The term liaison in liaison psychiatry means connection between patients and a medical treatment team and implies cooperation between psychiatrists and other specialists.
Recently, handling of patients in the borderline domain between dentistry and psychiatry has begun to be studied. It includes how best to refer patients from the Dentistry Department to the Psychiatry Department. However, many patients continue to refuse treatment even after being referred to the Psychiatry Department. Dentists sometimes find themselves in a situation where the patients is best treated by both departments together.
The case presented here is a woman with an obsessive-compulsive neurosis who primarily manifested maxillofacial and oral symptoms after dental trearment. This patient was referred back to the Dentistry Department from the Psychiartry Department, and eventually the symptoms significantly improved by long-term cooperation between the two departments
At the time of the first consultation the patient was 26 years old and suffered mandibular protrusion and odontoparallaxis. During dental therapy, which was initiated when she was 20 years old, an obsessive-compulsive neurosis developed secondary to her timidity and the authoritative approach of the dentist. The patient was referred to the Psychiatry Department but psychiatrists found it difficult to guide the patient in the treatment of her somatic problems. Therefore, the patient was referred to our department.
In our hospital, we formed a therapeutic term comprised of dentists from the Oral Surgery Department and the Prosthetic Department.
The following guidelines were developed, and the patient was treated accordingly:
The patient's assumption that all dentists are high-handed must be changed, and moreover patients must be trained to be treated by more than one therapist.
Patients should be treated without major surgery if they are unduly afraid, as was the patient in this case. Dental treatment should be coordinated with the Psychiatry Department by consultation and consensus. Brief psychotherapy cannot be ignored even in the Dentistry Department.
As a result, prosthesis treatment has gone well in this case, and mutual understanding and confidence has been achieved.
