Psychosocial factors for failure to adapt to dental prostheses.

Currently, the best approach to the care and treatment of the patient with phantom bite lies in the dentist's familiarity with the signs and symptoms of these syndromes. This is especially important for those dentists interested in the practice of prosthetic dentistry. The patient with phantom bite presents problems for which there are no conventional solutions. This situation is not an isolated phenomenon for dentistry. Rapid and major advances in dental technology and public health programs during the last few decades have radically changed the character of the patient population. Interventions have become more effective and thus more contributive to a larger chronic dental population. Fewer persons lose their teeth. Palliation has become an alternative to the edentate state. Prolongation of the dentition has created need for the more complex treatments. These resulting interventions have also increased the number of organic, psychogenic, sociogenic, and iatrogenic complaints. Many of these complaints are not curable but nor are they terminal with regard to the dentition. For these chronic patient groups, dentistry has become an illness maintenance system. Thus, treatment intervention must begin to be viewed within the context of the ever-increasing complexity of technologic advances. In many cases, prolonged dental intervention and palliation result in the emergence of symptoms secondary to treatment. These secondary symptoms or "side effects" are sometimes more destructive than the disease the treatment was intended to palliate. Treatment, although frequently helpful, can, under certain circumstances, harm the patient. Phantom bite may be a metaphor for such a circumstance, as virtually all treatments promote the illness. Nowhere in the practice of dentistry is the advice of Szasz more relevant: "Don't just do something, stand there!"