Hägglin Catharina, Boman Ulla Wide
Department of Behavioral and Community Dentistry, Institute of Odontology, the Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Swed Dent J. 2012;36(2):71-8.
Severe dental fear/phobia (DF) is a problem for both dental care providers and for patients who often suffer from impaired oral health and from social and emotional distress.The aim of this paper was to present the Swedish model for DF treatment within the National Health Insurance System, and to describe the dental phobia treatment and its outcome at The Dental Fear Research and Treatment Clinic (DFRTC) in Gothenburg. A literature review was made of relevant policy documents on dental phobia treatment from the National Health Insurance System and for Västra Götaland region on published outcome studies from DFRTC. The treatment manual of DFRTC was also used. In Sweden, adult patients with severe DF are able to undergo behavioral treatment within the National Health Insurance System if the patient and caregivers fulfil defined criteria that must be approved for each individual case. At DFRTC dental phobia behavioral treatment is given by psychologists and dentists in an integrated model. The goal is to refer patients for general dental care outside the DFRTC after completing treatment. The DF treatment at DFRTC has shown positive effects on dental fear, attendance and acceptance of dental treatment for 80% of patients. Follow-up after 2 and 10 years confirmed these results and showed improved oral health. In addition, positive psychosomatic and psychosocial side-effects were reported, and benefits also for society were evident in terms of reduced sick-leave. In conlusion, in Sweden a model has been developed within the National Health Insurance System helping individuals with DF. Behavioral treatment conducted at DFRTC has proven successful in helping patients cope with dental care, leading to regular attendance and better oral health.
严重的牙科恐惧/恐惧症（DF）对于牙科护理提供者和患者来说都是一个问题，患者常常口腔健康受损，并遭受社会和情感困扰。本文旨在介绍瑞典国家医疗保险体系内的DF治疗模式，并描述哥德堡牙科恐惧研究与治疗诊所（DFRTC）的牙科恐惧症治疗及其效果。我们对国家医疗保险体系以及韦斯特罗斯-哥特兰地区有关牙科恐惧症治疗的相关政策文件，以及DFRTC已发表的疗效研究进行了文献综述。同时也参考了DFRTC的治疗手册。在瑞典，如果患者及其护理人员符合为每个病例设定并必须获批的特定标准，患有严重DF的成年患者能够在国家医疗保险体系内接受行为治疗。在DFRTC，牙科恐惧症行为治疗由心理学家和牙医以综合模式进行。目标是在患者完成治疗后将其转至DFRTC以外的机构接受常规牙科护理。DFRTC的DF治疗已显示对80%的患者的牙科恐惧、就诊率和对牙科治疗的接受度产生了积极影响。2年和10年后的随访证实了这些结果，并显示口腔健康有所改善。此外，还报告了积极的身心和心理社会副作用，而且从减少病假来看，对社会也有明显益处。总之，在瑞典，国家医疗保险体系内已形成一种模式来帮助患有DF的个人。在DFRTC进行的行为治疗已证明成功地帮助患者应对牙科护理，使他们能够定期就诊并改善口腔健康。
