Effective Communication

Resident’s Name:  Joanne Lewis                                                            Date: September 11, 2009

Article title:  Engaging Children’s Cooperation in the Dental Environment through Effective Communication

Author(s):  David A. Nash, DMD, MS, EdD

Journal:  Pediatric Dentistry

Volume (number):  28(5)

Year:  2006

Major topic:  Communication techniques

Type of Article:  review

Main Purpose:  To review and discuss 3 communication skills that can aid the pediatric dentist in gaining the cooperation of children.

Discussion:  Establishing a trusting relationship with a pediatric patient is a prerequisite for gaining the child’s cooperation in providing dental care.  This article reviews 3 communication skills that are useful in developing such a relationship; these skills are reflective listening, self-disclosing assertiveness, and descriptive praise.

Reflective listening (or active listening) – a mirroring of the emotional communication of another.  Should demonstrate congruence (genuineness/honesty with child), empathy, and respect.  Many times pediatric dentists (and staff) try to talk children out of their feelings, or deny their feelings.  Example:  child – “I’m scared” dentist – “There is nothing to be scared of!”  Better to reply with  “I understand.  Sometimes new things are scary.  Sometimes I am afraid to try new things.”  All feeling should be permitted, but certain actions are limited; what children are feeling should not be translated into unacceptable behaviors.

Self-disclosing assertiveness – after empathetically acknowledging feelings through active listening, the clinician must motivate children to behave appropriately.  Often, expressions that are described as “roadblocks to communication” are used in an effort to gain cooperation.  These roadblocks include blaming, name calling, threats, commands(?), warnings, comparisons, sarcasm.  Self-disclosing statements (I-statements) permit pediatric dentists to confront uncooperative behavior without resorting to roadblock statements.  Examples:  “I see that your hands are not in your lap”, “I cannot see the teeth when the mouth is closed”, “Ouch!  That hurts me – I do not like to be bitten.”  I-messages cannot be argued with – they are the practitioner’s experience.  I-messages also place the responsibility on the child for modifying behavior.

Descriptive praise – positive feedback is a powerful way to reinforce correct behavior; the praise should deal only with the child’s efforts and accomplishments, not with his character or personality.  Praise using broad evaluative terms such as “great” and “wonderful” places the pediatric dentist in the role of a judge.  It is much more effective to praise a specific action, such as “You sat so still and kept your mouth open wide while I put your tooth to sleep.”  The child is left to judge the quality of his or her behavior.

Key points/Summary:  These communication skills are not natural or intuitive and must be practiced.  However, keep in mind that without compassion and authenticity, techniques fail.

Assessment of article:  Good reminder of communication pointers that we have all heard at one time or another.