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Eur J Dent Educ. 2019 May;23(2):220-229. doi: 10.1111/eje.12421. Epub 2019 Mar 25.

Moving the four habits model into dentistry. Development of a dental consultation model: Do dentists need an additional habit?

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Oral Health Centre of Expertise (OHCE) in Eastern Norway, Oslo, Norway.
Faculty of Dentistry, University of Oslo, Oslo, Norway.
Department of Oncology, Oslo University Hospital, Oslo, Norway.


A consultation model for dentistry is presented, with communication skills in a didactic and structural format, applicable for most types of visits, patients and problems. A characteristic of the dental visit is its division into dialogue phases and clinical phases, which makes verbal exchange especially challenging. The original Four Habits Model (4H) has been adapted from medicine to the specific structure and content of a dental visit, and a modified model is proposed. The dental model consists of a structural core framework relevant for all dental consultations, and additional extensions applicable to commonly occurring issues. Facilitate Perceived Control has been added to the model, due to its crucial importance in dental visits, and we suggest naming the model "The Four + One Habits Model for Dental Visits (4 + 1HD)." The proposed model should have clinical relevance for improving patient care and patient experience, as well as easing the busy everyday life for dentists in a variety of clinical settings. It is also likely to be a flexible framework for communication skills training at all levels of dental education. More research is needed to validate and test the model in various clinical and educational settings.


The Four Habits; consultation model; dental communication; patient-centered


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