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BACKGROUND AND OBJECTIVES: A review of psychology, dental, and medical literature aimed to identify key variables for an ideal dentist-patient relationship. When empathy surfaced as the key positive variable, a further aim, which became the aim of this paper, was to explore how empathy could be intentionally applied. METHODS: An online database search, limited to judgementally selected target-words, was conducted for peer-reviewed papers on the dentist-patient relationship. Review guidelines from the American Psychological Association were used to clarify concepts, identify where most work was focussed, and to explore the superiority of any approach to the topic, over another. RESULTS: The distinction between instrumental (information) and affective (emotional) communication was important with empathy being the key variable. Empathy was seen clearly to facilitate improved communication and the experience of dentistry for patient and practitioner alike. Empathy was positively associated with negotiated treatment plans, treatment adherence, increased patient satisfaction, and reduced dental anxiety. However, the concept of empathy was rarely operationally defined, or empirically measured. At best it was a scale score or a theme in qualitative data analysis. As such, applied empathy is discussed as a perceived concept. Dental school curricula and patient request forms were found to have the greatest potential to train dentists to convey empathy, and for patients to perceive empathy. CONCLUSION: Future directions are proposed, to apply empathy in the dentist-patient relationship through an integrated model of patient-centred communication.

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BACKGROUND: Children's unhappy visits to the dentist can negatively impact lifelong oral health. A possible intervention is to enhance empathy in the child patient-dental practitioner relationship through communication. The present paper presents a new instrument, the Survey of Anxiety and Information for Dentists (SAID), which targets children's dental anxiety, coping preferences and dental neglect, and offers children a change to request information and engage in treatment planning. METHOD: Five children's focus groups pilot tested the content, wording and response format of a prototype patient request form, the SAID. Participants were 34 10- to 13-year-old children who individually completed the form then discussed it item by item in their small groups. RESULTS: Children had no difficulty completing most items. They identified ambiguities, and items that were meaningless to them, and proposed a new item asking the dentist about their job. Children were polarized over the response format, but they were emphatic about passing the form directly to the dentist, and not to a receptionist or assistant, stressing the importance of having a conversation with their dentist. CONCLUSIONS: Before the pilot, dentists had expressed concerns about the potential for words in the SAID-provoking negative feelings. Children, however, wanted and needed facts, so requested that dentists use plain language, not euphemisms, to describe problems and treatment options. We report their selected practical suggestions. SAID-informed negotiated care may promote more patient cooperation and satisfaction at appointments, and more attention to oral hygiene between appointments.

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The plain abdominal film finding of a large air-filled cavity has a differential diagnosis that includes giant colonic diverticulum, volvulus, giant Meckel's or other small-bowel diverticulum, emphysematous cystitis, vesicoenteric fistula, bowel duplication, and mesenteric cyst. The case presented here expands this differential diagnosis to include tuboovarian abscess with fistulous communication to the bowel.

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Cystitis glandularis is an uncommon proliferative disease of the bladder epithelium. Involvement of the trigone, with infiltration of the submucosal ureter, may result in ureteral obstruction. We present 2 patients with biopsy-proven cystitis glandularis who presented with ureteral obstruction.

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The workup of left atrial myxomas has variably ranged from a physical examination, laboratory tests, and echocardiography to the invasive modalities of angiography and cardiac surgery. We propose that computed tomography (CT) be considered a sensitive, noninvasive adjuvant in the diagnosis of these tumors. This report describes successful utilization of CT imaging in one such case of proven left atrial myxoma.

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