[Some background data about the high dental anxiety of the Hungarian population]

100 dental patients waiting for hypnotic dental treatment (n = 100, 58 female, 42 male, mean age: 36.4 +/- 10.6 yr.) was investigated about their perceived origins of dental anxiety. Dental anxiety levels (DAS, DFS) and general anxiety were measured as well. Mean dental anxiety scores were high (DAS: 12.5 +/- 3.3; DFS: 47.9 +/- 17.3). The most frequent reason of high dental anxiety was previous painful dental treatment (20.0%), dislike of dentist's behaviour (15.0%), treatment error (5.0%), and "other reasons" (4.0%). A large amount of the patients (48.0%) did not know what to expect, and 8.0% indicate no fear related to dentistry. Previous painful dental treatment induced the highest dental anxiety (DAS: 15.1 +/- 3.1; DFS: 58.1 +/- 20.3), followed by the "other reasons" (DAS: 14.0 +/- 0.8; DFS: 50.5 +/- 13.5), treatment error (DAS: 13.0 +/- 3.7; DFS: 49.0 +/- 16.1), and dislike of dentist's behaviour (DAS: 11.4 +/- 2.8; DFS: 45.0 +/- 12.5). Increased general anxiety was found in the groups indicated previous painful dental treatment, "other reasons", and no expectation.

Factors influencing the use of behavioral management techniques during child management by dentists

Dental anxiety develops from a vicious cycle of bodily arousal from dental stimuli, cognitive interpretation and ineffective coping all working in a runaway feedback loop. Behavioral management strategies (BMT) aim at cognitive reorientation, which results in better compliance with instruction. This paper therefore tried to find out possible factors that influence the effective use of BMT during child dental management during treatment by dental operators in Nigeria. The levels of anxiety pre and post treatment were assessed using the short form of the dental version of the Child Fear Survey Schedule. Also, the type of treatment given to the child, the types and number of behavioral strategies employed during dental management as well as the gender and age of the child were noted. The professional status of the attending dental operator was also noted. Prior to the commencement of the study, the five students in the final year, who were to attend to the children in this study received one week training on the psychological management of dental anxiety in children. Results obtained from the dental operators were compared. The type of treatment received by the child did not significantly affect the dental anxiety score. The number of techniques combined by house officers and senior registrars were significantly higher than would be expected by chance (chi2=16.030, P=0.0001 and chi2=9.000, P=0.0001 respectively). Combination of techniques was also more frequent during invasive procedures and when dental anxiety levels were high. Combining techniques also tended to decrease dental anxiety more significantly than otherwise. Training has a role to play in the basic and efficient use in the management of the child dental patient. The training of dentists should thus entail the full spectrum (content and instructional effectiveness) of all psychological techniques.

The association between dental anxiety and oral health-related quality of life in Britain

OBJECTIVE

The aim of this study was to identify associations between level of dental anxiety and the impact of oral health on quality of life (OHQOL) in Britain, controlling for sociodemographic and oral health status (self-reported) factors.

METHODS

The basic research design included a cross-sectional study involving a random probability sample of 3000 UK residents. The outcome measures were: levels of dental anxiety, which were measured on the Corah Dental Anxiety Scale (DAS), and the impact of OHQOL, which was assessed using UK oral health-related quality of life instrument (OHQoL-UK (W)).

RESULTS

DAS was correlated with OHQoL-UK (W) scores (P < 0.01). Having controlled for sociodemographic factors (age, gender and social class) and oral health status factors (self-reported number of teeth possessed and denture status), known confounding factors associated with OHQOL, those with high levels of dental anxiety (DAS > or = 15) were approximately two times as likely to be among those experiencing the poorest OHQOL (below the population median OHQoL-UK (W) score) in Britain (P < 0.001; OR = 1.93; 95% CI 1.41, 2.65).

CONCLUSION

Dental anxiety is associated with the impact oral health has on life quality. Those experiencing high levels of dental anxiety are among those with the poorest oral health-related quality of life in Britain.

Dental anxiety and behavioural problems: what is their influence on the treatment plan?

AIM

This was to investigate the influence of emotional and behavioural problems on the choice of treatment type. In addition, the actual contents of the treatment of dentally fearful children was studied in an attempt to develop dental treatment protocols for children with such problems.

METHODS

The parents of 265 children (144 girls, mean age 88.4 months, SD+/-34.2 months), referred to a centre for special dental care, were asked to complete the Child Behaviour Check List (CBCL) before their first appointment. The CBCL was used to assess behavioural problems. All selected children were dentally anxious (score >or=35 on the Children's Fear Survey Schedule Dental Subscale, CFSS-DS). After treatment, the children's records were analysed on treatment type and contents.

RESULTS

The CBCL score was related to the type of treatment. Children treated with the aid of nitrous oxide sedation scored significantly higher on the CBCL than children treated with behavioural management or under intravenous anaesthesia (IVA). In the IVA group more surfaces were treated than in the other groups. The CBCL score was not related to the treatment contents (number of surfaces filled, amount of radiographs, sealants, stainless steel crowns or pulpotomies), the time spent on the child's treatment or the number of sessions.

CONCLUSION

Dentally anxious children with behavioural problems as assessed by the CBCL have dental treatment (contents and length) comparable with that of dentally anxious children without those problems. However, anxious children with behavioural problems are more often treated with nitrous oxide sedation. Therefore, there seems to be an urgent need for access to nitrous oxide sedation for dentists working in special dentistry.

Dental anxiety in a subpopulation of African children: parents ability to predict and its relation to general anxiety and behaviour in the dental chair

AIM

This was to investigate the ability of Nigerian parents to predict their child's dental anxiety level and the relationship between the child's dental anxiety, general anxiety and behaviour in the dental chair.

METHODS

A group of 53 mothers and 35 fathers and their respective children completed schedules that measured general and dental anxiety. The child's behaviour on the dental chair was also assessed. The child's self report of dental anxiety and general anxiety was compared with that of the parents. Dental anxiety ratings by the children and parents were correlated with the behaviour assessment of the dentist. Statistical significance was determined at <0.05.

RESULTS

There was no statistically significant difference between the parent's assessment of their child's dental anxiety level and the child's self report (t=0.389; p=0.689). However, the mothers were able to rate their child's dental anxiety level better than the fathers (r=0.497 and p<0.001 for mothers, r=-0.049 and p=0.789 for fathers). Also there was a moderate correlation between the child's self reported dental anxiety and general anxiety levels (r=0.58, p<0.05) and a low correlation between the clinical behaviour ratings and the child's self reported dental anxiety level (r=0.10, p>0.05).

CONCLUSION

The Nigerian mothers could be relied upon to make objective assessment of their child's dental anxiety. General anxiety appears to play a significant role in dental anxiety development in Nigerian children who appear to behave well in the dental chair despite their reported dental anxiety levels.

Anxiety related to dental general anaesthesia: changes in anxiety in children and their parents

AIM

To examine the anxiety levels of children referred for dental general anaesthesia and their parents at various key points of the referral and anaesthetic procedure.

METHODS

Structured interviews and anxiety measures were conducted with 50 children attending the Department of Paediatric Dentistry, Leeds Dental Institute, and progressing to general anaesthetic (GA) and their parents. Interviews were conducted with parents and children prior to initial assessment, following assessment and prior to a GA. Anxiety was measured at each interview, using the Visual Analogue Scale for parents and the Venham's Picture test for children. A fourth telephone interview was conducted with parents one week after the GA when the degree of upset caused to parents and children by the procedure was evaluated.

RESULTS

Anxiety of children remained constant at each interview. Parent and child anxiety were not related. There was a rise in parent anxiety following initial assessment in those families attending in response to a routine referral and progressing to GA (p<0.05). There was a further rise in parent anxiety in these families immediately prior to the GA itself (p<0.001). Parent upset was strongly related to their anxiety at each of the three interviews prior to the GA (p<0.01, 0.05 and 0.001 respectively) and to the distress of their child (p<0.02). Child distress was strongly related to anxiety at each of the three interviews prior to the GA.

CONCLUSION

The anxiety levels of children did not appear to change throughout the whole GA assessment and treatment process. Parent anxiety rose significantly following assessment and again just prior to the GA. Factors contributing to parent upset post treatment were child upset and pre treatment parent anxiety levels. Children who were most anxious prior to GA found the procedure most distressing.

Dental anxiety in Fiji

Despite the technological advances in dentistry, anxiety about dental treatment and the fear of pain associated with dentistry remains globally widespread and is considered a major barrier to dental treatment. This can have detrimental consequences to people's oral health and pose a serious epidemiological challenge to oral health care professionals. Dental anxiety is well described in the Western world however there is little literature on the situation in the developing world. The purpose of the study was to evaluate the levels of dental anxiety in Fijians using Corah's DentalAnxiety Scale (DAS). 120 adults, aged 18-45 years were randomly selected from the capital city of Suva until there were 60 Indigenous and 60 IndoFijians, with 30 males and 30 females from each group responding to questions from Corah's Dental Anxiety Scale. The average DAS for all the participants was 8.8. The average DAS for IndoFijians was 9.8 and was significantly higher than for Indigenous Fijians ie 78. IndoFijians only reported less anxiety with increasing age as the Indigenous Fijians generally displayed low levels of anxiety. There was no significant difference in DAS between the genders. A considerable proportion of IndoFijians (28%) were anxious with 13% being highly anxious. Young IndoFijian adults are more likely to possess dental anxiety and should be managed appropriately which may include behavioural and/or pharmacological therapy. This may require referral to dental specialists or involve a multidisciplinary approach to the management of these people.

[Psychological characteristics and quality of life of patients with chronic kidney diseases]

AIM

To study quality of life of patients with progressive renal pathology at the stage of conservative treatment.

MATERIAL AND METHODS

Quality of life and psychological features were examined in 40 patients with renal diseases (40% males, mean age 48.6 +/- 1.3 years). 77.5% examinees suffered from glomerulonephritis, the rest had diabetic nephropathy.

RESULTS

Personality, behavioral features of the patients were characterized as well as relationships between psychological and somatic factors in development of the disease. Factors influencing quality of life of the above patients are described.

CONCLUSION

Correction of the variables influencing, primarily, the psychological component of the quality of life and, by this component, satisfaction of the patients with their state as a whole may have a good effect on their rehabilitation.

The impact of childhood sexual abuse on dental fear

OBJECTIVE

Dental fear is a risk factor for poor oral health. Thus, treatment of dental fear is a challenge to dentists. The consequences of childhood sexual abuse (CSA) may include dental fear. A history of CSA complicates dental fear treatment, and it is often a secret. The aim of this study was to explore differences in subjective evaluations of use of dental services, experiences of dental treatment situations, dental appearance and dental problems in women who report both CSA and dental fear, and women who report dental fear only.

METHODS

In an anonymous survey, 58 women with dental fear and a history of CSA were compared with 25 women with dental fear without CSA. Twenty-five women without dental fear acted as a control group.

RESULTS

No differences between dental fear patients with and without a history of CSA were found in subjective evaluations of use of dental services, dental appearance and dental problems, or in the scores on the Dental Fear Scale (DFS). Women who reported a history of CSA and dental fear had statistically significant higher scores on the Dental Belief Scale (DBS).

CONCLUSION

The results suggest that women who report dental fear and a history of CSA assess interpersonal factors concerning communication, trust, fear of negative information and lack of control as more fear evoking than women who report dental fear without a history of CSA.

[Personality and characteristics of couples in infertile marriage]

OBJECTIVE

To estimate the basic personality and couple characteristics of men and women from infertile marriages.

DESIGN

Research psychodiagnostical study.

SETTING

Institute of Sexology, 1st Medical Faculty, Charles University, Prague, Iscare IVF, Prague.

METHODS

38 couples applying for assisted fertilization were psychologically examined by standard psychodiagnostical methods.

RESULTS

Men and women from infertile couples displayed moderate anomal behavioral characteristics, men from these couples are more neurotic than general population, women display more anxiety and social desirability. The relations in these marriages are not substantially disturbed and are even less conflictuous and the consistency of the male and female roles is even better than in general population. Men from infertile couples are perceived by themselves as well as by their wives as less masculine.

CONCLUSION

In men and women from examined couples there were no serious personality anomalies and the relations in these marriages were not substantially disturbed by infertility.

Surgery information reduces anxiety in the pre-operative period

PURPOSE: Patients preparing to undergo surgery should not suffer needless anxiety. This study aimed to evaluate anxiety levels on the day before surgery as related to the information known by the patient regarding the diagnosis, surgical procedure, or anesthesia. METHOD: Patients reported their knowledge of diagnosis, surgery, and anesthesia. The Spielberger State-Trait Anxiety Inventory (STAI) was used to measure patient anxiety levels. RESULTS: One hundred and forty-nine patients were selected, and 82 females and 38 males were interviewed. Twenty-nine patients were excluded due to illiteracy. The state-anxiety levels were alike for males and females (36.10 ± 11.94 vs. 37.61 ± 8.76) (mean ± SD). Trait-anxiety levels were higher for women (42.55 ± 10.39 vs. 38.08 ± 12.25, P = 0.041). Patient education level did not influence the state-anxiety level but was inversely related to the trait-anxiety level. Knowledge of the diagnosis was clear for 91.7% of patients, of the surgery for 75.0%, and of anesthesia for 37.5%. Unfamiliarity with the surgical procedure raised state-anxiety levels (P = 0.021). A lower state-anxiety level was found among patients who did not know the diagnosis but knew about the surgery (P = 0.038). CONCLUSIONS: Increased knowledge of patients regarding the surgery they are about to undergo may reduce their state-anxiety levels.

Influence of diazepam on blood glucose levels in nondiabetic and non-insulin-dependent diabetic subjects under dental treatment with local anesthesia

The effect of diazepam on blood glucose concentration (BGC) was investigated in a double-blind cross-over study in 10 healthy and 10 non-insulin-dependent diabetic subjects taking oral hypoglycemic drugs. In the first session, fasting blood samples were taken for blood glucose and glycosylated hemoglobin estimation and at 60, 80, 95, 125, and 155 minutes thereafter for glucose estimation. In another 2 sessions, a venous sample was taken immediately before premedication (5 mg diazepam or placebo randomly given during breakfast). One hour later a blood sample was taken, and the volunteers were submitted to periodontal treatment after injection of 1.8 mL of 2% mepivacaine with 1:100,000 adrenaline. Venous blood samples were taken at 15, 30, 60, and 90 minutes after injection. The changes in BGC were analyzed using analysis of variance (ANOVA) for repeated measures; the means were compared using Tukey test (P = .05). Statistically significant differences in the BGC were observed between diabetic and nondiabetic groups (P = .00003). However, there were no significant differences among the sessions of the same group (P = .29). The results of this study show that a single dose of 5 mg diazepam before dental treatment does not influence BGC in nondiabetic and non-insulin-dependent diabetic subjects.

Parental anxiety levels during pediatric induction with and without administration of premedication for general anesthesia

This study measured parental anxiety before, during, and after elective dental procedures under general anesthesia using the Spielberger State-Trait Anxiety questionnaire. State anxiety started relatively high before the procedures, peaked immediately after induction using general anesthesia, and dropped during recovery to below the initial score. Parents, whose children were premedicated and fathers in general, had significantly higher anxiety immediately after induction. This study supports interventions to lower anxiety of the parents as well as that of children.

[The Hungarian version of the "Dental Beliefs Survey (DBS)--preliminary data in the Hungarian population]

The Hungarian version of DBS was analysed on 100 participants (64 females, 36 males, mean age: 36.4 +/- 14.3) from 5 subgroups: dental students (n = 20), other intellectuals (n = 20), dental nurses (n = 19), dental patients (n = 20), family doctor's patients (n = 21). Mean values were: DBS: 29.1 +/- 10.8; DAS: 10.6 +/- 3.9; DFS: 39.0 +/- 16.7. Family doctor's patients scored higher (p < or = 0.05) on DBS than all other groups, and dental students scored lower on DBS than all other groups (p < or = 0.05; except other intellectuals). DBS scores of age group between 21-30 yrs. differed significantly from age groups 31-40 yrs. (p < or = 0.05) and 41-50 yrs. (p < or = 0.01). There were no differences related to gender and marital status related to DBS scores. Positive Pearson's correlation (p < or = 0.05) of DBS was stronger related to dental anxiety scores (DAS: r = 0.56, DFS: r = 0.63) than related to general anxiety scores, whereas Pearson's correlation between DAS and DFS scores was even more prominent (r = 0.82, p < or = 0.05).

Predicting dental anxiety. The clinical value of anxiety questionnaires: an explorative study

AIM

This was to explore the usefulness of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS) and the Child Behaviour Checklist (CBCL), used prior to treatment, in relation to the actual behaviour displayed during treatment.

METHODS

The study group was 26 children, referred to a special dental care clinic for behaviour management problems, mostly caused by dental fear. Questionnaires used were the parent versions of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS) and the Child Behaviour Checklist (CBCL). Behaviour was registered on videotape and scored by independent observers using the modified Venham scale. Treatment consisted of a familiarization visit and two restorative sessions.

RESULTS

There was a significant reduction in fear, based on pre and post treatment CFSS-DS scores, and also the child's fearful behaviour during the two restorative sessions appeared to be related. But no correlation was found between the CFSS-DS and the CBCL, nor between the CFSS-DS and the behaviour displayed during the treatment sessions.

CONCLUSION

The child's anxious behaviour during actual restorative dental treatment is not so much related to its own anticipatory dental anxiety or the anxiety of the mother. Results support the role of a multifactorial model.

Reliability and validity of measures used in assessing dental anxiety in 5- to 15-year-old Croatian children

AIM

The aim of the study was to evaluate reliability and validity of different questionnaires and predict related causes, as concomitant factors in assessing different aspects of children's dental anxiety.

STUDY DESIGN

Children were interviewed on dental anxiety, dispositional risk factors and satisfaction with the dentist after dental treatment had been accomplished. Parents were interviewed on dental anxiety as well.

METHODS

The study population included 165 children (91 boys) aged 5 to 15 years, referred to a university dental clinic by general dental practitioners because of a history of fear and uncooperative behaviour during previous dental visits. Children were treated by two dentists, both experienced in treating fearful children.

STATISTICS

Statistical analysis was performed in Statistics for Windows, Release 5.5 and Release 7.5. Pearson's correlation coefficients were calculated for validity and Cronbach alpha for reliability of the measures. Spearman Brown prophecy formula was used for correction of the alpha scores. Results The children's total average CFSS-DS score was 27.02, with no significant difference with respect to gender. The highest Cronbach alpha scores regarding reliability were obtained for the S-DAI, the CFSS-DS and the PDAS. Pearson's correlations regarding validity presented significant correlations between the CMFQ, the CDAS and the S-DAI, between the OAS, the CDAS and the S-DAI, as well as between the OAS and the DVSS-SV.

CONCLUSION

Previous negative medical experience had significant influence on children's dental anxiety, supporting Rachman's conditioning theory. Anxious children were more likely to show behaviour problems (aggression) and more introvert in expressing their judgement regarding the dentist. Both the S-DAI and the CFSS-DS, which were standardized in the Croatian population sample, showed the highest reliability in assessment of children's dental anxiety.

[Epidemiological study of dental fear scores in several Hungarian sub-populations]

Authors investigated the dental fear scores (DAS, DFS) and anxieties of 362 persons from several sub-populations living in Budapest. The subjects were: 253 females, 109 males, aged 14 to 73. Dental fear scores were rather high (DAS: 11.0 +/- 3.6; DFS: 42.0 +/- 16.0). Age influenced the dental fear scales (DAS and DFS) only; sex, and marital status influenced both dental fear scales and general anxiety scales (one-way ANOVA). A strong correlation between DAS and DFS, and somewhat lower correlation between these scales and the general anxiety scales were also demonstrated.

[Dental anxiety in an emergency dental service]

OBJECTIVE

The purpose of the study was to assess the frequency of dental anxiety and/or fear among patients in an emergency dental service.

METHODS

Research was based on interviews with 252 patients, aged 18 years old and over, attended at an emergency dentistry service of São Paulo, Brazil, from August to November, 2001. Two methods were used to measure dental anxiety: the Modified Dental Anxiety Scale (MDAS) and the Gatchel Fear Scale. The study group answered questions concerning major complaint, how much time had elapsed since their last visit to the dentist and since the initial symptoms leading to the current visit to the emergency service, level of education, family income and previous traumas. Statistical analysis (chi2 and Fisher exact test) was performed to evaluate these characteristics.

RESULTS

It was found that 28.17% of this sample was dentally anxious, according to the MDAS, and 14.29%, felt fear related to dental treatment according to the Gatchel Fear Scale. Women were more anxious than men at a statistically significant rate (MDAS). The time elapsed since the onset of initial symptoms was more than 7 days for 44.44% of the participants. A large proportion of anxious women returned to treatment during the last year. A previous traumatic experience with dental was identified in 46.48% of the dentally anxious patients. No significant relation between level of education or income and dental anxiety was found.

CONCLUSIONS

Dentally anxious patients frequent attend emergency care. Females are more likely to report high dental anxiety than males. Previous experience seems to be an important factor contributing to avoidance of dental care.

Sleep pathophysiology in posttraumatic stress disorder and idiopathic nightmare sufferers

BACKGROUND

Nightmares are common in posttraumatic stress disorder (PTSD), but they also frequently occur in idiopathic form. Findings associated with sleep disturbances in these two groups have been inconsistent, and sparse for idiopathic nightmares. The aim of the present study was to investigate whether sleep anomalies in PTSD sufferers with frequent nightmares (P-NM) differ from those observed in non-PTSD, idiopathic nightmare (I-NM) sufferers and healthy individuals.

METHODS

Sleep measures were obtained from nine P-NM sufferers, 11 I-NM sufferers, and 13 healthy control subjects. All participants slept in the laboratory for two consecutive nights where electroencephalogram, electro-oculogram, chin and leg electromyogram, electrocardiogram, and respiration were recorded continuously.

RESULTS

Posttraumatic nightmare sufferers had significantly more nocturnal awakenings than did I-NM sufferers and control subjects. Elevated indices of periodic leg movements (PLMs) during rapid eye movement (REM) and non-REM sleep characterized both P-NM and I-NM sufferers.

CONCLUSIONS

Posttraumatic nightmare sufferers exhibit more nocturnal awakenings than do I-NM sufferers and control subjects, which supports the hypothesis of hyperarousal in sleep in PTSD sufferers; however, elevated PLM indices in both P-NM and I-NM sufferers suggest that PLMs may not be a marker of hyperarousal in sleep of PTSD sufferers. Rather, PLMs may be a correlate of processes contributing to intense negative dreaming.

Mental health of patients visiting an outpatient menopause clinic

OBJECTIVE

It is understood that psychological factors affect climacteric disturbances. However, details behind these issues remain unknown. The aim of this study was to investigate the mental health of climacteric patients.

SUBJECTS AND METHODS

The subjects were 127 Japanese women who visited our outpatient menopause clinic, complaining chiefly of climacteric disturbances. There were 38 premenopausal patients included. The responses to the HADS (Hospital Anxiety and Depression Scale) and the SDS (Self-rating Depression Scale), obtained at the first examination, were compared with HADS data from 2,943 healthy women and 94 patients hospitalized to receive gynecological surgery.

RESULTS

The HADS score and the SDS score of the outpatients of the menopause clinic showed a relatively high (statistically significant) correlation. The average HADS total, anxiety and depression scores for these patients were significantly higher than those for healthy controls. The total and depression scores were also significantly higher than those for patients hospitalized to undergo surgery for benign conditions, and were comparable to those for patients with malignant conditions. The comparison between pre- and postmenopausal patients showed that the premenopausal group was more likely to be depressed. The anxiety score was also high in this group (not significantly).

CONCLUSIONS

These results indicate that patients with climacteric disturbances, especially premenopausal patients, often experience psychological discomfort, and that attention should be given not only to their depression but also to their anxiety.

The effects of deep diaphragmatic breathing and focused attention on dental anxiety in a private practice setting

PURPOSE

High dental anxiety is pervasive and associated with treatment avoidance and poor oral health. Ideally, anxiety reduction techniques should be easy to use, low in cost, non-pharmacological, comfortable, and effective. This study compared the effectiveness of two self-taught anxiety reduction techniques--breathing and focused attention--with a control group.

METHODS

Anxiety was assessed in 272 adult private dental practice patients with a modified dental anxiety scale-revised. Frequency of oral health care visits in the last 10 years to all dentists, including the current dentist, was collected. Immediately prior to the dental procedure, participants in the two experimental groups were given written instructions outlining the respective anxiety reduction technique they were to use. Efficacy of technique was assessed by subjective comparison to anxiety during previous oral health treatment. Participants also listed techniques that they believed to be effective for anxiety reduction.

RESULTS

Twenty-six participants (9.56%) scored high in dental anxiety. High anxiety was associated with infrequent oral health care visits. Compared to the recall of anxiety experienced during prior treatment, there were no significant differences in anxiety between breathing, focusing, and control groups. But there was a trend toward decreased anxiety overall. Controls who reported infrequent visits and use of their own anxiety reduction technique showed significantly reduced anxiety.

CONCLUSION

Dental patients employ numerous strategies for anxiety reduction. Anxiety reduction techniques not yet practiced may place unwanted expectations on patients. It is suggested that oral health care practitioners be aware of the patient's preferred technique for coping with anxiety and encourage them to use self-help techniques.

Dental anxiety and personality: investigating the relationship between dental anxiety and self-consciousness

This study investigated whether personality plays a role in a condition called dental anxiety. Specifically, the study examined the relationship between dental anxiety (the negative response to the stress elicited from a dental interaction) and self-consciousness (the tendency to evaluate aspects of oneself that are subject to private and public display). The purpose of this study was to identify the characteristics possessed by dentally anxious individuals who face potential health risks because of their avoidance. Sixty York University undergraduate students were recruited by convenience sampling to participate. These subjects completed Corah's Dental Anxiety Scale and the Self-Consciousness Scale. The Self-Consciousness Scale consists of three subscales, including private self-consciousness, public self-consciousness, and social anxiety. Results indicated an 0.54 significant correlation between dental anxiety and self-consciousness. The public self-consciousness and social anxiety subscales correlated the most with dental anxiety. Furthermore, the data did not indicate a significant moderating relationship for gender between the two aforementioned variables. These results contribute to the establishment of personality characteristics as one of the dimensions determining dental anxiety.

Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C

Hepatitis C virus (HCV) infection is a major public-health-care problem, with over 170 million infected worldwide. Patients with chronic HCV infection often complain of various cognitive problems as well as symptoms of depression, anxiety, and fatigue. Relatively little is known, however, about the specific cognitive deficits that are common among HCV patients, and the influence of psychiatric symptomatology on cognitive functioning. In the current study of 21 chronically infected HCV patients, we assessed subjective cognitive dysfunction, depression, anxiety, and fatigue and compared these symptom areas to cognitive tests assessing visuoconstruction, learning, memory, visual attention, psychomotor speed, and mental flexibility. Results revealed that cognitive impairment ranged from 9% of patients on a visuoconstruction task to 38% of patients on a measure of complex attention, visual scanning and tracking, and psychomotor speed, and greater HCV disease severity as indicated by liver fibrosis was associated with greater cognitive dysfunction. Objective cognitive impairment was not related to subjective cognitive complaints or psychiatric symptomatology. These findings suggest that a significant portion of patients with chronic HCV experience cognitive difficulties that may interfere with activities of daily living and quality of life. Future research using cognitive measures with HCV-infected patients may assist researchers in identifying if there is a direct effect of HCV infection on the brain and which patients may be more likely to progress to cirrhosis and hepatic encephalopathy.

Fear of dental care: are we making any progress?

BACKGROUND

Dental anxiety has been a well-studied phenomenon since the late 1960s. The purpose of this literature review was to compare self-reported levels of dental anxiety during the past 50 years.

METHODS

The authors reviewed more than 200 articles and examined 19 studies involving more than 10,000 adults to assess any trends in dental anxiety. They investigated mean anxiety scores for college students and general adult samples using four measures of dental anxiety. Comparisons were made across publication year and location of study.

RESULTS

Analyses of variance suggest stability in dental anxiety scores over time and region within both types of study samples. Regardless of assessment length (single item or multi-item), the authors found no significant trends suggesting an increase or decrease in self-reported anxiety levels.

CONCLUSIONS

These results suggest that despite an increase in general anxiety within the United States during the past 50 years, dental anxiety seems to have remained stable throughout the period.

PRACTICE IMPLICATIONS

The authors discuss the stable trend of self-reported dental anxiety levels in the context of increasing general anxiety in the United States and the current structure of individual dental practices.