Fear, Dental Clinical Trial
Official title:
Validation of Universal Scale in Oral Surgery (USOS) for Patient's Psycho-emotional Status Rating
Patient's psycho-emotional status is being affected during various dental procedures causing patient's and doctor's discomfort. There are three basic factors, composing psycho-emotional status: fear, stress and pain sensitivity. There aren't any objective method that may help in standard evaluation of oral surgery patient's psycho-emotional status. In the present non-standardized evaluation, there is a problem of heterogeneity between studies, and also ineffective patient's evaluation. Therefore, Universal Scale in oral surgery for patient's psycho-emotional status rating (USOS) was designed. Clinical trial to validate the USOS was constructed.
Patient's discomfort ant doctor's negative emotional feelings in various dental procedures
are related to patient's psycho-emotional status during the procedure. Three main factors,
determining patient's psycho-emotional status, were determined in earlier studies: fear,
stress and pain sensitivity.
Different elements cause patient's fear, stress and pain sensitivity, therefore in order to
improve patient's psycho-emotional status, the causative element should be known.
Multifactority o human's psycho-emotional status is described by anatomy - emotional state
depends on amygdala (lat. corpus amygdaloideum) and cerebellum (lat. cerebellum), which
interaction is related to development of fear to negative irritants. This process arise from
two steps learning system - negative experience may cause fear and corresponding reactions.
Dejean et al stated, that the main locations, in which memories causing fear are kept, are
in dorsomedial prefrontal cortex. In this area 4Hz frequency vibrations are found during the
fearful reactions. Neurologic examinations prove that emotional-physical relationships are
firm and negative emotions may cause various reactions in organism. However, changes caused
by fear, that are found in brain, are not specific. Various emotions may cause different
vibrations in specific recurrent cortex locations, therefore it is important to rate full
psycho-emotional status complex.
When the present of fears and phobias were examined, fear to dental treatment is in top-5 of
all fears and in phobias - it is number one. The strength of dental fear may vary according
to the upcoming procedure. Oosterink et al found that out of 67 dental procedures, oral
surgery is the most terrifying for patients. When only oral surgery procedures were
examined, third molar extraction was found as most fear producing.
Pain sensitivity - the other important part of patient's psycho-emotional status, which is
described as patient's painful reaction to minimal stimulus and opportunity to maintain the
maximum pain. Even though the pain is usually described as reaction to physical stimulus, it
is closely related to patient's psychology. Previous pain experience may generate negative
memories, which cause more sensitivity in repeated procedure. Also, it is known that
stronger pain may be felt if it was expected before. Only physical methods to control the
pain are not always effective - patient's psycho-emotional status correction is needed in
better control of pain, which can be achieved with non-interventional methods.
Stress is usually described as physical reactions provoked by negative stimulus, which arise
with active sympathetic nervous system and behavioral changes. It should be noted, that fear
and felt pain may cause stress. Also, it was found that long term felt stress may cause
chronic pains evaluations and vice versa - any pain felt provokes stressful reactions in
human's body. Therefore, stress as physiological reactions arise because of painful
interventions, same as for physiological fear - stimuli, that are constantly present during
oral surgery procedures.
Nowadays there are various medication and non-medication methods to control patient's fear,
stress and pain sensitivity in dental procedures. However, in order to examine effectivity
of these methods and overall the problem of patient's psycho-emotional status, measures are
needed. In earlier studies it was found that various general instruments are used to rate
patient's fear and anxiety before teeth extraction procedures. Because of non-standardized
rating, studies because such heterogeneous, that the results are incomparable between each
other. The use of different questionnaires often showed different results even in the same
situations. Because of their properties and actuality of the problem, there is a need to
standardize patient's psycho-emotional status evaluation methods, with a use of practically
adaptable measures.
Universal Scale in Oral Surgery (USOS) for patient's psycho-emotional status evaluation,
composed from patient's reported part and doctor's reported part, was designed in earlier
study by authors. The aim of present study is to assess the clinical effectivity and
validate the USOS in case of outpatient tooth extraction for adult healthy patients.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Not yet recruiting |
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