This document discusses effective communication with orthognathic patients regarding their diagnosis and treatment options. It is important to discuss the patient's case outside of their presence using clear language and involve the patient in discussions. Providing information through multiple methods like verbal, written and audiovisual aids can help patients better understand and retain information about their often complex treatment. Clinicians must clearly explain the patient's diagnosis, what may happen without treatment, and available treatment options with benefits and risks to gain informed consent.

1. Patient information provision to orthognathic patients
Effective communication
A. Discussing patient diagnosis and treatment options
 Clinicians routinely discuss a patient’s dentofacial appearance and possible surgical solutions
in their presence. Although important for teaching purposes, if the patient is not prepared and
made to feel part of the process, this may become a frightening, embarrassing and even
potentially psychologically traumatic experience for the patient. To avoid such
misapprehensions, it is far better for the clinicians and trainees to discuss a patient’s case using
the records immediately prior to seeing the patient on the clinic, to avoid undesirable language
with negative connotations (e.g. words such as ‘deformities’) in the patient’s presence, to be
honest yet reassuring, to involve the patient in any necessary discussions using jargon-free
language and to always make the patient feel involved in the treatment process.
 Always inform the patient beforehand if their case is going to be discussed with trainees or
colleagues on a consultation clinic or on the ward, so that the patient feels part of the process.
The patient should never be made to feel like a bystander.
B. Effective communication is required to increase
 Patient satisfaction and involvement in the consent and decision making process,
 Optimizing the information given to prospective patients regarding all aspects of what is
potentially a long and complex treatment pathway.
C. Time management
 Patients expect and clinicians need time in a consultation.
 Patient dissatisfaction often stems from poor communication or lack of information, leading to
a potential surprise at some point during the treatment process
D. After interviewing and examining the patient, and thereby having reached a diagnosis, the
clinician needs to communicate three things to the patient:
 Explain the diagnosis and how it has occurred in words the patient can understand.
 Explain what will happen if no treatment is provided, e.g. will the dentofacial appearance and
malocclusion become worse with further growth and development.

2.  Explain the treatment options that are available, including their benefits and risks.
E. Retention of information:
 Although clinicians provide patients with information at various stages of the treatment process
and obtain a signed ‘informed consent’ form before proceeding, short-term recall of
information has been found to be poor.
 In one investigation (Kiyak et al 2002), the preoperative meeting between 16 orthognathic
patients (and in some cases their parents) and their orthodontist was audio taped, and the
patients were interviewed in person immediately afterwards. Both patients and parents recalled
fewer than half the risks given by orthodontists, only 60% of the patient and parent
responsibilities, and 70% of the procedures they would undergo. Over 25% of patients recalled
no risks.
F. Selective recall
 Patients may also demonstrate selective recall of information provided to them, with a tendency
to recall information about potentially positive outcomes more frequently compared to
information about the surgical risks.
Information-seeking behaviour in patients
A. Patients may be broadly divided regarding their approach towards health information-seeking
behaviour into:
 Monitors actively seek information about their medical condition, and the information helps to
reduce anxiety and offers reassurance.
 Conversely, blunters actively avoid information and prefer less information, coping by
distracting themselves from the situation.
B. Information-seeking behaviour in orthognathic patients (Stephens et al. 2013) found that:
 The preferred method of obtaining information for orthodontic patients was verbal, followed
by audiovisual and written.
 Audiovisual information could be beneficial for those who find reading difficult or who
struggle to retain verbal information.
 Few patients were found to access information via the Internet, and this was attributed to
concerns about the reliability of the information.

3. Methods of information provision
A. Audiovisual information
B. World Wide Web
C. Written information
D. Verbal information
 It should be provided in a quiet and relaxed environment,
 Avoidance of medical jargon remains paramount.
 Arranged in a logical order and provide a condensed version, which will not overwhelm the
patient.
 Using information provision aids/tools is vitally important such as
1. radiograph,
2. photograph,
3. SM,
4. 3D imaging,
5. Plastic skull or Images of previously treated patients with similar condition
6. Schematic video/computerized demonstrations
7. Speaking with a previously treated patient