Clinical communication in orthodontics: Any questions?

Daniel Stonehouse-Smith*, Nikolaos Pandis, Dirk Bister, Jadbinder Seehra

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To measure patient-perceived standards of clinician communication and identify elements of deficient performance. Good communication can improve the quality of care, patient satisfaction and compliance with treatment. Design: Cross-sectional questionnaire service evaluation. Setting: Two university dental hospital orthodontic departments. Participants: Any patients aged 10 years and over attending the orthodontic department for treatment or consultation were eligible for inclusion. Patients who required third-party translation services were excluded. Methods: Clinicians provided the modified 15-item Communication Assessment Tool (CAT) to up to five patients in a clinical session. A front sheet for clinician characteristics was used and anonymised with a unique identifier. Univariable logistic GEE models examined associations among responses and clinician characteristics. Results: There were 55 clinicians with 204 patient responses. The overall percentage of ‘5=excellent’ ratings was 88% (SD 0.16). The lowest scoring item was ‘encouraged me to ask questions’ (55.8%). Based on clinician characteristics, there were lower odds of an excellent response for certain CAT items. There were higher odds of an excellent response if English was not the clinician’s first language (1.05; 95% confidence interval = 1.00–1.09; P=0.03). Conclusion: There is a high standard of patient–clinician communication in the hospital orthodontic setting. Key areas of communication that require attention include encouraging patients to ask questions, talking in terms they can understand, recognising their main concerns and involving them in the decision-making process. The results of this study can be used to inform communication skills training and be replicated in similar dental settings (primary and secondary care) as part of quality improvement.

Original languageEnglish
Pages (from-to)448-456
Number of pages9
JournalJournal of orthodontics
Issue number4
Publication statusPublished - Dec 2022


  • assessment
  • health services and quality of life aspects
  • psychological aspects of orthodontics
  • risk/benefit


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