Psychology and Dentistry

Mental Health Aspects of Patient Care

William Ayer, Jr.

• Publisher: Routledge
• Year: 2012
• ISBN:
  9781135794835
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Learn to build successful working relationships with your patients Psychology and Dentistry: Mental Health Aspects of Patient Care is a practical guide to an often-neglected aspect of dentistry-the contributions of the behavioral sciences to dental research and practice. Dr. William A. Ayer, Professor of Behavioral Sciences at Nova Southeastern University College of Dental Medicine in Fort Lauderdale, Florida, presents a comprehensive textbook that's an essential study aid for students preparing for their National Dental Board Examinations and a valuable classroom resource for dental school faculty. This unique book identifies the everyday concerns of dentists, dental students, and dental hygienists, offering proven strategies for patient management and for building—and maintaining—a successful dentist-patient relationship. Psychology and Dentistry examines the contributions of the behavioral sciences to the practice of dentistry, drawing subject matter from a wide range of disciplines that include psychology, sociology, education, anthropology, economics, epidemiology, health services, and public health. The book is a practical guide to developing the necessary skills to conduct effective patient interviews, for teaching patients to manage their dental fears and anxieties, and for dealing with patients who need counseling from mental health professionals. It also addresses special issues that have become relevant to dentists and their staffs in recent years, including child abuse and neglect, spousal violence, elder abuse, aging and changes associated with age, death and dying, and bereavement. Psychology and Dentistry examines:

• behavior therapies
  
• behavioral interventions
  
• management techniques for patients with acute and/or chronic pain
  
• how to train patients to manage their oral habits
  
• how to get patients to comply with health care recommendations
  
• pain perception and pain expression
  
• the therapeutic use of hypnosis
  
• how to make psychological referrals for patients
  
• the effect of stress on dentists and dental students
  
• and much more!

Psychology and Dentistry: Mental Health Aspects of Patient Care is an essential resource for anyone working in the dental field. The book's practical approach and unique insights are invaluable for helping you develop healthy relationships with your patients.

Chapter 1

The Development of the Behavioral Sciences in Dentistry

Cohen (1985) has provided an overview of the development of the behavioral sciences in dentistry by identifying the major research focuses as they have occurred over time (Table 1.1). During and after World War II research began to address human behavior in relation to disease, stress, medical conditions, and treatment (Cohen, 1985). During the 1940s and 1950s, several authors attempted to relate psychological concepts to dentistry (Ryan, 1946; Stolzenberg, 1950; Manhold, 1956). These efforts relied upon psychodynamic psychology, anecdotal accounts, and recipes for influencing patients’ behaviors (Borland et al., 1962). These applications were unsuccessful for the most part because the writers were inadequately prepared in the behavioral and social sciences and used inadequate conceptual or theoretical frameworks for studying these problems (Cohen, 1985).

TABLE 1.1. Phases of development of the behavioral sciences in dentistry.

Time Period	Areas
1940s to early 1950s	Behavior and Disease/Injury/Psychosomatics
Mid-1950s to early 1960s	Fluoridation, Psychology, Sociology, Political
Science
1960s	Dental Education and Manpower Studies
1970s	Health Services Research
1980s to 1990s	Prevention and Health Promotion
2000s	Public Policy

Source: After Cohen, 1985.

During the mid-1950s to early 1960s, the controversy surrounding the attempts to promote fluoridation probably influenced the Public Health Service to actively support research to determine the reasons for these conflicts (Cohen, 1985). Such studies provided useful data about the variables influencing implementation of fluoridation programs (Mausner and Mausner, 1955; Kegeles, 1962; Gamson and Irons, 1961). Unfortunately, because few intervention studies employed these variables in some overall theoretical model, the importance of these variables remains unclear (Cohen, 1985; Frazier, 1984). During this period, researchers from various disciplines had used these arenas to investigate issues of interest to them in their original fields. Following these investigations, they returned to their original disciplines and a cadre of dental, social, and behavioral scientists failed to develop.

Prior to the mid-1960s, most behavioral scientists interested in dentistry were employed in academic departments outside of dental schools. In 1964 (Cohen, 1981) the U.S. Public Health Service established the Social Studies Branch within its Division of Dental Health and can be viewed as the first organized group devoted to sociobehavioral research. Around this time, dental schools began recruiting behavioral scientists to their faculties, usually in community, social, or preventive dentistry and occasionally in behavioral sciences.

During this period, research was focused on studies of the dental student, dental education, curriculum design, the sociology of dentistry, and manpower studies (see Richards and Cohen, 1971). Again, the U.S. Public Health Service contributed with significant studies of dental school facilities, costs of education, manpower productivity, and forecasting (Cohen, 1985).

By 1968 researchers established a formal organization known as Behavioral Scientists in Dental Research (BSDR), which became a part of the American Association of Dental Research and the International Association of Dental Research. A similar group formed in the American Association of Dental Educators. In 1972, BSDR became affiliated with the Federation Dentaire Internationale. Members represented the fields of sociology, psychology, educational psychology, anthropology, economics, epidemiology, and health services research. These groups have expanded to include members from around the world with the opportunities to engage in cross-national research.

Another significant trend involved federal initiatives to foster dual training in the behavioral and social sciences with the belief that this would help to ensure quality research and establish a stable mass of researchers. These programs took a variety of forms and contributed significantly to the production of outstanding researchers and good science.

The 1970s focus on health services research resulted in an international collaborative study that examined dental care delivery systems and their impacts on oral health in ten countries (Barnes et al., 1985). In addition, a shift from psychodynamic approaches to cognitive-behavioral applications occurred, resulting in the development of effective methods for treating phobic or extremely fearful dental patients, managing oral habits, and treating myofascial pain syndrome.

Health promotion and disease prevention received emphasis in the 1980s and interventions were investigated to promote and improve healthy lifestyle behaviors. Research was conducted to determine what aspects of the social environment could be manipulated to facilitate the dispensing and receiving of dental services in optimal ways.

During the 1990s, goals were developed to reduce dental disease by specific amounts by the year 2000. These efforts and strategies will continue well into the twenty-first century.

Table 1.2 lists most of the books and monographs that were published from the 1940s to the present day. Prior to the 1970s, most of the attempts to apply psychology to dentistry utilized Freudian concepts.

Much of the subsequent work has emphasized the dentist-patient relationship and interviewing techniques. The subject matter has expanded considerably.

Behavioral and social scientists have contributed enormously to identifying and solving problems of concern to dentistry. During the coming years, it is realistic to expect they will make even more contributions as old challenges remain and new ones present themselves.

TABLE 1.2. Books and monographs on the behavioral sciences in dentistry.

Time Period	Authors and Titles
1940s	Ryan, Edward J. (1946). Psychobiologic Foundations in Dentistry. Charles C Thomas, Springfield, IL.
1950s	Manhold, J. (1956). Introductory Psychosomatic Dentistry. Appleton-Century-Crofts, New York. Stolzenberg, Jacob (1950). Psychosomatics and Suggestion Therapy. Philosophical Library, New York.
1960s	Cinotti, William R., Grieder, Arthur, and Heckel, Robert V. (1964). Applied Psychology in Dentistry. C.V. Mosby Company, St. Louis.
	Erickson, M.H., Hershman, S., and Secter, I.I. (1961). The Practical Application of Medical and Dental Hypnosis. Julian Press, NY.
	Moore, Douglas M. (1961). The Dental Student. Reprinted from the March 1961 issue of the Journal of the American College of Dentists, St. Louis.
1970s	Ayer, William A. and Hirschman, Richard D. (1972). Psychology and Dentistry: Selected Readings. Charles C Thomas, Publisher, Springfield, IL.
	Cinotti, William R., Grieder, Arthur, and Springbob, H. Karl (1972). Applied Psychology in Dentistry, Second Edition. The C.V. Mosby Co., St. Louis.
	Dworkin, Samuel F., Ference, Thomas P., and Giddon, Donald (1978). Behavioral Science and Dental Practice. The C.V. Mosby Co., St. Louis.
	O’Shea, R.M. and Cohen, L.K. (eds.) (1971). Towards a Sociology of Dentistry. The Milbank Memorial Fund Quarterly 49 (Pt. 2).
	Richards, N.D. and Cohen, L.K. (eds.) (1971). Social Sciences and Dentistry:A Critical Bibliography, Volume I. Federation Dentaire Internationale, Quintessence Publishing Group, Chicago.
	Sherlock, Basil J. and Morris, Richard T. (1972). Becoming a Dentist. Charles C Thomas, Publisher, Springfield, IL.
	Weinstein, Phillip and Getz, Tracy (1978). Changing Human Behavior: Strategies for Preventive Dentistry. Science Research Associates, Chicago.
1980s	Cohen, L.K. and Bryant, P.S. (eds.) (1984). Social Sciences and Dentistry: A Critical Bibliography, Volume II. Federation Dentaire Internationale, Quintessence Publishing Company, Ltd., London.
	Ingersol, Barbara (1981). Behavioral Aspects in Dentistry. McGraw-Hill/Appleton and Lange, New York.
	Kroeger, R. (1988). How to Overcome Fear of Dentistry. Heritage Publications, Cincinnati.
	Davis, Peter (1980). The Social Context of Dentistry. Croom Helm, London.
1990s	Cohen, L.K. and Gift, H.C. (1995). Disease Prevention and Oral Health Promotion: Socio-Dental Sciences in Action. Munksgaard, Copenhagen.
	Kent, G. and Croucher, R. (1998). AchievingOral Health: The Social ContextofDental Care, Third Edition. Wright, Oxford.
	Murphy, Denise C. (1998). Ergonomics and the Dental Care Worker. American Public Health Association, Washington, DC.
2000s	Humphris, Gerry and Ling, Margaret S. (2000). Behavioral Sciences for Dentistry. Churchill Livingston, Edinburgh.

REFERENCES

Ayer, W.A. and Hirschman, R. (1972). Psychology and Dentistry: Selected Readings. Springfield, IL: Charles C Thomas, Publishers.

Barnes, D.E., Cohen, L.K., et al. (1985). Oral Health Care Systems. London: Quintessence Publishing Co.

Borland, L.R., Sosnow, I., Kegeles, S.S., and Mims, M.E. (1962). Psychology in Dentistry: Selected References and Abstracts. Department of Health, Education, and Welfare, Publ. No. (PHS) 919. Washington, DC: U.S. Government Printing Office.

Cinotti, W.R., Grieder, A., and Heckel, R.V. (1964). Applied Psychology in Dentistry, Second Edition. St. Louis, MO: The C.V. Mosby Company.

Cohen, L.K. (1981). Dentistry and the behavioral/social sciences: A historical overview. Journal of Behavioral Medicine, 4:247-256.

Cohen, L.K. (1985). History and Outlook of Social Science Research in Dentistry. Paper presented at meeting, Dentistry and Social Change, sponsored by the German Dental Association and Volkswagen Foundation, Munich, FRG, July 4-6.

Cohen, L.K. and Gift, H.C. (eds.) (1995). Disease Prevention and Oral Health Promotion: Socio-Dental Sciences in Action. Copenhagen: Federation Dentaire Internationale, Munksgaa...