I recently attended the wedding of a very good friend. My family rejoiced at the prospect of me finally having a day off – a day, they assumed, that would not be punctuated by some work-related activity. Alas, that was wishful thinking.
During the evening celebrations, a karaoke rendition of ABBA’s Knowing Me, Knowing You provided both amusement and inspiration. While others sang along, I found myself multi-tasking – singing but also jotting down some thoughts for this editorial. In this context, ‘knowing me’ refers to the dentist’s self-awareness, while ‘knowing you’ refers to understanding the patient.
The ancient maxim ‘know thyself’, inscribed at the Temple of Apollo, has guided human thought for centuries. For philosophers, it highlights self-awareness as a basis for wisdom. In healthcare, the maxim must be extended and paired with another – to understand ‘the other’. The other is of course the patient. These two strands are the foundation of rapport.
In dentistry, ‘knowing me’ means the dentist recognising their own boundaries of skill and competence, as well as the influence of external pressures. Ambition, commercial drivers, and social media trends can all shape judgement in subtle ways. Self-knowledge is about:
Knowing when to refer or seek a second opinion.
Recognising when time pressures or business concerns are influencing decisions.
Being honest about knowledge gaps, inexperience, or learning needs.
Not allowing a curated social media identity to distort self-perception.
This kind of self-reflection is the key to safe, ethical, and defensible practice.
If self-knowledge is one strand, patient-knowledge is the other. ‘Knowing you’ requires the dentist to look beyond medical histories, charts, indices, and radiographs. It means understanding the patient’s motivation and attitude.
Many years ago, John Tiernan and I co-authored the textbook Risk Management in General Dental Practice (Quintessence, 2004). We reviewed and analysed more than 500 case files relating to patient complaints. One of the clear conclusions was that most complaints, dissatisfaction, and dentolegal claims arise not from technical error but from mismatched expectations, distorted perceptions, or communication breakdowns. That observation is even more relevant today, in an era where social media amplifies patient expectations and creates new pressures for both dentists and patients.
Patient expectations are increasingly shaped by social media – “before-and-after” transformations, influencer commentary, endorsements, and portrayals of treatment outcomes. These can create unrealistic ideals and distort perceptions of what dentistry can achieve. For the clinician, recognising the influence of social media is essential – it partly explains why patients may overestimate what is possible and underestimate biological costs.
A useful way of structuring this understanding is the Patient MAP:
M – Motivations and Mindset → Why does the patient want treatment? Internal goals or external pressures? What is their emotional readiness?
A – Attitudes and Aspirations → How do they see their oral health? Are expectations realistic, and do they understand limitations?
P – Preferences and Processing → How do they define success? How do they make decisions and process information? What is their tolerance for uncertainty or imperfection?
The Patient MAP is not a checklist to be ticked mechanically – it is a framework for dialogue and alignment before treatment begins.
The Patient MAP applies across dentistry but is especially valuable in elective care - cosmetic procedures for example. In such cases, expectations are higher, definitions of success more subjective, and dissatisfaction more likely. By contrast, essential treatments for pain, infection, or function are often approached with more pragmatic acceptance.
Janus, the Roman god of transitions, is often depicted with two faces looking in opposite directions – one to the past, one to the future. This dual gaze is precisely what risk management requires – 360° awareness. A dentist who only knows themselves may miss patient red flags, and one who only knows the patient risks blind spots in their own judgement.
Risk management is therefore Janus-headed - see figure 1 below.
Figure 1: 360° risk management
Risk in dentistry is managed not only by technical competence but also by awareness – of self and of the patient. Knowing me, knowing you is more than an ABBA lyric – it is a reminder that safe, ethical, and defensible practice rests on two forms of knowledge.
“I know myself and I know my patient” is a mantra every bit as important as “do no harm.”
Raj RattanDental Director, Dental Protection, and Editor-in-Chief, Riskwise
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