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  06.16.05 Issue #171


Communication Skills to Increase Patient Compliance

By Jean Gallienne
Hygiene Consultant McKenzie Management

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Look into a dental operatory, watch and listen to the operator communicating with the patient. What do you see? I am talking about the nonverbal communication going on. I know there are a lot of fantastic clinicians out there: Hygienist, Dentist, and Assistants. Some of them are the most talented and passionate about the profession of dentistry. However, if they are not equally talented in the skill of communication they will not be performing as much dentistry as they would like.

Communication involves the sender, the receiver, the message, the environment, attitudes, emotions, socio-cultural background, and values of both the sender and receiver. There is both verbal and nonverbal communication happening every minute of our existence.

Some of these factors the dental professional does not have any control over. If you sit and talk with your back to the patient, looking at x-rays, and avoiding eye contact while going over the treatment plan, you are less likely to gain the amount of trust that you will need in order to have that patient return to your practice. Interpersonal communication skills are truly central to the dental hygiene process.

The environment is easily controlled. It needs to be comfortable not too hot, too cold, too plush, or too untidy. The music needs to be at an appropriate level and appropriate style for the majority of the clients that you see. The office should smell clean and fresh. Even too much cologne on the operator could be a diversion to the patient. It is better to have an environment that is private. Particularly, when going over health needs or financials. The position of the chair is very important. Most people like to feel they have some control, when lying back in the chair some of that control is relinquished. It is better to have the patient sitting in the up position and with the patient bib removed. This will enable them to feel more in control and in a more natural position. The feelings and camaraderie the patient senses within the office workings will even have an effect. They want to feel that the people surrounding them are happy to be there and enjoy working with each other.

When it comes to attitudes and emotions the operator really does not have control over any preconceived attitudes or emotions. However, they do effect what the patient may feel or think about them by the actions and words they use. The hygienist should be compassionate but must act professionally. He or she needs to be sure to leave their own emotions that are rooted in their own personal life at the front door when they enter the office. The hygienist's own personal life should not interfere with patient care.

Values are beliefs that may have moral and ethical implications. Not all patients will value oral health at the same level. These values can and may change, but it is a very slow process. The best thing you can do is to know what you value and how it affects the choices you make. You need to also be aware of your patient's values. This can be done by observation, analysis of behavior, and good listening skills. The hardest thing to do is to avoid imposing your values on your patients. Educating your patient about oral health is the best method to help promote change.

America has a diverse population consisting of many multicultural beliefs and value systems. A dental hygienist that has a broad understanding of cultural diversity will be better prepared to communicate with patients from varying backgrounds. Improving ones cultural competence and sensitivity to the differences will be a huge step in overcoming many communication problems that may occur because of socio-cultural backgrounds. Seeking to better understand the cultures within your community will help you to understand their orientation toward health, disease, acculturation levels, and other related assessment items. This way, you will be better able to talk Western concepts of health, prevention, disease, and treatment in terms that are culturally understandable and relevant to the multicultural population in your area.

When it comes to verbal communication, no matter what population you are dealing with, just keep the word CARE in mind. This mnemonic was developed by Myerscough in order to help health professionals to remember the skills they should develop. Comfort, Acceptance, Responsiveness, Empathy.

The CARE principle can also be implemented with nonverbal communication. The factor with nonverbal communication is that it is essential for you to be able to read different aspects of kinesic behavior. You must also be aware of the nonverbal communication you are sending. This includes, posture, facial expressions, eye behavior, and overall body movement. The way a person gestures or the posture they maintain will tell us a lot about how they feel. The body movement may tell us they are uncomfortable or comfortable, bold, or timid. Shifting their posture may be an indication of an emotional change. Shifting towards a person indicates trust and liking. Movement away from a person indicates a negative message. Eye contact is a must in order to convey trust, interest, or attention. When eye contact is avoided it is a sign that one feels uncomfortable. When maintained steadily we are taking an offensive approach to someone. There are many nonverbal movements that may happen while you are working with your patients. Always keep in mind what they are saying to you and what you are saying to them. Be a good active listener. Make sure you have educated yourself about different cultures and what different body motions may mean in that particular culture. The same movement may mean two totally different things in different cultures. Be aware of your patient's acculturation level.

Communication also includes listening to the patient. This is the single most important part of the communication process with your patients. No matter what, the patient should always remain the center of attention. A good listener should have good eye contact, shoulder and legs toward the speaker, slight forward lean, and above all, be silent. Do not interrupt. To make sure you understand their wants and concerns, paraphrase back what they say. The patient is not going to want to hear what you are concerned about until you have answered their wants and concerns.

Utilizing these communication skills and knowledge will make your patients much more compliant and accepting of treatment plans.

Jean conducts 2 day Hygiene Performance Enrichment Programs for The Center for Dental Career Development and McKenzie Management in La Jolla/San Diego, CA. Contact her at or 1-877-777-6151 Ext. 23

Interested in having Jean speak to your dental group? Email us at or call 1-877-777-6151

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