Affect and cognition as antecedents of patients’ trust in the dentist

cross-sectional study




Affect, Cognition, Patient satisfaction, Trust


Aim: to evaluate the association of the patients’ perception about dentist’s affect and cognition on trust and, consequently, on intention to return and patient satisfaction with life. Methods: Analytical cross-sectional study conducted in patients’ adults and elderly at of two dentistry clinics in the south of Brazil. Patients had to have a previous relationship with the dentist (at least one previous consult) and 18 years of age or older. The data were collected through self-administrated questionnaire using measures adapted from other research, using structural equation modeling. We test using a chi-square difference test (p-value<0,05). Results: The mean age of the 197 patients was 37.0 years (σ = 15.5). The affect perceived by the patient at the dentist had a positive effect (β = .53) on the trust that the patient develops in relation to the dentist. The same is true for the effect of the rational or cognitive aspects perceived by the patient at the dentist (β = .41). The trust positively influences the patient’s intention to return to that dentist (β = .82). In addition, the intention to return to the dentist positively influences the patient’s satisfaction with life (β = .49). Conclusions: Affective and cognitive aspects positively influenced the patient’s trust in the dentist. The greater the patient’s trust in the dentist, the greater the intention to return to that dentist. Furthermore, a good relationship with the dentist improve the patient’s satisfaction with life.


Download data is not yet available.


Metrics Loading ...

Author Biographies

Lilian Rigo, Meridional Faculty

Departament of Dentistry School, Meridional Faculty/IMED, RS, Brazil.

Kenny Basso, Meridional Faculty

Department of Business School, Meridional Faculty/IMED, RS, Brazil.

Jandir Pauli, Meridional Faculty

Department of Business School, Meridional Faculty/IMED, RS, Brazil.

Michele Portilio, Meridional Faculty

Meridional Faculty/IMED, Brazil


Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71-5. doi: 10.1207/s15327752jpa4901_13. DOI:

Maynard A, Bloor K. Trust and performance management in the medical marketplace. J R Soc Med. 2003;96(11):532-9. doi: 10.1258/jirsm.96.11.532. DOI:

Hall MA, Zheng B, Dugan E, Camacho F, Kidd KE, Mishra A, et al. Measuring patients' trust in their primary care providers. Med Care Res Rev. 2002;59(3):292-318. doi: 10.1177/1077558702059003004. DOI:

Dugan E, Trachtenberg F, Hall MA. Development of abbreviated measures to assess patient trust in a physician, a health insurer, and the medical profession. BMC Health Serv Res. 2005;5:64. doi: 10.1186/1472-6963-5-64. DOI:

Hupcey JE, Miller J. Community dwelling adults’ perception of interpersonal trust vs. trust in health care providers. J Clin Nurs. 2006;15(9):1132-9. doi: 10.1111/j.1365-2702.2006.01386.x. DOI:

McAllister DJ. Affect- and cognition-based trust as foundations for interpersonal cooperation in organizations. Acad Manag J. 1995;38(1):24-59. doi: 10.2307/256727. DOI:

Johnson DS, Grayson K. Cognitive and affective trust in service relationships. J Bus Res. 2005;58(4):500-7. doi: 10.1016/S0148-2963(03)00140-1. DOI:

Thom DH, Hall MA, Pawlson LG. Measuring patients’ trust in physicians when assessing quality of care. Health Aff. 2004;23(4):124-32. doi: 10.1377/hlthaff.23.4.124. DOI:

Jacquot J. Trust in the dentist-patient relationship: a review. J Young Investig. 2005 Jun 1 [cited 2019 Sep 9]. Available from:

Trachtengerg F, Dugan E, Hall MA. How patients trust relates to their involvement in medical care. J Fam Pract. 2005;54(4):344-52.

Nooteboom B, Berger H, Noorderhaven NG. Effects of trust and governance on relational risk. Acad Manag J. 1997;40(2):308-38. doi: 10.2307/256885. DOI:

Garbarino E, Johnson MS. The different roles of satisfaction, trust, and commitment in customer relationships. J Mark. 1999;63(2):70-87. doi: 10.2307/1251946. DOI:

Ebn Ahmady A, Pakkhesal M, Zafarmand AH, Lando HA. Patient satisfaction surveys in dental school clinics: a review and comparison. J Dent Educ. 2015;79(4):388-93. DOI:

Irwin RS, Richardson ND. Patient-focused care: using the right tools. Chest. 2006;130(1 Suppl):73S-82S. doi : 10.1378/chest.130.1_suppl.73S. DOI:

Liu SS, Amendah E, Chang EC, Pei LK. Satisfaction and value: a meta-analysis in the healthcare context. Health Mark Q. 2008;23(4):49-73. DOI:

Lee WI, Chang TH, Chao PJ. The relationship between quality of healthcare service and customer satisfaction-an example of hospitals in Taiwan. J Chin Inst Ind Eng. 2007;24(1):81-95. doi : 10.1080/10170660709509024. DOI:

Mills I, Frost J, Cooper C, Moles DR, Kay E. Patient-centred care in general dental practice-a systematic review of the literature. BMC Oral Health. 2014;14:64. doi : 10.1186/1472-6831-14-64. DOI:

Bendall D, Powers TL. Cultivating loyal patients. J Health Care Mark. 1995;15(4):50-3.

Holt VP, McHugh K. Factors influencing patient loyalty to dentist and dental practice. Br Dent J. 1997;183(10):365-70. doi : 10.1038/sj.bdj.4809512. DOI:

Kessler DP, Mylod D. Does patient satisfaction affect patient loyalty? Int J Health Care Qual Assur. 2011;24(4):266-73. doi : 10.1108/09526861111125570. DOI:

Zhou WJ, Wan QQ, Liu CY, Feng XL, Shang SM. Determinants of patient loyalty to healthcare providers: An integrative review. Int Jr Qual Health Care. 2017;29(4):442-9. doi: 10.1093/intghc/mzx058. DOI:

Naidu A. Factors affecting patient satisfaction and healthcare quality. Int J Health Care Qual Assur. 2009;22(4):366-81. doi : 10.1108/09526860910964834. DOI:

Arrindel WA, Meeuwesen L, Huyse FJ. The satisfaction with life scale (SWLS): Psychometric properties in a non-psychiatric medical outpatients sample. Personal Individ Differ. 1991;12(2):117-23. doi : 10.1016/0191-8869(91)90094-R. DOI:

Sanders AE, Spencer AJ. Why do poor adults rate their oral health poorly? Aust Dent J. 2005;50(3):161-7. doi : 10.1111/j.1834-7819.2005.tb00355.x. DOI:

Dumitrescu AL, Kawamura M, Dogaru BC, Dogaru CD. Relation of achievement motives, satisfaction with life, happiness and oral health in Romanian university students. Oral Health Prev Dent. 2010;8(1):15-22. doi : 10.3290/j.ohpd.a18807.

Sirgy MJ, Hansen DE, Littlefield JE. Does hospital satisfaction affect life satisfaction? J Macromark. 1994;14(2):36-46. doi : 10.1177/027614679401400204. DOI:

Thom DH. Stanford Trust Study Physicians. Physician behaviors that predict patient trust. J Fam Pract. 2001 Apr;50(4):323-8.

Dagger TS, Danaher PJ, Gibbs BJ. How often versus how long: the interplay of contact frequency and relationship duration in customer-reported service relationship strength. J Serv Res. 2009;11(4):371-88. doi: 10.1177/1094670508331251. DOI:

Balkrishnan R, Dugan E, Camacho F, Hall MA. Trust and satisfaction with physicians, insurers, and the medical profession. Med Care. 2003;41(9):1058-64. DOI:

Silva M, Terres CP S, Basso K. Antecedents of the client’s trust in low- versus high-consequence decisions. J Serv Mark. 2015;26(1):26-37. DOI:

Gouveia VV, Barbosa GA, Andrade EO, Carneiro MB. [Measuring life safisfaction among physicians in Brazil]. J Bras Psiquiatr 2005;54(4):298-305. Portuguese.

Hair JF, Black WC, Babin BJ, Anderson RE, Tatham R. [Multivariate data analysis]. Porto Alegre: Bookman; 2005. p.688. Portuguese.

Anderson JC, Gerbing DW. Structural equation modeling in practice: a review and recommended two-step approach. Psychol Bull. 1988;103(3):411-23. DOI:

Garver MS, Mentzer JT. Logistics research methods: employing structural equation modeling to test for construct validity. J Bus Logist. 1999;20(1):33-57.

Birkhäuer J, Gaab J, Kossowsky J, Hasler S, Krummenacher P, Werner C, et al. Trust in the health care professional and health outcome: A meta-analysis. PLoS One. 2017 Feb;12(2):e0170988. doi: 10.1371/journal.pone.0170988.. DOI:

Quaschning K, Korner M, Wirtz M. Analyzing the effects of shared decision-making, empathy and team interaction on patient satisfaction and treatment acceptance in medical rehabilitation using a structural equation modeling approach. Patient Educ Couns. 2013;91(2):167-75. doi: 10.1016/j.pec.2012.12.007. DOI:

Hurts YK, Prescott-Clements LE, Rennie JS. The patient assessment questionnaire: |a new instrument for evaluating the interpersonal skills of vocational dental practitioners. Br Dent J. 2004;197(8):497-500. doi: 10.1038/sj.bdj.4811750. DOI:

Coulter A. Patients' views of the good doctor. BMJ. 2002;325(7366):668-9. doi: 10.1136/bmj.325.7366.668. DOI:

Rempel JK, Holmes JG, Zanna MP. Trust in close relationships. J Pers Social Psychol. 1985;49(11):95-112. doi: 10.1037/0022-3514.49.1.95. DOI:

Ommen O, Janssen C, Neugebauer E, Bouillon B, Rehm K, Rangger C, et al. Trust, social support and patient type—associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients. Patient Educ Couns. 2008;73(2):196-204. doi: 10.1016/j.pec.2008.03.016. DOI:

Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Soc Sci Med. 2000;51(5):657-68. doi: 10.1016/s0277-9536(00)00014-9. DOI:




How to Cite

Rigo L, Basso K, Pauli J, Portilio M. Affect and cognition as antecedents of patients’ trust in the dentist: cross-sectional study. Braz. J. Oral Sci. [Internet]. 2022 Aug. 22 [cited 2023 Jan. 30];21(00):e227228. Available from:



Original Research