Psychological problems

It has been reported that patients are more fearful of dental treatment than of major surgical operations. The severity of this fear is variable, but can manifest as:

¨ A simple faint—lie patient flat and elevate the legs to increase venous return to the heart. If bradycardia is sustained it may be necessary to give 0.2mg of atropine subcutaneously or intramuscularly.

¨ Hyperventilation—the patient complains of light-headedness, tingling in the extremities and tetany. Treat by encouraging the patient to breathe repeatedly into a plastic bag placed over the mouth and nose. This allows the patient’s carbon dioxide levels to return to normal, and recovery takes about 5 minutes

 

Most patient respond well to a little TLC and time. A full explanation of proposed treatment can do much to allay patients’ worries or fears. Some patients, however, remain frankly dental–phobic or needle-phobic, and may require specialist help involving a clinical psychologist of hypnotherapy.

 

Chronic anxiety is an important component of burning mouth syndrome, whereas stress has been associated with the development of temporomandibular joint dysfunction and recurrent aphthous ulceration.

 

Patients with more serious psychological disorders (i.e. schizophrenia) may also present with bizarre clinical findings. Such patients require referral for appropriate treatment which can be organized through their GMP.