Chapter 2

Basic Communication Skills

Aim

To present the fundamental building blocks and processes of communication between dental personnel and patients.

Outcome

After reading this chapter the reader will understand the components of communication skills and have guidance on when to use each skill appropriately.

The Importance of Clinical Communication Skills

A fundamental skill for the practising dentist is to be able to communicate well with patients and members of the dental team. For many health professionals there is good agreement that being able to communicate is central to assessing patient needs, providing information and gaining compliance. With the provision of ever more complex treatments and a drive towards comprehensive dental care, these skills may become ‘automatic’, and bad habits develop as attention is focused on technical or administrative areas. Good communication skills prevent complaints (see Chapter 3), increase acceptance of treatment decisions and adherence to recommendations. Communication is key to successful dentist-patient interaction and can contribute to a thriving dental practice. It consists of:

• introducing oneself to patients and staff

• appreciating the importance of non-verbal communication

• use of language appropriate to persons and situations

• use of open and closed questions

• proximity and the special case of dental practice

• empathic responding

• explaining and advising.

Communication skills divide naturally into two major categories divided by the use of words as opposed to actions without words. These two categories and constituent behaviours are summarised in Table 2-1.

By careful questioning and effective listening the dentist can uncover difficulties patients have experienced and establish how they feel in the dental setting. By watching and observing the patient’s non-verbal behaviours (NVBs), the dentist can assess:

• the patient’s emotional state

• how consistent the patient’s NVBs match the content of what the patient says.

Therefore the communication skills a dentist utilises should enable him/her to satisfy the following clinical goals:

• create the right atmosphere to establish rapport

• encourage patients to volunteer information and to feel involved in their own care

• identify and negotiate dental health goals with the patient

• use a style and language that is appropriate to each particular patient at each stage of the interaction

• recognise when an interview is going wrong and make appropriate adjustments

• seek the patient’s compliance with treatment plans and health goals.

Six key elements of communication have been identified:

1. understanding non-verbal communication

2. listening

3. engaging people to talk

4. asking questions and obtaining feedback

5. acknowledging other people’s feelings

6. giving feedback.

The skills involved in questioning, explaining and listening are fundamental to interviewing techniques. Communication is usually thought of as a two-way process in which the dentist initially appears to be passive, listening, and the patient active, talking. This is initially an unfamiliar situation for both dentist and patient, since the dentist is often active and the patient passive – an apparent reversal of roles. Further difficulties arise as the patient may feel that the dentist is being critical or judgmental while the dentist may feel that s/he is being supportive and tactful in approach.

Other problems arise in communication as a result of time in consultation and the confines of the dental surgery. Both of these can cause distortion of the communication process, which can be further exacerbated by:–

• the equipment in the surgery presenting a clinical and impersonal environment

• patients’ reluctance to express their feelings, thoughts and anxieties (the patient may feel that this area is not the domain of the dental consultation process)

• the dentist adopting a rigid question-and-answer format that becomes overly formulaic.

The dentist must listen actively, processing what the patient is saying, meaning and feeling. In addition, he or she must make educated guesses of what the patient may be avoiding to say and encourage him or her to feel able to reveal a p/>

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