Dental Radiography: Patient Relations and the Dental Radiographer
Dental Radiography: Principles and Techniques
Chapter 13: Patient Relations and the Dental Radiographer
Key Concepts
Patient Relations
Importance of establishing a positive rapport with patients during dental procedures.
Enhances trust, comfort, and overall experience for patients.
Objectives of Lesson 13.1
Define key terms associated with patient relations.
Discuss the roles of verbal, nonverbal, and listening skills in enhancing communication.
Explain how facilitation skills can build patient trust.
Interpersonal Skills
Definition: Skills used to communicate with and relate to others.
Categories:
Communication Skills:
Verbal: The use of spoken or written language to convey information.
Nonverbal: Communication without words, utilizing gestures, facial expressions, and body language.
Listening: The act of actively receiving and interpreting spoken information.
Facilitation Skills:
Used to ease communication and build trust with patients.
Key Techniques:
Encouraging questions: Inviting patients to express their concerns or seek clarification.
Answering questions: Providing clear and informative responses to inquiries from patients.
Responding with action: Demonstrating that patient concerns are taken seriously by acting upon them.
Expressing warmth: Using friendly and personable behavior to make patients feel comfortable.
Patient Relations Dynamics
First Impressions:
The initial impression a patient forms of the dental team, heavily influenced by the dental auxiliary.
Key Attributes for Positive First Impressions:
Grooming: Personal hygiene and presentation of the dental professional.
Greeting: Proper and warm welcome of the patient as they enter the practice.
Chairside Manner:
Definition: The comportment of the dental professional while attending to the patient in the dental chair.
Characteristics:
Relaxing for the patient: Creating a calm atmosphere.
Confidence: Displaying assurance during procedures to instill trust.
Attitude:
Definition: The physical demeanor and behavioral posture of the dental professional, which reflects their mood and professionalism.
Importance of Professional Courtesy:
Demonstrating patience and honesty in all interactions with patients.
Communication Enhancements
Creating Comfort:
Utilizing small talk to ease tension and build rapport with patients.
Explaining procedures clearly to help patients understand their care.
Maintaining efficient processes to minimize wait times and stress.
Encouraging a calm environment that promotes relaxation.
Importance of Educating Patients About Dental Images:
Many patients may not comprehend the significance of dental imaging.
Explanation Needs to Cover:
Why dental images are necessary.
The specific uses of dental images in practice.
The overall benefits of dental images to the patient.
Educational Methods Used by Dental Radiographers:
1. Oral Presentation:
Face-to-face interaction where the dental radiographer discusses the importance and particulars of dental images.
2. Printed Literature:
Distribution of brochures, flyers, or other written materials that explain dental imaging.
3. Combination of Both:
Utilizing both oral presentations and printed materials to convey information effectively.
Impact of Patient Education
Enhances Understanding:
Patients become informed about the necessity and benefits of dental imaging, leading to improved patient experiences.
Decreases Fear of X-Ray Exposure:
Knowledge demystifies the process and alleviates anxieties regarding x-ray safety.
Increases Cooperation:
Educated patients are more likely to participate in necessary dental procedures, including imaging.
Increases Motivation for Regular Dental Visits:
As patients understand the role of imaging in dental health, they are encouraged to prioritize dental care.
Frequently Asked Questions about Dental Imaging
Necessity Questions:
Are dental x-rays really necessary?
How often do I need dental x-ray images?
How often should children have dental x-ray images?
Can I refuse x-ray images and be treated without them?
Instead of taking x-ray images, can you use the dental images from my previous dentist?
Exposure Questions:
How do you limit my exposure to x-rays?
Why do you use a lead apron?
Should I avoid dental x-ray exposure during pregnancy?
Why do you leave the room when x-rays are used?
Safety Questions:
Are dental x-rays safe?
Will dental x-rays cause cancer?
Digital Imaging Questions:
What are the advantages of digital imaging?
Are there risks associated with digital imaging?
Miscellaneous Questions:
Can a panoramic x-ray be exposed instead of a complete series?
Who owns my dental images?
Purpose
Introduce dental radiographers to challenges when imaging patients with special needs.
Address management of:
Hypersensitive gag reflex patients
Patients with physical or developmental disabilities
Pediatric patients
Endodontic (root canal) patients
Edentulous patients
Gag Reflex in Patients
Definitions
Gagging: An involuntary effort to vomit.
Gag Reflex: Retching elicited by stimulation of sensitive soft palate tissues.
Trigger Areas
Soft palate
Lateral posterior third of the tongue
Precipitating Factors
Psychogenic stimuli: Originating from the mind.
Tactile stimuli: Originating from touch.
Management of the Gag Reflex
Strategies
Operator Attitude:
Convey confidence, patience, and understanding.
Explain the imaging procedure beforehand.
Patient and Equipment Preparations:
Limit time the receptor is in the mouth.
Complete preparations before receptor placement to minimize gagging.
Exposure Sequencing:
Start with anterior exposures; expose posterior premolar before molar receptors.
Note: Maxillary molar receptor is most likely to trigger gag reflex.
Receptor Placement Techniques:
Avoid sliding the receptor along the palate.
Bring receptor into contact with palatal tissues in a decisive motion.
Demonstrate placement by rubbing a finger along intended area; inform the patient.
Extreme Cases:
If uncontrollable gag reflex, utilize extraoral images (panoramic or lateral jaw) for diagnostic information.
Helpful Hints
Do not suggest gagging; reassure the patient instead.
Suggest controlled breathing and distractions.
Try to reduce tactile stimuli and use topical anesthetics if necessary.
Patients with Disabilities
Definition
Disability: A physical or mental impairment that substantially limits major life activities.
Types of Disabilities
Physical Disabilities
Vision Impairment:
Use clear verbal explanations for communication.
Hearing Impairment:
Ask the patient's preferred communication method, or involve a caregiver as interpreter.
Mobility Impairment:
Offer assistance if needed.
Developmental Disabilities
Defined as a substantial impairment of mental or physical functioning occurring before age 22.
May lead to coordination or comprehension difficulties.
For patients who cannot tolerate intraoral exposure, consider extraoral methods.
Patient Management with Disabilities
Helpful Hints
Follow the Golden Rule in treatment approaches.
Avoid personal questions regarding disabilities.
Think before speaking and offer assistance.
Communicate directly with the individual with a disability.
Pediatric Patients in Dentistry
Definition
Pediatrics: The dentistry branch focusing on diagnosing and treating dental diseases in children.
Key Considerations
Awareness of tooth eruption sequences, image prescriptions, recommended techniques, types of examinations, digital sensor issues, and patient management required.
Tooth Eruption Sequences
Age Eruption Timings
Central Incisors:
Maxillary: 7-8 years; Mandibular: 6-7 years.
Lateral Incisors:
Maxillary: 8-9 years; Mandibular: 7-8 years.
Canines:
Maxillary: 11-12 years; Mandibular: 9-10 years.
1st Premolar:
Maxillary: 10-11 years; Mandibular: 10-12 years.
2nd Premolar:
Maxillary: 10-12 years; Mandibular: 11-12 years.
1st Molar:
Maxillary: 6-7 years; Mandibular: 6-7 years.
2nd Molar:
Maxillary: 12-13 years; Mandibular: 11-13 years.
3rd Molar:
Maxillary: 17-21 years; Mandibular: 17-21 years.
Prescribing Dental Images
Image prescribing depends on child’s individual needs and cooperation ability.
It’s recommended to capture all tooth-bearing areas during early mixed dentition after the first permanent tooth erupts.
Recommended Imaging Techniques
Techniques for pediatric patients resemble those for adults.
Typical examinations vary based on primary and transitional dentitions.
Types of Examinations
A baseline series of images showing all tooth-bearing areas is necessary for new pediatric patients.
Examination Series Types
Four, eight, twelve, or sixteen-image series recommended.
Digital Sensor Considerations
Pediatric patients may vary in their ability to tolerate wired digital sensors.
Size compatibility is crucial; wireless sensors are generally preferred.
Patient and Equipment Preparation
Implement detailed explanations of procedures, lead apron usage, exposure factors, and appropriate receptor sizes.
Patient Management Strategies
Exhibit confidence, demonstrate behavior, reassure, request assistance, and postpone examinations when necessary.
Endodontic Patients
Definition
Endodontics: The dentistry branch that deals with the diagnosis and treatment of dental pulp diseases.
Dental images are critical during root canal procedures, requiring a series of exposures pre-, mid-, and post-treatment.
Receptor Placement
Modifications in receptor positioning may be necessary.
Use of the EndoRay alignment device is recommended for accurate receptor placement during root canal procedures.
Whenever possible, apply the paralleling technique for image acquisition.
Edentulous Patients
Imaging Needs
Imaging for edentulous patients may include:
Detecting root tips or impacted teeth.
Identifying embedded objects in bone.
Establishing normal anatomic landmarks relative to the alveolar ridge crest.
Observing the quantity and quality of existing bone.
Examination Types
Panoramic Examination:
Most common method for evaluating the edentulous jaw.
Periapical Examination:
Used as an alternative if panoramic imaging is unavailable or as follow-up to prior panoramic exams.
Occlusal and periapical examinations may also be utilized.