Refu'at ha-peh veha-shinayim (Tel Aviv, Israel : 1969)最新文献

Responsibilities of the dental practitioner impose stress situations similar to those of any manager. These deal with elements of interpersonal behavior and skills not customarily taught to the dental practitioner. In an effort to train dentists so that they may better cope with these managerial situations a method was devised using as the primary instrument the Dental Managerial Situation Study (DMSS). The DMSS employs a variety of problem situations that the dentist is likely to encounter as a means of eliciting his or her managerial tendency (Managerial Profile). A managerial profile is then applied for diagnostic and training purposes. In group discussions, most appropriate behavior (i.e. normative responses) is determined and new ways to behave are learned as each student witnesses advantages and disadvantages of certain responses. The method described in this paper imparts a lexicon (knowledge) of alternative coping or non-coping behaviors to managerial situations. The dental practitioner is able to apply this knowledge in future situations in a way that is more coping and thus he or she may alleviate some managerial stress.

A close doctor-patient relationship should be considered a prerequisite for successful treatment. Better communication will help the dentist to preceive a patient's fears and expectations and will provide the information that must precede diagnosis. A student should not devote his time solely to acquiring mechanical skills but should learn something of the behavioral sciences and understand emotional states. He should be able to assess a patient's ability to cooperate, adjust or reject, as well as the effect of the surgery environment on him. The patient as an individual should not be ignored. A dentist who recognizes his role in society and sees his profession as a vocation will anticipate patients' responses and deal with them more effectively and atraumatically.

The important role of orthodontics and its contribution to the success of prosthetic dentistry in the adult patient is discussed. Cases undergoing restorative dental procedures, where preliminary minor tooth movement was necessary, are presented. Orthodontic treatment was limited in these cases to local malpositions and to the movement of individual teeth with simple appliances.

In the formulation of a treatment plan for patients with advanced periodontal disease, the benefits that orhtodontics can supply must be considered. By improving the position of malposed teeth, a better environment is created for the health of the gingivae and attachment apparatus, as well as the possibility to improve osseous defects as the result of orthodontically stimulated osteogenic activity. The ultimate goal of treatment must be, in addition to control of inflammation, plaque and trauma, the creation of optimal morphologic and functional conditions which will allow these objectives to be attained. This will provide the prosthodontist and periodontist with a better chance to prolong the life of the dention.

Dental disease is frequently accompanied by anxiety and fear of the treatment and of dentists. The etiology of any anxiety is sought in early conditioning life experiences; here it may be related to infants' responses to first teething. The universality of dental anxiety makes it a paradigm of psychosomatic disorders. These are conceptualized as pathologic exaggerated reactions to early traumatizing events, a causality not unlike that of conversive-hysteric symptoms or "normal" bodily characteristics. Psychiatric-etiologic considerations of dental anxiety are not to be found in the literature. Recalling the cheerful manner in which children's loss of their first tooth is greeted, one gathers that repressed ambivalence is involved. A clarification of the etiology is here attempted and the dynamics compared with those of other psychosomatic diseases.

Talon cusp is a rare dental anomaly hitherto considered to affect permanent dentition only. A case of talon cusp in a deciduous maxillary incisor is described, suggesting that both dentitions may be affected by this anomaly.