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Informed patients make satisfied patients

by: Zorica Markovic

Zorica Markovic of Nobel Biocare’s Austrian office recently sat down with Professor Werner Zechner to talk about how he effectively meets prospective implant patients and their concerns.

Werner Zechner is a professor at the Department of Oral Surgery of the Bernhard Gottlieb Dental School, which is a department of the Medical University of Vienna, Austria. Widely published, he is an expert on implant surfaces and computer-aided implant placement and prosthetic rehabilitation. He lectures internationally, is in private practice in Vienna and has been kind enough to answer a few of our questions:

When you first meet with a patient who is not familiar with dental implant surgery, what is their primary concern?

Prof. Werner Zechner: Predictability. During initial visits with patients, I often notice a degree of uneasiness in their voices. Even if they don’t bring up the topic immediately, these first conversations almost always turn towards issues of anxiety. Many patients are recommended to me specifically because reducing concerns over implant treatment is a major focus of my work.

How do you deal with anxious or frightened patients?

Zechner: After examining information that I receive from my referring physicians, I ask my patients to describe their desire for treatment in their own words. Together with an initial clinical assessment, this makes it possible for me to quickly get a grasp of their fears and reservations, and provides me with an opportunity to discuss both their realistic and unrealistic wishes. Here I pay attention both to what is said as well as to non-verbal signals.

Are patients interested in knowing how the procedure will be done?

Zechner: Without question! At our very first meeting, patients almost always ask me to explain the essential steps. Both my team and I continue to explain and answer questions at every treatment step and at follow-up appointments. After the treatment has been completed, many patients express how valuable our regularly recurring, situationally relevant explanations have been, both during and after the procedure. These explanations give patients a sense of security, for which they are very grateful.

How do you explain implant treatment to patients?

Zechner: Pictures and models, demonstrating procedures and results, have always been essential communication aids, and have now been supplemented with 3D computer graphics. The three-dimensional visualizations that can be found today in the NobelClinician diagnostics and treatment planning software make it possible to dive into great detail.

Using NobelClinician Software, I can easily explain implant treatment to patients with such precision that they can gain a solid understanding of even complex treatment situations — such as where bone augmentation is required or can be avoided.

What are other effective ways to put a patient at ease?

Zechner: There are many small measures that can be taken by each member of the team, all of which help to effectively reduce the fears of the patient.

Treating the patient and his or her anxieties with respect engenders feelings of security. The tone in which my staff and I communicate with each other affects the patient as well, and the value of calm, well-mannered dialogue should not be underestimated.

Occasionally, it may also be helpful to guide the patient during the procedure by suggesting mental images of sheltered environments and safe emotional states. These techniques help the patient relax, which benefits the entire treatment team.

How did NobelClinician change the manner in which you explained proposed treatment to patients?

Zechner: NobelClinician is a very effective medium for communication with patients: A picture really is worth a 1000 words, after all. The visual nature of the software is very valuable to me in consultations with the patient.

Looking back, I realize that the benefits and the assistance provided by NobelClinician are even more powerful than I initially anticipated. I can sit with the patient and — on an equal footing — discuss how the treatment will proceed and what the result should look like. I can easily show the patient what his or her needs are, and visually demonstrate realistic scenarios that will provide a solution. I can also display detours that may need to be taken en route, and easily account for the total amount of work involved.

The discussion facilitated by NobelClinician promotes a partnership approach with the patient. Mutual decision-making increases the likelihood of initial patient commitment and ultimate patient compliance.

How do patients react when you explain treatment using NobelClinician?

Zechner: Patient reactions to NobelClinician are solely positive. Even less computer-savvy patients are highly impressed by the degree to which medical treatment procedures are supported by this advanced technology. Visualizing predictable outcomes engenders a tremendous sense of security.

Do you have any stories or anecdotes to share concerning patient reactions to the level of detail displayed by NobelClinician and how much thought and design goes into the procedure?

Zechner: I once had a patient — who was an older, rather timid, lovable lady and artist — in for a sinus floor elevation. Initially, the procedure proved psychologically impossible for her to accept. Among other tools, I used NobelClinician in four counseling sessions over a period of about nine months before she finally summoned the courage to let me place guided implants in her right upper jaw.

Immediately after the procedure, she sincerely and fervently embraced me as tears of relief streamed down her cheeks. Realizing how unproblematic and straightforward the procedure had been, she lamented, “If I had only believed you nine months earlier!” For me, the extent of emotional relief expressed by this patient is something I will always remember.

Did using NobelClinician make you even more confident not only in explaining the proposed treatment but also in performing the ultimate surgery?

Zechner: NobelClinician has helped me in many cases to solve complex treatment challenges in a predictable manner. And NobelGuide, when used in the proper indications and with the appropriate implants, provides a highly ergonomic experience. It all makes for a very useful treatment concept, and we have demonstrated its effectiveness in numerous scientific studies.

Do you ever find yourself wondering how you ever lived without NobelClinician?

Zechner: After many years, with more than 1500 guided implants placed, and numerous studies later, I could not imagine maintaining such a high level of predictability for such a wide range of indications without NobelClinician. Without this valuable tool, we would have to perform a significantly higher number of augmentations, which would probably result in significantly fewer patients opting for implants.

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