In the last article we considered four areas where behavioural change would benefit patients and practitioners through a win-win approach to preventive care. This philosophy can of course be applied to all areas of healthcare.

These were:

1. Initial attendance.

2. Uptake of care (case acceptance).

3. Compliance with preventive strategies on a long-term basis.

4. Attendance for continuing recall visits.

In this article we will consider the first of these. Why do patients fail to attend in the first place? I think we can put this down to two main factors:

1. Fear. This is caused by paradigms created by first-hand painful experiences from the past, or by the infection of a patient via second- hand word-of-mouth experiences. This often occurs from parent to child.

2. Expense. Patients often consider that dentistry costs a lot of money. We know that the value we offer is tremendous but patients would rather, it appears, spend their disposable income on other things. I feel that this is the fault of the profession. We have simply failed to get over to patients the importance and benefits of what we have to offer.

Both of these are basically the result of a lack of education. We need to change the patients’ paradigms. So how do we get the message across to the public that they have nothing to fear and that we offer great benefits – more so than the new car!

National campaigns will have some effect. Widespread educational programmes will help. However I think the greater effect will come if this backs up the gradual infusion of patients with the overwhelming enthusiasm of the individual professionals – professionals being heard at a local level. These individual voices, speaking from the same universal clinical values, will eventually coalesce and become a widespread phenomenon. Remember the Unison adverts with the ants?

How is this achievable?

1. Quality clinical education incorporating both knowledge and technique development.

2. Development of a quality practice brand and environment.

3. Team development and training.

4. Dissemination of the message to patients in the community. Through appropriate visual and verbal communication the feelings of patients towards their local dental practice will change for the better. It may take some time to have the message spread but with determination and a consistent message it will happen. Do we create the market or is the market already there?

5. Exceeding patient expectations when they attend.

Once we have got the patients through the door, then the next steps to behavioural change can take place.