Abstract
ObjectivesThe aim was to study self-image and the level of psychological symptoms in patients with symptoms attributed to their dental restorative materials.Materials and methodsA questionnaire containing questions regarding dental and medical history was answered by 257 participants, one group with local oral symptoms only (LSO), and one group with multi-symptoms (M-S). A reference group was randomly selected from a research database at the Department of Psychology, Umeå University, Sweden. The self-image was assessed using the Structural Analysis of Social Behavior (SASB). Psychological symptoms such as somatization, depression, and anxiety were assessed using the Symptom Check List 90 (SCL-90) and the Global Severity Index (GSI) was used to determine the level of psychological symptoms.ResultsSASB showed that the M-S group and the LSO-group scored significantly higher on the “spontaneous” and “positive self-image” than the reference group. In the SCL-90, the M-S group scored significantly higher than the LSO-group and the references on the somatization subscales. On depression, anxiety, and the GSI scale, the M-S group scored significantly higher than the reference group.ConclusionsThe two subgroups scored significantly higher on the SASB Spontaneous and Positive clusters which indicates that these patients have an excessively positive self-image, are very spontaneous and have an overconfidence in themselves compared to the reference group. In the M-S group there was a clear tendency to somatization, depression, and anxiety and they were more psychologically stressed than the reference group.Clinical relevanceAmong the patients with illness attributed to their dental materials, the M-S-patients had a significantly higher level of general psychological distress and somatization than the control group which may lead to mental stress.
Highlights
Health problems associated with dental restorative materials, especially dental amalgam, have in Sweden been discussed extensively on and off during the last 30 years [1,2,3]
The Symptom Check List 90 (SCL-90) showed that the M-S group scored significantly higher than the reference group on the somatization subscales and significantly higher on depression, anxiety, and on the Global Severity Index (GSI) scale compared to the reference group (Table 2)
This study showed a clear difference in self-image in Structural Analysis of Social Behavior (SASB) between the two groups of patients with symptoms attributed to dental materials and the reference group
Summary
Health problems associated with dental restorative materials, especially dental amalgam, have in Sweden been discussed extensively on and off during the last 30 years [1,2,3]. These health complaints resemble the symptoms reported by patients with other environmental intolerances, for example multiple chemical sensitivity which is characterized by somatic distress upon exposure to odors [4]. When there are somatic symptoms without an organic disease and a lack of demonstrable structural lesions or established biochemical changes, patients often get the diagnosis Bmedically unexplained physical disorder^ [8, 9].
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