Child in the dental chair : communicating beyond words

Abstract

Patients often judge a successful dental encounter based on the professional ability of the dentist as well as his ability to personally interact with them. Quite often, dental practitioners encounter patients who are in distress as a result of orofacial pain or discomfort. A number of individuals seeking oral care may be suffering from pain, they may anticipate pain. Patients may have preconceived notions about dental care, based on past dental experience, stories by friends and family, or due to the presence of certain phobias. The dentist and staff who encounter such individuals must be able to communicate effectively, in order to make them comfortable and establish a positive relationship to help provide the best possible oral care. Common difficulties faced in attaining communicative influence with these patients, within the confines of a dental operatory, include - intimidating environment, anxiety provoking thoughts of pain & discomfort, use of ineffective communication techniques, etc. Studies in the past have described how the knowledge of silent language of people can help a dental team tremendously. Some studies have suggested that non-verbal messages conveyed by health care professionals can either encourage or discourage patient’s trust. The ability to study and use body language may therefore be a valuable tool in clinical dental practice. A review of the literature on the studies of non-verbal communication in dentistry was carried out as a part of this thesis. It pointed to the limited research work in this field, within the various disciplines of dentistry. There was no evidence-based support for the use of non-verbal communication for behavior management in paediatric dentistry. This study showed the presence of a gap in literature with regards to understanding and effective utilization of non-verbal communication in clinical practice. A mixed methods study was carried out to examine the body language of the dental team and the child patients (age 5 to 12 years), using audio-visual recording technique, during routine dental checkup and consultation visits. The study design paid emphasis on the qualitative analysis of dental interactions, occurring naturally, during a paediatric patient’s visit to the dental hospital. A new coding system was developed and applied to the digital data, to analyze various forms of body movements used in the dental setting. The analysis described how verbal as well as non-verbal communication strategies are used together in paediatric dentistry, to achieve cooperation of the young patients. This study also demonstrated how video-analysis and non-verbal coding system can be a useful tool for enhancing the understanding of non-verbal interactions between the dental team and their patients.

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