–cooperation model GUIDANCE – COOPERATION
MUTUAL PARTICIPATION • Offers best hope for establishing growth oriented relationship between dentist and patient. • Suited for chronic disease such as dental caries and periodontal disease. • Dentist help patient in every sphere. • Negotiating preventive health goals: an example of the mutual-participation model
B. GAZDA ET AL put forward a new approach to dentist patient relationship which describes as a helping relationship.
GOALS OF DISCOURSE Information for dental diagnosis and treatment Communication for establishing a relationship Feedback of information for health care and prevention Information for understanding the patient’s attribution, requests and feelings etc DENTIST PATIENT COMMUNICATION(THE DISCOURSE)
Patient’s name ,age, family background and, Complaint of patient and his expectation from dentist. Patient’s attribution or his own diagnosis Patient if willing or unwilling to undergo treatment Certain dental habits History of his being to past dentists Medical conditions, especially those which exaggerate dental conditions IN COMMUNICATION DENTIST SHOULD NOTE:
It is evident that desirable interaction between dentist and patient leads to more satisfied patients Patients satisfaction has been widely recognized as a principal outcome measure of health care quality PATIENT’S SATISFACTION WITH DENTAL CARE
Kress in 1988 elaborated three basic questions regarding patients satisfaction What are the factors that affect dental patient satisfaction? How does satisfaction affect the behavior of dental patients? What are the implications for the care provider?
conclusion Dental healthcare which acknowledges the role of the real relationship, the treatment alliance and the transference within a dynamic framework, will maintain the equality of the dentist-patient relationship. It is by an appreciation of the complexities of the dentist–patient interaction that the dental health professional will be able to enable patients not only to accept dental care but also to empower them to take responsibility for their own oral health.
