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Aarvik RS, Svendsen EJ, Agdal ML. Held still or pressured to receive dental treatment: self-reported histories of children and adolescents treated by non-specialist dentists in Hordaland, Norway. Eur Arch Paediatr Dent 2022; 23:609-618. [PMID: 35763246 PMCID: PMC9338127 DOI: 10.1007/s40368-022-00724-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/03/2022] [Indexed: 12/19/2022]
Abstract
Aim This study aimed to estimate the prevalence of a self-reported history of restraint in children and adolescents when receiving dental care by non-specialist dentists and to assess differences in dental fear and anxiety (DFA), intra-oral injection fear, and trust in dentists between patients with and without a self-reported history of restraint. Methods An electronic cross-sectional survey was distributed to all 9 years old (n = 6686) and 17 years old (n = 6327) in the Public Dental Service in Hordaland County, Norway, in 2019. For statistical evaluation, we generated descriptive statistics and Mann–Whitney U tests. Results The response rate ranged between 43.5 and 59.9% for the different questions. The prevalence of a self-reported history of being held still against one’s will during dental treatment and pressured to undergo dental treatment against one’s will was 3.6% and 5.1%, respectively. In general, these patients reported higher DFA, and higher intra-oral injection fear compared with those without such histories of restraint. Patients who had reported being held still against their will during dental treatment had significantly higher distrust in dentists than those who did not report restraint (p < 0.001). Conclusion To feel pressured to receive dental treatment and to be held still against one’s will overlap with the concepts of psychological and physical restraint. Patients with a self-reported history of restraint recorded significant differences in DFA, intra-oral injection fear, and trust in dentists compared to those who did not report restraint. Future studies should explore the role that restraint may play in relation to a patient’s DFA, intra-oral injection fear, and trust in dentists.
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Affiliation(s)
- R S Aarvik
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway. .,Oral Health Centre of Expertise in Western Norway, Bergen, Norway.
| | - E J Svendsen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - M L Agdal
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
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2
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Vanhee T, Mourali S, Bottenberg P, Jacquet W, Vanden Abbeele A. Stimuli involved in dental anxiety: What are patients afraid of?: A descriptive study. Int J Paediatr Dent 2020; 30:276-285. [PMID: 31724773 DOI: 10.1111/ipd.12595] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/21/2019] [Accepted: 11/07/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dental anxiety is a psychological response inducing aversion following a dental ill-defined stimulus, non-imminent and perceived as potentially dangerous. It is better to intervene during childhood than to resolve in adulthood when dental anxiety is more settled. AIM The purpose of this study is to determine the nature of dental anxiety-provoking stimuli in young patients. DESIGN A questionnaire was submitted to 566 children between 3 to 18 years in health institutions and schools in Brussels, Belgium. The items were divided into 3 groups: environment (ENV), local anaesthesia (LA), and intervention (INT) and summarized through averaging per group. Descriptive analysis and non-parametric testing were combined with logistic regression after discretization, above mild, for the group averages. RESULTS About 7.2% of the respondents expressed high to severe dental anxiety. Several items presented a clear bimodal distribution dividing the population in fearless and fearing patients, for example, sight and feel of the syringe, sight and taste of blood and extraction. Others presented with a gradually lower incidence with increasing fear level. Fear for the environment was generally low. Gender and ethnic origin contribute significantly to the prediction of fear caused by LA. For fear caused by INT, first the place of questioning enters the models, thereafter follow: negative experience, frequency of dental visit, and gender (P < .05). CONCLUSIONS While the dental environment is in general not causing fear, the invasive part of the anaesthesia and the invasive dental procedures are involved. Fear seems to be related to culture, previous experience, and gender.
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Affiliation(s)
- Tania Vanhee
- Department of Paediatric Dentistry, Université Libre de Bruxelles, Brussels, Belgium
| | - Sandrine Mourali
- Department of Paediatric Dentistry, Université Libre de Bruxelles, Brussels, Belgium
| | - Peter Bottenberg
- Oral Health Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wolfgang Jacquet
- Oral Health Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Astrid Vanden Abbeele
- Department of Paediatric Dentistry, Université Libre de Bruxelles, Brussels, Belgium
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3
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Lima DSM, Barreto KA, Rank RCIC, Vilela JER, Corrêa MSNP, Colares V. Does previous dental care experience make the child less anxious? An evaluation of anxiety and fear of pain. Eur Arch Paediatr Dent 2020; 22:139-143. [DOI: 10.1007/s40368-020-00527-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
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Roh J, Han M, Kim KN, Kim KM. The in vitro and in vivo effects of a fast-dissolving mucoadhesive bi-layered strip as topical anesthetics. Dent Mater J 2017; 35:601-5. [PMID: 27477225 DOI: 10.4012/dmj.2015-369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To overcome pain on injection, the dentist can apply a topical anesthetic spray. Despite the convenience, it is not easy to apply it locally. So, we developed an oral mucoadhesive bi-layer film containing an anesthetic. We used polyvinylpyrrolidone (PVP)/hydroxypropyl methylcellulose (HPMC) and HPMC-only layer as the drug-containing layer and ethyl cellulose (EC) as the backing layer. The lidocaine released was tested in vitro together with the adhesion time and cytotoxicity of the film. Mucosa permeability was tested in vivo. Statistical analysis was performed, with p at 0.05 taken to be significant. The lidocaine was released significantly faster in the PVP/HPMC than HPMC-only group and 80% of the drug was released within 1 min (p<0.05) and they attached at least 3 h. The test groups showed no toxicity and the drug effectively permeated the mucosa (p<0.05). We suggest this new mucoadhesive anesthetic may reduce dental phobia.
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Affiliation(s)
- Jiyeon Roh
- BK 21 PLUS Project, Yonsei University College of Dentistry
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Liinavuori A, Tolvanen M, Pohjola V, Lahti S. Changes in dental fear among Finnish adults: a national survey. Community Dent Oral Epidemiol 2015; 44:128-34. [PMID: 26482701 DOI: 10.1111/cdoe.12196] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 09/12/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate changes in dental fear among adult Finns aged 19 years and over at the beginning of the study in 2000-2011 in a nationally representative sample. METHODS The study was based on Health 2000 and 2011 Surveys by the National Institute for Health and Welfare in Finland. The Health 2000 Survey used a stratified two-stage cluster sampling design (N = 9 922). Those who participated in 2000 (n = 7 964) were invited to participate in 2011. The number of participants was 3 961. Dental fear was assessed by a single question: 'How afraid are you of visiting a dentist?' (not at all, somewhat, very much). Background variables included were age (categories 30-34, 35-39, 40-44, 45-54, 55-64, 65-74, 75+ years), gender, marital status (nonsingle, single), and education (basic, secondary, higher). To match the population sizes in different areas and thus forming a nationally representative data, the data were weighted based on age, gender, and area. General linear modeling for repeated measures was used to evaluate changes in dental fear and associations with background variables. RESULTS Between 2000 and 2011, dental fear decreased more often than increased among adults in Finland. Change from being very afraid to not at all afraid of visiting a dentist was most common in the oldest group. For most participants, dental fear remained stable; being very afraid of visiting a dentist was more stable among participants from 35 to 54 years of age than among younger or older participants. CONCLUSIONS Dental fear is still common among adult Finns and it seems to depend on age. As the most obvious consequence of dental fear is avoidance of dental care, reducing dental fear should be taken into account when planning and reorienting oral healthcare services.
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Affiliation(s)
- Arja Liinavuori
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Vesa Pohjola
- Department of Community Dentistry, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
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Determining Cut-Off Points for the Dental Fear Survey. ScientificWorldJournal 2015; 2015:983564. [PMID: 26491721 PMCID: PMC4602336 DOI: 10.1155/2015/983564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/13/2015] [Indexed: 12/27/2022] Open
Abstract
Objective. To determine a high fear cut-off point score for the Dental Fear Survey (DFS) using a single-item self-report questionnaire. Methods. The DFS, a 20-item questionnaire assessing fear of dental treatment, was completed by 1,256 participants with a mean age of 22.3 years (SD = 5.1). Another self-report questionnaire was used to collect data on previous dental experiences. A high fear cut-off point score was determined by calculating the receiver operating characteristic (ROC) curve for the DFS. Descriptive statistics and multinomial logistic regression were calculated; a significance level of p < 0.05 was used for all tests. Results. The ROC curve indicated that a DFS score ≥53 corresponds to a sensitivity of 88.9% and a specificity of 92.5%. Most participants (n = 895; 71.5%) reported no fear of going to the dentist. There was significant association between DFS score and fear assessed with the question “Are you fearful of going to the dentist?” (p < 0.001). Conclusion. A cut-off point of 53 on the DFS total score represents the best compromise between sensitivity and specificity and can be used to predict high dental fear.
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Carter AE, Carter G, Boschen M, AlShwaimi E, George R. Pathways of fear and anxiety in dentistry: A review. World J Clin Cases 2014; 2:642-53. [PMID: 25405187 PMCID: PMC4233415 DOI: 10.12998/wjcc.v2.i11.642] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/21/2014] [Accepted: 09/04/2014] [Indexed: 02/05/2023] Open
Abstract
The aim of this article was to analyze the theories underpinning dental fear, anxiety and phobias. To be included, articles must have been published between the years of 1949 and 2013 concerning fears and phobias within dentistry and/or psychiatry. Of 200 articles originally under review, 140 were included and reviewed by the authors.Five specific pathways relating to dental fear and anxiety were identified; Cognitive Conditioning, Informative, Visual Vicarious, Verbal Threat, and Parental. Eight currently accepted management techniques across all dental disciplines for dental fear and anxiety were identified. Further research is required to identify clinical diagnosis and treatment for fears originating from different pathways.
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Luoto A, Tolvanen M, Rantavuori K, Pohjola V, Karlsson L, Lahti S. Individual changes in dental fear among children and parents: a longitudinal study. Acta Odontol Scand 2014; 72:942-7. [PMID: 24922091 DOI: 10.3109/00016357.2014.923582] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim was to study longitudinal changes in dental fear among children and one of their parents separately for girls, boys, mothers and fathers over a 3.5-year period. MATERIALS AND METHODS 11-12-year-old children in Pori, Finland (n = 1691) and one of their parents were invited to participate in this longitudinal study. Dental fear was measured in 2001, 2003 and 2005 when the children were 11-12, 13-14 and 15-16-years-old, respectively. The participants were asked if they were afraid of dental care (1 = 'not afraid', 2 = 'slightly afraid', 3 = 'afraid to some degree', 4 = 'quite afraid', 5 = 'very afraid' and 6 = 'I don't know'). The participants' gender was also registered. Mean values of the change scores were studied. Prevalence and incidence of dental fear and changes in dichotomized dental fear (responses 4-5 = high dental fear and responses 1-3 = low dental fear) were studied using cross-tabulations and Cochran's Q test. RESULTS Overall, the prevalence of dental fear slightly increased and female preponderance in dental fear became more evident during the follow-up. Of the mothers and children with high dental fear at the baseline, 24% and 56%, respectively, reported not to be fearful at the end of the follow-up. CONCLUSIONS Dental fear seems to be more stable in adulthood than in childhood. Thus, it might be better to intervene in dental fear during childhood rather than during adulthood.
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Affiliation(s)
- Anni Luoto
- Department of Community Dentistry, Institute of Dentistry, University of Turku , Turku , Finland
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Goettems ML, Schuch HS, Demarco FF, Ardenghi TM, Torriani DD. Impact of dental anxiety and fear on dental care use in Brazilian women. J Public Health Dent 2014; 74:310-6. [PMID: 24946683 DOI: 10.1111/jphd.12060] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 05/04/2014] [Indexed: 12/15/2022]
Affiliation(s)
- Marília Leão Goettems
- Post-Graduate Program in Dentistry; Federal University of Pelotas; Pelotas Rio Grande do Sul Brazil
| | - Helena Silveira Schuch
- Post-Graduate Program in Dentistry; Federal University of Pelotas; Pelotas Rio Grande do Sul Brazil
| | - Flávio Fernando Demarco
- Post-Graduate Program in Dentistry; Federal University of Pelotas; Pelotas Rio Grande do Sul Brazil
- Post-Graduate Program in Epidemiology; Federal University of Pelotas; Pelotas Rio Grande do Sul Brazil
| | - Thiago Machado Ardenghi
- Post-Graduate Program in Dentistry; Federal University of Santa Maria; Santa Maria Rio Grande do Sul Brazil
| | - Dione Dias Torriani
- Post-Graduate Program in Dentistry; Federal University of Pelotas; Pelotas Rio Grande do Sul Brazil
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10
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Schuller AA, van Buuren S. Estimation of caries experience by multiple imputation and direct standardization. Caries Res 2013; 48:91-5. [PMID: 24296647 DOI: 10.1159/000353140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 05/20/2013] [Indexed: 11/19/2022] Open
Abstract
Valid estimates of caries experience are needed to monitor oral population health. Obtaining such estimates in practice is often complicated by nonresponse and missing data. The goal of this study was to estimate caries experiences in a population of children aged 5 and 11 years, in the presence of nonresponse and missing data. Four estimation methods are compared. Each method makes implicit assumptions about the processes that caused the nonresponse and the missing data. Three of the four methods are based on unrealistic assumptions about the missing data and underestimate caries experience. Under the missing at random assumption, multiple imputation in combination with direct standardization corrects for the deficiencies of current methodology. In the presence of missing data and nonresponse, we recommend a combination of multiple imputation and direct standardization to obtain correct estimates of caries experience.
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Affiliation(s)
- A A Schuller
- Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
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11
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Tolvanen M, Hagqvist O, Luoto A, Rantavuori K, Karlsson L, Karlsson H, Lahti S. Changes over time in adult dental fear and correlation to depression and anxiety: a cohort study of pregnant mothers and fathers. Eur J Oral Sci 2013; 121:264-9. [DOI: 10.1111/eos.12026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | - Hasse Karlsson
- FinnBrain study group; Department of Psychiatry; Institute of Clinical Medicine; University of Turku; Turku; Finland
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12
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Dental Anxiety Is Considerably Associated With Pain Experience During Dental Procedures. J Evid Based Dent Pract 2013; 13:29-30. [DOI: 10.1016/j.jebdp.2013.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Armfield JM, Slade GD, Spencer AJ. Dental fear and adult oral health in Australia. Community Dent Oral Epidemiol 2009; 37:220-30. [DOI: 10.1111/j.1600-0528.2009.00468.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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