Coolidge Trilby, Irwin Scott P, Leyster Kimberly A, Milgrom Peter
Division of Dental Public Health Sciences, Oral Health Sciences, University of Washington, Seattle, WA USA.
SAAD Dig. 2012 Jan;28:52-60.
Dental fear may be the most common reason for referral for intravenous sedation. Intravenous sedation offers many patients an opportunity to obtain needed dental care. However, intravenous sedation also has costs and may not help patients overcome their fear. Given a sample of 518 dentally-fearful patients in the USA presenting for dental care, this study examined the variables which predicted receiving intravenous sedation or not. About one-fifth of the patients received intravenous sedation, while the others received only cognitive behavioural therapy. Having more carious teeth, higher dental fear, more negative beliefs about dentists, lifetime diagnoses of panic disorder and/or generalized anxiety disorder, fewer existing coping skills, and a lower desire to cope with the dental situation were each predictive of having intravenous sedation. When the variables were considered simultaneously, only lower desire to cope contributed uniquely to the prediction. In a setting where psychological treatment for dental fear is available, patients' desire to cope with their fear was the most important factor in determining whether they received intravenous sedation or not.
牙科恐惧可能是转诊接受静脉镇静的最常见原因。静脉镇静为许多患者提供了获得所需牙科护理的机会。然而，静脉镇静也有成本，并且可能无法帮助患者克服恐惧。在美国，以518名因牙科护理前来就诊的牙科恐惧症患者为样本，本研究考察了预测是否接受静脉镇静的变量。约五分之一的患者接受了静脉镇静，而其他患者仅接受了认知行为疗法。龋齿较多、牙科恐惧程度较高、对牙医的负面信念较多、有惊恐障碍和/或广泛性焦虑症的终生诊断、现有的应对技巧较少以及应对牙科状况的意愿较低，这些因素都预示着会接受静脉镇静。当同时考虑这些变量时，只有较低的应对意愿对预测有独特贡献。在有针对牙科恐惧的心理治疗的情况下，患者应对恐惧的意愿是决定他们是否接受静脉镇静的最重要因素。
