Dentistry

Tandlaegebladet. 1990 Jan;94(2):58-60.
[Dental fear--relevant clinical methods of treatment] [Article in Danish]
Moore R.

The treatment of odontophobia is often relegated to treatment under general anesthesia as a quick solution, but this has proven to be ineffective in the long run. Other more cognitive approaches include flooding, where the patient learns through courageous participation to endure the fear through several routine dental treatments. Since this can often backfire on the patient, systematic desensitization is preferred, in combination with psychotherapy that is aided by progressive muscle relaxation or fading, biofeedback training or stress inoculation training. Hypnosis can also help the patient to restructure negative thinking towards more positive expectations from treatment. These are all meant to build up the patient's psychic coping resources. Assertiveness training in psychotherapy is used to build up the patient's social skills so that he/she can deal with dental personal in a diplomatic yet self determined way. Finally, modelling good patient behaviors to dental fear patients has been shown to be effective and is especially used by childrens' dentists. Use of sedatives the night before a dental appointment is often helpful and enables some patients with insomnia to be fresh and rested in order to deal with the often strenuous learning processes described above.

Aust Endod J. 2001 Dec;27(3):123-5.
Dental distress. A possible relief.
Boundy M.

The exacting task of endodontics can be considerably complicated by the behaviour of patients who have heightened fears and reactions to the manipulations involved. Hypnotherapy may offer a way to reduce these fears and enhance the comfort of both patient and dentist.

Am J Clin Hypn. 1996 Oct;39(2):89-92.
Teaching clinical hypnosis in U.S. and Canadian dental schools.
Clarke JH.
Oregon Health Science University, School of Dentistry, Portland 97201, USA.

This paper reports the results of a 1995 survey of the teaching of hypnosis in U.S. and Canadian dental schools. Responses were received from 50 schools (78%). The results are compared with prior surveys by Parrish (1973) and Simpson, Dedmon, Logan and Jakobsen (1980). The number of complete courses in hypnosis increased from 1973 to 1980 but has remained static since then. The number of other courses in which a one to two hour introduction to hypnosis is presented increased from 18% in 1980 to 30% in 1995. However, during approximately that same period (1982-1995) dentist membership in A.S.C.H. dropped from 14.9% to 4.4%. Some commentary on this phenomenon and needed future studies are offered.

Spec Care Dentist. 1993 Jan-Feb;13(1):15-8.
When pharmacologic anesthesia is precluded: the value of hypnosis as a sole anesthetic agent in dentistry.
Kleinhauz M, Eli I.
Section of Behavioral Sciences, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel.

Occasionally, a dental patient presents his/her dentist with a history of hypersensitivity to local anesthetic agents. The symptoms may include immediate reactions to the injection procedure (dizziness, shortness of breath, tachycardia, etc), or delayed reactions to the anesthetic (swelling, urticaria, etc). Although the true incidence of local anesthetic allergy is low, such a history often involves the patient's anxiety regarding the use of the drug in question, and the dentist's apprehension to treat the "problematic" patient. In such cases, hypnosis can play a major role in controlling pain and the associated distress. In the present article, the method concerning the implementation of hypnosis to induce local anesthesia is described and illustrated through case demonstrations.