Taking time to build rapport

Once, a man in his late 20s was referred to Dr Joanna Ngo, 30, for dental treatment under general anaesthesia. He had badly decayed teeth and was deemed uncooperative by the polyclinic that referred him.

The man, who has cerebral palsy, was not willing to open his mouth when he visited polyclinic dentists despite needing root canal treatments and fillings.

"On the first visit, I had a chat with him and realised that he's quite intelligent. It turned out that him being uncooperative had a reason - his mouth area is very sensitive," said Dr Ngo.

In that first hour-long visit, she coaxed him into opening his mouth long enough for a cleaning and a small filling.

Before sending the patient home, Dr Ngo told his parents she needed time to build rapport with him and help him get used to dental procedures to avoid the use of general anaesthesia.

The man's dental issues could have been fixed in two to three hours by putting him under general anaesthesia - instead of the eight visits with Dr Ngo so far and counting.

But she said that any surgery could lead to complications and, worse, his dental problems could re-emerge, with him and his parents not knowing how best to take care of his teeth.

"You can go for general anaesthesia, anyone can, but there's no behavioural training. The patient doesn't learn how to behave in the dental chair," added Dr Ngo, who practises special-needs dentistry at Khoo Teck Puat Hospital, the Institute of Mental Health and the National Dental Centre.

Kok Xing Hui

A version of this article appeared in the print edition of The Sunday Times on November 01, 2015, with the headline 'Taking time to build rapport'. Print Edition | Subscribe