Stress-induced psychoemotional strain reactions among patients while visiting a dentist

Psychoemotional strain (PsES) - dentophobia, which manifests itself as fear and scare of the forthcoming stomatological interventions, is a weighty factor that may be a background for developing and aggravating cardiovascular reactions and diseases. The scare and the fear are multilevel manifestations of dentophobia; they cause typical body reactions: changes of the heart rate (HR), arterial pressure (AP), blood sugar level, etc., and cannot be differentiated by the existing methods. The scare -psychoemotional overstrain (PsEOs) - arises independently of the thinking and its medicamental correction is supposed; the fear - a moderate psychoemotional strain - develops at the level of thinking and can be treated by persuading. This study was aimed at analyzing the obtained hemodynamic, hematologic and biochemical data which characterize the PsES development stage during the stomatological interventions. 194 patients (62 men and 132 women) agedfrom 17 to 60 were examined. In order to assess the state of the cardiovascular system during the stomatological intervention, the hemodynamics (using "Cardiotechnika-4000-AD ” monitor), biochemical and hematologic data were examined. Short-term Holter monitoring revealed hemodynamic data (systolic and diastolic AP, HR, myocardium hypoxia, arrhythmia), system toxicity of the anesthesia, the patient’s body psychoemotional strain level. The "emotional” type arrhythmias became the "key” to differentiate the fear and the scare according to the cardiac monitoring data. The aggregated functional, biochemical (blood plasma glucose, medium molecule oligopeptides), and hematologic data (leucocyte indexes) indicate that 61.9 per cent of the patients who addressed with a moderate PsES experienced the rise of their AP, HR, and blood plasma glucose; 28.6 per cent of the patients experienced no change of these values, and 9.5 per cent showed the reduction of these values. The psychoemotional overstrain state characterized with emotional arrhythmias; both rise and reduction of the AP; rise of the leucocyte indexes, medium molecule oligopeptides in the saliva. Detecting system toxicity of the anesthesia when the recommended doses of the anesthetic were injected mainly among the patients with the psychoemotional overstrain means that the patients of this group may develop paradoxical reactions. Based on the results of the conducted study, it has been concluded that the data obtained due to the short-term Holter cardiac monitoring were informative enough to determine the intensity degree of the patients’ psychoemotional strain while being at the dentist. The patients with the psychoemotional overstrain were subject to the greatest risks, the patients with physiologically normal reactions to the psychoemotional load were the least prone to suffer from the risks. The hemodynamic data aggregated with the data about the glucose changes at the initial stage and while conducting the anesthesia are the basis for devising medicamental correction and preventing complications among patients with psychoemotional strain.

psychoemotional stress, visiting a dentist, hematologic data, cardiac monitoring, hemodynamic