In everyday practice, the dentist treat a variety of patients who need medical and dental care which constitute a special group of patients with a variety of concomitant somatic diseases, mental disorders, neuro-endocrine disorders. The textbooks for students of the Faculty of Dentistry and medical interns highlight particular certain aspects of dental treatment in patients with concomitant diseases of the cardiovascular system, circulatory disorders, diabetes, certain blood diseases, allergic states. But it is not covered aspects of dental care to patients with neuro-endocrine disorders, in particular with the hypothalamic syndrome, which prompted us to describe the dental treatment of the patient with such a disorder. Describes a clinical case of a patient with multiple complicated by dental caries and associated diseases - hypothalamic syndrome, vascular dystonia on the mixed type applied for dental care. Explaining dental history discovered that the patient is suffering from a panic attack with a drop in blood pressure, loss of consciousness, seizures that are caused, in particular, the need to consult a dentist, experienced in childhood pain during dental treatment (removal of Milk teeth), painful dental treatment in adolescence age, and the refusal of several dentists from dental care in a planned manner, as "complex comorbidities" and the threat of loss of consciousness during treatment. During sympathoadrenal and vagoinsular crisis in our patient noted rapid heartbeat, general weakness, anxiety, that the complaints expressed feeling short of breath, fear of suffocation and death, headache, rush of heat to the face. Objectively marked numbness and coldness of the hands, pale skin, dry mouth, vomiting, general tremors, blood pressure 150/100 mmHg, body temperature 37,8OC. The patient was given emergency care, scheduled sedative drug preparation on the eve of the subsequent dental treatment. With the help of psychotherapy, adequate sedation and anesthetic management carried out surgical and therapeutic rehabilitation of the oral cavity of the patient, prepare the patient for prosthetic dentition defects.
Full text: PDF (Rus) 305K