THE EDITOR'S CORNER

It can be a trying experience for the patient and the orthodontist to attempt almost any procedure on an overly apprehensive child. It is astonishing the change that you can make in this relationship by giving the patient a hand mirror and letting him watch what you are doing.

You can spot this patient in a variety of ways. Sometimes you will hear that peculiar dry cough out in the corridor before the patient even enters your office. Sometimes you will see that look in the eyes like a trapped animal. Sometimes you will see that the patient is on the verge of tears. Sometimes they will be so rigid that you can't get them to relax their position. Sometimes they will refuse to open their mouths. Sometimes you will feel them pull away from you to the other side of the dental chair. Sometimes the mother will let you know how frightened the patient is. Frequently they have been "prepared" for this visit by stories from friends which may be preposterous, but which they may believe. Sometimes they will tell you that they are scared.

A great many of our patients approach a visit to our offices with varying degrees of apprehension. It can be relieved almost every time--even for the most severe forms of it--by the simple expedient of handing the patient a mirror and saying, "Here. You hold this mirror so that you can watch me and see what I am doing". It is probably a combination of taking the mystery out of what is happening and a sense of participation--the distraction of doing something--but it works. For this reason, I suspect a hand mirror is superior to a large mounted mirror which may not permit the patient to see as well and which doesn't get him involved in a positive activity.

The question arises whether the mirror will get in the orthodontist's way. Sometimes it may. All you have to do is have the patient move it. Also, all but the most severe cases will shortly be weaned away from the mirror when they gain confidence in you and when they become familiar with your routine of treatment.

The mirror also promotes a better personal relationship because it stimulates conversation and the patient can see what you are talking about. That patient can gain a better understanding of what you are trying to do. In addition, it gives you an opportunity to point out things like better toothbrushing and care of appliances. You can encourage the patient by letting him see the progress he is making, or you can show him the progress he is not making.

I think another key to better rapport with patients may lie in your sitting down on a stool alongside the dental chair. Of course, a great many orthodontists already do this. The initial impetus may have been to save the orthodontist's back and legs. The fringe benefit may be equally important. Getting down to the patient's level rather than looming over him and breathing down on him seems to make patients feel more friendly and relaxed, perhaps less apprehensive.

A third builder of some bond between the orthodontist and the patient lies in something that Dr. Robert Ricketts once said. That is to use touch, physical contact with the patient. This does not imply caressing patients. This is a touch, a pat, a nudge. And, I would confine it to hands, arms, shoulders, and head. It is a momentary thing, but patients are well aware of it. There is some chemistry about touch. It connotes friendliness.

So there you have three simple things--a mirror, a stool, and the touch of your hand. If there are any of that group that you have not been accustomed to using, try them. I think that you are going to find that they work and that you can have an even more easy, pleasant, and more rewarding relationship with your patients. And who knows, they may even be impelled to cooperate with you a little bit better.