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05 orofacial pain considerations in geriatrics

Terms in this set (23)

SOMATIC SYMPTOM AND RELATED DISORDERS

previously called "somatoform disorders or somatization"

psychological factors that influence and produce the physical pain experience in patients (including OFP):
-axis 2 pain classification = mood, anxiety, somatoform disorders, and additional psychological aspects that may impact orofacial pain conditions

excessive and disproportionate thoughts, feelings, and behaviors regarding physical symptoms

could cause further permanent damage to the body and/or interfere with daily function

comorbidity: anxiety, depression, fibromyalgia, cardiac disease, irritable bowel syndrome, epilepsy

99% with depression have mod-severe somatization

elderly vs. adults = depression with higher prevalence of anxiety. if assessed properly, 1/3 of cases with anxiety

PSYCHOMETRIC TESTS:
-minnesota multiple personality inventory
-beck depression inventory
-beck anxiety inventory
-4 dimensional symptom questionaire
-symptom check list
-patient health questionaire

TREATMENT:
-multiple therapeutic modalities (individualized psychotherapy, medications like TCA/SSRI/SNRI and group therapy)
-other factors include patient's readiness, importance of changing patients belief or ability to change
-avoid unnecessary dental/medical/surgical treatments
-well balanced diet, biofeedback training, cognitive behavioral therapy, relaxation training, self-care
-ask open ended questions to strengthen doctor-patient communication
-thorough intake of medical, dental, social history along with physical examination
-multidisciplinary approach
-prefer to treat when patient is under reasonable control
-avoid irreversible treatments
-reassure patient
-refer to dental and/or medical specialists