Abstract
In 1989, a 23-year-old man was referred to the author by his psychiatrist, complaining of severe nausea and fear of dental treatment. He was diagnosed as a case of dental phobia and treated with a combination of desensitization technique and autogenic training. Six months later, he underwent extraction of his upper molar teeth without gagging. But 5 months later, he had a relapse of dental phobia and could not accept any dental treatment at all. He could not clarify the object of his fear during dental treatment.
Because behavioral therapy only had limitations, an interview was held in a supportive atmosphere. This revealed that he had escaped from situations of his conflict by complaining of nausea. He could not reject verbally what he would not like to accept in his word, but expressed it by complaining of nausea. After this insight, he became able to accept various dental treatments without nausea, including full mouth impression, preparation and extraction of teeth. Almost four years after his first visit, his dental treatment finally ended successfully.
This case might be diagnosed as panic disorder, taking account of his symptoms which were considered to be a panic attack. This case suggests necessity of further evaluation of the concepts and criteria of dental phobia.
