Psychology As A Tool For Fostering Better Dentist Patient Relationship : A Practical Guide.

Why are some dental practices more successful than others? Skill, though undoubtedly important is not the complete answer.Simply put, a successful practice is directly proportional to the number of satisfied patients. And for a patient to be satisfied, it his needs that have to be met – voiced and unvoiced! Thus to be able to deliver effective dental care, needs as perceived by the patient and dentist need to be in sync. But to achieve this first and foremost a dentist must acknowledge the existent gulf that exists between professional and lay perception of needs and then proceed to bridge the gap between the two. This article looks at various ways in which the science of psychology can aid the dentist overcome this ubiquitous impasse. Psychology helps not only in assessing the underlying concerns of a patient but also in addressing them. And this in turn lays the foundation for a long lasting dentist-patient relationship which is what lies at the heart of any successful practice!

Mitral valve repair for nonrheumatic mitral regurgitation.

BACKGROUND: We studied the results of mitral valve repair in patients with severe mitral regurgitation of nonrheumatic etiology. METHODS AND RESULTS: Between January 1988 and April 2002, 116 patients, of which 59 were male and 57 female, with severe mitral regurgitation of nonrheumatic etiology, underwent mitral valve repair using a variety of techniques. Their mean age was 26.4 years (range 2-67 years). The cause of mitral regurgitation was congenital in 56 patients, myxomatous in 44, infective endocarditis in 7, and ischemic in 9. Ninety patients were in preoperative New York Heart Association class III, and 26 in class IV. Reparative procedures included posterior teflon felt collar annuloplasty (modified Cooley's) in 80 patients, chordal shortening in 37, cusp excision in 34, cleft closure in 8, chordal transfer in 6, and neochordae in 3. The early mortality was 3.4% (4 patients). Follow-up ranged from 1 to 167 months (mean 47 months), and was 95% complete. There were 2 late deaths (1.7%). Six patients (5.2%) underwent reoperation for severe mitral regurgitation post-repair. Of the remaining 104 patients, 90 (86.5%) had no or trivial mitral regurgitation at the last follow-up. Actuarial, reoperation-free, and event-free survival at 130 months was 93%+/-3.6%, 89.9%+/-6%, and 69.7%+/-13.7%, respectively. Ninety-two patients (88.5%) were in New York Heart Association class I at the last follow-up. CONCLUSIONS: Mitral valve repair in nonrheumatic mitral regurgitation patients provides satisfactory results with current surgical techniques, and is the preferred option in this subset of patients.