Mini habit #5

Small talk.

Small talk (known in academia as non-task comments) is a key component of relationship building and in the healthcare setting it has long been recognised that “the opening exchange of either information or pleasantries is important and should not be omitted”. (1)

Small talk serves as a preliminary to the interaction at a more substantive level and should involve subjects that don’t invite strong opinions – my first job as a Dentist in Northern Ireland taught me to never stray into the territory of religion or politics and this rule holds true for me to this day!

A seemingly universal way of beginning is some variation the HAY (how are you?) question – it is generally acknowledged that this is not a literal question but a curtain raiser for the business to follow.

There are many variations of the HAY introduction from the simple “G’day” to the aristocratic “how do you do?” and it pays to know the local variations if you work with a specific group of people. My own Irish experiences varied from “Well?” in my hometown (a shortening of “are you well?”) to “Howaya?” in Dublin where I studied (a shortening of “How are you?”) to “What about ye?”, often shortened to “bout ye?” which completely flummoxed me when I went to work in Derry in Northern Ireland.

Small talk acts as a gentle transition for the patient from the tension and expectation of sitting in the waiting room to the task at hand in the dental chair. It is a social lubricant in a flexible and non-threatening way and I am always amazed at the relaxation in a patient’s nervous body language following a minute or so of small talk at the start of the visit.

Topics may be universal;

  • Weather – the trusty default option,
  • “Have you been away on holidays recently?”,
  • Traffic,
  • Sports,
  • Light current affairs.

Sometimes it is specific to the person/ situation;

  • “I like your shoes/ hair/ watch”,
  • “How are your kids?”,
  • “We are having some renovations at the practice”.

There may be some topics that are more pertinent to your patient demographic, for example it would be prudent to have a basic knowledge of rural issues if you work in the country.

The reverse of this is also important – the need for congruence – it can look very staged or false if you ask someone about the football and it soon becomes apparent that you don’t know one end of a ball from the other, or compliment someone on their shoes if this is not your thing (I leave that one up to my assistant, and it can work very effectively to bring a big smile to that patient’s face).

In summary, the use of small talk is a ritual we use as a warm up to the main event of the clinical issue at hand. It acts as a gentle transition for the patient from waiting to sitting in the dental chair and helps build rapport, showing the patient that you recognise them as a person and not just a disease entity to be managed.

Use of small talk is a skill – like any skill it can be developed, made into a mini habit and fortunately we can learn and practice relatively safely in any social situation.

Small talk makes for BIG CONVERSATIONS – the amazement on a patient’s face when you remember that their daughter was getting married, or you ask about a special holiday they were going on – this is the intangible gold that will build resilient relationships and, in turn, a thriving busy practice.


  1. Holli, B and Calabrese, R. (1998) Communication and education skills for dietetics professionals: Williams and Wilkins.





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