Abstract
A 26-year-old female patient with schizophrenia was referred to us by her psychiatrist, complaining of the breakage of half of her bridge in the 5+5 region. Denture treatment was suitable for this case, in view of the long span of missing tooth in the 3+3 region, the condition of the abutment tooth, her mental problem and financial standing. She persisted, however, in demanding the bridge and never accepted denture treatment. All efforts to make her understand the suitability of the treatment proved useless due to the failure of mutual understanding. Her demands for the prosthesis were often unreasonable and bizarre.
The author gave her time to change her mind while performing other tooth treatment. Three years and 7 months after her first visit, her partial denture was completed. At first, she was not able to accept it because of her youth and for aesthetic reasons. Often, she revealed unreasonable and delusional reactions to her denture. However, she came to accept it a little more day by day and now wears it normally, although it remains unclear whether she is fully reconciled to its use in her heart.
The greater part of the difficulty in managing this patient was due to the lack of mutual undertanding and her bizarre thoughts and behavior caused by her schizophrenia. On the basis of this case, it is suggested that dentists treating such schizophrenic patients should try to 1) recognize the patients' mental pathology but not become involved in that, 2) understand the patient's desire for a certain treatment but reject it firmly if it is unreasonable, 3) sustain the dentist-patient relationship with patience, 4) wait for improvement in the patient's delusions and behavior regarding dental treatment, and 5) bring the treatment to the appropriate goal by these means.
