Patient Management (Behavioral Science and Ethics)
Behavior and communication
Questions test your ability to read anxiety, apply behavioral techniques appropriately, and respect autonomy. Core techniques include tell-show-do, voice control, positive reinforcement, distraction, and modeling; pharmacological adjuncts range from nitrous oxide to oral or intravenous sedation. Dental fear and phobia differ from simple anxiety - the phobic patient may avoid care entirely and needs a gradual, predictable approach.
Ethics
Know the four principles: autonomy (the patient decides), beneficence, nonmaleficence, and justice. Valid informed consent requires capacity, disclosure of risks, benefits, alternatives and the consequences of no treatment, and voluntariness. For minors, a parent or guardian consents; mature-minor and emancipated-minor rules vary by jurisdiction.
Records and confidentiality
Document contemporaneously: history, findings, diagnosis, options discussed, consent, and treatment rendered. Confidentiality is broad but not absolute; exceptions include suspected child or elder abuse (mandatory reporting), certain communicable disease requirements, and court order.
Difficult situations
Managing the angry or noncompliant patient, appropriately refusing treatment, dismissing a patient from a practice, recognizing impairment in a colleague, and treating patients with infectious disease without discrimination.
Traps
Examiners like the refusal scenario: if a patient declines necessary treatment, document informed refusal and continue appropriate care rather than abruptly terminating the relationship. A patient's HIV status does not change standard precautions and generally is not disclosed without consent.
Rule of thumb
When unsure about disclosure or refusal, ask two questions: what would a reasonable patient want to know, and what does the law require me to report?