The Relationship between Emotional Intellegence and the Practice of Relationship-based Complete Restorative Dentistry

Build your relationships first….then your dentistry. ~ Bob Barkley

The Relationship between Emotional Intellegence and the Practice of Relationship-based Complete Restorative Dentistry

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Dana C. Ackley, PhD, Irwin Becker, DDS, Richard Green, DDS

Most who want to help others achieve optimal dental health understand they often must positively influence patients’ behavior to achieve this objective. This requires leading others to do a number of things that may not come naturally or easily for them,

To be effective in this area, requires one to become somewhat of a practical psychologist. In 1984 dental consultant Avrom King said “Dentistry is the one of the most behavioral of all the sciences” and he was indeed correct. Psychology is the scientific study of behavior and how to influence it. And it involves skill sets which are highly relevant to the successful practice of dentistry today. 

Integration of psychological principles into dental practice is not new, but many still struggle with its application. Historically psychological models have been hard to understand and to put into use.The failure to effectively integrate proven phycological concepts into dentistry has resulted in the need for dentists to rely on their commonly held beliefs and assumptions rather than facts regarding what motivates and influences others.

To complicate matters, dentists also must influence another group of people – often at the same time – their care team. Again, much of the psychological resources available to dentists regarding leadership and influence have not been particularly helpful.

The good news is that there is a growing body of knowledge that has made research based psychological knowledge much more user friendly to the lay community. Many advancements have been made in the area now known as Emotional Intelligence (EQ). Discerning leaders in business, education, medicine, and dentistry have learned how to integrate the concepts of EQ into their work environment. The result has been considerable success in influencing behavior for the common good.

As stated, EQ is based on sound psychological research. This research has been completed in both in laboratory environments and in the real world scenerios of business executives, physicians, and dentists. This report represents the synopsis of a recent study we completed that examined how EQ contributes to the ability of Pankey Institute trained dentists to implement significant changes to their practices via their ability to influence others as well as develop themselves personally and professionally..



Definition: EQ can be defined as the set of skills people use to read, understand, and respond intelligently to the emotional signals sent to us by others and by ourselves. Examples of EQ skills include empathy (the ability to accurately read what other people are feeling), emotional self awareness (the ability to read what we ourselves are feeling), stress tolerance (the ability to withstand anxiety without falling apart), and the ability to create mutually satisfying relationships.

As a dentist, you are  aware that emotions have a major influence on behavior:

  • fear keeps many potential patients away from dentists
  • anxiety prevents dentists from presenting complete treatment plans to patients
  • confusion and frustration undermine team member performance
  • anger toward insurance company’s reimbursement patterns undermine our ability to talk with patients rationally about the topic

When dentists learn to better understand their own emotions, the emotions of their patients as well as those of team members, they can assume control of a powerful tool which advances their core mission of dental health.

The Pankey Institute for Advanced Dental Education was founded in honor of Dr. L. D. Pankey. Dr. Pankey was an internationally regarded thought leader and speaker in dentistry for many years. Much of his success was directly related to a masterful understanding of human behavior – applied practical psychology. Dr. Pankey recognized that positive influence is most effective within the context of a mutually beneficial relationship, and he made this a central part of his teachings.

Following Dr. Pankey’s lead, the focus of the Pankey Institute blends the latest in dental technical knowledge with proven approaches regarding how to best establish successful working relationships with patients. This advanced understanding of the dynamics of relationships helps Pankey Institute trained dentists create more opportunities where their highly developed technical skills can be utilized,

To better understand the relationship between EQ and a dentist’s ability to successfully apply proven comprehensive restorative methods and the patient-centered practice model, a research study was designed. The study tested the association between EQ and the Pankey trained dentist’s ability to successfully implement the Pankey Institute’s philosophy.




The study was designed to answer two questions: First, do stronger EQ skills contribute to the success dentists have in implementing principles of optimal care as taught at the Pankey Institute? Second, if so, which of fifteen specific EQ skills are most critical to that success?

Method: The subjects in our study were dentists who had completed at least six Continuum levels at the Pankey Institute. Thus, all participants had been thoroughly exposed to the Pankey philosophy of optimal care. We examined how the EQ of these dentists correlated with the success that they were having implementing that philosophy into practice. Most dentists begin attending the Institute several years after graduation from dental school. Thus, they typically develop their practice around a traditional insurance-cented, problem-focused practice model. Implementation of the Pankey philosophy often involves a dentist transitioning their practice to a more comprehensive care insurance-independent model. .

EQ was measured with the EQ-i. To measure implementation success, we created a 92 item self report instrument, The Survey of Progress (SOP).[1] It asks participants to report the frequency with which they engage in Pankey encouraged behaviors in three areas:

  • technical diagnostic skills taught at the Institute
  • behavioral steps of relationship building, (such as initial patient interviews, co-discovery, and team development)
  • business practices that benefit both patient and dentist.

Participant-dentists went on-line to complete both instruments. Data was collected at the website of Multi-Health Systems, which publishes the EQ-i. This process provided anonymity to participants.


Two hundred twelve dentists responded to recruitment letters from the authors. Of those, 144 (130 men and 14 women) provided a complete, usable set of responses. Their ages ranged from 33 to 63 years with a mean of 48.6 years. Fifty-six had completed six weeks of training at Pankey, seventy had completed seven weeks of training, sixteen had completed the Master’s Forum, and two were at the Pankey Scholar level.

Items on both the SOP and the EQ-i are set up on a five point scale. The higher the number (i.e., 5), the more frequently the respondent engages in the behavior or skill being measured. Table One presents mean scores and standard deviations on both instruments for the 144 participants.

The EQ-i average score is 100, with a standard deviation of 15. Participants scored significantly higher on most aspects of the EQ-i than the norm group (3,831 North Americans) on nine out of fifteen EQ skills.

Table One

Mean Scores and Standard Deviations



Mean (Standard Deviation)

Survey of Implementation Progress



Technical Issues

             3.10 (0.62)

Behavioral Factors

             4.00 (0.46)

Business Practices

             3.85 (0.52)

Total Score

             3.65 (0.43)








Total EQ

         103.49 (13.34)**

   Self-Regard (SR)

         103.73 (13.12)***

   Emotional Self-Awareness (ES)

         101.74 (15.98)

   Assertiveness (AS)

         102.04 (15.22)





         107.35 (11.90)***

   Self-Actualization (SA)

         106.67 (13.94)***

   Empathy (EM)

         101.70 (13.94)

   Social Responsibility (RE)

         105.16 (10.53)***

   Interpersonal Relationship (IR)

           99.18 (15.71)

   Stress Tolerance (ST)

         103.94 (13.44)***

   Impulse Control (IC)

           99.80 (14.14)

   Reality Testing (RT)

         103.21 (13.15)**

   Flexibility (FL)

           99.31 (16.12)

   Problem Solving (PS)

         101.45 (14.01)

   Optimism (OP)

         106.24 (11.95)***

   Happiness (HA)

         102.58 (14.38)*


              *Statistically significant at p<.05; **p<.01; ***p<.001.

Training Level: One-way independent measure ANOVA’s were done to determine whether there is a relationship between time spent at Pankey (training level) and EQ. No such relationship was found.

Correlational Analysis: Pearson correlations measured the relationship between scores on the EQ-i and the SOP.

Table Two

Correlations: SOP and EQ-i



                                                                        Survey of Progress (SOP)            


Bar-On EQ-i  Scale  



Technical Issues 

Behavioral Factors

Business Practices

Total EQ










   Emotional Self-Awareness



























   Social Responsibility





   Interpersonal Relationship





   Stress Tolerance





   Impulse Control



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