First impressions matter

Oct. 28, 2015
You have just one-tenth of a second to make a lasting impression

You have just one-tenth of a second to make a lasting impression

BY Midge Chiantella Junghans, CRDH

It has been said that you never get a second chance to make a first impression, and that saying continues to resonate in dental offices now more than ever. The people we once thought of as dental patients are now frequently seen as dental consumers. These dental consumers are perfect examples of our cherished family members, neighbors, and friends.

When we engage with our family members, we listen. We acknowledge that we are listening by having good eye contact, turning our bodies toward them, and smiling when it's appropriate. All of these behaviors demonstrate that we value people. If we were to consciously think of every person who comes through the operatory as a person we value, it's likely that we would have delighted patients. The retention rates and new-patient referrals would soar. A major added bonus is that we would feel fulfilled in our profession.

We routinely hear dental personnel remark that new patients walk in the front door and out the back door. It is critical that we examine the cause. How many seconds do you think it takes to make that first impression? It has been reported that it takes anywhere from 20 to 60 seconds, but in "Psychological Science," two Princeton psychologists conducted experiments on first impressions and discovered that people make judgments in the first one-tenth of a second.1 Longer exposures did not change opinions and only enhanced the original judgments.1 This valuable information can help us to correct how we welcome and retain dental consumers.

What they want

What is the first thing a dental consumer wants to know when visiting an office? In my opinion, they want to know if we sincerely care about them. When you think about it, each of us knows deep inside when someone has genuine concern for us. The people we treat are intelligent and have good intuition.

It is also apparent when someone is rushing us. A pharmacology professor from my college days once arrived to class wearing a T-shirt emblazoned with the words, "Drill 'em, fill 'em, and bill 'em!" It was shocking to my class. But shocking us was exactly what the doctor was trying to do that day. He wanted us to be outraged so that he could make a point about treating people with dignity and respect. He was essentially teaching us to listen before jumping into treatment.

Even today, when I was running 20 minutes late-my heart pounding with concern that I had kept someone waiting-I could hear the condensed lecture in my ears: "Don't be in a hurry to get to the teeth!" I had to stop, take a deep breath, and look the person straight in the eyes to tell them how sorry I was to have kept them waiting. I also promised to take excellent care of them. People are always pleasantly surprised and are usually instantly forgiving.

The impact of tardiness and trust

Obviously, in a perfect world, we would always be on time, but sometimes we cannot control our circumstances and we do run late. How we handle those times is of utmost importance in demonstrating that we value a person's time. Some offices will offer free whitening or another product to ease the tension of a person who has waited.

It has been my experience that a heartfelt apology, along with a courtesy product, can go a long way toward making a person happy. When that person is at a social gathering where people are complaining about waiting in professional offices, he or she will chime in to say that feeling valued by the dental team is a reason for returning to a particular office. Likewise, if there is an unhappy patient/consumer and a concern is ignored, that will be the person who will walk out and go somewhere else. Worse yet, that one person will tell many people about a less-than-satisfactory experience. There are too many offices from which to choose instead of remaining in one office and feeling dissatisfied.

The second concern people have when they visit a dental office is about whether we are worthy of their trust. Once again, if we are in a hurry to get to the teeth and diagnose-instead of listening first-we can never go back and remake that first impression. Rushing into treatment and talking at a person will not gain his or her trust. When we ask sincere, open-ended questions, instead of using a scripted agenda, we will begin the process of building trust in our relationships with our patients.

Examples of open-ended questions are questions beginning with who, what, where, when, why, and how-in other words, any question that cannot be answered with a "yes" or "no." Asking a person, "How may I help you?" is more likely to elicit conversation than "Can I help you?"

It is important to listen and demonstrate that we understand in all relationships, especially when a person feels vulnerable. It may seem apparent that, by building a relationship with patients from the very beginning, they will be far less likely to "walk out the back door."

Asking questions about what is important to the people we treat shows intelligent listening and leadership abilities. When we know a patient's priorities, we can better serve his or her needs. Too often, we only assume what is highly valued by a person. In many offices, I have heard assumptions about how much money a dental consumer may or may not have. When we carefully listen and understand what a person values, we can offer the best options for treatment. If we do not ask the open-ended questions, listen, and gain understanding, we are neglecting a significant aspect of how we can best serve people.

As dental professionals, if we involve the patient in making treatment decisions, we can further strengthen trust. When it comes time to share information, it is essential to ask a person for permission. For example, you might say: "If you would like, I have some information that you may find helpful with reducing bleeding in the area that is bothering you." Asking permission demonstrates your respect for the other person.

A behavior to avoid is scolding since it does nothing to foster a healthy relationship. There is no one in the world who likes to be scolded. Out of guilt, patients often tell us before we say a word that they know that we are going to be "mad" and "yell" at them for being overdue or for having terrible teeth. It is a good idea to reassure them that your office is a judgment-free, no-scolding zone. The important thing is that the person is there. The fact that they are in your office shows that they have made a tremendous effort to begin the process of being proactive in their dental health and that they are relying on you to guide them.

One can tell a lot about a person by how they treat a child, the elderly, a restaurant server, or a new patient. We have to accept that people feel profoundly vulnerable when they enter our operatories. Once again, kindness and listening will go a long way in building trust, confidence, and the office patient base. We are striving for long-term relationships with the people we treat-instead of only a prophylaxis and a filling. Our patients, like our family members, want us to show that we understand. Sometimes, during the first visit, we want to tell the patient everything we know that may improve his or her dental health. Instead, if we develop a long-term relationship, there will be plenty of time to share all of our knowledge.

Recently, I had an opportunity to temp at a local dental practice. As an alternative to diving in and educating with overwhelming amounts of information (much like a fire hydrant gushes water), I decided to practice involving patients in the process of care by asking open-ended questions.

To begin appointments, I asked patients if they had noticed anything in their mouths that they wanted to discuss with me. If they said there were no concerns, I gave a list of possible concerns-for example, teeth that don't feel clean after brushing, bleeding gums, bad breath, sensitivity, or teeth that are bothersome. If a patient had bleeding gums, I did not launch into my "telling" mode. Instead, I asked the patient if he or she would like to learn two ways to promote healthier gums and reduce/stop the bleeding.

Only one patient said that he did not want to learn new techniques, and I respected his wishes. Perhaps he had something going on in his life and thought he might be unable to process anything more.

All of the patients I saw that day remarked that they had never felt so "listened to" while visiting a dental office. The patients were pleased, and so was I. It was wonderful for them to feel that I was listening, and it was rewarding for me to feel that I had made a difference in their lives. When the doctor entered my operatory and remarked that he was pleased with how I educated patients, I felt as though my technique was validated.

In the past, I had not used much of an "interviewing" technique with the people I treated. Now, I am enthusiastic in growing my skills to better demonstrate how much I care for the people I treat in my operatory.

We cannot deny that people do not care about how much we know until they know how much we care. That is true in all relationships. A person can be the most skilled clinician, but without empathy for others, it is unlikely that he or she will have the opportunity to treat people. No one cares how many credentials you have if you do not display caring behavior. The more the entire dental team becomes adept at demonstrating how much they care, the greater the effect for the patient and practice.

When we demonstrate compassion, concern, and understanding for the people we treat, everyone wins: Patients become more educated as consumers, feel more valued, and remain loyal to the practice. Asking open-ended questions and permission to educate takes practice. Practice is also necessary for developing the skill of treating every person in your chair as if they are the most important person in the world.

As I mentioned in the beginning, most people have good intuition and can sense whether you sincerely care about them. How will you change the way you interact with people now that you have been reminded about skills that we take for granted? How will you use that one-tenth of a second that you will never get back? Remember, you can only treat the teeth of people who continue to choose your office! RDH

Midge Chiantella Junghans, CRDH, BS, lives and practices dental hygiene in Florida. She is known as a committed leader in the dental hygiene profession with over 30 years of clinical and educational experience. Currently, she is studying myofunctional therapy as it relates to sleep apnea and is an educator/speaker for various health concerns. She can be reached at [email protected]


1. Willis J, Todorov A. First Impressions: Making Up Your Mind After a 100-Ms Exposure to a Face. Psychol Sci. 2006 Jul;17(7):592-8. http://pss.sagepub.com/content/17/7/592.short?rss=1&ssource=mfc.
2. Ramseier CA, Suvan JE, editors. Health Behavior Change in the Dental Practice. Hoboken, NJ: Wiley-Blackwell; 2010.