ABSTRACT
An 18-year old woman was referred to the department of oral and maxillofacial surgery with 1 to 2 week episodes of tongue ulcerations that had lasted for a year. Food intake was limited due to pain, resulting in a loss of 10 kg during the previous year. Following a clinical diagnosis of 'aphthous ulcers', she was treated with tetracycline and clobetasol mouthwash, which had little effect. An injection with triamcinolone acetonide did not prove effective either. Some time later, the patient reported at the emergency department with a deep, ulcerative wound to the tongue with characteristic features of bite trauma. She said she had consistently worn her protective mouthguard. The symptoms suggested self-mutilation. The patient was admitted to a psychiatric department, where a diagnosis of anxiety disorder and self-mutilation was reached.
Subject(s)
Oral Ulcer , Self Mutilation , Tongue Diseases , Adolescent , Female , Humans , Mouthwashes , TongueABSTRACT
Fear of dental treatment sometimes already begins during childhood. Different kinds of diagnostic instruments can measure children's dental anxiety. In this study the reliability and convergent validity of 7 instruments are compared. Results show that there is no 'gold standard' with which convergent validity can be established unambiguously. Furthermore, self report measures are investigated more often than observational measures even though the latter are more commonly used. Generally, the compared measures are satisfactory in respect to their reliability. Nevertheless, sufficient interest coherence is sometimes lacking. This could be explained by the multidimensional character of the construct 'fear' and, in some cases, the type of measuring-method. In almost none of the compared studies were norms defined prior to the study by means of which statistical indicators could be unambiguously interpreted. In the present study, such norms were established.
