牙科畏惧症的诱发因素与防治策略
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摘要
目的:牙科畏惧症是指患者在牙科治疗中的一种特殊心理和行为的异常表现。虽然牙科畏惧症在牙病诊治中不会危及生命安全,但由于其发生率高达50%以上,不仅会明显降低牙病的早期就诊率,同时还会降低医护人员的诊治质量和工作效率,并有恶化医患关系的危险。近年来,随着舒适化医疗在临床诊治过程中的快速推进,牙科治疗中的镇静镇痛技术也得到了非常迅速的发展。本文就近年来有关牙科畏惧症的相关诱发因素、临床表现及危害,特别是其预防和治疗新策略的进展情况等作一综述。
Dental phobia is a special social and behavioral abnormal activity of some individuals when receiving dental treatment. Although the dental phobia does not threat the safety of life,the incidence rate is as high as above 50%,which decreases the quality and efficiency of dental care and prevent the dental treatment willing of the patients,at the same time it may worsen doctor- patient relationship. Recently,the sedation and analgesia techniques have been applied for dental treatment with the rapid progress of comfortable medical care for clinical diagnosis and treatment. The current review will introduce the dental phobia related inducing factors,clinical manifestation and harm,the prevention and new strategies for the manifestation of dental phobia.
Dental phobia is a special social and behavioral abnormal activity of some individuals when receiving dental treatment. Although the dental phobia does not threat the safety of life,the incidence rate is as high as above 50%,which decreases the quality and efficiency of dental care and prevent the dental treatment willing of the patients,at the same time it may worsen doctor- patient relationship. Recently,the sedation and analgesia techniques have been applied for dental treatment with the rapid progress of comfortable medical care for clinical diagnosis and treatment. The current review will introduce the dental phobia related inducing factors,clinical manifestation and harm,the prevention and new strategies for the manifestation of dental phobia.
引文
[1]Morgan A.Summary of:Inter-rater agreement between children's self-reported and parents'proxy-reported dental anxiety[J].Br Dent J,2015,218(4):236-237.
[2]徐礼鲜.舒适化医疗是主导未来麻醉学科发展的方向吗?[J]医学争鸣,2012,3(2):18-20.
[3]Patel H,Reid C,Wilson K,et al.Inter-rater agreement between children's self-reported and parents'proxy-reported dental anxiety[J].Br Dent J,2015,218(4):E6.
[4]Getka EJ,Glass CR.Behavioral and cognitive-behavioral approaches to the reduction of dental anxiety[J].Behavior Therapy,1992,23(3):433-448.
[5]吴承芳,范江宏,王旭,等.牙科畏惧症患者的异常心理分析[J].中华老年口腔医学杂志,2014,12(3):172-174.
[6]谭欢艳.成人牙科畏惧症的临床分析[J].右江民族医学院学报,2013,(6):815-816.
[7]蒋银杨,胡颖,何克新.口腔门诊成人患者牙科焦虑症调查及相关因素分析[J].实用口腔医学杂志,2009,25(5):725-727.
[8]Appukuttan D,Subramanian S,Tadepalli A,et al.Dental anxiety among adults:an epidemiological study in South India[J].N Am J Med Sci,2015,7(1):13-18.
[9]Welch PS,Jacks ME,Smiley LA,et al.A study of statistics anxiety levels of graduate dental hygiene students[J].J Dent Hyg,2015,89(1):46-54.
[10]张博文,李蓝,李中杰,等.成年患者牙科焦虑临床原因分析[J].牙体牙髓牙周病学杂志,2013,23(11):724-726.
[11]Blum IR.Summary of:repair vs replacement of failed restorations in general dental practice:factors influencing treatment choices and outcomes[J].Br Dent J,2015,218(1):22-23.
[12]卢博一.美国口腔镇痛镇静与麻醉的发展史及其贡献和展望[J].实用口腔医学杂志,2005,21(6):858-861.
[13]De Jongh A,Muris P,ter Horst G,et al.One-session cognitive treatment of dental phobia:preparing dental phobics for treatment by restructuring negative cognitions[J].Behav Res Ther,1995,33(8):947-954.
[14]Armfield JM,Heaton LJ.Management of fear and anxiety in the dental clinic:a review[J].Aust Dent J,2013,58(4):390-407.
[15]Coldwell SE,Wilhelm FH,Milgrom P,et al.Combining alprazolam with systematic desensitization therapy for dental injection phobia[J].J Anxiety Disord,2007,21(7):871-887.
[16]孙玉荣,张立霞,赵锡群.心理行为诱导对牙科畏惧症患儿临床价值研究[J].中国实用口腔科杂志,2010,3(12):752-753.
[17]Lau T,Heimann F,Bartsch D,et al.Nongenomic,glucocorticoid receptor-mediated regulation of serotonin transporter cell surface expression in embryonic stem cell derived serotonergic neurons[J].Neurosci Lett,2013,554:115-120.
[18]Hamzah HS,Gao X,Yung YC,et al.Managing dental fear and anxiety in pediatric patients:A qualitative study from the public's perspective[J].Pediatr Dent,2014,36(1):29-33.
[19]Schienle A,Kchel A,Leutgeb V.Frontal late positivity in dental phobia:a study on gender differences[J].Biol Psychol,2011,88(2-3):263-269.
[20]Marsac ML,Funk JB.Relationships among psychological functioning,dental anxiety,pain perception,and coping in children and adolescents[J].J Dent Child(Chic),2008,75(3):243-251.
[21]Zhou Y,Cameron E,Forbes G,et al.Systematic review of the effect of dental staff behaviour on child dental patient anxiety and behaviour[J].Patient Educ Couns,2011,85(1):4-13.
[22]Mac Leavey C.The role of dental therapists in pharmacological and non-pharmacological treatment of anxious and phobic patients[J].SAAD Dig,2013,29:64-69.
[23]Matsumoto T.Study on factors concerning patients'anxiety in a dental clinic[J].Kokubyo Gakkai Zasshi,2009,76(2):100-108.
[24]Lieberman MI,Velez I,Mejia L,et al.Management of the anxious dental patient[J].J Mich Dent Assoc,2014,96(5):40-43.
[25]Griffiths M.pnosis for dental anxiety[J].Dent Update,2014,41(1):78-80.
[26]Nathan JE,Venham LL,West MS,et al.The effects of nitrous oxide on anxious young pediatric patients across sequential visits:a double-blind study[J].ASDC J Dent Chlld,1988,55(3):220-230.
[27]中华口腔医学会.口腔治疗中笑气-氧气吸人镇静技术应用操作指南[J].中华口腔医学杂志,2010,45(11):645-647.
[28]Noone J,Critchley E,Cullingham P,et al.The implications of substance misuse for intravenous conscious sedation practice[J].Br Dent J,2015,218(4):227-230.
[29]Robb N.The role of alternative(advanced)conscious sedation techniques in dentistry for adult patients:a series of cases[J].Br Dent J,2014,216(5):223-227.
[30]卢博一,刘冰,徐浩,等.口服镇静药在口腔疾病治疗中的临床应用[J].实用口腔医学杂志,2015,31(1):141-144.
[31]Heaton LJ,Leroux BG,Ruff PA,et al.Computerized dental injection fear treatment:a randomized clinical trial[J].J Dent Res,2013,92(7Suppl):37S-42S.
[32]王戎.牙科畏惧症的产生及预防[J].甘肃医药,2012,31`(6):422-424.
[33]American Academy of Pediatric Dentistry.Guideline on protective stabilization for pediatric dental patients[J].Pediatr Dent,2013,35(5):E169-E173.
[2]徐礼鲜.舒适化医疗是主导未来麻醉学科发展的方向吗?[J]医学争鸣,2012,3(2):18-20.
[3]Patel H,Reid C,Wilson K,et al.Inter-rater agreement between children's self-reported and parents'proxy-reported dental anxiety[J].Br Dent J,2015,218(4):E6.
[4]Getka EJ,Glass CR.Behavioral and cognitive-behavioral approaches to the reduction of dental anxiety[J].Behavior Therapy,1992,23(3):433-448.
[5]吴承芳,范江宏,王旭,等.牙科畏惧症患者的异常心理分析[J].中华老年口腔医学杂志,2014,12(3):172-174.
[6]谭欢艳.成人牙科畏惧症的临床分析[J].右江民族医学院学报,2013,(6):815-816.
[7]蒋银杨,胡颖,何克新.口腔门诊成人患者牙科焦虑症调查及相关因素分析[J].实用口腔医学杂志,2009,25(5):725-727.
[8]Appukuttan D,Subramanian S,Tadepalli A,et al.Dental anxiety among adults:an epidemiological study in South India[J].N Am J Med Sci,2015,7(1):13-18.
[9]Welch PS,Jacks ME,Smiley LA,et al.A study of statistics anxiety levels of graduate dental hygiene students[J].J Dent Hyg,2015,89(1):46-54.
[10]张博文,李蓝,李中杰,等.成年患者牙科焦虑临床原因分析[J].牙体牙髓牙周病学杂志,2013,23(11):724-726.
[11]Blum IR.Summary of:repair vs replacement of failed restorations in general dental practice:factors influencing treatment choices and outcomes[J].Br Dent J,2015,218(1):22-23.
[12]卢博一.美国口腔镇痛镇静与麻醉的发展史及其贡献和展望[J].实用口腔医学杂志,2005,21(6):858-861.
[13]De Jongh A,Muris P,ter Horst G,et al.One-session cognitive treatment of dental phobia:preparing dental phobics for treatment by restructuring negative cognitions[J].Behav Res Ther,1995,33(8):947-954.
[14]Armfield JM,Heaton LJ.Management of fear and anxiety in the dental clinic:a review[J].Aust Dent J,2013,58(4):390-407.
[15]Coldwell SE,Wilhelm FH,Milgrom P,et al.Combining alprazolam with systematic desensitization therapy for dental injection phobia[J].J Anxiety Disord,2007,21(7):871-887.
[16]孙玉荣,张立霞,赵锡群.心理行为诱导对牙科畏惧症患儿临床价值研究[J].中国实用口腔科杂志,2010,3(12):752-753.
[17]Lau T,Heimann F,Bartsch D,et al.Nongenomic,glucocorticoid receptor-mediated regulation of serotonin transporter cell surface expression in embryonic stem cell derived serotonergic neurons[J].Neurosci Lett,2013,554:115-120.
[18]Hamzah HS,Gao X,Yung YC,et al.Managing dental fear and anxiety in pediatric patients:A qualitative study from the public's perspective[J].Pediatr Dent,2014,36(1):29-33.
[19]Schienle A,Kchel A,Leutgeb V.Frontal late positivity in dental phobia:a study on gender differences[J].Biol Psychol,2011,88(2-3):263-269.
[20]Marsac ML,Funk JB.Relationships among psychological functioning,dental anxiety,pain perception,and coping in children and adolescents[J].J Dent Child(Chic),2008,75(3):243-251.
[21]Zhou Y,Cameron E,Forbes G,et al.Systematic review of the effect of dental staff behaviour on child dental patient anxiety and behaviour[J].Patient Educ Couns,2011,85(1):4-13.
[22]Mac Leavey C.The role of dental therapists in pharmacological and non-pharmacological treatment of anxious and phobic patients[J].SAAD Dig,2013,29:64-69.
[23]Matsumoto T.Study on factors concerning patients'anxiety in a dental clinic[J].Kokubyo Gakkai Zasshi,2009,76(2):100-108.
[24]Lieberman MI,Velez I,Mejia L,et al.Management of the anxious dental patient[J].J Mich Dent Assoc,2014,96(5):40-43.
[25]Griffiths M.pnosis for dental anxiety[J].Dent Update,2014,41(1):78-80.
[26]Nathan JE,Venham LL,West MS,et al.The effects of nitrous oxide on anxious young pediatric patients across sequential visits:a double-blind study[J].ASDC J Dent Chlld,1988,55(3):220-230.
[27]中华口腔医学会.口腔治疗中笑气-氧气吸人镇静技术应用操作指南[J].中华口腔医学杂志,2010,45(11):645-647.
[28]Noone J,Critchley E,Cullingham P,et al.The implications of substance misuse for intravenous conscious sedation practice[J].Br Dent J,2015,218(4):227-230.
[29]Robb N.The role of alternative(advanced)conscious sedation techniques in dentistry for adult patients:a series of cases[J].Br Dent J,2014,216(5):223-227.
[30]卢博一,刘冰,徐浩,等.口服镇静药在口腔疾病治疗中的临床应用[J].实用口腔医学杂志,2015,31(1):141-144.
[31]Heaton LJ,Leroux BG,Ruff PA,et al.Computerized dental injection fear treatment:a randomized clinical trial[J].J Dent Res,2013,92(7Suppl):37S-42S.
[32]王戎.牙科畏惧症的产生及预防[J].甘肃医药,2012,31`(6):422-424.
[33]American Academy of Pediatric Dentistry.Guideline on protective stabilization for pediatric dental patients[J].Pediatr Dent,2013,35(5):E169-E173.