ANY discussion of the dentist-patient professional relationship must begin with one singular but critical observation. There is an unfortunate tendency in the dental literature to assume that there is only one kind of dentist-patient relationship. Such conceptualisation has limited the kinds of research carried out and compromised the relevance of the reported findings, because successful treatment in the healing arts is not attributed exclusively to the administration of an appropriate remedy.
Notably, once there is person-to-person interaction, a certain degree of understanding must prevail. In the dentist-patient relationship, the concept of success after treatment should be balanced when both parties have systematically analysed the results.
The fact is that there are three types of relationships which vary according to the relative amounts of responsibility required of the dentist and patient. The importance of being aware of these explains the doubts about whether there is any guarantee of dental work done by the dentist.
In one model, the dentist assumes full responsibility for the patient’s care. In its most extreme form, the patient is incapable of reaction; that is, they are unconscious or in a coma, etc.
The second type of relationship is that of the guidance-cooperation model. The dentist gives advice, direction or instructions, and the patient is expected to carry them out. This type of relationship is probably the most traditional and familiar one.
The third type of relationship is that of mutual participation. In this model, both dentist and patient share equally. The patient is expected to take responsibility for his welfare and to promote his own health. Only here can he engage in preventive and health-promoting behaviours or adhere to prescribed regimens to control chronic disease.
Studies done have described the “good patient” as obedient, conforming and willing to assume the role of the patient. According to researcher E. F. Borgatta, the degree to which the patient poses little risk or threat to the professional and the extent to which he readily conforms define the patient in positive terms.
In addition, individuals characterised as “good patients” are described as agreeable, likeable, warm and attractive, according to T. A. Wills writing in the Psychological Bulletin (1999).
The psychiatric and social work literature has demonstrated that the professional’s first impression of the patient, as measured by the dimensions discussed above, significantly affects treatment outcome. Patients who are cooperative and behave well tend to get the better of the dentist. In fact, studies show that the patient’s professional image on the first visit is significantly related to treatment outcome.
Findings of Horning and Massagli (2001) indicate that as professionals become more specialised, there appears to be an increased emphasis on the patient’s negative characteristics, with a tendency to label them as negative persons who exaggerate small ailments and are headstrong.
It is conceivable that patients who challenge professionals’ integrity tend to receive labels which place them outside of the professional’s area of expertise or define them as untreatable.
A survey conducted some years ago in the USA reported that, for dentists, the ideal patient was a female between the ages of 25 and 55, well-educated and at the upper end of the social scale. This aspect further proved the physical appearance dimension in relation to treatment.
Also, almost half the dentists surveyed had lost patients due to poor interpersonal relationships. On the other hand, patients believe that critical factors in choosing a good dentist include their personality, ability to reduce fear and anxiety, and technical ability.
