University of Zagreb. School of Dental Medicine. Chair of Pharmacology.
Abstract
U današnje se vrijeme od doktora dentalne medicine očekuje da omoguće pacijentima bezbolan i što manje stresan boravak u ordinaciji, što i jest u skladu s etičkim načelima. Budući da oko jedna petina pacijenata pati od nekog oblika dentalnog straha, to za doktore predstavlja popriličan izazov. Da bi se uopće moglo pristupiti terapiji takvih pacijenata, treba znati prepoznati anksiozne pacijente, u čemu pomažu brojni upitnici. Uz farmakološke metode sedacije postoje i nefarmakološke, poput kontrole ponašanja i komunikacijskih vještina, koje se upotrebljavaju u svakodnevnom radu sa svim pacijentima.
Za smanjenje napetosti pacijenata u ordinaciji dentalne medicine koriste se hipnotici i anksiolitici (psihosedativi) koji spadaju u depresore središnjeg živčanog sustava. Hipnoticima se postiže jača, tj. dublja sedacija nego anksioliticima, tako da je u kliničkoj praksi češća primjena anksiolitika, iako postoji vrlo malo razlika između te dvije skupine lijekova. Benzodiazepini, odnosno diazepam jest lijek koji se danas najviše propisuje, no njegova uporaba u dentalnoj medicini nije još zaživjela u punom opsegu. Provođenjem farmakološke sedacije u praksi olakšali bi se dentalni zahvati, kako pacijentima tako i doktorima, te bi se postotak anksioznih i fobičnih pacijenata s vremenom smanjio.Nowadays doctors of dental medicine are expected to make the patient’s time in the clinic as painless and as stress-free as possible, which is in accordance with the ethical principles. Since around one fifth of the population suffers from some form of dental fear and anxiety, this presents quite a challenge for the doctors. In order to start treating patients with dental fear and anxiety, they should be recognized as such and there is a variety of surveys which can help. Alongside pharmacological methods of sedation there are also non-pharmacological, such as behavior management and communication skills which are used daily while working with patients.
In order to reduce tension and anxiety among patients, hypnotics and anxiolytics are used, which belong to central nervous system depressants. Hypnotics cause deeper sedation than anxiolytics, so the latter are more commonly used in dental practice even though there is very little difference between the two groups of drugs. Benzodiazepines, specifically diazepam is the most commonly prescribed drug today, but its use in dental medicine has not yet been fully established. Implementing pharmacological sedation in everyday practice would make dental procedures easier, both for the patients and for the doctors, and it would reduce the percentage of anxious and phobic patients over time
