DeMartino B K
Dent Clin North Am. 1987 Jan;31(1):11-6.
Once the determination has been made that the patient's fears are not psychiatrically related, the dentist has the initial responsibility of evaluating the degree of anxiety present and attempting to relate this to a method of alleviating it. The most frequently used methods are behavioral and consist of talking to the patient, explaining the procedure clearly, reassuring the patient, and accurately estimating the degree of discomfort that may be associated with the treatment. Prescribing adequate pain control methods suited to the patient's needs come next. It is not appropriate to shoehorn each patient into a preset method of treatment. If one is not skilled in advance forms of anxiety and pain control, the kindest service is to refer the patient to another dentist who may be better equipped. This is a far better practice than to make extravagant claims about one's capability with conscious sedation, nitrous oxide analgesia, and so forth. Patient's confidence in your ability is constantly tested against the treatment they receive and the success of that treatment.
一旦确定患者的恐惧与精神疾病无关,牙医首先有责任评估患者当前的焦虑程度,并尝试找到缓解焦虑的方法。最常用的方法是行为疗法,包括与患者交谈、清晰地解释治疗过程、安慰患者以及准确估计治疗可能带来的不适程度。接下来是根据患者的需求开出处方,提供适当的疼痛控制方法。将每个患者强行纳入预设的治疗方法是不合适的。如果一个人不擅长预先采用的焦虑和疼痛控制形式,那么最贴心的做法是将患者转介给可能更有能力的另一位牙医。这比吹嘘自己在清醒镇静、笑气镇痛等方面的能力要好得多。患者对你能力的信心会不断根据他们接受的治疗以及治疗的成功与否受到考验。