Waldman H B
Department of General Dentistry, State University of New York at Stony Brook 11794-8706, USA.
ASDC J Dent Child. 1996 Nov-Dec;63(6):434-7.
Psychiatrists now recognize that the disorders of children are serious, treatable conditions and as precursors of adult psychopathology. These conditions can seriously influence the patient's behavior when undergoing dental treatment. The dentist will probably assume that the behavior problems are directly related to the nature of the dental service, rather than particular underlying personality characteristics of preschool and school-age children. It is important that practitioners recognize and understand these conditions as they attempt to provide adequate treatment. No national epidemiological studies have been conducted in this country that would provide valid indicators of either the prevalence or incidence of mental disorders among children. Local studies, however, have been done that diagnosable disorders in children range from 17.6 percent to 22 percent, including 3 percent to 5 percent who have severe emotional or behavioral problems. The prevalence of many mental disorders is greater in males than in females, ranging from a ratio of 2:1 to 9:1. Lifetime prevalence of mental disorders, first diagnosed in infancy, childhood, and adolescence range as high as 15,000 cases per 100,000 persons. It is important for the dentist to recognize that (1) even the youngest of children seen in a dental practice may be in need of mental health services, (2) management problems may stem from mental health problems, and (3) families are unaware or unwilling to admit that a child may need help.
精神科医生现在认识到，儿童的精神障碍是严重的、可治疗的疾病，并且是成人精神病理学的先兆。这些情况在儿童接受牙科治疗时会严重影响其行为。牙医可能会认为行为问题与牙科服务的性质直接相关，而不是与学龄前和学龄儿童特定的潜在人格特征有关。从业者在试图提供充分治疗时认识并理解这些情况很重要。该国尚未进行全国性的流行病学研究来提供儿童精神障碍患病率或发病率的有效指标。然而，已经开展了一些本地研究，结果显示儿童中可诊断的精神障碍发生率在17.6%至22%之间，其中3%至5%的儿童存在严重的情绪或行为问题。许多精神障碍的患病率男性高于女性，比例从2:1到9:1不等。首次在婴儿期、儿童期和青少年期被诊断出的精神障碍终生患病率高达每10万人15000例。对牙医来说，认识到以下几点很重要：（1）即使是牙科诊所中最年幼的儿童也可能需要心理健康服务；（2）管理问题可能源于心理健康问题；（3）家庭没有意识到或不愿意承认孩子可能需要帮助。
