Moving the four habits model into dentistry. Development of a dental consultation model: Do dentists need an additional habit?

Abstract

A consultation model for dentistry is presented, with communication skills in a didactic and structural format, applicable for most types of visits, patients and problems. A characteristic of the dental visit is its division into dialogue phases and clinical phases, which makes verbal exchange especially challenging. The original Four Habits Model (4H) has been adapted from medicine to the specific structure and content of a dental visit, and a modified model is proposed. The dental model consists of a structural core framework relevant for all dental consultations, and additional extensions applicable to commonly occurring issues. Facilitate Perceived Control has been added to the model, due to its crucial importance in dental visits, and we suggest naming the model “The Four + One Habits Model for Dental Visits (4 + 1HD).” The proposed model should have clinical relevance for improving patient care and patient experience, as well as easing the busy everyday life for dentists in a variety of clinical settings. It is also likely to be a flexible framework for communication skills training at all levels of dental education. More research is needed to validate and test the model in various clinical and educational settings.

More than just a dental practitioner: A realist evaluation of a dental anxiety service in Norway

“…This is a space in which the dental practitioner has created a predictable environment that allows the patient to gain a stronger sense of control. A previous study investigating dentistry consultation models found that creating predictability and establishing a safe space affected the therapeutic alliance, which likely positively influences practitionerpatient collaboration and interaction [52]. A safe space is also considered essential to facilitating dental attendance for abuse survivors and children with dental anxiety [12,53].…”

Dentist‐administered cognitive behavioural therapy versus four habits/midazolam: An RCT study of dental anxiety treatment in primary dental care

“…The model has produced favourable outcomes in Norwegian hospitals [23]. It has been adapted to dentistry and is today an essential part of the dental curriculum at the University of Oslo [24,25]. This model comprises four main elements, for didactic reasons called habits, which involve the communication skills and behaviours of the health professional.…”

Maximizing Student Clinical Communication Skills in Dental Education—A Narrative Review

“…Sociolinguists Coleman and Burton [18] originally pointed out that there is considerable difference between dental and medical consultations in that the latter are hands-on treatment sessions only in exceptional cases. This has also been echoed recently in the dental literature [13,19,20]. The functions of the physician in a typical consultation are to investigate symptoms and patient perceptions, aid diagnosis, prescribe treatment, review progress and give information and advice.…”

“…The functions of the physician in a typical consultation are to investigate symptoms and patient perceptions, aid diagnosis, prescribe treatment, review progress and give information and advice. The structure as described by sociolinguist Long and others [20,21] is a sequence of phases, which closely resemble other decisionmaking schemes in other disciplines: (1) greeting the patient; (2) discovering the patient's reasons for attending; (3) conducting a physical or verbal examination (or both); (4) sharing information with the patient; (5) detailing further courses of action (i.e., prescription of drugs or referral); and (6) closing the consultation. More recently, it has evolved towards patient-centered communication and is called the "six-functions model" as reviewed by King and Hoppe [11]: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease-and treatment-related behavior in closure.…”