Radiology Lecture 13.docx

Lecture 13 Chapter 13 – Patient Relations and the Dental Radiographer Patient relations are important for all dental professionals. The dental radiographer needs good interpersonal skills to communicate with patients and establish trusting relationships Skills that promote good relationships bet...

Lecture 13 Chapter 13 – Patient Relations and the Dental Radiographer Patient relations are important for all dental professionals. The dental radiographer needs good interpersonal skills to communicate with patients and establish trusting relationships Skills that promote good relationships between individuals are termed interpersonal skills. Communication can be defined as the process by which information is exchanged between two or more persons. Certain words detract from the professional image of the dental radiographer. For example, the term pull sounds less professional than extract, and the word fix sounds less professional than repair or restore. Some words used in the dental setting (e.g., cut, drill, scrape, zap) are associated with negative images and must be avoided. Excessive use of technical words may cause confusion and result in miscommunication. The dental radiographer should always choose words that can be easily understood by the patient. In the dental clinical setting, patients prefer the use of a soft tone of voice, as it is soothing and effective in conveying warmth and concern. Nonverbal communication involves the use of body language. Nonverbal messages can be substituted for verbal messages. When nonverbal messages are consistent with verbal messages, the patient is more likely to relax and trust the dental professional. When nonverbal messages are not consistent with verbal messages, however, the patient is more likely to respond with apprehension and mistrust. Posture and body movement are important nonverbal cues that convey the attitude of the dental radiographer. Eye contact is another nonverbal means of communication that is important in the dental setting. A lack of eye contact is often interpreted as indifference or lack of concern. Facial expressions are also a very important part of nonverbal communication and indicate much about a person's mood. Listening involves more than just hearing; listening refers to the receiving and understanding of messages. Careful listening results in better communication and less chance for misunderstandings. When listening to a patient, the dental radiographer should give undivided attention to the patient. Facilitation skills are interpersonal skills used to ease communication and develop a trusting relationship between the dental professional and the patient. The term facilitation is defined as “the act of making something easier.” When a patient trusts the dental professional, the patient is more likely to provide information, cooperate during procedures, comply with prescribed treatment, and return for further treatment. Inviting a patient to ask questions enhances communication. Examples of good interpersonal skills include: Explaining the rationale for dental radiographs Explaining the appointment process Encouraging the patient to ask questions Essentially talking and listening to the patient. In dentistry, the term patient relations refers to the relationship between the patient and the dental professional. Patient relations are important to all dental professionals: the dentist, the dental hygienist, and the dental assistant. The patient's first impression of the dental team most often involves the dental auxiliary, specifically the auxiliary's appearance and greeting The professional appearance of the dental auxiliary is important. The dental auxiliary should always wear clean clothing and be well groomed. In many offices, the dental auxiliary is the first dental professional to meet and greet the patient. Chairside manner refers to the way a dental professional conducts himself or herself at the patient's chairside. The dental auxiliary must develop a relaxing chairside manner that makes the patient feel comfortable and at ease. The attitude of the dental auxiliary will affect patient relations. Attitude can be defined as “a position of the body, or manner of carrying oneself, indicative of a mood.” Honesty is also a vital part of a professional attitude. Some procedures are uncomfortable in dental imaging, and the dental auxiliary must be honest and inform the patient of the potential discomfort. Chapter 14 – Patient Education and the Dental Radiographer The dental radiographer must be able to educate patients about the importance of dental images and also be prepared to answer common questions about the need for dental images, x-ray exposure, the safety of dental x-rays, and miscellaneous concerns. Educating dental patients about the importance of dental images is critical, yet patient education is often overlooked by dental professionals. Many patients have heard or read about the damaging effects of x-radiation. Newspapers, magazines, and television magazine shows often highlight the damaging effects of radiation and cast doubt on the necessity and benefit of dental imaging examinations. Such reports are often misleading and are not well researched. As a result, these reports cause patients to fear the use of x-radiation and to avoid all radiation exposure. Because of such misinformation, the dental radiographer must take the time to educate the patient. Comprehensive dental health education is one of the greatest services that a dental professional can provide to the patient. A patient who is knowledgeable about the importance of dental images is more likely to realize the benefit of such images, accept the prescribed treatment, and follow prevention plans. Patient education is also likely to decrease fears of x-ray exposure, increase cooperation, and increase motivation for regular dental visits. The dental radiographer can use an oral presentation, a video, printed literature, or a combination of these methods to educate the dental patient. An oral presentation, in conjunction with sample dental images, can be used to communicate the importance of dental images. The use of digital imaging may further aid in patient education. This helps patients view their own periapical, bite-wing, or extraoral images on a computer monitor or television screen instead of looking at detailed information on mounted radiographs. A combination of an oral presentation and printed literature is probably the most effective method of educating the dental patient about dental images. The use of both approaches can stimulate a question-and-answer type of discussion about dental images. Questions about any diagnosis related to a dental image must be answered only by the dentist. Necessity questions Question: Are dental x-ray images really necessary? Answer: Yes. Many diseases and conditions such as tooth decay, gum disease, cysts, and tumors cannot be detected simply by looking into your mouth. Dental images are always prescribed to benefit you, the patient; the primary benefit is disease detection. Question: How often do I need dental x-ray images? Answer: The first step to limiting the amount of radiation that you receive is the proper prescribing, or ordering, of dental images. Decisions about the number, type, and frequency of dental x-ray images are determined by the dentist based on your individual needs. Because every patient's dental condition is different, the frequency of dental imaging examinations is also different. The frequency of your dental imaging examination is based on your individual needs. No set interval exists between x-ray examinations. For example, a patient with tooth decay or gum disease needs more frequent dental imaging than a patient without such diseases. Question: How often does my child need dental x-ray images? Answer: The interval between dental imaging examinations should be based on the individual needs of the child. There is no set interval between x-ray examinations. For example, a child with tooth decay needs more frequent dental imaging than a child without tooth decay. WHAT ARE CARIES? CAVITIES, TOOTH DECAY Question: Can I refuse x-ray images and be treated without them? Answer: No. When you refuse the prescribed dental x-ray images, the dentist cannot treat you. The standard of care requires that the dentist decline to treat a patient who refuses necessary x-ray images. Treatment without necessary images is considered negligent. No document can be signed to release the dentist from liability. Legally, you cannot consent to negligent care. Question: Instead of taking additional images, can you use the dental images from my previous dentist? Answer: Yes. Previous dental images can be used, provided they are recent and of acceptable diagnostic quality. Exposure Questions Question: How do you limit my exposure to x-rays? Answer: the dentist custom-orders your x-ray images on the basis of your individual needs. During exposure, a thyroid collar and lead apron, fast film or a digital sensor, and a beam alignment device will be used to protect you from excess radiation. Question: Why do you use a lead apron? Answer: A lead apron and a thyroid collar are used to protect reproductive, blood- forming, and thyroid tissues from scatter radiation. The use of an apron acts as a shield, prevents radiation from reaching radiosensitive organs, and protects you from unnecessary radiation exposure. Question: Should I avoid dental x-ray exposure during pregnancy? Answer: When a lead apron is used during dental imaging procedures, the amount of radiation received in the gonadal region is nearly zero. No detectable exposure to the embryo or fetus occurs with the use of the lead apron. The American Dental Association, together with the Food and Drug Administration, has stated in the most recent Guidelines for Prescribing Dental Radiographs that the recommended guidelines “do not need to be altered because of pregnancy.” Although scientific evidence indicates that dental x-ray procedures can be performed during pregnancy, some dentists elect to postpone such x- ray procedures because of patient concerns. Question: Why do you leave the room when x-rays are used? Answer: When you are exposed to x-rays, you receive the diagnostic benefit of the dental images; I do not receive any benefit. An individual should only be exposed to x-radiation when the benefit of disease detection outweighs the risk of exposure. Since I do not benefit from your x-ray exposure, I must use proper protection measures. Safety Questions Question: Are dental x-rays safe? Answer: The amount of x-radiation used in dental imaging is small, but biologic damage does occur. No amount of radiation is considered safe. As a result, dental x-rays must be prescribed only when the benefit of disease detection outweighs this risk of harm. Also, dental professionals should only take the images needed to provide a thorough oral assessment for each patient. Question: Will dental x-rays cause cancer? Answer: Not a single recorded case of a patient developing cancer from diagnostic dental x-ray exposure exists. The radiation exposure that occurs during a dental x-ray examination is very small, and the chance that it will contribute to or cause cancer is exceedingly small. When cancer occurs, it is over 1000 times more likely to be unrelated to radiation exposure. Digital Imaging Questions Question: What are the advantages of digital imaging? Answer: Digital imaging requires less exposure to radiation, which benefits you, the patient. Question: Are risks associated with digital imaging? Answer: Because radiation is involved, a certain amount of risk does exist. With digital imaging, your exposure is less than with film-based imaging. Your radiation exposure time may be reduced by 50% to 90%. Question: Can a panoramic image be exposed instead of a complete intraoral series? Answer: No. A panoramic image cannot be substituted for a complete series of dental images. A complete series of dental images is required when information about the details of the teeth and surrounding bone are needed. A panoramic image does not clearly reveal changes in teeth, as in tooth decay, or the details of the supporting bone. The panoramic image is useful for showing the general condition of a patient's teeth and bone. Question: Who owns my dental images? Answer: All your dental records, including the dental images, are the property of the dentist. As a patient, however, you have the privilege of reasonable access to your dental records. For example, you can request a copy of your dental images or request that a copy be sent to a dentist of your choice. Digital images may also be electronically sent to a referring doctor. The dentist retains the original dental images as part of the patient record.