Journal of Clinical Preventive Dentistry
John H. Manhold, D.M.D., Editor-in-Chief
352 Shunpike road, Chatham Township
New Jersey 07928


October 8, 1980


Dr. Mary F. Robertson
Department of Psychiatry
Box J-234
J. Hillis Miller Health Center
University of Florida
Gainesville, Florida 32610


Dear Dr. Robertson,


Your paper entitled "Psychosomatic Implications of Environmental Alternatives in the Dental Office" has presented a challenge to some of my reviewers because of the psychoanalytical concept orientation. However, they, as well as I find the material to be quite interesting and, form my own background acceptable and something which I feel would be of interest to my readers, both from this standpoint and from the approach, which is a little different from that which they usually encounter. Under the circumstances I would liek to accept the paper from you and Dr. Chang, but will require your signature (because of new copyright laws) on the enclosed form, and I shall need original illustrations for publication purposes. If you could send these to me as soon as possible I can process your manuscrip[t much more expeditiously.



Very Truly Yours,


John H. Manhold






Discussion section of paper:


Environmental alternatives are not usually considered when focusing on patients with psychosomatic diseases. However, it is recognized that environmentally alien structures produce uneasiness and at times hostility to the structures that cause alienation. Children have little opportunity to express or to formulate ways in which environments would be more compatible to them. Hospitals for children are increasingly designing environments for the psychological well-being of the patients. At Children's Hospital in Washington, viewing areas have been inserted so that children can see down into lower areas of the building. Playrooms are arranged so that children go directly from them into surfery areas) in personal observation).

Dentists are increasingly aware of the need to develop alternative parallel environmental experiences for their patients. Pain is no longer considered something to be stocially endured. It is recognized as alterable both psychologically as well as environmentally. Dr. Chang's Disco/Dental Complex is an environmental approach to depressing the pain/fear factors in dental treatment. Longitudinal studies are needed to determine in what ways children cope differently with dental treatment when there are environmental alternatives.

It is also important in all health care delivery to recognize that painful procedures are not confined to the time in which they occur. Freud ( 1886-1899) has pointed out the long-term significance in the life cycle of psychological trauma. Little has been reported on the long-term effects of physical trauma. The use of alternate environments in Dental Complexes addresses the concern of individuals who are involved in the psychological factors in health care.


childpsy.jpg (114001 bytes)


childpsy2.jpg (93643 bytes)