Art of Listening.

How to cite this article: Asokan S. Art of Listening. Int J Clin Pediatr Dent 2021;14(S-2):S105-S106.

Is communication, the key to successful dental practice? If yes, what is multisensory communication? What is the role of listening in communication? While most of us would agree to the fact that active listening is important to effective and efficient dental practice, we must pause and give it a thought – “listening in our dental practice”. Do we really listen? Do we have the time to do it when we have patients seated in the waiting area? Were we assessed for soft skills in our university exams? We were trained to be clinicians and not listeners. But it is a bit strange that each of us talk about listening in some sphere of our life because we understand its importance somehow, from somewhere or someone. Do we just preach it or do we really practice it? Do we hear or listen? Do we still want to have the last word with our patients, their parents, our team and our family?

“To listen is an effort, and just to hear is no merit. A duck hears also.”

— Igor Stravinsky

Hearing is involuntary and active or reflective listening needs human effort. Literature shows that physicians predominantly (69%) interrupt the patients’ opening statement in about 15–18 seconds.[1] Research also says that most patients do not explain the most important attributes or complaints in the beginning and hence most doctors never get to know the actual complaints of their patients. The scenario in dentistry is quite different. It does not end with talking. We need to do much more than that. Additionally, the sight and sound of the drills, threatening equipment and gadgets and the strange smells does not make the dental operatory a great place for conversation. In a pediatric dental practice, few children talk endlessly because they are anxious, curious and afraid of what is about to happen. Some children become silent, making conversation even more difficult. In the midst of all the chaos, the pediatric dentist must try to establish rapport. Listening has to (may or may not now) happen in the communications between the following:

Pediatric dentist– Child and parents

Dental team– Child and parents

Pediatric dentist– Dental team

Listening to what the child and parents are saying while watching for nonverbal cues is essential to establish a rapport. It encourages the child to speak. When the child and parents feel they are “heard” (actually listened to) the connect in the conversation is strengthened. The age-specific skills needed for efficient communication with children in the dental setting has been described as “Pediatric Dentistese”.[2] Pediatric dentists must be trained to distinguish between a hurt cry, frightened cry, obstinate cry, and whining cry, just by listening. The dental team inclusive of the receptionist, assistants, and auxiliaries also need to be equipped with reflective listening skills. It helps them understand the words and body language of the child and parents whom they are talking to. Children's feeling's can be acknowledged by (a) listening to them quietly, (b) acknowledging the feeling with words like “I see,” or “I understand” (c) giving a name to their feeling or by reflecting their feeling (e.g.) “Are you tensed nervous/anxious about this dental visit?”[3] (d) restating or paraphrasing the child's own words, and (e) summarizing the whole statement along with the emotions of the child. In restatement, the dentist just repeats exactly what has been told by the child. However, summarizing is bit more extensive as the dentist coherently ties various information obtained during the conversation.[4]

The dental team must be trained to listen to the dentist's instructions and pick up nonverbal cues in the presence or the absence of the child and parents. Listening coupled with observation (rather than just seeing) can greatly enhance communication and organizational skills of the entire dental team.

Time is money. Listening is no doubt, time consuming. But the art of listening is worth mastering it. Children and their parents do not really know how to assess the treatment done, but they very much know how they were treated and how they felt. It is a mutual reward when they tell us how we made them feel comfortable and how happy they felt when they were finally “heard.” Happy Listening!

I would like to thank the Editor of IJCPD, Dr Nikhil Marwah, for giving me this opportunity to write the editorial for this issue on behavioral pediatric dentistry.