Psychology and dentists

  • W. A. Ayer
USA: Haworth Press price $24.95, pp 148 ISBN 09780789022967 | ISBN: 978-0-7890-2296-7

This is a compact, well laid out, easily readable book aimed at dental students and practitioners. Written by an eminent American academic, the contents cover the psychological aspects of providing dental treatment. Two of the chapters, on hypnosis and interviewing, are written by specialist clinicians.

I was bitterly disappointed by this book. The text focuses largely on the historical aspects of the subjects covered. This was reflected in the references used. For example, in Chapter 4: Fear and anxiety in dentistry, the references for the prevalence of adult dental fear date from 1954 and 1958. Of the 40 references for the chapter, eight date from before 1970; 24 from the 1970s (when the author was at his most research-productive); six from the 1980s and just two from 1990 onwards. Thus there is no mention of the major steps taken in identifying the cognitive aspects of dental fear. The chapter also lacks clinical skills descriptors detailed enough to help clinicians develop their skills.

I have similar concerns about other major omissions. For example, Chapter 8, Stress in dentistry makes no reference to the phenomenon of burnout. Neither do Chapter 2, Behavioural foundations of dentistry nor Chapter 6, Compliance with health care recommendations mention Prochaska and diClemente's Stages of Change model.

The missing opportunities for clinically insightful help are illustrated by Chapter 3, Pain, which states that: 'Measures of pain are available and are adequate for scientific and clinical study', but no examples are reproduced or references given.

Chapter 10, Hypnosis in dentistry is much more useful. It contains historical and theoretical backgrounds to dental hypnosis and gives clinical examples and skills hints. This chapter leaves the reader with an understanding of the potential uses of hypnosis in dentistry.

Chapter 11, Interviewing concerns patient-clinician communication and history taking. Written by a psychologist, it draws heavily on research into the formation of good therapist-patient relationships in the field of psychotherapy and there is much of relevance to dentistry in the text.

Both Chapters 10 and 11 draw on an appropriately balanced and up-to-date set of references.

Would I buy this book? No (unless I was a dental historian). There are other textbooks written by UK clinicians/researchers which are more thorough, relate theory to clinical relevance more convincingly and are more up-to-date, despite earlier publication dates.