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Dentistry

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by

Sasithorn L

on 8 December 2014

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Transcript of Dentistry

Finally
Verbal Communication
Meet the Patients
Factors that can make a difference to our communication
Voice Management
Intonation
Word stress
Speed
Loudness of voice
Pitch
Pausing
Non-verbal Communication
Ways to communicate verbally
Active Listening
- What can prevent you from hearing what people are saying?
Cultural Awareness
Cultural quiz
1. An Indian man shakes his head to show _______

2. What does the OK gesture (thumb and forefinger curled in an O) means in Japan?

3.How should one point in China?
Context
Gender
Level of Education
Relationship of speakers to each other
Native or non-native speakers
Dentist: Do you have any history of cardiac arrest in your family?

Patient: No, we have never had trouble with the police.
External noise
Strong accent
Mumbling
Speak very quickly
Wrong stress
- What can prevent you from listening to people?
Thinking about what you are going to say next

Day-dreaming

Filtering out only certain words

Making a judgment in advance

Predicting what the speaker is going to say.
- How can you show you are actively listening?
Showing you are prepared to listen

Showing your understanding by making utterances

Using communication strategies

Using appropriate body language

Pausing before you ask further questions
eye contact
proximity
Facial expression
Posture
Gesture
- Orientation
- Proximity
- Touch
Touch
Clothing and accessories
Environment
- Facial expressions - Gestures

- Pitch and pace of speech - Touch

- Eye contact - Orientation

- Proximity (distance between speakers)

- Clothing and accessories - Environment
Non-verbal Communication
uncooperative unfriendly hostile
scared
frightened
fearful
doubtful
not trusting
clueless
happy
satisfied
toothache
pain
agreement
money
with an open hand
Dentist
What makes a good dentist?
First impression
stupid
incapable
unprofessional
relaxed
sadistic?
inappropriate
unprofessional
kind
nice
friendly
Talking to the patients
a. invite patient to describe symptoms

b. greet patient and introduce oneself

c. take history

d. give information

e. give instructions during examination
1.____ Just relax.
2.____ If you feel pain or discomfort...
3.____ What brings you here today?
4.____ We don’t have the equipment to perform...
5.____ I’m going to lean the chair back.
6.____ When were your teeth last cleaned...
7.____ Which tooth is bothering you?
8.____ Good morning, Mr. Owen. I’m Dr. Teera.
a
e
e
d
e
c
a
b
9. ____ I’m going to push your teeth back...
10.____ How long have you had this...
11.____ You have a cavity.
12.____ Rinse your mouth, please.
13.____ Are you allergic to any medication?
14.____ Please open your mouth wide.
15.____ We still have 5 more teeth to fix.
16.____ What seems to be the problem?
e
c
d
e
c
e
d
a
Interviewing the patient
HPC: history of the present complaint

MH: medical history

SH: social history

DH: dental history

EOE: extra-oral examination

IOE: intra-oral examination
Allergies
Assessment of periodontal condition
Charting of the teeth present
Checking for any inflammatory process within the mouth
Current status of the patient’s general health
Dental home care and use of oral hygiene products
Detection of any swelling, deformities or abnormalities of the head, neck, and mouth area
Diseases running in the family
Exacerbating and relieving factors
MH
IOE
IOE
IOE
MH
DH
EOE
SH
HPC
Examination of lymph nodes
Examination of the integrity of any restorations present
Fluoride intake
Habits related to oral diseases
Information about treated diseases
Inspection for caries
Inspection of any skin lesions on the face
Inspection of the occlusion
Marital status
EOE
IOE
DH
SH
MH
IOE
EOE
IOE
SH
Medications taken at the moment
Occupational hazards
Onset and pattern of symptoms, their duration and character
Oral hygiene practices
Oral symptoms other than those associated with the chief complaint
Origin and radiation of pain
Past dental visits (frequency, reasons, treatment, complications)
Present and past occupations
Tenderness of teeth to percussion
MH
SH
HPC
SH
DH
DH
DH
SH
IOE
Language for history taking
Did the pain start on its own?
Has your orthodontic treatment been completed or are you still wearing a brace?
Are you allergic to penicillin or any other drug or substance?
Have you any pain in the temple of the ear?
Could you lift your tongue up, please?
Have you come into contact with anybody who is HIV positive or suspected AIDS?
Are you attending or receiving treatment from a doctor or hospital at present?
Is the tooth sensitive to hot and cold?
Are you expecting?
Have you ever had any clicking from your jaw joints?
Does the pain spread?
Why did you come to see us today?
HPC
DH
MH
EOE
IOE
SH
MH
HPC
MH
EOE
HPC
HPC
Are you taking any medications at the moment?
Do you bite your nails?
Do you grind your teeth?
Do you have heart problems or high blood pressure?
Can you feel anything when I tap your tooth?
Do your gums bleed when you brush your teeth?
Clench/unclench your teeth, please.
Could you tilt your head to one side, please?
Could you describe the pain?
Remove your glasses, please.
Do you floss?
Is there any history of bronchitis, epilepsy, diabetes, hepatitis?
MH
IOE
EOE
MH
IOE
DH
IOE
EOE
HPC
EOE
DH
MH
Do you smoke? If yes, how many a day?
Have you had any operation?
Could you open and close your mouth slowly, please?
What types of dental treatment have you had previously?
Do you drink a regular or diet Coke/Pepsi?
What symptoms are present?
Do you use mouth rinses?
Take out your dentures, please.
Could you stick out your tongue forward, please?
How long did you have your orthodontic brace for?
Do you ever get cold sores?
Does the pain keep you awake at night?
SH
MH
EOE
DH
SH
HPC
DH
IOE
IOE
DH
DH
DH
Which side is the pain at?
Is the tooth tender when you bite on it?
Do you or have you taken steroids in the last two years?
I have to dry the surface of your tooth now.
Do you have a sweet tooth?
Have you ever had excessive bleeding after extractions, surgery or injury?
Where do you live?
Is this the first time you have had pain in that tooth?
Move your jaw forward and backward, please.
Where is the pain?
How long do you brush your teeth for?
Have you ever had any form of a heart surgery?
HPC
HPC
MH
IOE
SH
MH
SH
HPC
EOE
HPC
DH
MH
Carrying out Patient-centered Communication
Small talk
Express disapproval
Invite a person to describe symptoms
Ask consent for the treatment
Ask for explanation
Give information
Express agreement
Introduce self
Brief a person on what he/she should expect in a clear and simple way
Greet & ask about the person’s well-being
Explain the steps of the procedure
Reassure a person
Request information or clarification
Express surprise
Instruct a person
Indicate that the examination is over
Express refusal
Small talk
P
D
D
P
D
P
D
D
D
D
D
P
P
D
D
P
Treatment plan and informed consent
1. Diagnosis 2. Treatment alternatives
3. Benefits, hazards & patient’s responsibility
4. Verify patients’ understanding
5. Clarify patient’s emotions
6. Discussion 7. Treatment decision
8. Post-treatment encouragement
9. Document
Informed decision
Consent decision
(1) explanation of what is to be done in lay terms (2) discussion of all reasonable risks
(3) mention of feasible alternatives.
You said that most of your teeth are false teeth and that you have two real teeth.
Six months ago, you had a mouth infection, didn't you? You got antibiotics to treat this problem, but they didn't help. Additionally, you were allergic to them.
Three years ago, you had bleeding gums and your top teeth gave you pain, which went away with pain killers.
Today, you have bleeding gums and a severe toothache in your bottom teeth and where your denture is. You have taken the same pain killers, but they don't help.
You need to have a tooth taken out. We can't fill it or save it because it's badly decayed, and the gum is in poor condition.
First, the dentist will check all of your mouth, and then he will x-ray the bad tooth. Then, before he takes the tooth out, he will give you a small injection into the gum, which will take away the pain.
When he removes the tooth, he will grasp it with an instrument and you will feel him rocking it or moving it about before it comes out, to loosen it.
When it has been taken out, he will tidy up the area and clean the empty socket with sterile salt water. Before you go home, he will put a piece of gauze, like cotton wool, in the empty space and you should gently bite on that for about an hour, in case there is a little bleeding.
You can eat later on, but for today eat only soft foods which are not too hot. Please feel free to ask me any questions.
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