Leeners Brigitte, Stiller Ruth, Block Emina, Görres Gisela, Imthurn Bruno, Rath Werner
Department of Gynecology and Obstetrics, University Hospital Zurich, Zurich, Switzerland.
J Psychosom Res. 2007 May;62(5):581-8. doi: 10.1016/j.jpsychores.2006.11.009.
Around 20% of female patients seeking dental care may have experienced childhood sexual abuse (CSA). Several similarities between abuse situations and dental treatment lead to dental fear. Since dental fear hampers oral health, the long-term effects of CSA on dental care and the specific factors that lead to increased stress during dental treatment have been investigated in women exposed to CSA.
A self-administered questionnaire, which was developed to investigate the objectives of the study, was distributed to 111 women recruited from support centers for women with CSA experiences. CSA was explored with a modified version of the questionnaire developed by Wyatt. Data from 85 women with CSA experiences were used for comparison to the data of 170 matching control women recruited, who were mothers of children attending kindergarten.
Compared to controls, women exposed to CSA exhibited several long-term effects on dental care in terms of major psychological strain during dental treatment (36.5%/18.8%; P<.005), a lower number of prophylactic controls (72.9%/89.4%; P<.005), and preference for a female dentist to a male dentist (29.4%/8.2%; P<.0001). Women with CSA experiences considered four of five defined stressors associated with dental treatment as more intense. Of these women, 28% suffered from memories of their original abuse situations during dental treatment, and 29.4% believed that the dentist should have known about their history of abuse.
CSA experiences may increase psychological strain during dental treatment. To improve dental care for women exposed to CSA, dentists should adjust their treatment plans to the specific needs of these patients.
在寻求牙科护理的女性患者中，约20%可能曾遭受童年性虐待（CSA）。虐待情况与牙科治疗之间的一些相似之处导致了牙科恐惧。由于牙科恐惧会妨碍口腔健康，因此对遭受CSA的女性进行了研究，以探讨CSA对牙科护理的长期影响以及导致牙科治疗期间压力增加的具体因素。
为调查该研究的目标而编制的一份自填式问卷，被分发给从CSA经历女性支持中心招募的111名女性。使用Wyatt编制的问卷的修改版来探究CSA情况。将85名有CSA经历的女性的数据与170名匹配的对照女性的数据进行比较，对照女性是幼儿园儿童的母亲。
与对照组相比，遭受CSA的女性在牙科治疗期间的主要心理压力方面（36.5%/18.8%；P<0.005）、预防性检查次数较少（72.9%/89.4%；P<0.005）以及更倾向于选择女牙医而非男牙医（29.4%/8.2%；P<0.0001）等方面，对牙科护理表现出若干长期影响。有CSA经历的女性认为与牙科治疗相关的五个既定压力源中有四个更为强烈。在这些女性中，28%在牙科治疗期间会回忆起最初的虐待情况，29.4%认为牙医应该知晓她们的虐待史。
CSA经历可能会增加牙科治疗期间的心理压力。为改善对遭受CSA的女性的牙科护理，牙医应根据这些患者的特殊需求调整治疗方案。
