December 2021

The delivery of dental services attracts continuing debate by health service management, public health specialists and public representatives. There is little argument, that communication among dental service providers and client groups is a vital component of exemplary services. However, the exact requirements of what constitutes good communication becomes problematic. Definitions can be applied to detailed observations of elements of dental staff behaviour. Such observational audits are rarely applied, due to the large resources required, and believing this approach is purely a research-only exercise. We acknowledge the demanding nature of any such endeavour in real-time by a trained observer. An alternative is to video-record clinical sessions. Although this has been possible for some decades, the widespread use of recording samples of clinical sessions, for example to assess staff engagement in prevention advice, is not realistic using current methodologies, even if the considerable ethical concerns could be assuaged. In addition, hitherto, there has been a wide ranging set of views of what would be considered poor, just good enough or excellent communication. Part of this difficulty is due to the complexity of the communication processes themselves. The variety of health service settings, staff experience and training received in the field of communication and the sheer spectrum of patient types and problems that surface which require treatment, advice and instruction makes a universal framework of what constitutes acceptable communication skills difficult to specify. Furthermore, when no established standard can be agreed the status of rewarding good communication is therefore under-valued and simply ignored from service contracts. Our thesis is that technological and communication theory advances converge to establish, perhaps for the first time, the characteristics to enable commissioners to design systems to catalogue, examine, analyse and reward staff and services for exemplary, consistent high-quality messaging and communication skills with patients attending local services. There are many instances in the dental consultation when communication skills are key to successful clinical delivery. We focus just on two areas where communication skills are vital, and they include: 1. anxiety management, and 2. delivery of preventive advice, information and recommendations for changing dental health behaviour.