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Psychology in dentistry: Why should you care?

Feb. 24, 2021
Doing a better job of addressing anxiety and understanding the psychological components of the dental experience will help patients more than you may realize.

Growing a dental practice is more difficult than it has ever been. With increased competition, lower reimbursements from insurance companies, and the overall changing medical climate, dentists need to work smarter to remain successful, particularly in the private sector.1

An area that is largely overlooked in the dental community is the sensory experience of the patient. Although almost every dental office claims to provide personalized care, gentle dentistry, and a warm and welcoming staff, what does the team actually do to make the patient experience more than marginally better compared to any other office? With over 70% of the population dealing with at least some level of dental anxiety,2 this is where dentistry and psychology are not connecting.

The sights, smells, sounds, and general intimacy of the dental experience assaults the sensory system from almost every angle. This leaves many people unsure as to why they dislike receiving dental care; their body just tells them it isn’t pleasant.

This is because the sensory system was developed to provide indicators that help us determine whether an experience is good or bad.3 From there, we cognitively make judgments and ultimately buying decisions (think case acceptance).4

If a dental team can reduce these sensory assaults and actually encourage the sensory system to be more relaxed, patients will be able to make more positive judgments about their experience. Their judgment will influence their willingness to build trust and ultimately accept treatment, comply with maintenance recommendations, and commit to keeping appointments. This has a huge impact on the bottom line for any dental practice.

Interestingly, calming the sensory system allows patients to open their bodies more, which can make them easier to treat.5 Imagine the body language of an anxious person—clenching muscles, fists in balls, and crunching inward. A relaxed body is expansive, open, and loose.6 This makes for easier anesthetic blocks, an improved view of the oral cavity, and more efficient delivery of care.

There are various ways to have a positive impact on the sensory system. First, understanding what aspects of the dental experience trigger anxious feelings can assist the team in identifying what may be helpful to patients. Patients often say the noise of the dental drill is bothersome. In these cases, noise-cancelling headphones can help. Other patients may report that the smell of a tooth being drilled is off-putting. Using essential oils on the patient bib can help reduce that negative sensory experience.

The information about what triggers sensory perceptions in each particular patient can be derived from a special intake form that asks about their feelings about receiving dental care, any negative dental experiences, and common sensory triggers they experience. Among the common sensory triggers are the sight of dental instruments, specific textures or tastes, touch indicators (i.e., pressure or pain), tooth sensitivity, and dislike of being numb.

Products found to be helpful in providing comfort and reducing anxious feelings include weighted blankets, knee and neck pillows, heated neck wraps, use of fidgets, eye masks, and massage. With a well-established system, these items can all be implemented within the typical time frame of a patient’s appointment.

The way in which providers communicate with patients can also elicit anxious feelings. Whenever possible, place yourself at the same eye level when talking directly with patients or when having in-depth conversations. This will likely require you to sit down if the patient is already in the dental chair. During treatment, it can be helpful to offer warnings for when patients may feel pressure, taste anesthetic, etc., so they are not surprised as a new sensation arises. It can also be helpful to talk patients through the treatment timeline but avoid overexplaining or using complex dental jargon.

For example, “Mrs. Smith, the first step is to remove the old crown by sectioning it into pieces. Once the crown is removed, all remaining defective tooth structure will be removed prior to taking a digital scan of your tooth. This process will take approximately 20–30 minutes. After the doctor has designed your crown with our CAD system, the crown will take about 30 minutes to fabricate. The final bonding of the crown to your tooth will take about 15 minutes. And that’s it!”

Your team may have a read on which patients may appreciate knowing the steps and approximate time for each ahead of time and which patients would not want/require this level of detail. This is another great question to have on your intake form.

While some of these comfort items may seem trivial, remember that your patients don’t visit a dental office every day. Dental professionals are desensitized to the smells, sights, and sounds; your patients are not. This is of special consideration with children for which the whole dental experience is new. If your team can tune into what truly helps your patients feel comfortable, you’ll be going the extra step toward exceptional customer service.

When your office can provide an exponentially better experience, get more patients to accept treatment, and have patients consistently show up for their scheduled appointments, many common challenges will be solved. This approach also allows people who have put off dentistry for a number of years due to fear and anxiety to receive needed care comfortably, which often results in high-production services.

It’s not all about the bottom line. Doing a better job of addressing dental anxiety and understanding the psychological components of the dental experience will help patients, period. That’s what most dental professionals say they got into the field for—to use their talents to help people. When you help more people and grow the dental business, it’s truly a win-win!

Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles at this link and subscribe here.

References

  1. Runkle, Ken. The business of dentistry. Dental Economics. January 1, 2011. Accessed March 26, 2020.  https://www.dentaleconomics.com/practice/article/16394720/the-business-of-dentistry
  2. Foley KE. So many people are afraid of going to the dentist psychologists don’t know how to quantify it. Quartz Media. March 8, 2017. Accessed March 25, 2020. https://qz.com/926892/so-many-people-are-afraid-of-going-to-the-dentist-psychologists-dont-know-how-to-quantify-it/
  3. Aday J, Carlson JM. Neural mechanisms of emotions and affect. In: Jeon M, ed. Emotions and Affect in Human Factors and Human-Computer Interaction. Elsevier; 2017. Accessed March 26, 2020. https://www.sciencedirect.com/topics/social-sciences/sensory-systems
  4. Murray PN. How emotions influence what we buy: the emotional core of consumer decision-making. Psychology Today. February 26, 2013. Accessed March 26, 2020. https://www.psychologytoday.com/intl/blog/inside-the-consumer-mind/201302/how-emotions-influence-what-we-buy
  5. Brent NJ. How to help reduce your patients’ anxiety. Nurse.com. November 11, 2016. Accessed March 26, 2020. https://www.nurse.com/blog/2016/11/11/how-nurses-can-help-reduce-their-patients-anxiety/
  6. The body language of anxiety. ExploringYourMind.com. January 4, 2019. Accessed March 26, 2020. https://exploringyourmind.com/body-language-anxiety/

Jessica Martin, EdS, MS, has more than 12 years of consulting experience and is on a mission to improve dentistry for patients and practice owners. She and her husband, Dr. Tony Martin, own a successful dental practice in Altoona, Wisconsin. Jessica also owns and operates Martin Management, a dental spa consulting business that trains teams how to effectively address dental anxiety with systems that are proven to reduce sensory overstimulation.