The psychodynamic approach to immediate denture prosthesis

Abstract

The psychodynamic approach to immediate denture prosthesis is predicated on the need to treat the dental patient as a total personality with an understanding of his emotional requirements and with respect for his uniqueness. The dental situation produces apprehension and dread in all persons, normal as well as neurotic. The kind of fear experienced by the neurotic patient can be understood only in the light of the psychogenicity of anxiety. Neurotic anxiety is not directly related to the real threat in the environment (that is, the pain of the operation and the loss of teeth), but originates in unconscious ideation in which extraction of teeth takes on symbolic meaning. Such anxiety also may be the product of traumatic experiences of the patient or of parents or siblings which are related to dental situations. It is recommended that the dentist obtain a full anamnesis covering medical, psychological, and dental background of his patient. Basic to psychological understanding and good management is the establishment of a doctor-patient relationship built on an empathic, permissive, and accepting attitude of the dentist toward his patient. The alert practitioner, in recognizing certain symptoms, can obtain an over-all picture of the personality structure of his patient with a view to helping him handle his anxiety and adjnst to the traumatizing situation. The use of the hospital for surgical prosthesis is a most important aid in allaying anxiety in the patient, reducing both his physical and psychological trauma, and hastening the recuperative process. In addition, the hospital lends status to a surgical procedure which too often is regarded as routine office practice, and gives professional dignity to the dentist by removing him from the “everyday concept” of the title, dentist.