Bouma J, Uitenbroek D, Westert G, Schaub R M, van de Poel F
Department of Social Sciences in Dentistry, University of Groningen, The Netherlands.
Community Dent Oral Epidemiol. 1987 Dec;15(6):301-5. doi: 10.1111/j.1600-0528.1987.tb01739.x.
The process of not attending the dentist is a vicious cycle in which anxiety plays a crucial role. A research project concerning the disease and non-disease reasons for full mouth extraction provided an opportunity to describe the dental histories in terms of dental attendance pattern and related factors which resulted in full dentures. Three profiles of dental histories could be outlined: 1) The regular attenders (19%). Because of their age (means = 47 yr), their positive attitude towards dentistry together with their positive attitude towards full dentures, it is suggested that the possibilities of keeping the natural dentition were exhausted so that full mouth extraction was an acceptable solution. 2) The symptomatic attenders (38%). Because anxiety, which was widespread in this group, was not based on negative experiences, it is suggested that anxiety is caused by social learning. Together with their positive attitude towards full dentures, the high prevalence of full dentures in their social environment and their low socioeconomic status, the conclusion is drawn that these patients lived in a culture which supports behavior that leads to total tooth loss. 3) Once regular attenders (43%). In this group anxiety leads to a negative perception of dental visits and to a negative attitude towards dentists. As a consequence dental visits are deferred, which results in deterioration of the dentition. Experiences with dentists are distorted in a negative way, which increases dental anxiety. Facilitated by a positive attitude towards full dentures, their bad dental condition finally urges them to take full dentures at early age.
不看牙医的过程是一个恶性循环，焦虑在其中起着关键作用。一项关于全口拔牙的疾病和非疾病原因的研究项目提供了一个机会，可根据看牙模式和导致佩戴全口假牙的相关因素来描述看牙史。可以勾勒出三种看牙史类型：1）定期看牙者（19%）。由于他们的年龄（平均47岁）、对牙科的积极态度以及对全口假牙的积极态度，表明保留天然牙列的可能性已用尽，因此全口拔牙是一个可接受的解决方案。2）有症状看牙者（38%）。由于该组中普遍存在的焦虑并非基于负面经历，表明焦虑是由社会学习引起的。再加上他们对全口假牙的积极态度、社会环境中全口假牙的高普及率以及低社会经济地位，得出的结论是这些患者生活在一种支持导致全口牙齿脱落行为的文化中。3）曾经的定期看牙者（43%）。在这组中，焦虑导致对看牙的负面认知和对牙医的负面态度。结果，看牙被推迟，导致牙列恶化。对牙医的体验被负面扭曲，这增加了牙科焦虑。在对全口假牙的积极态度的推动下，他们糟糕的牙齿状况最终促使他们在早年就佩戴全口假牙。
