How to Communicate with Patients of Different Ages?

In Conversation with Dr. Thomas Quasten

The human body is an extraordinary machine. But people are a lot more complicated and can’t be treated like machines. That’s why dentists must hone their communication skills to interact effectively with different patients. As an orthodontist, Thomas Quasten has to regularly deal with patients of all ages — from young adolescents to septuagenarians. He has truly mastered the art of communicating effortlessly with all age groups and types of individuals.

Our team at Zircon Medical recently hosted Thomas Quasten on our podcast series to discuss how to communicate effectively with different patients.

Introducing  Thomas Quasten, the owner of a private orthodontic dental practice in Willich.

Thomas Quasten is an orthodontist with a special passion for digital orthodontics and 3D printing in-house. He’s the owner of a private orthodontic dental practice in Willich, which he runs independently.  Quasten also hosts courses and educational seminars with his colleague Martin Baxmann, and he’s an active presence on YouTube and social media.

Quasten says his desire to become an orthodontist was cemented at a fairly young age when he’d had orthodontic treatment. Although he doesn’t come from a family with any relation to medicine or dentistry, he was fascinated by his orthodontist’s craftsmanship. He recalls thinking, “I can do what he can do.” And that set him on the path to dental school, wherein he was always razor-focused on orthodontics. He frankly states that other parallel fields of dentistry, such as prosthodontics, periodontology, and surgery, held no sway over him — he was always destined to be an orthodontist, ever since he was 12 years of age.

The importance of adapting your communication style according to the patient

As an orthodontist,  Quasten has worked with patients across the age spectrum, from young 6-year-olds to septuagenarians. He says everyone, regardless of age, has the same underlying goal of straightening their teeth, but the treatment process is communicated differently. That seems perfectly natural because older patients have different sets of concerns, knowledge, and interests than younger patients. It’s the orthodontist’s task to perceive the individual patient’s requirements and concerns and address them directly. 

According to  Quasten, older patients already have a fixed idea of what they want, and they openly communicate their goals, desires, and concerns. However, the orthodontic possibilities are also limited to adult patients because the orthodontist can’t take advantage of natural bone growth and malleability as with younger patients. Older patients are very concerned about learning about all their possibilities, and it’s often necessary to combine orthodontics with other areas of dentistry to provide better long-term results.

With younger patients, you must relay accurate information modified according to their vocabulary. It’s also important to be more careful about your narrative constructions — not using constructions like, “don’t worry, it won’t hurt.” You need to pay more emphasis on the child’s emotional well-being to convince them of the value of orthodontists. However, you must still convey all the appropriate information — in an attempt to avoid negative constructions, you can’t be dishonest or avoid crucial information. The orthodontist must maintain a delicate tightrope balance.

Regardless of age,  Quasten believes an orthodontist must follow a few key guidelines with all patients.

• First Impressions
  

Nothing beats the value of a good first impression because it establishes the patient’s outlook through the entire interaction. Whether the first impression comes in person or phone consultation, they must feel warm towards the orthodontic clinic.

• Personality
  

The orthodontic clinic must have a welcoming personality. It should be beautifully designed, tidy, clean, and brightly lit to put the patient in a good mood. The practice can also be personalized with newspapers, magazines, drinks in the waiting room, friendly staff, and a minimal waiting period.

• Clarification
  

Quasten emphasizes the need for clarity in your communication with patients. The consultation can take a lot longer than 10 minutes if it must, but the patient must leave without any pending concerns, questions, or doubts. They should know exactly what the treatment entails, why it’s necessary, what they can expect from the process, the results, and more.

Convincing younger patients to get braces

Quasten believes the greatest difference between communicating with older and younger patients arises when convincing them to get braces. One must maintain a delicate balance of honesty and sensitivity. 

The following are some of  Quasten’s guidelines on convincing younger patients to get braces:

• Be Honest

You can’t sugarcoat things with children. You have to honestly communicate that a brace will be visible, it will have to be worn constantly, and that it might occasionally cause discomfort. He strongly advises against lying to make them feel better because it makes them trust you less.

• Convince the Child, not the Parents
  

You must treat the child as a patient in their own rights, not their parents. As such, the orthodontist is responsible for ensuring the child truly understands why they need the braces. They should understand that the process might not be very comfortable, but you should convince them it’s necessary anyway.

• Avoid Negative Language
  

Quasten strongly advises against using negative language with children. Examples of negative language include “this isn’t going to hurt” or “it won’t be long now.” Saying these things in advance will make the child more sensitive and receptive to the pain. Furthermore, the phrase “won’t be long now” holds no meaning because it’s not quantifiable, and the orthodontist shouldn’t rush through the procedure anyway.

Quasten believes all dentists can learn lots about their practice if they look at it through the eyes of a patient. He recommends sitting in the waiting room chairs, entering the practice as a patient would, and looking around with fresh eyes. He says doing so will allow you to observe things that a patient would, which, in turn, will help you improve the patient experience, regardless of the patient’s age.

You can find  Thomas Quasten at his orthodontic dental practice in Willich, in the triangle between Düsseldorf, Mönchengladbach, and Krefeld. You can also register for his training course via the homepage of his website https://www.orthodentix.de/. And you can listen to  Quasten in our Zircon Medical podcast or continue reading for a detailed article on communicating with different types of patients.

In the previous section, we discussed  Thomas Quasten’s recommendations on communicating effectively with patients of different ages. He highlighted the importance of modifying your communication style to address each age group’s unique needs and personalities, referring specifically to the communication differences between children and adults. While he discussed the subject as an orthodontist, we believe it applies to all dentists and most medical professionals.

Communication is pivotal for all medical encounters, but it’s especially true for dentistry. As a dental professional, you have to spend a lot of time discussing the value of various treatments with patients, such as orthodontics, preventative care, or other aspects of dentistry. Without effective communication, you can’t break through the patient’s natural barriers to impress upon them the need to heed your advice. However, the way you “break through” with older and younger patients is different.

This article provides tips on effective communication with older and younger patients.

How to improve communication with older patients?

#1. Older patients need more time

Older patients need more information from their physicians and dentists, but they often receive or process less information due to various factors. Hearing issues make it harder for them to grasp the information communicated. They may lack focus and communicate poorly, leading to a communication gap between the dentist and the patient. If the dentist appears uninterested or hurried, the patient may shut down completely. It’s important to take your time with older patients, slow down, repeat the information conveyed, and account for the time in your schedule.

#2. Maintain face-to-face interactions

Older patients often experience hearing and vision loss to various degrees. As such, a large number of older patients rely on lip reading for information. Some older patients also get distracted easily, especially if you’re not actively holding their attention. It helps to engage them in a face-to-face interaction wherein you give them your undivided attention. Maintaining eye contact with the patient also helps them trust you and let their guards down, making them more receptive to information and advice.

#3. Listen patiently to their concerns

One of the most common complaints that older patients have is that their doctors don’t listen carefully. Listening is one of the most important aspects of good communication. Even if the patient seems to be rambling, it’s important to avoid the impulse to cut them off or interrupt. Doing so will break their trust, making them less likely to follow your advice. It also prevents them from communicating important details you might need for effective treatment.

#4. Clear and loud communication

Older patients generally process and absorb information slower than younger patients. As such, it’s crucial to slow down, speak clearly, and communicate loudly. Don’t shout at them, but take the time to speak loudly and clearly. However, clear communication is also about using language they’re familiar with. Instead of using medical jargon, you should explain potentially complicated subjects in a layman’s language.

#5. Strike the correct balance in your communication

When speaking to older patients, physicians often fall into two extremes of communication — overcorrection, and undercorrection. Overcorrection refers to using infantilizing baby talk (also known as “elderspeak”) to communicate with older patients. This includes overly simplistic grammar, infantilizing tone, and extremely loud vocals — these acts indicate negative stereotypes about older adults, quickly leading to a downward spiral in communications.

Undercorrection refers to using complex sentences and grammatical structures without acknowledging older individuals’ different needs. Undercorrection may make your patients feel isolated, unable to comprehend what you’re saying, and less likely to clarify their concerns. As such, it’s important to strike the correct balance — using shorter and simpler sentences with clear language, but not to an infantilizing extent.

#6. Written instructions are essential

When providing instructions, you must avoid overly long and complex sentences and explanations. Use short, crisp, and direct instructions. While you should relay the information in person, you must also provide written instructions. The writing should be large, clear, and legible with hierarchical breakdowns to denote different sections and information. If possible, use different colors or bold text to emphasize the most important details. If the instruction is based on something they must do daily, such as at-home dental care, create a timeline of everything they need to do from the morning to the night.

#7. Use visual aids to support your instructions

Visual aids are particularly useful when conveying complex information or instructions, such as how a set of braces will move the patient’s teeth or how dental implants work. In these cases, providing large, clear, and graphical illustrations or charts will help older patients consume the information better.

#8. Repeat the instructions, not the language

Repetition helps everyone, not just older patients, recall information better. That’s a universal fact that applies to people of all ages. However, it’s especially true for older patients. After you convey some information, you can ask your patient to repeat it back. If they’re incorrect, you can repeat the information using slightly different or shorter phrases. Patients don’t like being patronized, so they might not appreciate you repeating the same instructions in the same form.

#9. Make it clear that questions are welcome

You must make it absolutely clear that questions are welcome and that it’s normal for most patients to have concerns or questions. Older patients often avoid clarifying their doubts because they’re intimidated or don’t want to seem like they can’t grasp the information. You can overcome that barrier by telling them that most patients have difficulty grasping the information, so all questions are welcome and normal. That should make them feel more comfortable clarifying their doubts and concerns.

How to improve communication with pediatric patients?

#1. Give them time to warm up to you

Most pediatric patients get nervous when they first visit a new dental clinic or dentist. As such, you must give them sufficient time to warm up to their new surroundings. Instead of jumping right down to business, you can talk to them about their interests, school, activities, etc., to get them to open up. You can also give them some time in the waiting room and let them play around before you see them. Your first session with a pediatric patient should focus primarily on building a relationship, getting them to a place where they’re comfortable sitting on a chair while you work on their teeth.

#2. All children aren’t the same — adjust your speech patterns similarly

There’s no universal communication style that applies to all children. That’s because children of different ages have entirely different communication styles and needs, and you must tap into those needs accurately to adapt your communication style. When communicating with children under 10, you might want to talk to them about their schoolwork, favorite movies, and hobbies.

However, teenagers often bristle when they feel they’re being talked down to or treated like children, so you should speak to them as you would with adults. Furthermore, children often have developmental differences; some mature faster than others, so a younger patient might seem more advanced for their age. Generally speaking, it’s a good idea to take your cues from the specific patient and use the kind of language they’re using.

#3. Let them know what they can expect from the appointment

Pediatric patients are often nervous about their dental appointments and don’t know what to expect. As such, you can walk them through the entire process, from the initial consultation to the recovery. You should also warn them about simple things, like using certain tools and equipment. It’s a good idea to introduce them to all the tools you’ll use for the procedure beforehand — this will make them far more receptive to the treatment.

#4. Avoid negative constructions in your communication

Younger dentists and physicians often make the mistake of using negative constructions to calm children. Phrases like “don’t worry, it won’t hurt” have the opposite effect — they make the patient more aware of the possibility of pain. As such, a patient who might not have noticed the discomfort will become more susceptible to pain. Furthermore, it can make the patient feel betrayed by you for misleading them, which, in turn, makes them less likely to heed your advice moving forward.

#5. Body language is a key component of communication

Younger patients and children are extremely aware of body language. In fact, unspoken body language is a crucial component of communication, sending signals that you might not want to send. Towering over pediatric patients, for example, is likely to make them feel anxious and make you seem frightful. You should ideally sit down at the child’s level or have them sit on their parents’ lap so you can be at the same level.

You should also smile at the patient and make eye contact. The child is your patient, and you should treat them as such. While it’s important to communicate with the parents, your primary focus should be on the patient. It’s also important to gain mastery over your emotions, facial expressions, and body language — if the patient notices a frown or a sullen silence, they may worry that something’s wrong.

Although these tips might seem simple, it takes active effort to implement them in your day-to-day life. After all, changing your entire communication style for different patients isn’t as simple as flipping a switch. Over time, as you communicate with various patients of different ages, these tips can guide you towards maintaining optimal communication styles with all patients, regardless of age or other differences.