Authors: Heidi B. Magyar.
Dental implants have changed the face of dentistry over the past 30 years. This extensive, permanent procedure is used to treat people with terminal dentition, dental aversion, and for cosmetics; it is both a functional and aesthetic procedure. Other invasive and permanent procedures such as gastric bypass and cosmetic plastic surgery rely on a psychiatric evaluation prior to surgery to either rule out inappropriate candidates or develop a plan for management. However, research suggests that this is not a common practice among oral surgeons and dentists. Failure to screen for psychiatric illnesses leaves the dentist and the patient vulnerable to a myriad of potential time consuming and costly problems. It is not always evident initially that a person may be inappropriate for implants and being able to identify warning signs early is essential because once the surgical process has started, it is a long-term commitment that is extremely difficult or impossible to reverse.
The aim of this manuscript is to increase awareness of the unique needs, not only of the patients, but also the provider. Understanding the impact that patients with mental illness have on a practice is important and care must be taken to determine if implant procedures are appropriate. This presentation will center around three psychiatric disorders particularly relevant to aesthetic dentistry. They are: 1) dental phobia, 2) obsessive-compulsive disorder, and 3) body dysmorphic disorder. Suggestions for screening prior to surgery will be also discussed. It is important to note that these illnesses are not obstacles for every patient who experiences them, but good practice warrants an understanding of these disorders for the development of a positive approach to treatment.
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