Humanizing clinical dentistry through a person-centred model

Person-centered or patient-centered care (PCC) focuses on the individual's needs and concerns. Although PCC is widely acknowledged as a core value of modern medicine, there has been a lack of research on how dental curricula could engage future dentists in PCC approaches. The aim of this study was to assess the impact of a PCC course on empathy in dental students. A controlled study was conducted with fourth-year dental students in four dental faculties in France in 2014-15. The test group (n=63) received 20 hours of PCC training including arts-based approaches, narrative dentistry activities, and workshops on communication based on the Calgary-Cambridge guide. There was no change in the curriculum of the control group (n=217). Pretest and posttest measures with the Toronto Empathy Questionnaire (TEQ) and Jefferson Scale of Physician Empathy (JSPE) were compared for the two groups. The comparisons showed no significant differences on the TEQ or JSPE (p=0.25 and p=0.08, respectively). However, there was a higher proportion of students with more than an eight-point decrease in TEQ values in the control group (p=0.02). The stabilization of empathic ability in the test group may have counteracted the tendency for natural erosion of empathy among students during their clinical activities. These results suggest that PCC training constitutes a promising approach to developing dental students' empathic ability, but there is a need to assess the effects of such training over longer periods.Dr. Rosenzweig was an MSc student,

Patient- or person-centred care is the current paradigm in the health profession yet there is still no clear understanding of what it means or how it could be implemented in dentistry. Building on a previously proposed person-centred model in clinical dentistry, in this article a person-centred dental clinical approach is presented. The approach consists of three guiding principles - humility, hospitality and mindfulness - that influence the different processes of the dental clinical encounter: connecting, examining, sharing, and intervening. The presented approach provides a rich opportunity for dentists to fine tune their own clinical approach in order to keep up with the upcoming expectations of their patients.

The biomedical model has been severely criticized in the last decades and its dominance challenged. This is why the concept of person-centred dentistry has penetrated the professional discourse and become a growing concern for our profession. Furthermore, dentists have been urged to take patients' environment more into account and tackle the social determinants of their health, illness, and access to care. Unfortunately, dentists still poorly comprehend person-centredness and social dentistry, and face difficulties to implement biopsychosocial approaches.To respond to these issues, we propose the Montreal-Toulouse Biopsychosocial Model for Dentistry, which encompasses patient-centredness and social dentistry. Our model presents three types of tasks (understanding, decision-making, and intervening) that dentists should take in each of three overlapping levels (individual, community, and society). We also propose a "Q-List", an original tool designed to help dental professionals adopting this model and reflecting upon their actions. This Q-List includes key-questions to elicit dentists' reflexiveness and support their biopsychosocial practice of dentistry.We invite dental professionals to adopt biopsychosocial approaches and use the Montreal-Toulouse Model as a guide. We also encourage them to use our Q-List and adapt it to their context of practice.

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