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Occlusion is the last assessment to make for a fully seated crown. Articulating foils and shim stock are needed to check for occlusion. Both crown and adjacent teeth should hold shim stock firmly in the intercuspal position (ICP).A large flame shaped diamond bur is used to reduce high areas. Once ICP has been re-established the excursions can be checked preferably with a different coloured foil. Occasionally, it may be necessary to adjust the tooth opposing a restoration to avoid crown perforation or exposure of rough opaque porcelain.

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Prof. Dr Anka Letic, DDS., PhD

Delivering superior customer service that exceeds patient expectations will ensure enhanced treatment acceptance and patient referrals. In most dental clinics today there is competition for attracting and retaining patients and it is critical to remember that in most cases exceptional customer service is truly the only thing that differentiates you from your competitors.

It is important to remember that humans are addicted to feeling good and looking good. Therefore, understanding patient’s need very quickly is of utmost importance. What it is that they need,  to feel good enough and to happily pay you for your services?  Exceptional communication skills and understanding how your patient feel  will help greatly (Tab.3).

 Patients will refuse treatment for two main reasons, lack or poor communication (Tab.1)

Tab. 1. Communication

 leading to unfulfilled expectations and lack of money to pay for the treatment. It is up to the dentist to understand situation. Emotional Intelligence  Model (Tab. 2)

Tab. 2. EMOTIONAL INTELLIGENCE MODEL

 would be important in this moment and would facilitate procedures. Additionally, the indicators of patients intent about future treatment would help (Tab. 3).

Tab.3.  INDICATORS OF PATIENTS INTENT, NEEDS AND WANTS

Purchase intent  - to make gain

Emotionally – avoid fear and loss

Attention activation – pleasure

Pride

Perceived product value -  Right pricing strategy

Social approval

Uniqueness  among competitive displays

Compatibility with  Dental Office Brand

 There are 3 main challenges on that road, while trying to understand what your patient want:  ATTENTION, EMOTIONAL ANGAGMENT AND EMPATHY.  Be careful, patients will not or can not express  consciously exactly  what  they feel or want, due to complex relationship between different minds: Conscious versus Subconscious Minds (Tab. 6). Therefore, start with simple things: design a behavior management program to lessen and or ameliorate anxiety, conflict and aversive behavior in all phase of treatment (Tab.5). So, insist, be emotionally intelligent and give full attention to the communication with patient, starting from non verbal  communication, facial expression, facial coding, tone of voce and verbal  expressions (Ch.1,Tab.4). What is the secret quintessence? The answer is in clearly understanding people, knowing that people need to feel good about your service (Ta.2,4). It is possible to have some training and experience  courses of delivering specialized behavioral management techniques (request author). This is even more important  with children with special needs and particularly those with communication difficulties. Augmentative and Alternative Communication (AAC) aids can be used when there is speech or communication impairment. Their use can reduce the stress and the frustration of not being able to communicate. People with communication difficulties may rely on AAC systems to enable them to communicate messages by augmenting speech or by using speech alternatives such as photographs, colored pictures, or line drawings.

Draw a road map of every point of contact with patients in your practice (Tab.1). For example; the first call, the first time they see your practice from the road, the first time they walk into your reception area and so on. Then analyze each point of contact to determine the potentials for a positive experience. Your road map should start way before the initial contact and continue until it comes to a full circle.

Make a correct assessment of the patient’s psychological and emotional needs. Understand the factors that are responsible for creating  Difficult Patients, through gaining basic knowledge of the common emotions such as Fear, Anxiety and Phobia. Understand the interplay of cultural factors and their influence on behavior and try to understand and use the various behavioral modalities that help modify behavior.

Measuring  patient emotions is critical in gaining a competitive advantage. Emotions shape opinions by shaping  behavior (Tab.2,5). When trying to design a better service or product, you need to understand the emotional impact that it has on your patients (Tab 5). Traditionally, whenever we needed customer insights, we would simply ask. However, in order to gain a complete, 360 degree understanding of the customer, you need to go straight to the source – to the brain. Neuroscience tools now offer insight into the role of emotion in decision making. While the scientific terminology can sound complicated, emotional measurement easily break down into the following market indicators (Tab.2, 5).  More importantly, people refer friends to people/doctors they like and they trust.

Utilize a variety of behavior assessments modalities that include verbal and nonverbal communication, observation and interaction, written questionnaires and proper listening and attitudinal skills designed to provide the development of a positive personalized and professional patient-doctor relationship.

 

Tab. 4 Model of HEALTHCARE PERFORMANCE

Tab 5. Expressing EMPATHY to patients

Responding to emotions with words (NURSE)

Patient’s emotional statement:  ”These  tooth aches are killing me”

N

Name the emotion or feeling

“It sounds like this has been frustrating.”

U

Understand the emotion or feeling

“It must be difficult to be in pain like that.”

R

Respect the patient

“I’m impressed that you’ve been able to keep up with your treatment and the rest of your life while having these tooth pains.”

S

Support the patient

“I will help you with this tooth ache.”

E

Explore the emotion

“Tell me more about how this pain is affecting you”


Tab. 6. Different Minds: Subconscious versus Conscious

Subconscious

  Conscious

üFeeling

üThinking

üFive times more rapid

üSlow

üHabitual

üPlans - Do planning

üConserves energy

üUses up energy

üAware of what we’re aware of

 

üReflective

 

üImagines future

 

üAlert without knowing it

 

üInstinctive

 

üResponsive

 

üAutomatic

 

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