A patient with post-traumatic stress disorder presents for dental treatment. What is the MOST appropriate approach before beginning care?

Correct answer: B. Identify the patient's specific triggers and agree on a stop signal and treatment plan in advance

• A. General anesthesia is a legitimate option for some patients but is not the routine approach and carries its own risks. It also removes control entirely, which for some patients is itself distressing.
• B. CORRECT. The foundation of trauma-informed care is RESTORING THE PATIENT'S SENSE OF CONTROL. Dental treatment recreates several conditions common to traumatic experience — reclined and physically restricted posture, a person leaning over you, inability to speak, loud sounds, bright lights, latex and gauze in the mouth. Identifying which of these are triggers, agreeing on a STOP SIGNAL the patient can use at any moment, and explaining each step before performing it converts an experience of helplessness into a collaborative one.
• C. PTSD is not a contraindication. Refusing care on this basis is discriminatory and abandons a patient who often has substantial unmet dental need.
• D. Ignoring the diagnosis risks precipitating a flashback or panic response mid-procedure, at which point the patient may be unable to communicate.

Note: Practical trauma-informed measures: seat the patient more upright, explain before touching, use a raised-hand stop signal and honor it immediately, allow a support person, offer headphones or sunglasses, and avoid approaching from behind.