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The focus of our original article (1) was on the high rates of fear of dental treatment in patients with mental disorders. We pointed out possible options for improving the early detection of such dental anxieties. A critical evaluation of therapeutic options and indications was not the subject of our study.

Professor Beck raises an important issue when she discusses the indication for general anesthesia in patients with dental phobia, which doctors and dentists have to handle in a responsible fashion. We mostly agree with her sentiments. In view of the risks the indication should be defined critically and other therapeutic options considered.

Anesthetics cannot be used to treat the causes of any fear or anxiety, whereas psychotherapeutic interventions represent promising therapeutic options (2). If such therapeutic services are used early then highly acute, and complication-prone, dental situations can be prevented, which often make general anesthesia inevitable.

Fear of dental treatment is easily detected in routine clinical practice (1). Such fears should be considered especially in patients with posttraumatic stress disorder, anxiety disorders, or depressive disorders, as they are often associated with just such disorders (1).

Doctors from all medical specialties who are in contact with such patients can help with early detection. We were particularly pleased to receive questions from general practitioners and anesthesiologists who emphatically expressed their interest in psychotherapeutic interventions.

Identifying fear of dental treatment early is an important task, and appropriate measures should be taken, relative to the severity of the fear.

Not all fear patients require long term therapy, but less severe cases should also be taken seriously.

Everybody should benefit equally from the advances of modern dentistry. This entails enabling and supporting patients to make use of preventive measures, such as their annual checkup with their dentist, especially if they have existing fears.

DOI: 10.3238/arztebl.2013.0751b

Maria Lenk

Prof. Dr. med. Joraschky

Prof. Dr. med. Weidner

Klinik und Poliklinik für Psychotherapie und Psychosomatik

Universitätsklinikum Carl Gustav Carus Dresden

maria.lenk@mailbox.tu-dresden.de

Prof. Dr. med. dent. Hannig

Poliklinik für Zahnerhaltung

Universitätsklinikum Carl Gustav Carus Dresden

Conflict of interest statement

The authors of both contributions declare that no conflict of interest exists.

1.
Lenk M, Berth H, Joraschky P, Petrowski K, Weidner K, Hannig C: Fear of dental treatment—an underrecognized symptom in people with impaired mental health. Dtsch Arztebl Int 2013; 110(31–32): 517–22 VOLLTEXT
2.
Kvale G, Berggren U, Milgrom P: Dental fear in adults: a meta-analysis of behavioral interventions. Community Dent Oral Epidemiol 2004; 32: 250–64 CrossRef MEDLINE
1.Lenk M, Berth H, Joraschky P, Petrowski K, Weidner K, Hannig C: Fear of dental treatment—an underrecognized symptom in people with impaired mental health. Dtsch Arztebl Int 2013; 110(31–32): 517–22 VOLLTEXT
2.Kvale G, Berggren U, Milgrom P: Dental fear in adults: a meta-analysis of behavioral interventions. Community Dent Oral Epidemiol 2004; 32: 250–64 CrossRef MEDLINE

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