Building the dental dream team: behavioral styles in the practice

There are four different behavioral styles evident in a dental team and in patients. The styles are based on observable behaviors relating to degrees of "assertiveness" and "responsiveness." The Behavioral Style model helps to clarify why some people relate positively with each other and why others may conflict. Using finely tuned observational skills and an understanding of these styles, interpersonal transactions can be more effective, dental teams become more cohesive, and patients will be more satisfied with service provided in the dental practice. Each member of the team should understand his/her own personal style and those of teammates. Once that understanding is gained by all, it may be effectively applied to understanding patients. Behavior modification is at the heart of this concept. Adjusting your own behavior to the needs of others enables a patient to achieve more comfort with the dental team, and they are more likely to hear your verbal messages.

Customer service in dental offices: analyses of service orientations and waiting time in telephone interactions with a potential new customer

Increasing competition among health care organizations has prompted greater concern for the quality of "customer service" in brief encounters with patients. This study examined service practices engaged by dental office staff interacting over the telephone with a potential new customer. The goals of the study were to determine whether the staff displayed customer-oriented and control-oriented service communication behaviors and to examine the relation between these service behaviors and waiting time required of customers. Structured observational data were collected in phone encounters with staff in 84 dental offices. Approximately 40% of the staff engaged in the customer-oriented behavior of inviting the customer to share questions or concerns, and 31% exhibited the control-oriented behavior of reciting promotional pitches on behalf of the dental office. Six other communication behaviors were observed with less frequency. Staff who made customers wait on the line longer were more likely to use promotional pitches. Analyses revealed no significant relation between waiting time and other service communication behaviors.

Enhancing telephone communication in the dental office

Answering the telephone is an important first contact with the dental office. The voice tone, inflection and other non-verbal aspects of the person answering all have a profound impact on how the caller perceives the dental office. Suggestions are presented which are designed to avoid communication problems and to project a positive professional image to a caller. Audio clips are included to demonstrate variations in telephone technique to assist the reader in the development of a telephone answering protocol that reflects a desirable image for the office staff and for the dental practice.

Improving access for Medicaid-insured children: focus on front-office personnel

BACKGROUND

Access to dental services for low-income children is limited. Front-office personnel play a role regarding dentists' participation in the Medicaid program.

METHODS

Subjects (N = 24) represented general dental offices in Spokane County, Wash., and included participants and nonparticipants in the Access to Baby and Child Dentistry, or ABCD, program, a dental society/community program aimed at expanding dental services provided to Medicaid-insured children. The authors stratified the participants according to the number of claims their practices submitted to Medicaid for ABCD children: non-ABCD, low-ABCD and high-ABCD. Five two-hour focus group sessions were conducted to determine participants' beliefs about, attitudes toward and experiences in serving this population.

RESULTS

The authors' data analysis consisted of a comprehensive content review of participants' responses from transcripted audiotapes. They synthesized frequently mentioned concepts and ideas into relevant themes. The major factors affecting practices' participation in Medicaid were office policy on seeing Medicaid-insured patients; staff members' personal connection to Medicaid-insured patients; staff members' attitudes about Medicaid-insured patients; and staff members' perceptions of Medicaid-insured patients' barriers to care.

CONCLUSIONS

The data suggest that factors affecting dentists' participation in the Medicaid program are more complex than the often-stated dissatisfactions with low reimbursement fees and hassles with paperwork.

CLINICAL IMPLICATIONS

Efforts to increase dentist participation in serving Medicaid-insured patients will continue to be relatively ineffective until many of the concerns raised by this study's subjects are better understood and addressed.

Transcultural patient assessment: a method of advancing dental care

It is essential for persons who work in a dental office to understand the differences in individuals from culture to culture. It is also important to appreciate that each patient and family is culturally unique and brings this uniqueness to the dental office. Since the caregivers also bring their own unique cultural heritage, the dental office setting is rich with possible variations and differences. It is important to refrain from imposing personal values and beliefs on the patient and to respect the uniqueness and differences each brings to the care environment.

Experiences with sedation and restraint during dental treatment in Romania

In August, 1995 dental treatment was provided in an orphanage in Romania. This treatment took place over three weeks using three different dentists. Two dental nurses served for full the duration. For the last two weeks the team was joined by a dental health educator. All have given accounts of their time in Romania. The patients had various degrees of handicap but generally co-operation for treatment was poor. Most patients needed pre-operative sedation of oral valium. A papoose board was used for restraint. All the contributors agree that this was extremely helpful in controlling the patients. Dental treatment was mostly-restricted to extractions. A parallel preventive programme was run by the dental health educator. The team encountered bureaucratic problems which were overcome. All 220 children in the orphanage were screened and treated. Local children and adults were also given dental treatment when time allowed. The team wish to express gratitude to all who helped and supported them. They plan a future mission in 1997. In 1994, a dental team had previously travelled to Romania and carried out treatment of handicapped children using sedation & restraint. The principal difference between 1994 and 1995 was the introduction of the papoose board as the method of restraint. The papoose board is a temporary restraint device for use during medical or dental procedures. It is a set of canvas flaps with velcro fasteners on a board. A head strap and wrist straps are important accessories. Pre-operative sedation was given to the children 2-3 hours in advance of dental treatment. This usually was 10-20 mg oral valium. The child was then led into the dental surgery by hand and placed on the papoose board, which was already situated on the reclined dental chair. Before the child realised what was happening the wrist straps and leg straps were in place. Within seconds the other straps were closed and the child was totally restrained and ready for dental treatment. Dental treatment was then carried out using local anaesthesia. Care has to be taken that the restraint does not impair the patient's breathing, circulation, cause over-heating or positional injuries. A dental health education programme was run in parallel with the treatment service. The individual accounts of experiences follow. Firstly, the joint account of Dental Nurses Catherine Treacey and Karen Vaughan from the Dublin Dental Hospital, who were working for the full three weeks. Then follow the accounts of the dentists. On week 1 by Anne O'Neill, who works with the Eastern Health Board in the Dun Laoghaire area, week 2 by Robert Gorby, a dentist in private practice in Carlow, and week 3 by Brendan Fanning who works part-time for the Eastern Health Board, in Wicklow and part-time in practice in Ashford, Co. Wicklow. The final account is of the dental health education programme by Miriam Henshaw, Health Educator who works for the Eastern Health Board in the Wicklow area.

The triangle of health: applications for general practice, Part 2: The dental team

The triangle of health (physical, psychological and social) allows the dental health professional to appreciate the importance of the holistic view of health. The three dimensions of health are as applicable to the health and well-being of the dental health professional as they are to the patients they treat. Parallels between physical, psychological and social determinants of oral health for the patient are related to those for the health of the dental team members. Through an awareness of such matters dental health professionals can promote health for their patients and themselves.

Satisfaction with care of patients attending a dedicated dental clinic: comparisons between 1989 and 1994

This investigation aimed to audit patient satisfaction with care at a dedicated dental clinic, using previously developed standards and criteria. A self-complete questionnaire was administered to a group of 161 patients assessing the dimensions of care availability, affective behaviour and technical competence. Comparisons with baseline showed a high but slightly decreased level of satisfaction with technical competence, a significantly higher level of satisfaction with the affective behaviour of the clinic staff but a continuing level of dissatisfaction with the availability of care. Respondents with AIDS reported higher levels of satisfaction for all 3 dimensions. Women were less satisfied with the availability of care. The results indicate the inter-related nature of the dimensions of technical competence and care availability. Satisfaction with care availability will only improve if initiatives beyond the clinic are introduced to increase the overall supply of dental services available to this population.

Putting patients at ease

Compared to the past, modern dentistry offers a wide range of treatment options to the public. These options are more likely to be appreciated and accepted when we take the feelings of our patients into account. Dr. T. J. Murray, a former dean of Dalhousie University's medical school, says: "I believe it is just as important now, in the era of scientific medicine and dentistry, to practise the art of our profession as it ever was. Our professions were always a balance of caring and healing. In modern times, the concepts and approaches to healing have had a scientific underpinning, but they have not supplanted the need for humanistic care. In fact, many persons have problems and illnesses that are not amenable to scientific treatment or cure, and the approach is for caring, understanding, explanation, reassurance, and 'being there' for the patient."