Chairside Manner and Dental Schools
The myth that dentists tend to be insensitive to their patients’ sensitivities dies hard--sustained, I’m sure, by generations of cartoons depicting practitioners in all manner of fiendish gyrations.
But I hope it may provide some comfort to people to report that, by and large, dentists not only have a natural human sympathy for patients’ feelings but dealing effectively with these feelings, assuaging patients’ qualms, is an integral part of training in our leading dental schools.
As in any profession, some practitioners are going to absorb and apply this teaching better than others. But the guidance is there, and it is getting wider observance all the time.
The latest impetus to the myth of dentists’ insensitivity came, ironically, from a Southern California dentist. He was quoted recently in these columns (“Can You Trust a Smiling Dentist?” June 2, by Catherine M. Spearnak) as saying, “Unlike physicians who take classes in bedside manner during medical school, dentists aren’t schooled in making patients feel comfortable. To fill the educational void, the dental school at USC may add a class in ‘chairside manner’ to its curriculum.”
In this observation he was, alas, almost a quarter-century behind the times. The void he refers to was filled in 1964 when the USC School of Dentistry instituted a Department of Behavioral Dentistry.
It was one of the first, if not the first, such departments in the United States, and has been a leading element in dental education ever since.
Aware of the growing significance of patient ease, four teachers at the dental school teamed with three psychologists from the USC School of Medicine to develop a curriculum in “chairside manner.”
The instruction centered, among other things, on communication skills--notably, the art of listening to patients and responding, both verbally and nonverbally, with understanding and empathy. The importance of “chairside manner” and other inter-personal factors in treatment has been systematically imparted to students ever since.
The results in the initial years seemed to justify spreading the word. In 1970, one of our psychologists, Dr. Murray Wexler, described the curriculum in the September issue of the Journal of Dental Education.
Then, to convey our concepts more graphically, Dr. Wexler and I scripted a film, “Treating Fear in the Dental Patient” and enlisted some of Hollywood’s leading lights in the undertaking. Under the supervision of Sol Lesser, the film was produced by the USC School of Cinema, and narrated by Walter Matthau. It evoked an enthusiastic response at the 1972 American Dental Assn. meeting in San Francisco, and later was shown at major regional dental gatherings throughout the United States and abroad.
The same year, the curriculum was the subject of the lead article in the September issue of the American Medical Assn.’s lay magazine, Today’s Health. It described a method developed at USC of helping fearful patients learn to shed their fears. This method gained recognition and was featured at the Federation Dentaire Internationale meeting in Toronto, Canada, in 1977, with the use of the film as the theme for the Behavioral Dentistry section.
By 1981, the subject of dentist-patient empathy had gathered sufficient momentum to occasion the first National Conference on Applied Behavioral Science in Dentistry, held at Case Western University, where I described our advanced program on fear reduction.
For the last three years at USC we have been conducting research on the fear reduction technique mentioned above, called Iatrosedation, which focuses on calming patients through the practitioner’s behavior. The results of a pilot study showing the effectiveness of this technique were presented last March to the International Assn. of Dental Research in Montreal. This led to a grant by the American Fund for Dental Health for a three-year research project which is now under way.
So there is no need at this point to reinvent the wheel. Eliminating all patient apprehension remains a perpetual challenge. But the state of the art is there.
