This document discusses the importance of the dentist-patient relationship, highlighting the impact of communication, motivation, and patient perceptions on dental care experiences. It outlines various models of dentist-patient interactions and factors that influence patient compliance and satisfaction in dental visits. The conclusion emphasizes the need for dentists to foster trust and understanding to improve the overall dynamics of their relationships with patients.

1. Dentist patient relationship
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2. Content
• Introduction
• Doctor-patient relationship
• Dentist patient relationship
• Theories of motivation
• Components of behavior
• Doctor and patient perspective
• Dentist patient relations
• Models of Dentist patient relationship

3. Content
• Dentist patient communication
• Models of communication
• Analysis of dentist patient relationship
• Compliance
• Factors affecting dentist patient relationship.
• Conclusion
• References

4. Introduction
• A dental appointment is often an experience patients
would rather avoid. Some 75% of patients experience a
degree of anxiety before the actual encounter and 5- 10
% are so distraught that they avoid it.
• Such anxiety can be reduced some what by establishing
a good dentist – patient relationship.

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6. According to a patient ,
a good dentist is one who can
• recognize and manage anxiety in the patient.
• establish and maintain support.
• provide information and explanations about the various
procedures, possible complications ,etc.

7. Bad dentist
• Majority of the patients complain about dentist’s lack of
social skills rather than professional skills.
• Those who are dissatisfied for any reason are less likely
to keep the appointment or to arrive on time .

8. Doctor patient relationship
• Part of medical sociology in which complex social factors
are implicated.
Orders

9. Levels of communication
Communication
Communication
on an
emotional
plane
Communication
on a cultural
plane
Communication
on an
intellectual
plane

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11. Dentist-patient relation
Implement the oral
health policies
both at state and
national levels

12. • Prevention
• Patient cooperation
• Motivation
• Healthy discussions
2 important factors –
1. Behavior change
2. Patient willing to seek and pay for
services

13. Changing attitude and lifestyle- escalating cost can be met
Involves personal preventive activities and acceptance of
professional services
Pattern of behavior depends upon many factors – healthy and
unhealthy behaviors.

14. • Pathology diagnosed from
problem
Disease
• Personal experience of disease
and takes into account attitude,
feelings, thoughts and values.
illness

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16. Cultural and subjective
criteria – S/S
Literary
level
Economic
background
General
attitude

17. • Deci has proposed a theory on intrinsic motivation to
analyze human functioning and has defined the need for
competence and self determination.
• It was based on the formulation that a need for
effectance is a basic motivational property

18. 5 intrinsic and extrinsic dimensions of motivation in
a classroom learning have been proposed
1. Learning motivated by curiosity Vs learning in order to
please the teacher
2. Working for ones own satisfaction Vs working to
please the teacher to get good grades.
3. Preference for challenging work Vs preference for
easy work
4. Desire to work independently Vs dependence on
teachers help
5. Internal criteria for failure and success Vs external
feedback.

19. Theories of motivation
Interaction between person and
environment.
Psychological variables -related dental
hygiene behavior.
Normative influence- regular dental
attendance.
Social
learning
theory

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21. Deals with perceived
causes of failure and
success.
Stable vs unstable Internal vs external
Controlled vs
uncontrolled
Weiner’s
attributional
theory

22. Theory of intrinsic
motivation
• Independence.
• Women>men
• Highly qualifies>less qualified.
• Positive verbal feedback.

23. Motivational study conducted by
ADA
Professional
(upper middle
class)
Interested in
preventive
dentistry
Feel the need
for artificial
substitutes
Loss of teeth
signifies
ageing
Small business
and white collar
workers
(middle class)
Similar
Skilled and
semiskilled
workers
(upper lower
class)
Not concerned
with prevention
Tooth diseases
are felt
untreatable- fall
or extracted.
Tooth loss is
normal
Unskilled workers
(lower class)
Tooth loss
is inevitable
at any age.

24. Components of behavior
Components of
behavior
Unhealthy
Failure to seek
professional
service
Failure to take
personal
preventive
action
Healthy

26. Role of a dentist Role of a patient Perception of
patient about
dentist
Perception of
dentist about
patient
Effect of
education
Society Technical ability,
quality and
competence
Financial
capabilities
Motivational
power
Value Cost of treatment Compliance
appreciation
and motivation
Overall behavior Family
background
Convenience,
availability and
access to treatment
Oral health
status
Social status Personality,
behavior and
appearance of
dentist
Ease of
understanding,
friendliness,
communicativeness
and supportiveness

27. Doctors perspective
• Doctor looks at the deviation from normality in a person
in a cold, clinical way.
• He considers it in terms of pathological state, with
derangement of bodily functions giving rise to certain
characteristic S/S.
• He attempts to diagnose based on knowledge.
• If necessary clinical tests performed.
• Success of treatment evaluated.

28. Patients perspective
• Concerned with symptoms which are interpreted in own
way .
• Ascribes the presence of illness according to way of
thinking, influenced by exposure in childhood.
• Ascribe it to diet, change of environment, stress, evil
eye.
• Own way of treating before consulting doctor.
• Own way of thinking- minor or severe.

29. Dentist patient relationships
• Two way honest communication
Friend
• Complete faith in his awe and marvel to
preserve, maintain and restore teeth and
supporting structures.Savior
• Paternalistic behavior
Parents
Servant Some accept advice while some may develop
negative attitude and feel that they will dictate.

30. • Business like attitude as consumer –
provider of service without any
personal regard.
• Excellent care is expected at a min
cost.
Provider
• Attitude and are afraid of dentist.
• Dentist looked as a foe rather than
friend.
Adversary

31. Models of dentist patient
relationship
Paternalistic
model
Informative
model
Interpretive
model
Deliberative
model
Lele while discussing prevention of legal action by patient
against doctors has described 4 models

32. Paternalistic model
• Doctor presents selective information to the patient so that he gives consent to
the treatment which doctor considers to be the best in interest of the patient.
• Doctor acts as the guardian.
• Moral obligation to keep the patients interest above his own.
• In case of doubt- consult colleagues.
• Advice in best interest of patient, even if it means that doctors financial gain will
be less.

33. Informative model
Doctor provides all relevant information not selected one.
Patient free to weigh pros and cons of different
alternatives- particular intervention.
Doctors duty to implement the decision of the patient-
patients belief, attitudes and values determine the
treatment.
No role of doctors value or for the doctors understanding
of the patients value.
Concept of patient autonomy and control over medical
decision making- which may at times not be in patients
interest.

34. Interpretive model
• Doctor aims at elucidating the patients value and wishes.
• He selects from the possible alternative interventions
from the ones which will help the patient to realize the
values.
• He is merely a guide or advisor.
• Patient decides which value and course of action is
better.
• Joint consultation but final decision making resting with
the patient.

35. Deliberative model
• Doctor acts as a guide and a teacher but takes an active
part.
• He informs regarding various alternatives and on the
basis of values and wishes plans the course of action.
• Thus suggesting what is best and suggesting what
should be chosen.
• Difference from other models is takes into consideration
the values the patients point of view, takes him into
confidence and help the patient to agree to best
alternative that will satisfy him.

36. • Patient entitled for free two way communication.
• Understands from the doctors implication in the light of
his own health related values, their worth and actively
participating in decision making in partnership with
doctor.
• Thus is a combined outcome perspective of doctor and
patient.

37. Types of dentist patient
relationship
• Szasz and Gikkander 1956 have described three
basic types of doctor patient relationships
1. Active – passive
2. Guidance – co operation
3. Mutual participation
• Gazda et al 1975 put forward a new approach to
dentist patient relationship which they described as the
helping relationship

38. Active- passive
• Active- dentist, passive- patient.
• Patient is helpless.
• Limited utility.
• More of operatory than preventive.

39. Guidance –cooperation
• Preventive oriented dentists.
• Patient expected to follow dentists direction.
• Dentist tells patient what is good and expects to full
cooperation.
• Patients own perception is denied.

40. Mutual participation
• Offers best hope for establishing growth oriented
relationship between dentist and patients.
• Suited for chronic diseases.
• Patient centered approach.

41. Principles of patient –oriented approach
summarized by Silberman and Ames (1980)
• The patient is more than his disease.
• A person is more than his body.
• Each person has the capacity to define himself and fulfill
his requirements.
• Physical diseases often have a meaning within a
persons relationship of body, emotion, mind and spirit.
• The patient is the colleague of the health professionals
and must therefore be respected in the process of health
care.

42. • If patient active –
1. Self direction and self control are encouraged through
minimizing command relationship.
2. The patient is encouraged to use and develop more
and more of his abilities.

43. • Gazda et al (1975) –
• Dentist explores the problem in a sympathetic way.
• Does not impose his values and refrain from prejudging
him.
• The dentist patient relation must promote the patients
growth towards greater self awareness and
independence.

44. Procedural goal
Facilitative dimension Transition dimension Action dimension
Empathy
(Depth understanding)
Concreteness
( ability to be specific)
Formulate goals
Respect
(belief in)
Genuineness
(honesty-realness)
Develop alternatives
Warmth
(caring-love)
(non verbal)
Self-disclosure
( ability to convey
appropriately)
Consider consequences
Select alternatives
Act on selection
Self evaluation
Self exploration
Better
Self understanding
More appropriate
Action of direction

45. Doctor-patient communication:
models
Communication
Normative
Biomedical Biopsychosocial
Empirical

46. Empirical model
Features of providers and patient which are proposed to affect the
process of encounters.
1. Patients prior experience of care.
2. Patients objective of visit.
3. Patients expectation.
4. Type of problem
5. Number of patients concerns.
6. Providers expectation
7. Providers prior knowledge of patients concern.
8. Characteristic of providers practice setting
9. Patient and provider personality.

47. Outcomes
1. Patient knowledge
2. Provider-patient congruence on problems,
recommendations.
3. Patient satisfaction( care, treatment ).
4. Patient compliance
5. Resolution of patient concerns or symptoms.
Language based theory of persuasion- Burgoon et al showed that
when physician deviate from expected strategies during an
encounter patient compliance increases.

51. • Conclusion - empirical model tries to describe and analyze
the relation between provider and patient as completely as
possible.
• They do not evaluate the various components, nor do they
produce any recommendations.
• It is a self imposed task of normative model.

52. Normative model
• Biomedical model – etiology/ deviation from normal.
• Active and passive roles.
• Patient compliance problem.
• Criticized- hardly any active participation from patient
and autonomy compromised.

53. • Roter and Hall described doctor patient relationship as a
function of the control of the encounter.
• What the talk contains and how it is said.
Physician control
Patient control Low High
Low Default Paternalism
High Consumerism Mutuality

54. • Biopsychosocial model- better.
• Role of patient is active.
• Prominent problem becomes patient satisfaction with
care rather than compliance.
• Difference – shift from paternalism to shared decision
making.

57. • Commercial or consumerism model-
• Medical care is considered to be on sale.
• Provider and consumer.
• Encounter becomes a marketplace for negotiation about
the entity for exchange and the price set in that entity.
• Doctor and patient best compete to make bargain.
• Patient need will only play an indirect role.
• Patients autonomy is partly preserved , replaced by
negotiation skill and purchasing power.

58. • Relationship of Default- total lack of control by both.
• Neither biopsychosocial nor biomedical.
• Relationship of failed expectation and frustrated goals.
• It reflects a stagnant situation in which changed
circumstances are not likely to be assimilated by the
relationship.
• Patient might drop out of care and vanish and the doctor
will be unaware of the reason for loss of patient.

59. Dental context
Variables
having
effect on
dental
attendance
Sex
Perceived
economic
barriers
Type of
appointment
Long
waiting
time
Social
condition
Pain
tolerance
Oral
conditions
Dental
anxiety

60. • Other models have tested variables that influence
preventive dental health care behaviors such as patients
judgment of his coping capabilities and patients
personality scored by a locus of control.
• Few other models actually affecting dentist patient
relationship are – variables affecting its characteristics,
impact on different outcome measures- satisfaction,
compliance, knowledge, quality of care, dental health
status, recall and fear/ anxiety reduction.

61. • Widely accepted that psychosocial aspect is powerful
factor affecting the overall outcome of an encounter.
• Communication is an important aspect to elucidate the
psychosocial interplay between dentist and patient
during visits.
• Ex – the excellent quality of dental technology procedure
is not always followed by high patient satisfaction with
care.

62. • Explanation-
• Background variables and process variables are
important for outcome.
• Patient might have difficulty in separating adequate from
inadequate technical treatment.
• Patient perception of relationship might impinge on
outcome, without concerning with high quality of
treatment.

63. Dentist patient communication
• The purpose of creating good interpersonal relationship
• The purpose of exchanging information
• The purpose of making treatment related decisions

64. Corah et al formulated a model of dentist-patient
relationship stating that satisfaction can reduce stress
and stress in turns promotes satisfaction.
Thus greater compliance
Dentist behavior that were strongly associated with
satisfaction pertained to good information-
communication.
Purpose of creating a good interpersonal relationship.

65. Explore each other mentally , to establish diagnosis and
treatment plans and to motivate behavior that increase health.
Dentists need- difference in expectation and preference -
relationship.
If these differences remain-can negatively affect outcome.
Authoritarian dentists have fixed notion about the best treatment
and do not seem interested in the patients perception of problem.
Purpose of exchanging information.

66. To reach mutual understanding of nature of the
problem and its solution, a dynamic communication
should take place.
Drift toward shared decision making meant to improve
outcomes like- satisfaction, cooperation and
compliance.
Purpose of making treatment related decisions.

67. Analysis of dentist patient
relationship
• Evaluation of dentists characteristics- technical
competence, communication and interpersonal skill
specially regard to reducing patient anxiety and how
affects outcome measures like- satisfaction, cooperation
and compliance.
• Dentists view of their patients- preferred compliant and
tractable patients.

69. Suggestion of new model

70. Factors affecting compliance of
patients with preventive dental
regimens
• Multifactorial problem.
• Two components- macro and micro
• Macro- social issues
• Minor- dentist patient relationship

71. Essentials for a GP establishing a
preventive programme.
Clear and precise definition
of the problem
Monitoring frequency of the
problem behavior
Specifying the aim of
intervention
Changing the behavior
Reinforcement
Failure to comply with a
preventive programme
• Verbal and non verbal
• Gives information on scope to both.
• Establish a baseline from which
improvement can be made.
• Allows supervising member to
monitor effectiveness.
Motivation
Commitment
Staff participation
Social background

72. Reasons for non compliance
Parents-
Previous experience
Dentist-
Upbringing
Family attitudes
Childs personality
Immaturity
Other reasons- lack of information, time, perceived needs or benefits, fear,
laziness, costs, job demands, forgetfulness and indifference.

73. Patients satisfaction with dental
care• Satisfaction is widely recognized as a principal outcome
measure of health care quality.
• Marketing – consumers satisfaction.
• Kress posed and elaborated 3 basic questions regarding
patient satisfaction-
1. What are the factors that affect dental patient
satisfaction.
2. How does satisfaction affect the behavior of dental
patients.
3. What are the implications for the care providers

74. • Quality assessment
1. Reliability- ability to perform promised service
dependably and accurately.
2. Responsiveness-willing to help customer
3. Assurance-trust and confidence
4. Empathy- (understanding and entering into others
feeling.) caring, individualized attention.
5. Tangibles-appearance of physical facilities, equipment,
personnel.

75. Improving dentist patient
relationship
• Understand point of view.
• Good communication.
• The doctor should understand the way symptoms are
presented by patient, the terms used and how cultural
influence affects and patient should understand doctors
terminology and try to interpret it correctly.
• Doctor should keep in mind that his own cultural
background, prejudice, social position and similar factors
influence his communication with the patient.

76. Conclusion
• Although dentists are still highly regarded and widely
trusted by the majority of the populace, there is still much
work that can be done in order to instill a greater sense
of trust into their patients and to improve the dynamics of
the patient-dentist relationship.
• For a consultation based upon mutual trust and
communication, both parties must accommodate each
other’s needs and demands for equal roles in the entire
process.

77. • Dentists should be the ones to relinquish more control
and take an active role in understanding and valuing
their patients as individuals.
• Moreover, to ensure a successful relationship and
continuity in the treatment process, dentists need to
focus on building a strong sense of trust that pervades
all aspects of dentist-patient interactions

78. References
• Horst G Ter, Wit C A. Review of behavioral research in
dentistry 1987-1992: dental anxiety , dentist patient
relationship, compliance and dental attendance. Int Dent J
1993;43:265-272
• Reisene S,.Soical and psychological theories and their use for
dental practice. Int Dent J 1993;43:279-289
• Influence of dentist patient relationship on attitudes and
adjustment to dental treatment. JADA 1969;79:879-884
• Sondell K, Soderfeldt B. Dentist patient communication: a
review of relevant models. Acta Odontol Scand 1997;55:116-
125

79. • Milgrom P, Weinstein P. Dental fears in general practice : new treatment
guidelines for assessment and treatment. Int dent j 1993;43:288-289
• Blinkhorn A. Factors affecting the compliance of patients with preventive
dental regimens. Int Dent J 1993;43:294-296.
• Sikri V.Community dentistry ,CBS pub 1st ed 1999,
pg 534-554.
• Sathe PV. Textbook of community Dentistry. Paras publication 2nd edition
pg 39-41.
• M. Kirshner .The Role of Information Technology and Informatics
Research in theDentist-Patient Relationship Adv Dent Res 17:77-81,
December, 2003© 2003 .
• Park K. Textbook of preventive and social medicine, 19th edn. Banarasidas
Bhanot publication
• Newsome P.R,H and Wright G.H. A review of patient satisfaction: concept
of satisfaction. BDJ 1999; 186(4): 161-65.