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Over the years and with the evolution of cinema, the representations of the dentist have also evolved. From silent to talking pictures, from black and white to colour, from Hollywood to European cinema, we have tried to identify the characteristics of the dentist in the films. From being a secondary and anecdotal character, he has now become the protagonist of choice. From a caricature and a scripted argument, the dentist has gradually become a complex protagonist. The public's perception of the dental profession is influenced by these changes, giving hope for a better relationship between patients and dentists, with the aim of improving oral public health. (AU)

A lo largo de los años y con la evolución del cine, las representaciones de los dentistas también han evolucionado. Desde el cine mudo hasta el sonoro, desde el blanco y negro hasta el color, desde Hollywood hasta el cine europeo, hemos tratado de identificar las características del dentista en las películas. De ser un personaje secundario y anecdótico, ha pasado a ser el protagonista por excelencia. De ser una caricatura y un argumento guionizado, el dentista se ha ido convirtiendo en un protagonista complejo. Estos cambios influyen en la percepción que el público tiene de la profesión dental, lo que permite esperar una mejor relación entre pacientes y dentistas, con el objetivo de mejorar la salud pública bucodental. (AU)

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In children and young people, complex and prolonged dental treatment can sometimes be met with resistance despite previously successful treatment appointments. While this has traditionally been referred to as a 'loss of cooperation' or 'non-compliance', these children may actually be experiencing 'burnout', of which many may have the potential to recover and complete their course of treatment. Burnout has been defined as "the extinction of motivation or incentive, especially where one's devotion to a cause or relationship fails to produce the desired results". Traditionally, burnout is experienced by those who deliver services rather than be in receipt of a service; however, the burnout concept proposed in this paper explores it as an alternative perspective to other dentally relevant psychosocial conditions and should be considered when employing appropriate behaviour management techniques and coping strategies for paediatric patients. The intention of this paper is not to establish firm grounds for this new concept in healthcare, but to start a discussion and motivate further theoretical and empirical research. The introduction of the 'burnout triad model' and the importance of communication aims to highlight the tripartite influence of patients, parents and professionals engaged in the central 'care experience' and underlines the belief that early recognition and management of potential signs of burnout may help reduce the likelihood of those involved developing the condition.

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OBJECTIVES: To assess the association between aspects of the dentist-patient relationship at age 65 and Oral Impacts on Daily Performances (OIDP) at ages 65 and 70 and to examine whether dental avoidance behaviours play a role in explaining that association. BACKGROUND: Information about the quality of the dentist-patient relationship is important for dental care provision and healthy ageing. METHOD: Secondary data analysis of a cohort study of Norwegians born in 1942. The participation rate in 2007 (age 65) and 2012 (age 70) was, respectively, 58.0% (n = 4211) and 54.5% (n = 3733). A total of 70.0% (n = 2947) of the baseline participants responded in 2012. Dentist-patient relationship aspects were assessed in terms of communication with the dentist, satisfaction with dental care, unpleasant experiences and changes of dentist. Generalised Estimating Equations (GEEs) were used to account for repeated measurements. RESULTS: Prevalence of oral impacts (OIDP) was 29.0% in 2007 and 28.4% in 2012. Participants who received communication on oral hygiene during dental visits had a higher likelihood, whereas participants who reported satisfaction with dental care, no unpleasant experience and did not change dentist had a lower likelihood of reporting oral impacts over these 5 years. Corresponding odds ratios were: 1.2 (95% CI 1.0-1.5), 0.4 (95% CI 0.3-0.5), 0.6 (95% CI 0.5-0.7) and 0.5 (95% CI 0.3-0.6). Associations between dentist-patient relationship aspects and OIDP remained unchanged after adjustment for avoidance behaviours. CONCLUSION: Training dentists in relationship skills might improve social interaction with patients and the oral health-related quality of life of older people in Norway.

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PURPOSE/OBJECTIVES: Empathetic communication of dentists with their patients is a primary characteristic of their health care. This study aims to evaluate dental students' empathy levels during the transitional period of internship and postgraduate studies of different specialties at one of the oldest dental schools in Saudi Arabia and explore how this empathy was affected by gender, age, and study duration. METHODS: In this study, the self-reported empathy level among the participants was assessed using the Jefferson scale of empathy-student version (JSE-HPS). This survey includes a 20-question Likert scale formulated to measure clinical empathy in health care professionals. The JSE-HPS was distributed to all registered dental interns and postgraduate students during the academic year 2019-20 in King Abdulaziz University Faculty of Dentistry (KAUFD), Jeddah, Saudi Arabia. RESULTS: Mean total score of empathy of the participants was (101.07 ± 14.8) with a response rate of 89%. A statistically significant higher empathy score appeared among dental postgraduate students in general (p = 0.04) and specifically among the females (p = 0.04) and those with postgraduate programs for more than four years, (p = 0.02). Dental postgraduate students scored significantly higher in the parameters of standing in patients' shoes (p = 0.02). CONCLUSION: Gender, academic level, and duration of postgraduates' studies influenced empathy more than the age of the dental graduates in KAUFD. Our recommendation is to integrate empathy into the dental curriculum emphasizing interactive communication skills and early patient contact.

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INTRODUCTION: This study examines undergraduate dental students' perceptions of their self-confidence in communicating with patients and paradental staff. MATERIALS AND METHODS: A survey questionnaire was designed based on a literature review and input from students and academic staff relating to clinical communication skills with 19 questions across 7 domains. Through email, a convenience sampling of undergraduate students were invited to complete the survey questionnaire. Qualitative and quantitative analysis of the responses was performed with a thematic analysis to the open-ended questions. RESULTS: In total, 102 students were surveyed from 4 years of students with a 36.6% response rate. Students reported some areas of low confidence across various communication domains, in particular, building rapport, behavioural change, management of patient expectation and breaking bad news. Students reported insufficient confidence and knowledge in specialist clinical areas, layperson terms and success rates and longevity of treatment items when communicating with patients. Information sheets and visual aids such as models or photos were suggested by students to be helpful in patient communication. Students also reported challenges in communication with nurses when they might challenge or change their clinical decisions in front of their patients. CONCLUSION: Our study reveals areas of low confidence among undergraduate dental students in communication towards patients and paradental staff. Barriers and challenges have been identified with an action plan suggested accordingly. There is a need for additional training in the form of learning content and communications experiences, and channels of communications for undergraduate students.

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OBJECTIVES: The aim of this study was to examine the typical personality traits of dentists and to discuss critically their influence on the necessary characteristics for a good dentist-patient relationship. METHODS: Two groups were invited via e-mail to participate the study in 2015-2020. One group consisted of German dentists (DENT N = 580). The other group was formed by German speaking psychotherapists from Germany, Austria and Switzerland (DACH N =  1.027). The Personality Styles and Disorder Inventory was used in its short form (PSDI-S) via online survey. The normalization sample (NORM N = 3.392) of the PSDI-S was used to compare the results with a normative sample. RESULTS: Dentists differed in 10 out of 14 personality styles from the normalization sample (NORM), and in 13 out of 14 personality styles compared with the psychotherapists (DACH). Female dentists differed in 7 out of 14 personality styles to their male colleagues. CONCLUSIONS: The most significant differences in personality styles were willful (PN), spontaneous (BL), reserved (SZ), ambitious (NA), optimistic (RH) and conscientious (ZW), which seem to be necessary for a good dentist-patient relationship and dental procedures. The expression of personality styles is most likely to influence the choice, delivery and cost as well as patient perception of treatment. CLINICAL SIGNIFICANCE: Dentist's personality has an important impact on the interpersonal, which influences the dentist-patient relationship and its therapeutic outcome.

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This article aimed to set into perspective the unique aspects of trust within the dentist-patient relationship by exploring the literature as well as historical aspects of dentistry in the association between trust/distrust and patient anxiety. In order to characterise this uniqueness, the assumptions for trusting in dentistry are compared and contrasted with other professions using a conceptual analysis. The professions of medicine, sociology, psychology, nursing and dentistry were check listed according to the tenets of a concept analytical approach reported by Hupcey et al., in 2001. Recommendations for patient/person-centred care, as opposed to dentist-centred care, that would improve trust are specified according to the literature. These include empowering patients, practicing active listening, empathy and relationship building that might benefit dental patients in relation to the perceived risks of anxiety or induced pain. It was concluded that global distrust of dominating dentists must give way to person-centred professional strategies so that dentists and patients can tackle their dental anxiety-trust challenges, both in the public's image of the dental profession and in clinical relationships. Future directions would be to explore incentives for dentists to change to patient/person-centred care.

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Objetivo: Avaliar a presença do medo odontológico em universitários brasileiros e observar se a teoria do ciclo vicioso do medo é identificada nesta população. Materiais e métodos: Foi realizado um estudo transversal com universitários ingressantes na Universidade Federal de Pelotas em 2016. Os dados sociodemográficos, medo odontológico, o uso de serviços odontológicos, a percepção de cárie e dor dentária foram coletados através de um questionário auto--administrado. A exposição do estudo foi medo odontológico, e os desfechos incluíram padrão de consulta odontológica, experiência de cárie e dor dentária e autopercepção de saúde bucal. Características sociodemográficas foram incluídas como fatores de confusão. Para testar a associação do medo odontológico com os desfechos, foram utilizados modelos de regressão de Poisson com variância robusta, a fim de estimar as Razões de Prevalência e Intervalos de Confiança. Resultados: Foram avaliados 2.014 universitários, dos quais 22.4% reportaram medo odontológico. Aqueles que reportaram medo odontológico apresentaram uma maior prevalência de não terem ido ao dentista no último ano e, entre os que consultaram, a visita ter sido motivada por dor/problema. Adicionalmente, ter medo aumentou a presença de cárie, dor dentária e autorrelato da saúde bucal negativa. Discussão: Os achados sugerem a presença do ciclo vicioso do medo nesta população de universitários do sul do Brasil. Conclusão: Evidenciou-se a associação entre a presença de medo odontológico e a menor procura por atendimento odontológico, a presença de cárie dentária, dor dentária e saúde bucal autorreportada negativa, corroborando com a teoria do ciclo do medo.

Aim: To evaluate the presence of dental fear among Brazilian undergraduate students and to observe whether the cycle of dental fear theory applies to this population. Materials and methods: A cross-sectional study were conducted with first year students of the Federal University of Pelotas, Brazil, in 2016. Sociodemographic data, dental fear, as well as the use of dental services and perception of caries and dental pain were collected through a self-administered questionnaire. The exposure was dental fear, and the outcomes included dental visit pattern, experience of dental caries and dental fear and self-rated oral health (SROH). Sociodemographic characteristics were included as aconfounding factor. To test the association between dental fear and the outcomes, Poisson regression models with robust variance were used, to estimate Prevalence Rations and Confidence Intervals. Results: 2,014 undergraduate students were evaluated and 22.4% of them reported dental fear. Those who reported dental fear had a higher prevalence of not visiting the dentist in the last year and, among those who visited, to have had only a pain/problem-oriented visit. Additionally, having fear increased the presence of dental caries, dental pain and negative SROH. Discussion: Our findings suggest the presence of the vicious cycle of dental fear in this population of undergraduate students in southern Brazil. Conclusion: This study provided evidence on the association between dental fear and the lower frequency of dental visit, dental caries, dental pain experience and negative SROH, corroborating with the cycle of dental fear theory.

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INTRODUCTION: Oral health mirrors systemic health; yet, few clinics worldwide provide dental care as part of primary medical care, nor are dental records commonly integrated with medical records. OBJECTIVES: To determine the degree to which misreporting of underlying health conditions poses problems for dental clinicians, we assessed misreporting of 2 common medical health conditions-hypertension and diabetes-at the time of dental examination and assessment. METHODS: Using comparative chart analysis, we analyzed medical records of a diverse group of patients previously seen at the University of Texas Physician outpatient practice and then treated at the University of Texas Health Science Center at Houston School of Dentistry. Electronic health records of patients aged ≥18 y were extracted from 2 databases: Allscripts (University of Texas Physician) and axiUm (University of Texas Health Science Center at Houston). We identified 1,013 patients with the commonly occurring conditions of diabetes, hypertension, or both, with nonintegrated records contained in Allscripts and axiUm. We identified the percentage of those patients previously diagnosed with diabetes and/or hypertension by their physicians who failed to report these conditions to their dental clinicians. RESULTS: Of those patients with diabetes, 15.1% misreported their diabetes condition to their dental clinicians, while 29.0% of patients with hypertension also misreported. There was no relationship between sex and misreporting of hypertension or diabetes, but age significantly affected reporting of hypertension, with misreporting decreasing with age. CONCLUSIONS: Because these conditions affect treatment planning in the dental clinic, misreporting of underlying medical conditions can have negative outcomes for dental patients. We conclude that policies that support the integration of medical and dental records would meaningfully increase the quality of health care delivered to patients, particularly those dental patients with underlying medical conditions. KNOWLEDGE TRANSFER STATEMENT: Our study illustrates an urgent need for policy innovation within a currently fragmented health care delivery system. Dental clinicians rely on the accuracy of health information provided by patients, which we found was misreported in ~15% to 30% of dental patient records. An integrated health care system can close these misreporting gaps. Policies that support the integration of medical and dental records can improve the quality of health care delivered, particularly for dental patients with underlying medical conditions.

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OBJECTIVES: In health care, empathy is associated with compassion, thoughtfulness, attentiveness and caring. While empathy is perceived as desirable and positive, it can potentially be associated with negative aspects, such as secondary traumatic stress or vicarious trauma (VT). VT addresses the secondary vicarious influences of patients' pain and discomfort on clinicians. Dentists are routinely exposed to patients' anxiety, pain and discomfort. These may lead to VT, which in turn can affect empathy. The objectives of the present study were to examine the existence of VT among dentists and its association with their empathic approach. MATERIALS AND METHODS: Two-hundred and fifty dentists were approached personally and by mail, and asked to complete: (i) the Jefferson Scale of Physician Empathy - Health Professionals; (ii) the Vicarious Trauma Scale; and (iii) demographic, personal and professional data, including age, definition of professional speciality, number of working hours per week and number of sleeping hours per night. RESULTS: A total of 200 dentists responded (80% response rate). No differences were found between genders regarding empathy or VT. Dentists who have been accredited as a specialist in one of the dental fields (dental specialists) presented higher empathy scores than general practitioners. VT correlated positively with number of working hours per week and negatively with empathy. The best predictor of empathy was number of sleeping hours per night, followed by VT and age. CONCLUSIONS: Empathy in the clinical setting is closely associated with secondary VT among dentists. Decreasing dentists' VT may benefit dentists' empathy and through this lead to better clinical outcomes.

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The provision of dental care services, related to the quality requirements of health policies and patient satisfaction rates, increasingly requires the creation of qualitative indicators, instruments and criteria based on specific objectives, to validate the quality of the services provided. objective: the aim of this study is to determine the main dimensions of the dentist-patient relationship associated with patient satisfaction in a clinical context, with emphasis on the needs and expectations of patients themselves. method: a sample of 88 adults who attend primary care units at public emergency services in the central area of Chile were studied using a qualitative approach based on the social psychology of health and on grounded theory. from these, categories emerged that identify processes, attitudes and behaviors that define the assessment of care providers based on their practices. results: in an interactional context characterized by the patient's expectation regarding the provision of care and anxiety due to potential pain, two already recognized main axes emerged, namely: the capacity to generate trust through interpersonal and communicative good treatment strategies, and the capacity or technical skills of the professional care provider. conclusion: this study proposes a protocol of good care practices, which takes into account the needs and expectations of patients regarding the role of the dentist.

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In today's digital era, people are increasingly relying on the Internet-including social media-to access health information and inform their health decisions. This article describes an exploratory initiative to better understand and define the role of dentists in patient education in the context of e-patients and Health 2.0. This initiative consisted of four phases. In Phase I, an interdisciplinary expert advisory committee was assembled for a roundtable discussion about patients' health information-seeking behaviors online. In Phase II, a pilot case study was conducted, with methods and analysis informed by Phase I recommendations. Phase III consisted of a debriefing conference to outline future areas of research on modernizing health communication strategies. In Phase IV, the findings and working theories were presented to 75 dental students, who then took a survey regarding their perspectives with the objective of guiding potential curriculum design for predoctoral courses. The results of the survey showed that the validity of online content was often secondary to the strength of the network sharing it and that advocacy online could be more effective if it allowed for emotional connections with peers rather than preserving accuracy of the information. Students expressed high interest in learning how to harness modern health communications in their clinical care since the role of the dentist is evolving from giving information to giving personalized guidance against the backdrop of an often contradictory modern information environment. The authors recommend that the dental profession develop patient-centered health communication training for predoctoral students and professional development and continuing education for practicing professionals.

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INTRODUCTION: Awareness of gender- or nationality-driven preconceptions can help dentists to have a better interpretation of the dentist-patient relationship. It is even more noteworthy to understand these predilections in Saudi society, where women and men are usually segregated due to religion- and culture-based considerations. This study is one of the first to explore the preferences of patients when selecting a dentist with respect to gender and nationality in the city of Riyadh, Saudi Arabia. MATERIALS AND METHODS: A total of 445 community residents residing in Riyadh were randomly selected for a cross-sectional study. The participants completed a survey designed to assess which of two factors (gender and/or nationality) were perceived as most relevant in choosing a dentist. Statistical analysis of the data was performed using the SPSS 11.5 software. RESULTS: Female participants did not show any preference for the gender of the dentist, whereas 40% of the male participants preferred a male dentist. Participants also favored male dentists in the felds of oral surgery (78.9%), implants (74.1%), endodontics (67.5%), orthodontics (65.8%) and prosthodontics (64.2%). An exception was noted in pediatric dentistry, for which female dentists were favored by 52.8% of the participants. Additionally, most (66.1%) participants did not have any preference for the nationality of the dentist. CONCLUSION: Riyadh residents showed a general preference for a male dentist but demonstrated no preference for nationality when selecting a dentist.

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The importance of developing good dentist-patient relationships has been well documented, but previous studies have focused on social techniques, not considering the psychological and behavioral characteristics of patients, and have used definitions and instruments that were not dental-specific. Therefore, the aims of this study were to propose a definition of dentist-patient relationship skills, derived from dental faculty members' criteria and informed by Emotional Intelligence concepts, and to propose a preliminary dental-specific, face-valid, and reliable self-assessment instrument. The study was conducted in three phases. Phases I and II defined dentist-patient relationship competence through literature analysis and semi-structured interviews with expert key informants, establishing the outcome skills. In Phase III, the instrument was constructed and piloted. Communication skills and basic psychological tools resulted in core topics for use in practice. The definition both specifies and broadens social interactions in dentistry by including dental faculty members' criteria and topics such as psychological tools and pre-, intra-, and postoperative topics appropriate for use during consultation, examination, and treatment. The instrument was found suitable, reasonable, and accessible with a Cronbach's alpha level of 0.95. Future studies are needed to confirm the definition, as well as the instrument's validity, reliability, transference, and sensitivity to the dental educational environment.

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En este artículo presentamos una revisión en torno a la importancia de la enseñanza de la relación odontólogo-paciente, describimos los dilemas que se evidencian en la literatura sobre el desarrollo de éstas prácticas, realizamos un ejercicio reflexivo a partir de los lineamientos que rigen el currículo en la Facultad de Odontología de la Universidad el Bosque bajo el enfoque del modelo biopsicosocial; complementado con un programa transcurricular en bioética, formación que a pesar de tener esta orientación holística, parecen existir tensiones entre el modelo de formación y las prácticas formativas en los últimos semestres en la asistencia o en la relación estudiante-paciente-docente, repercutiendo en serias implicaciones bioéticas. A partir de esta discusión se plantean algunas de las dificultades en la apropiación del modelo y se proponen acciones para mejorar la implementación exitosa de este en la formación docente-asistencial.

In this article we present an overview about the importance of dentist-patient relationship education, we describe the dilemmas that are evident in the literature on the development of these practices, and perform a reflective exercise based on the principles governing the curriculum at the El Bosque University Dental School under the approach of the biopsychosocial model and complimented with cross-curricular program in bioethics, an education that despite having this holistic orientation, there appear to be tensions between the education model and training practices in the advance semesters in attendance or on the student-patient-professor relation marking serious bioethical implications From this discussion some difficulties are exposed in appropriating the model and actions are proposed to improve the successful implementation of this in the internship program.

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OBJETIVO: devido à crescente preocupação dos profissionais em adquirir novos pacientes e mantê-los satisfeitos com o tratamento, o presente estudo tem por objetivo avaliar o nível de satisfação de pacientes em tratamento ortodôntico em relação à atuação do ortodontista. MÉTODOS: foram avaliados 60 questionários preenchidos por pacientes em tratamento ortodôntico com profissionais especialistas em Ortodontia, da cidade de Curitiba-PR. Os pacientes foram divididos em dois grupos: o grupo 1 compreendia 30 pacientes que se consideravam insatisfeitos e se transferiram de profissional nos últimos 12 meses; os 30 pacientes participantes do grupo 2 consideravam-se satisfeitos e estavam em tratamento ortodôntico com o mesmo profissional há pelo menos 12 meses. RESULTADOS E CONCLUSÕES: após a realização da análise estatística pelo teste qui-quadrado, foi possível concluir que os fatores estatisticamente relacionados com o nível de satisfação dos pacientes avaliados, considerando a atuação do ortodontista, foram: titulação, recomendação do profissional, motivação, classificação técnica, interação profissional/paciente, e relacionamento pessoal com o paciente. Na avaliação do tratamento ortodôntico, os fatores que determinaram diferenças estatisticamente significativas no nível de satisfação dos pacientes foram: quantidade de pacientes atendidos simultaneamente e integração do paciente durante as consultas.

OBJECTIVE: Considering the increasing professional preoccupation in accounting new patients and establish a close rapport with satisfied patients, this study aimed to evaluate the patient satisfaction level in orthodontic treatment in relation to orthodontic actuation. METHODS: Sixty questionnaires filled out by patients in orthodontic treatment with specialists in Orthodontics, from the Curitiba city. The patients were divided into two groups. The first had 30 patients which considered unsatisfied with the orthodontist's conduct or treatment and transferred of orthodontist in the last 12 months. The second group had 30 patients which considered satisfied, and were in treatment with the same professional during, at least, 12 months. RESULTS AND DISCUSSION: After the statistical analysis (chi-square test), it was concluded that patient's satisfaction with orthodontist actuation is strongly related to the doctor-patient personal relationship and interaction, motivation, technical degree, doctor's indication and titles. The factors that predicted satisfaction of the patient with the orthodontic treatment were the number of patients attended simultaneously and the integration of the patients during the proceeding.

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