Color Atlas of Dental Medicine Periodontology by Klaus H. Rateitschak, Edith M. Rateitschak, Herbert F. Wolf,

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By Klaus H. Rateitschak, Edith M. Rateitschak, Herbert F. Wolf, Hassell

Booklet via Rateitschak, Klaus H., Rateitschak, Edith M., Wolf, Herbert F., Hassell

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In a review of the placebo literature as it relates to dentistry, Beck (1977) summarized the main factors that enhance the placebo influence. Placebos are most effective when the level of patient stress is high, when patients expect or anticipate relief, when the patient has had a previous history of successful medical or dental treatment, if there is a good relationship between the patient and the practitioner, and if the practitioner and/or the institutional context of the practitioner enjoy fame or high status.

Lower SES groups experience more dental disease and receive less dental care than upper SES persons, are apt to receive remedial rather than preventive treatment, are less inclined to adopt preventive habits, usually do not have a continuing personal relationship with a dentist, and may not get the best care from the dentist they visit. Attitudes toward the dentist also affect attendance rates. Patients who admire, trust, and like their dentists, and are satisfied with the service they receive, are more likely to be regular in their attendance than patients with a negative attitude toward their dentists.

For practical purposes, however, tissue damage is a major determinant of pain reaction. But, the degree of the pain response is not necessarily a direct function of the magnitude of the tissue damage occurring. A classic study by Beecher (1956) illustrates this point. Of 150 seriously wounded soldiers, only 32% wanted a narcotic for pain relief, compared to 83% of the 150 civilians suffering a similar surgical injury. Beecher attributed the difference in pain response to the meaning of the wound rather than the extent of tissue damage.

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