RESUMO
A 36-year old man is referred to a centre for special dental care due to problems with treatability in the general dental practice and a deteriorated oral state. His behaviour is unpredictable due to the possible development of sudden changes in the patient's consciousness which are accompanied by severe aggression. The patient suffers from a conversion disorder, a serious mental disorder which expresses itself in his case with the occurrence of psychogenic non-epileptic seizures. The patient fears that dental treatment will provoke a seizure and that he will react aggressively to his surroundings. He therefore requests that he undergoes dental treatment using general anaesthesia and patient fixation measures. This case study provides an example for the discussion of the problems and the rights of patients with severe mental disorders and the use of measures of physical restraint in dentistry.
Assuntos
Anestesia Geral , Transtorno Conversivo/complicações , Assistência Odontológica para a Pessoa com Deficiência/métodos , Transtornos Psicofisiológicos/complicações , Convulsões/prevenção & controle , Adulto , Ansiedade ao Tratamento Odontológico/complicações , Ansiedade ao Tratamento Odontológico/psicologia , Humanos , Masculino , Convulsões/etiologiaRESUMO
BACKGROUND: This study aimed to adapt a measure of trust in physicians to trust in dentists and to assess the reliability and validity of the measure. METHODS: Questionnaire data were collected from a simple random sample of 596 Australian adults. The 11-item General Trust in Physicians Scale was modified to apply to dentists. RESULTS: The Dentist Trust Scale (DTS) had good internal consistency (α = 0.92) and exploratory factor analysis revealed a single-factor solution. Lower DTS scores were associated with less trust in the dentist last visited, having previously changed dentists due to unhappiness with the care received, currently having dental pain, usual visiting frequency, dental avoidance, and with past experiences of discomfort, gagging, fainting, embarrassment and personal problems with the dentist. CONCLUSIONS: The majority of people appear to exhibit trust in dentists. The DTS shows promising reliability and validity evidence.