Cases in Psychosomatically Induced Dental Pain

Four cases are presented: a 39 year old male and three women aged 37, 46 and 39 years. The male patient had an initial chief complaint of enormous pain with treatment, but later in interviews discovered that it was more an extreme distrust of dentists. The women patients each had their own emotionally significant reasons for extreme pain reactions to dental drilling and unsuccessful attempts at local anesthetic. In the safety of therapy and away from the dental chair, they learned that they could visualize dental drilling and could actually “feel” the pain in their teeth. They also learned that they could stop the pain or control it through relaxation exercises and positive thinking. This illustrates the subjectivity of pain perceptions and subsequent pain reactions. It also shows how important it is that dental practitioners understand that providing effective dental anesthesia is more than just making sure that anesthetics in adequate doses reach nerves and dental pulp. Patient and dentist beliefs and expectations affect emotional meanings of dental pain in a mutually reinforcing manner. Dentists should explore patients’ pain-related expectations and beliefs in order to achieve optimal analgesic outcomes.

Keywords: dental pain, suffering, dental anxiety, social context of pain, psychosomatic pain, local anesthesia, analgesia, emotional significance.