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June 2018--If you've been practicing dentistry long enough, you know the sweetest words the patient can say to you are “Whatever you say, Doc. I trust you.’” Dr. Barry F. Polansky, author of “The Art of Case Presentation,” says there are five essential behaviors dentists should habitually practice in order to build patient trust for case acceptance.


It usually takes time and frequency of contact to build what Stephen Covey calls an “emotional bank account” of sufficient size for a patient to accept extensive dentistry. So, a major challenge that dentists face is the time it takes. In today’s world, patients move from dentist to dentist with increasing frequency, like they might a barber shop or hair salon. One dentist is like any other, right? Wrong.

Any practice, whether it be private, group, or DSO affiliated, that does not slow down to make a connection with the patient is in for a lot of patient turnover. In many practices, patients come in for emergency dentistry, want a quick exam and dental cleaning, and the dental team never sees the patient again. 

When patients come through the front door and out the back door, there isn’t sufficient time and frequency of contact to build trust. 


The Case for Slow Dentistry

Research has demonstrated that trust is the fastest and most efficient motivator in human existence. But with people, fast is slow and slow is fast. In other words, the faster you go in and present treatment, it will slow down trust. But if you slow down and spend time with people, they'll make their decision faster. It’s wonderful to give time to people to build that level of trust. But, when you have someone standing over you, saying you can only give 15 minutes and no more to a patient, that’s undermining trust and autonomy.

If the job is simple like a filling, you can get case acceptance. But, if the job is a full mouth reconstruction case with implants, that's a whole different level of trust.


The Foundations of Trust

The silent questions dental patients are always asking are: 

  • “Can I trust you to put me ahead of yourself? 
  • Can I trust you to do the job?” 

Patients need to experience you and your team before they know if you are going to treat them in a transactional way or in a way that sees them as a real person you care about to treat with honesty, respect, and fairness. They need to know they can count on you to understand them and have their best interests in mind, not view them as a means to earn money. 

If they are experiencing physical discomfort, know they have multiple health problems, fear dentistry, or have had treatment they counted on fail in the past, they especially need to know you will manage their problem in the best way to help them personally. They want results that will last. They are counting on you for honesty, significant information, demonstration of your ability, and guidance.


The 5 Essential Behaviors

Patient trust is built on witnessing core human virtues in action. These are behaviors they see in you that allow them to know you care about them ahead of yourself and that you can do the job.

Demonstrate Justice

through honesty, fairness, respect … and love, in the form of a caring connection of empathy and understanding of their situation. Don’t be judgmental. Don't have a self-focused agenda. 

Demonstrate Courage

through the confidence with which you facilitate conversations and lead the patient, even if it takes multiple visits and conversations before the patient is ready to accept treatment.

Demonstrate Wisdom through:

  • Your explanations of their oral health circumstances.
  • Your careful and comprehensive approach to diagnosis and consideration of treatment options.
  • Communicating the reasoning behind your recommendations.
  • Consideration of the patient’s feelings and concerns. Validate what patients say.
  • Welcoming and respecting the patient’s input. 

Demonstrate Self-Control through:

  • Your ability to partner with the patient and take the patient’s concerns, situation, and readiness into consideration. 
  • The time you take with the patient to help them fully understand their oral health situation, what they can expect to happen if they do not accept treatment, what treatment options are appropriate for them, and guide them.
  • Patience… allowing the patient whatever time they need to feel comfortable enough to move forward with treatment. 
  • Leaning on reason and rationale and not being emotional.
  • Guiding the patient through conservative phases of treatment that do not overwhelm the patient with too much too soon.


Demonstrate Capability through:

  • Before and after treatment images of patients with similar problems.
  • Stories that allow patients to imagine their preferred, future selves.
  • Testimonials from other patients.


Keep in mind it's not about you. It never was about you. It’s about the patient. Be generous with your energy and go the extra mile. Spending an extra five minutes with a patient can make a world of difference in that patient trusting your care, skill, and judgment. You can learn more about the art of building trust in my book The Art of Case Presentation.

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