Each and every patient you see will be different; they have different mouths with different areas of concerns, and different motivations regarding their oral health. The more you understand the patient the better able you are to improve the patient experience. This is something most of us will do subconsciously on some level, from using a tone of voice when talking to children, to taking a few extra seconds to talk through procedures with a patient who is clearly nervous. We use our understanding of the patient to give the most effective care. Whilst this will immediately benefit the patient in terms of their oral health, it also has a positive impact on the practice’s reputation.
There are now over 2m Muslims living in the UK so it is worth taking a brief look at some of the practical considerations when treating Muslim patients.
Patient records
Many Muslims, particularly those from the Indian subcontinent, will use a traditional naming method. Boys may have a personal name (such as Siddiq or Altaf) which is either preceded or followed by a religious name (Muhammad Siddiq and his brother Altaf Hussain). This explains why brothers could have different surnames.
For women, Bibi can be a Miss and Begum a Mrs. Razia Begum, the wife of Abdul Rashid is denoted Razia Rashid.
Alcohol use is forbidden under Islamic law, and in many communities smoking is also prohibited, so it is worth using sensitivity when approaching these topics with Muslim patients.
Appointment times
A Muslim prays five times a day following calls to prayer at specific times of the day, which vary according to changing daylight hours. For many Muslims Friday lunchtime prayers are the most important so appointments around this time can be inconvenient.
Greetings
Whilst there are many schools of Islamic law on the subject, it is worth noting that a handshake at the start or end of an appointment may not be reciprocated. For some, handshakes are only permitted between people of the same sex, whilst others say no such prohibition exists.
Ramadan
During the Islamic month of Ramadan, a Muslim will fast. The individual will ingest no food or drink, including water, from dawn to sunset for each day of the month. When a patient is fasting there is an increase in the concentration of sulphur containing compounds present in the oral cavity causing a marked malodour, which may be misdiagnosed.
A patient presenting at the dental practice during a fast may show signs of irritability or a degree of cognitive impairment. This has been shown to be associated with the lack of intake of addictive substances such as nicotine and caffeine. Individuals who are fasting during daylight hours attempt to compensate for the lack of intake of food during the night. A common practice includes waking to consume a meal before sunrise. The sleep disturbance together with the lack of caffeine as a central nervous system stimulant may result in tiredness, irritability and lack of concentration.
One should determine what treatment that the patient considers acceptable during Ramadan. For example a patient may accept no oral medication during fasting but may allow sublingual angina sprays or asthma inhalers as enter the trachea not the oesophagus. Some will not have operative dental treatment as there is a risk of swallowing water/debris when rinsing their mouth.
Conclusion
A holistic approach to dental care recognises that spirituality and health is intertwined for most patients. To be able to perform an accurate assessment and provide competent and effective care, the clinician must consider the patient’s religious and spiritual beliefs. Whilst a background understanding of Islam might help when treating a Muslim patient, ultimately no matter what faith the patient is they should be treated with courtesy and respect.