PREVENTION AND OVERCOMING ANXIETY IN PATIENTS WITH GENERALIZED PERIODONTAL LESIONS

Abstract

The professional activity of a dentist is one of the most emotionally stressful. This is connected with a large number of unpredictable and uncontrollable professional situations, with an unregulated work regime, with a high degree of professional and personal responsibility. In modern conditions, in order to provide comprehensive dental care to patients, the doctor must take into account not only the nature of the main disease, but also the features of the patient’s anxiety state and his attitude to dental treatment. In the dental office, the patient’s reaction to previous medical manipulations is accompanied by emotional stress and varies from episodes of dental anxiety to the development of neurosis. Persistent anxiety, psycho- emotional attitude to pain, negative experience of previous treatment, forces the patient to postpone a visit to the dentist for a long time. All this negatively affects the worsening of the disease, aggravates and complicates treatment during a dental appointment. The level of patient anxiety, both personal and situational, caused by a visit to the dentist plays a significant role during the appointment, affects trust during communication and affects the quality of dental services. The purpose of the work is to study the problems of generalized periodontal lesions in patients associated with manifestations of anxiety, to study scientific developments, research results, and to determine preventive methods for overcoming dental anxiety in patients. Materials and methods. The materials were the results of a comprehensive clinical examination of the state of the periodontium and oral cavity using the Green-Vermillion hygiene index, RI and RMA. In addition to the oral hygiene examination, the groups were tested according to the Korakh DAS dental anxiety scale [14; 17], thanks to this technique, anxiety, fear and other negative emotions associated with treatment and visiting a dental clinic were investigated. Prior to the beginning of the examination and treatment of generalized periodontal lesions in patients with anxiety symptoms, according to the study protocol, voluntary informed consent was obtained from the patients to participate in it. Compliance of the research and treatment protocol with the norms of bioethics was confirmed by the Commission on Bioethical Expertise and Ethics of Scientific Research at O.O. Bogomolets. The materials for the study were the results of the examination of 285 patients, of which 157 people, 28.7% were men and 71.3% were women. aged 35–55 years, had generalized lesions of periodontal tissues, these patients were identified for further observation. Results of the study: The examination of patients with generalized periodontal lesions associated with manifestations of anxiety revealed complaints of bleeding while eating solid food (94.8% of patients), discomfort in the gums (87.3%), and complaints about the mobility of individual teeth (42.7%), bad breath from the oral cavity (58.5%) and rapid formation of dental plaque (62.4%). During the objective examination, hyperemia, cyanotic shade of the gums, change in the shape of the gingival papillae, thickening of the marginal edge, looseness and swelling of the gums were revealed. Significant deposits of supra- and sub gingival calculus were observed in 72.4% of the examined patients, periodontal pockets had a depth of 2.0 mm to 4.0 mm mainly in the area of the interdentally spaces found in 42.5% of patients. We also tested the Korach DAS dental anxiety scale. The results of the study proved that 21.5% of women and 36.7% of men do not feel any special worries while waiting for a dentist appointment, 14.6% of female patients and 26.5% of male patients experience anxiety, 37.5% expect painful sensations. women and 16.9% of men, 24.5% of women and 18.5% of men are frightened by possible actions of the doctor. According to the results of the survey, it was found that relaxation in the dentist’s chair during the preparation of the drill for work is characteristic of 3.0% of women and 10.1% of men, a state of anxiety is inherent in 17.2% of female patients and 32.6% of male patients, tension present in 28.3% of women and 23.2% of men. Anxiety and fear are experienced by 21.9% of women and 17.7% of men. Conclusion. Prevention of dental diseases and treatment of periodontal tissues include therapeutic, surgical, physiotherapeutic and other measures, which are the basis for preventing the development and progression of destructive changes in the periodontium. But no less important techniques in outpatient dental practice are: observation of the patient’s behavior, his motility, emotional and vegetative reactions; a survey that allows you to find out the specifics of subjective experiences and the patient’s attitude towards them, so the dentist needs not only to know the basics of medical psychology and psychoprophylaxis, but also to apply them in his daily practice; possession preventive techniques and exercises to overcome anxiety. These techniques can help the patient cope with some of her symptoms, such as rapid breathing, palpitations, and muscle tension.