Hypnosis in dentistry

Question 1

What is hypnosis? (2)

Answer 1

Like an intense daydream, may be directed by therapist and pt collaboratively for therapeutic benefit
Within this ‘daydreamy’ state critical appraisal is reduced –> beneficial suggestions are much more readily accepted and acted upon

Question 2

What happens in hypnosis? (5)

Answer 2

Role of clinician is essentially as teacher and guide
By the use of rapid rapport building and active listening skills, will establish needs of pt and remove any doubts, fears and misconceptions they may have about hypnosis
Close empathic rapport is the first stage of the hypnotic process, generally followed by induction, following which the patient is guided into a state of deep relaxation (deepening). Within this state communication is retained, and specific suggestions geared to that person’s presenting concerns are made. The benefits, and growth of the patient’s autonomy are reinforced by self hypnosis techniques, and by post hypnotic suggestions.

Question 3

What is hypnosis used for? (7)

Answer 3

As many physical and psychological problems – within dentistry as much as any other medical condition – are ameliorated by relaxation alone, hypnosis can be seen as an adjunct to virtually all interventions.
These may include:-
relaxation I stress management
pain management
adjunct to R.A. and G A
surgical procedures
impression taking
children… fissure sealing etc
phobia and habit management

Question 4

Safety/ risks (3)

Answer 4

There is no risk provided the clinician is working within his/her areas of competence, but patients with psychiatric illness and depressive illness are contraindicated unless the practitioner has specialised training. Alerting, and removal of suggestions of altered perception given in hypnosis must be very carefully handled.
The very young and very old are less likely to benefit, as to enter hypnosis requires a degree of understanding which they may not be capable of.
Above all, the patient must be MOTIVATED, and your own communication skills come into play to enhance this.

Question 5

Stages (6)

Answer 5

preparation……..rapport, empathy, mutual respect, motivation
induction………..a starting point…..sets a framework
deepening………increased level of dissociation
specific suggestions……eg in pain or gagging management
post hypnotic suggestions..eg .to improve future behaviour
alerting……critical to manage this sympathetically

Question 6

Is hypnosis dangerous? (5)

Answer 6

it isn't as dangerous as dentistry...!	
a chaperone is essential
watch yourself as well as the patient
abreaction
why are you using it ?