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Cunoti N, Qorri R, Irmscher L, Qorri E, Magerfleisch L, Berth H. Dental anxiety and dental care - a comparison between Albania and Germany. BMC Oral Health 2024; 24:1121. [PMID: 39313815 PMCID: PMC11421110 DOI: 10.1186/s12903-024-04887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 09/09/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND The present study is the first in Albania on dental fear and dental anxiety and also in the field of psychosocial medicine. The purpose of this study was to find out whether there are differences in dental anxiety using the Dental Anxiety Scale, their level of psychological distress using the Brief Symptom Inventory-18 and the evaluation of oral health among Albanian and German patients. METHODS This study was conducted in the period from December 2019 to July 2020, a sample of N = 263 patients (133 Germans, 130 Albanians) using the Dental Anxiety Scale questionnaires to determine anxiety before dental treatment and the Brief Symptom Inventory-18 to evaluate psychological distress. Moreover, the patients answered questions regarding their oral health and dental care. In Germany, there were four refusals to entrance in the study due to various reasons, in contrast to Albania, where there were no refusals at all For the purposes of this study, data on both populations aged 14 years and older were used. RESULTS The questionnaires results were calculated for all participants. The current subjective health status of Albanian patients was assessed to be significantly worse than that of German patients (p < 0,000). Germans were more susceptible to signs of Anxiety (p < 0,000), Depression and Somatization and scored higher on the Dental Anxiety Scale and the Global Severity Index (p < 0,000) than Albanian patients. Additionally Albanian patients scored significantly lower on the preventive care index (p < 0,000). Despite an elevated DAS anxiety level, German patients reported going to the dentist more frequently than Albanian patients. CONCLUSION The results showed that between both populations differences in dental anxiety, psychological distress and oral health exists. Patients from Germany report more psychological distress and described more dental anxiety compared to Albanian patients. Albanian patients reported not utilization on oral health care.The implementation of educational programs and preventive measures, would contribute to raising awareness about the importance of oral health and increased use of dental services.
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Affiliation(s)
- Nertsa Cunoti
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany
| | - Rezart Qorri
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany
| | - Lisa Irmscher
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany
| | - Erda Qorri
- Department of Dentistry, Faculty of Medical Sciences, Albanian University, Tirana, 1001, Albania
| | - Laura Magerfleisch
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany
| | - Hendrik Berth
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
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Almarzouq SSFS, Chua H, Yiu CKY, Lam PPY. Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:537. [PMID: 38470648 PMCID: PMC10931341 DOI: 10.3390/healthcare12050537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12. METHOD A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses. RESULT A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell-show-do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell-show-do and other NPBIs in reducing DFA among children. CONCLUSIONS The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA.
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Affiliation(s)
| | - Helene Chua
- National Healthcare Group Polyclinics, Singapore 308433, Singapore
| | - Cynthia K. Y. Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
| | - Phoebe P. Y. Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
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Alghofaily M, Alsalleeh F. Levels of Anxiety and Fear Related to Non-Surgical Root Canal Treatment Performed by Endodontic Residents and Endodontists. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.851834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
ObjectivesDespite advances in endodontic treatment procedures, root canal treatment is still associated with anxiety and fear. This may cause care avoidance and subsequent oral complications due to untreated endodontic infections. Anxiety and fear levels in response to non-surgical root canal treatment performed by endodontic residents and endodontists were analyzed.MethodsA descriptive, cross-sectional survey was conducted among patients visiting the endodontic clinics at the University Dental Hospital. The questions addressed the participant's demographics, previous root canal treatment visits, clinician's level of training, and post-treatment experience.ResultsDemographics play a role in anxiety and dental fear in root canal treatment. Men scored significantly lower in the high-anxiety category than women, and patients treated by endodontic residents expressed lower levels of anxiety. Post-treatment experience of an endodontist or endodontic resident was a significant factor in reducing dental fear and anxiety.ConclusionThe level of anxiety and fear related to root canal experience of endodontists or endodontic residents is very low. Most of the patients expressed willingness to undergo further root canal treatment to save a tooth.
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Silveira ER, Cademartori MG, Schuch HS, Armfield JA, Demarco FF. Estimated prevalence of dental fear in adults: A systematic review and meta-analysis. J Dent 2021; 108:103632. [PMID: 33711405 DOI: 10.1016/j.jdent.2021.103632] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To systematically review the literature about: 'What is the global estimated prevalence of dental fear in adults?'. DATA/SOURCES Inclusion criteria were observational population-based studies reporting the prevalence or raw data of dental fear in adults (>18 years). Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library and Web of Science) were searched without language restrictions up to March 2020. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. Risk of bias was performed using the Joanna Briggs Critical Appraisal Checklist for Prevalence and Incidence studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed. STUDY SELECTION The search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. Three studies presented low risk of bias and 28 studies presented high risk of bias. A total of 72,577 individuals 18 years of age or older composed the sample of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 15.3 % (95 %CI 10.2-21.2), 12.4 % (95 %CI 9.5-15.6) and 3.3 % (95 %CI 0.9-7.1), respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instruments used to measure dental fear also affected its prevalence. CONCLUSIONS Dental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women. CLINICAL SIGNIFICANCE Evidence suggests fear negatively impacts dental care pattern, clinical and subjective oral health conditions. A better knowledge of the global prevalence and the factors associated with this problem will allow that prevention or even behavior modulation strategies of the fearful individual's in dental setting being carried out.
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Affiliation(s)
- Ethieli Rodrigues Silveira
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Mariana Gonzalez Cademartori
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Helena Silveira Schuch
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Jason A Armfield
- Australian Centre for Precision Health, University of South Australia, Adelaide, 101 Currie St, Adelaide, SA, 5001, Australia.
| | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil; Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, 1160, Marechal Deodoro Street, 96020-220, Brazil.
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Fear and Anxiety Pathways Associated with Root Canal Treatments Amongst a Population of East Asian Origin. Eur Endod J 2020; 5:2-5. [PMID: 32342030 PMCID: PMC7183800 DOI: 10.14744/eej.2019.46338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/22/2019] [Indexed: 10/26/2022] Open
Abstract
Objective This study aimed to identify and compare the pathways of endodontic fear and anxiety amongst East Asian origin patients attending Griffith University's Dental Clinics, Gold Coast, Australia. Methods East Asian patients who attended the Griffith University dental clinics were included in this study. The "My Endodontic Fear" survey was used. The pathways involved in self-perception of dental fear and anxiety were assessed through 5 different questions. Chi-square test was for statistical analysis and the level of significance was set at P<0.05. Results One hundred and forty six participants (n=146) (ages 18-62 years) of East Asian descent met the criteria to participate. 58.2% were females, and 41.8% males. The ethnicities were split into Chinese origin and non-Chinese origin (Korean, Phillipino, Japanese, Vietnamese). Results indicate multiple pathways affect the origin of fear, regardless of ethnicity. The Cognitive Conditioning pathway was the primary pathway selected by the Chinese and non-Chinese sub groups (51.4%, 43.6%) followed by the Informative (38.3%, 38.5%), then Vicarious (27.1%, 33.3%) and Parental (18.7%, 33.3%) pathways respectively.The Verbal Threat pathway was the least selected pathway for both groups, however the non- Chinese group selected this pathway significantly more often than the Chinese group (P<0.001). Conclusion This study demonstrates that the Cognitive Conditioning pathway was the primary fear and anxiety pathway utilized by both East Asian sub-groups. Understanding how patients develop fear and anxiety can help treating dentists discuss triggering factors for patients and alleviate undue anxiety prior to treatment.
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Kim KY, An SY. Investigation of the impact of dental fear on Child Oral Health Impact Profile scores. J Dent Anesth Pain Med 2019; 19:271-276. [PMID: 31723667 PMCID: PMC6834720 DOI: 10.17245/jdapm.2019.19.5.271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/12/2019] [Accepted: 10/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background The Child Oral Health Impact Profile (COHIP) is a measure of oral health-related quality of life (OHRQoL) in children and adolescents. This study examined the impact of dental fear on the OHRQoL by comparing the COHIP scores of children with and without dental fear. Methods The OHRQoL in children and adolescents was measured using the Korean version of the COHIP. In total, 102 students (49 boys and 53 girls) filled in a questionnaire designed to evaluate dental fear and the OHRQoL in 2012 and 2014. Results In 2012, the group without dental fear showed higher COHIP scores than the group with dental fear; the difference between the two groups was statistically significant. In 2014, the same pattern was observed, but the difference was non-significant for all COHIP items other than those pertaining to social-emotional well-being. Comparison of COHIP scores according to changes in fear showed that the group with continuous dental fear showed significantly lower overall COHIP, negative COHIP, and low social-emotional wellbeing scores, than the group without continuous fear in 2012 and 2014. Conclusion We expected children with dental fear to have poor oral health, affecting their OHRQoL; however, dental fear did not affect the OHRQoL.
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Affiliation(s)
- Ka Young Kim
- Department of Pediatric Dentistry, College of Dentistry, Wonkwang University, Daejeon, Korea
| | - So-Youn An
- Department of Pediatric Dentistry, College of Dentistry, Wonkwang University, Daejeon, Korea
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Kamel AF, Al-Harbi A, Al-Otaibi F, Al-Qahtani F, Al-Garni A. Dental anxiety at Riyadh Elm University Clinics. SAUDI JOURNAL OF ORAL SCIENCES 2019. [DOI: 10.4103/sjos.sjoralsci_33_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Carter AE, AlShwaimi E, Boschen M, Carter G, George R. Influence of culture change on the perception of fear and anxiety pathways in Endodontics: A pilot proof of concept study. AUST ENDOD J 2018; 45:20-25. [PMID: 29336506 DOI: 10.1111/aej.12253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2017] [Indexed: 12/28/2022]
Abstract
This study assessed the influence of cultural changes (known as acculturation) on pathways of fear and anxiety in Endodontics. A purposive sampling technique identified patients of Saudi Arabian descent living in Australia and Saudi Arabia. Only patients with root canal fillings (or treatment planned for endodontic treatment) were included. Patients with intellectual disabilities, surgical root therapy, and aged under 20 were excluded. Consenting patients attending the dental clinics of University of Griffith University, Australia and University of Dammam, Saudi Arabia completed the "My Endodontic Fear Questionnaire." Three hundred and twenty-four patients (21-75 years) were included, 90% of participants reported more than one pathway. Australian Saudi Arabians mainly utilised vicarious pathway (94.9%), whilst Saudi Arabians utilised the verbal threat (93.5%) and parental pathway (78.3%). This study highlights the possible role of acculturation on the perception of fear and anxiety in Endodontics; however, further research with other ethnic groups is essential to enhance our understanding.
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Affiliation(s)
- Ava Elizabeth Carter
- School of Dentistry, Griffith University, Southport, Gold Coast, Queensland, Australia
| | - Emad AlShwaimi
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - Mark Boschen
- School of Applied Psychology, Griffith University, Southport, Gold Coast, Queensland, Australia
| | - Geoffery Carter
- School of Human Education and Resources, Griffith University, Southport, Gold Coast, Queensland, Australia
| | - Roy George
- School of Dentistry, Griffith University, Southport, Gold Coast, Queensland, Australia
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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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Carter AE, Carter G, Boschen M, AlShwaimi E, George R. Ethnicity and Pathways of Fear in Endodontics. J Endod 2015; 41:1437-40. [DOI: 10.1016/j.joen.2015.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/24/2015] [Accepted: 04/19/2015] [Indexed: 12/17/2022]
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Gordon D, Heimberg RG, Tellez M, Ismail AI. A critical review of approaches to the treatment of dental anxiety in adults. J Anxiety Disord 2013; 27:365-78. [PMID: 23746494 DOI: 10.1016/j.janxdis.2013.04.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
Dental anxiety and specific phobia of dental procedures are prevalent conditions that can result in substantial distress and oral health impairment. This paper critically reviews 22 randomized treatment trials aimed at reducing dental anxiety and avoidance in adults, published in peer-reviewed journals between 1974 and 2012. The following treatment techniques are reviewed: various forms of cognitive-behavioral therapy (CBT), relaxation training, benzodiazepine premedication, music distraction, hypnotherapy, acupuncture, nitrous oxide sedation, and the use of lavender oil scent. CBT delivered in a variety of formats, including one-session treatment, has the most evidence for its efficacy. Cognitive techniques, relaxation, and techniques to increase patients' sense of control over dental care are also efficacious but perform best when combined with repeated, graduated exposure. Other interventions require further study in randomized trials before conclusions about their efficacy are warranted. Limitations of the extant outcome research and implications for future treatment and research are discussed.
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Affiliation(s)
- Dina Gordon
- Adult Anxiety Clinic, Department of Psychology, Temple University, Philadelphia, PA 19122, USA.
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Smith A, MacEntee MI, Beattie BL, Brondani M, Bryant R, Graf P, Hornby K, Kobayashi K, Wong ST. The influence of culture on the oral health-related beliefs and behaviours of elderly chinese immigrants: a meta-synthesis of the literature. J Cross Cult Gerontol 2013; 28:27-47. [PMID: 23397228 DOI: 10.1007/s10823-013-9187-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Neglect of the mouth can lead to impairment, disability, and discomfort; as a result, it can have a negative impact on quality of life in old age. Some minority groups in North America shoulder a disproportionate burden of dental impairment compared to people of European origins, possibly because of different cultural beliefs and a distrust of Western oral healthcare. This paper explores these factors in elderly Chinese immigrants through a meta-synthesis of selected literature that reveals a dynamic interplay of traditional Chinese beliefs about oral health, immigration, and structural factors mediating access to Western dentistry. It also identifies several conceptual issues and gaps in knowledge, offers avenues of research including the cross-cultural application of two recent models of oral health, and discusses various strategies for improving access to dental services for minority populations.
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Affiliation(s)
- André Smith
- Department of Sociology and Centre on Aging, University of Victoria, Victoria, British Columbia, Canada
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Agorastos A, Haasen C, Huber CG. Anxiety disorders through a transcultural perspective: implications for migrants. Psychopathology 2012; 45:67-77. [PMID: 22269637 DOI: 10.1159/000328578] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 04/15/2011] [Indexed: 01/12/2023]
Abstract
BACKGROUND/METHODS This paper analyses the psychopathology and differential diagnosis of anxiety disorders and their worldwide prevalence. It focuses particularly on migrant-specific aetiopathogenetic factors and approaches prevalence and important cultural aspects of anxiety disorders in migrants as a narrative empirical review. RESULTS Transcultural research demonstrates the universal existence of anxiety disorders. However, the cross-cultural comparison of the epidemiological data is complicated and often leads to systematic bias. The described psychopathology varies significantly across cultures, indicating different ways of expressing and experiencing the basic emotion of anxiety. As a result, anxiety disorders manifest themselves differently across cultures, which may affect the diagnostic and therapeutic procedure. Migration is an additional extraordinary stressor playing a substantial role in the development of anxiety disorders. However, despite the high prevalence of anxiety disorders among migrants, a high threshold due to several barriers leads to an underrepresentation of migrants in the utilization of the mental health system. CONCLUSIONS In the transcultural differential diagnosis of anxiety disorders, as among migrants, understanding and openness to other cultures and their standards is essential. Thereby, a migrant-specific treatment approach with a long-term binding of patients in a multimodal and culture-sensitive and -permissive treatment option is of vital importance.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
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Li KY, Wong MCM, Lam KF, Schwarz E. Age, period, and cohort analysis of regular dental care behavior and edentulism: a marginal approach. BMC Oral Health 2011; 11:9. [PMID: 21410991 PMCID: PMC3073963 DOI: 10.1186/1472-6831-11-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 03/17/2011] [Indexed: 12/03/2022] Open
Abstract
Background To analyze the regular dental care behavior and prevalence of edentulism in adult Danes, reported in sequential cross-sectional oral health surveys by the application of a marginal approach to consider the possible clustering effect of birth cohorts. Methods Data from four sequential cross-sectional surveys of non-institutionalized Danes conducted from 1975-2005 comprising 4330 respondents aged 15+ years in 9 birth cohorts were analyzed. The key study variables were seeking dental care on an annual basis (ADC) and edentulism. For the analysis of ADC, survey year, age, gender, socio-economic status (SES) group, denture-wearing, and school dental care (SDC) during childhood were considered. For the analysis of edentulism, only respondents aged 35+ years were included. Survey year, age, gender, SES group, ADC, and SDC during childhood were considered as the independent factors. To take into account the clustering effect of birth cohorts, marginal logistic regressions with an independent correlation structure in generalized estimating equations (GEE) were carried out, with PROC GENMOD in SAS software. Results The overall proportion of people seeking ADC increased from 58.8% in 1975 to 86.7% in 2005, while for respondents aged 35 years or older, the overall prevalence of edentulism (35+ years) decreased from 36.4% in 1975 to 5.0% in 2005. Females, respondents in the higher SES group, in more recent survey years, with no denture, and receiving SDC in all grades during childhood were associated with higher probability of seeking ADC regularly (P < 0.05). The interaction of SDC and age (P < 0.0001) was significant. The probabilities of seeking ADC were even higher among subjects with SDC in all grades and aged 45 years or older. Females, older age group, respondents in earlier survey years, not seeking ADC, lower SES group, and not receiving SDC in all grades were associated with higher probability of being edentulous (P < 0.05). Conclusions With the use of GEE, the potential clustering effect of birth cohorts in sequential cross-sectional oral health survey data could be appropriately considered. The success of Danish dental health policy was demonstrated by a continued increase of regular dental visiting habits and tooth retention in adults because school dental care was provided to Danes in their childhood.
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Affiliation(s)
- Kar-Yan Li
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
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Erciyas K, Hamamci Z, Buyukozturk S, Erciyas AF. Revised dental beliefs survey: reliability and validity of a 22-item modified Turkish version. J Oral Rehabil 2009; 36:831-9. [PMID: 19793386 DOI: 10.1111/j.1365-2842.2009.02001.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The aim of this study is to create a Turkish version of the Revised Dental Beliefs Survey (DBS-R) and describe its psychometric properties. The participants were 420 general dental patients. The results of the exploratory factor analysis revealed that the DBS-R consisted of three factors consisting of 22 items. Confirmatory factor analysis results showed that the 22-item three-factor version fit the data better than the original 28-item English language four-factor structure model proposed in Odontol Scand (2004;62:21). The internal reliability of the Turkish version of the DBS-R was Cronbach alpha of 0.88. The correlation between the Turkish version of the DBS-R and the Modified Dental Anxiety Scale (MDAS) was 0.29. Scores on the 22-item version were higher for anxious participants (MDAS > or = 15) than those determined to be not anxious [59.4 +/- 15.5 vs. 51.1 +/- 17.2 (t = -4.38, P < 0.0001)]. In conclusion, a 22-item modified version of the DBS-R in Turkish appears reliable and valid.
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Affiliation(s)
- K Erciyas
- Department of Periodontology, Gaziantep University
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Thomson WM, Broadbent JM, Locker D, Poulton R. Trajectories of dental anxiety in a birth cohort. Community Dent Oral Epidemiol 2009; 37:209-19. [PMID: 19508269 DOI: 10.1111/j.1600-0528.2009.00473.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine predictors of dental anxiety trajectories in a longitudinal study of New Zealanders. METHODS Prospective study of a complete birth cohort born in 1972/73 in Dunedin, New Zealand, with dental anxiety scale (DAS) scores and dental utilization determined at ages 15, 18, 26 and 32 years. Personality traits were assessed at a superfactor and (more fine-grained) subscale level via the Multidimensional Personality Questionnaire at age 18 years. Group-based trajectory analysis was used to identify dental anxiety trajectories. RESULTS DAS scores from at least three assessments were available for 828 participants. Six dental anxiety trajectories were observed: stable nonanxious low (39.6%); stable nonanxious medium (37.9%); recovery (1.6%); adult-onset anxious (7.7%); stable anxious (7.2%) and adolescent-onset anxious (5.9%). Multivariate analysis showed that males and those with higher DMFS at age 15 years were more likely to be in the stable nonanxious low trajectory group. Membership of the stable nonanxious medium group was predicted by the dental caries experience at age 15 years. Participants who had lost one or more teeth between ages 26 and 32 years had almost twice the relative risk for membership of the adult-onset anxious group. Personality traits predicted group membership. Specifically, high scorers (via median split) on the 'stress reaction' subscale had over twice the risk of being in the stable anxious group; low scorers on the traditionalism subscale were more likely to be members of the recovery trajectory group; and high scorers on the 'social closeness' subscale had half the risk of being in the stable anxious group. Dental caries experience at age 5 years was also a predictor for the stable anxious group. Membership of the late-adolescent-onset anxious group was predicted by higher dental caries experience by age 15 years, but none of the other predictors was significant. CONCLUSION Six discrete trajectories of dental anxiety have been observed. Some trajectories (totalling more than 90% of the cohort) had clear associations with external influences, but others were more strongly associated with characteristics such as personality traits. A mix of both influences was observed with only the stable anxious dental anxiety trajectory.
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Affiliation(s)
- W M Thomson
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
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Ng SKS, Leung WK. A community study on the relationship of dental anxiety with oral health status and oral health-related quality of life. Community Dent Oral Epidemiol 2008; 36:347-56. [DOI: 10.1111/j.1600-0528.2007.00412.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yuan S, Freeman R, Lahti S, Lloyd-Williams F, Humphris G. Some psychometric properties of the Chinese version of the Modified Dental Anxiety Scale with cross validation. Health Qual Life Outcomes 2008; 6:22. [PMID: 18364045 PMCID: PMC2289811 DOI: 10.1186/1477-7525-6-22] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 03/25/2008] [Indexed: 01/04/2023] Open
Abstract
Objective To assess the factorial structure and construct validity for the Chinese version of the Modified Dental Anxiety Scale (MDAS). Materials and methods A cross-sectional survey was conducted in March 2006 from adults in the Beijing area. The questionnaire consisted of sections to assess for participants' demographic profile and dental attendance patterns, the Chinese MDAS and the anxiety items from the Hospital Anxiety and Depression Scale (HADS). The analysis was conducted in two stages using confirmatory factor analysis and structural equation modelling. Cross validation was tested with a North West of England comparison sample. Results 783 questionnaires were successfully completed from Beijing, 468 from England. The Chinese MDAS consisted of two factors: anticipatory dental anxiety (ADA) and treatment dental anxiety (TDA). Internal consistency coefficients (tau non-equivalent) were 0.74 and 0.86 respectively. Measurement properties were virtually identical for male and female respondents. Relationships of the Chinese MDAS with gender, age and dental attendance supported predictions. Significant structural parameters between the two sub-scales (negative affectivity and autonomic anxiety) of the HADS anxiety items and the two newly identified factors of the MDAS were confirmed and duplicated in the comparison sample. Conclusion The Chinese version of the MDAS has good psychometric properties and has the ability to assess, briefly, overall dental anxiety and two correlated but distinct aspects.
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Affiliation(s)
- Siyang Yuan
- Dental Health Research Unit, Mackenzie Building, Ninewells Hospital, University of Dundee, UK.
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Nicolas E, Collado V, Faulks D, Bullier B, Hennequin M. A national cross-sectional survey of dental anxiety in the French adult population. BMC Oral Health 2007; 7:12. [PMID: 17927808 PMCID: PMC2098754 DOI: 10.1186/1472-6831-7-12] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 10/10/2007] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Dental anxiety is a public health problem but no epidemiological study has been undertaken in France to evaluate its prevalence. The aim of this study was to estimate the prevalence, severity and associations of dental anxiety in a sample of the French adult population. METHODS A convenience sample of 2725 adults (mean age = 47 years, SD16, minimum = 16, maximum = 101 years), representative of the French population with regard to age and urban distribution, completed a French version of the Corah Dental Anxiety scale (DAS) and a questionnaire relating to their dental appointments. RESULTS Moderate dental anxiety (14>or=DAS>or=13) was revealed for 172 persons (6.2%), while 195 (7.3%) had severe dental anxiety (DAS>or=15), giving an overall prevalence of dental anxiety of 13.5%. Prevalence was lower proportionally with age (P < 0.001) and was higher in French overseas territories and in the countryside (P < 0.01). Farmers and low skilled workers were significantly more anxious than executives and shopkeepers (P < 0.001). Anxiety was associated with avoidance of care (p < 0.001) and lack of regular dental appointments (p < 0.001). CONCLUSION Dental anxiety in France appears to concern a similar proportion of the population as in other industrialised European, Australasian or North American countries. Recommendations for prevention and management of dental anxiety are made with reference to dental education and health care services in France.
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Affiliation(s)
- Emmanuel Nicolas
- CHU Clermont-Ferrand, Service d'Odontologie, Hôtel-Dieu, F-63000 Clermont-Ferrand, France
- Univ Clermont1, EA 3847, Faculté d'Odontologie, 11 bvd Charles de Gaulle, F-63000 Clermont-Ferrand, France
| | - Valérie Collado
- CHU Clermont-Ferrand, Service d'Odontologie, Hôtel-Dieu, F-63000 Clermont-Ferrand, France
- Univ Clermont1, EA 3847, Faculté d'Odontologie, 11 bvd Charles de Gaulle, F-63000 Clermont-Ferrand, France
| | - Denise Faulks
- CHU Clermont-Ferrand, Service d'Odontologie, Hôtel-Dieu, F-63000 Clermont-Ferrand, France
- Univ Clermont1, EA 3847, Faculté d'Odontologie, 11 bvd Charles de Gaulle, F-63000 Clermont-Ferrand, France
| | - Brigitte Bullier
- Univ Clermont1, EA 3847, Faculté d'Odontologie, 11 bvd Charles de Gaulle, F-63000 Clermont-Ferrand, France
| | - Martine Hennequin
- CHU Clermont-Ferrand, Service d'Odontologie, Hôtel-Dieu, F-63000 Clermont-Ferrand, France
- Univ Clermont1, EA 3847, Faculté d'Odontologie, 11 bvd Charles de Gaulle, F-63000 Clermont-Ferrand, France
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Enkling N, Marwinski G, Jöhren P. Dental anxiety in a representative sample of residents of a large German city. Clin Oral Investig 2006; 10:84-91. [PMID: 16477408 DOI: 10.1007/s00784-006-0035-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2004] [Accepted: 01/04/2006] [Indexed: 10/25/2022]
Abstract
In a demographic survey, 300 residents of a German city were questioned to determine the prevalence of dental anxiety. The correlation between the amount of dental anxiety and the age, sex, and education of the subjects was examined and the reasons for avoiding dentist's appointments, the duration of this avoidance, and what the subjects desire from future dental treatment. The Hierarchical Anxiety Questionnaire (HAQ) was used to measure the amount of dental anxiety. The average level of anxiety was 28.8+/-10.1 according to the HAQ. Young people were more afraid than older people (p=0.007), and women were more anxious than men (p=0.004). Of the women, 72% go to the dentist regularly, but only 60% of the men do (p=0.020). A painful experience while receiving dental treatment was given by 67% as the main reason for their dental anxiety, followed by a fear of needles (35%). The people wished for the most accurate information available about the dental treatment they receive (69%), followed by a compassionate dentist (62%), and treatment that is free of pain (62%). Of the people, 11% [95% CI: (7.5%; 14.5%)] suffer from dental phobia. All dental phobics were able to state the cause of their fear and more urgently wished for help from the dentist in overcoming their anxiety than the non-phobics (p=0.030). To satisfy the needs of the phobic patients, it appears necessary to screen the phobics out of the group of all patients and then offer them adequate therapy, or refer these patients to specialised treatment centres.
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Affiliation(s)
- Norbert Enkling
- Department of Oral Surgery, Faculty of Dental Medicine, University of Witten/Herdecke, Augusta- Kranken- Anstalt, Bergstrasse 26, 44791 Bochum, Germany
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Ng SKS, Stouthard MEA, Keung Leung W. Validation of a Chinese version of the Dental Anxiety Inventory. Community Dent Oral Epidemiol 2005; 33:107-14. [PMID: 15725173 DOI: 10.1111/j.1600-0528.2004.00199.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To translate the English version of Dental Anxiety Inventory (DAxI) and its short-form (SDAxI) and to validate their use in Hong Kong Chinese. METHODS The DAxI and SDAxI were translated into Chinese. A total of 500 adults (18-64 years) were interviewed, the Chinese DAxI, Symptom Checklist 90 (SCL-90), Depression Anxiety Stress Scales (DASS) and State-Trait Anxiety Inventory (STAI) were completed. Based on their initial DAxI scores, 135 interviewees were invited to attend a dental examination 1 month later. Then, the subjects completed the DAxI again, together with Beck Anxiety Inventory (BAI) which measured the state anxiety level of the participants. Two months after the initial interview, all 500 subjects were asked to complete the DAxI again. Another 300 adults were recruited and interviewed for the SDAxI validation. RESULTS Cronbach's alpha of the Chinese DAxI and SDAxI were 0.77 and 0.80 and the test-retest correlation coefficients were 0.90 and 0.84, respectively. High correlation between BAI and DAxI scores and its stability over time supported construct validity of the Chinese DAxI. Small positive correlations between the DAxI and other subscales of the SCL-90, DASS and STAI supported discriminant validity of the instrument. The SDAxI demonstrated comparable validity and reliability with DAxI. CONCLUSION The translated Chinese DAxI demonstrated good validity and reliability. It is available for use in dental anxiety research in adult Chinese. In situations where a short-form is desirable, the Chinese SDAxI is a simple, valid, reliable and interpretable scale for measuring dental anxiety in both research and dental practice.
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Affiliation(s)
- Sam K S Ng
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Martin MD, Kinoshita-Byrne J, Getz T. Dental fear in a special needs clinic population of persons with disabilities. SPECIAL CARE IN DENTISTRY 2002; 22:99-102. [PMID: 12240894 DOI: 10.1111/j.1754-4505.2002.tb01170.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study reports findings from a survey of dental fear in a special needs dental clinic population. Subjects were recruited from the University of Washington's Dental Education in Care of Persons With Disabilities (DECOD) clinical program (n = 132). Dental fears were assessed using the Kleinknecht Dental Report. Fear levels were examined among patients with differing categories of primary disabilities and between genders, races and educational levels. Some level of dental fear was reported by 43.2% of the respondents, indicating that dental fear may be an important factor in dental care for this population. Gender and educational level were significantly associated with fear levels (both p < 0.05). Significant differences in fear levels were found between individuals with differing classes of disability. Accompanying caregivers also were interviewed (n = 72) to allow for a comparison of patient and caregiver perceptions. Both patient and caregiver were interviewed whenever possible to create paired reports. Generally, caregivers significantly overestimated fear levels compared with patients (p < 0.01). However, when scores were compared in matched caregiver-patient analyses, the fear scores were not significantly different, indicating that caregivers accurately estimated their client's level of dental fear. A regression model including disability group, gender, and years of education was significant for predicting fear level as measured by the Kleinknecht survey (p = 0.02). We conclude that dental fear may be a significant, though little understood problem for a population of persons with disabilities as well as for their oral care providers, and that further investigation is needed.
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Affiliation(s)
- Michael D Martin
- University of Washington School of Dentistry, Seattle 98195, USA.
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State and trait anxiety: A cross-cultural comparison of Chinese and Caucasian students in Canada. CURRENT PSYCHOLOGY 2001. [DOI: 10.1007/s12144-001-1006-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Haugejorden O, Klock KS. Avoidance of dental visits: the predictive validity of three dental anxiety scales. Acta Odontol Scand 2000; 58:255-9. [PMID: 11196400 DOI: 10.1080/00016350050217091] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of this study was to determine the sensitivity, specificity, positive and negative predictive values for Corah's Dental Anxiety Scale (DAS) and two modified versions of it (MDAS; MDAS/4). A questionnaire was mailed to a simple random sample of 1,190 25-year-old residents in the west of Norway in 1997. Half the sample received DAS, the other half MDAS. The response rate after one reminder was 62%. The respondents completed the scales, gave demographic particulars and answered one question about dental visiting habits during the last 5 years plus an open-ended question about reasons for non-attendance. Using the answers to the latter question as validating criterion, it was found that, for all scales, sensitivity decreased while specificity improved when changing from a liberal to a stringent cut-off point. The scales gave low positive predictive values (< or = 0.26), but high negative predictive values (> or = 0.98). Since DAS and MDAS/4 gave almost identical findings, the two samples were combined. At a cut-off point > or = 13 sensitivity was 0.83, specificity 0.84, positive predictive value 0.18 and negative predictive value 0.99. The corresponding estimates when the cut-off point was > or = 15 were 0.67, 0.90, 0.22 and 0.98. It is concluded that, in this test, DAS and the two versions of MDAS gave acceptable, or near acceptable sensitivity, specificity and negative predictive values, but far too low positive predictive values to be useful for prediction at the individual level.
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Affiliation(s)
- O Haugejorden
- Department of Odontology-Community Dentistry, Faculty of Dentistry, University of Bergen, Norway.
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Abstract
OBJECTIVE This paper reports on a study of dental anxiety among adults aged 60 years living independently in Britain. DESIGN A national cross-sectional study carried out with the assistance of the Office for National Statistics' Omnibus Surveys in 1999. SETTING Data was collected by face to face interviews with older people in their homes. MEASUREMENTS Data on dental anxiety were collected from 973 subjects by means of face to face interviews and was measured by the Dental Anxiety Scale (DAS) (Corah, 1969). In addition, data on dental service use and oral health status (self-reported) was collected. RESULTS The mean DAS score was 8.4 (sd 3.5), and 13% (129) of subjects were classified as dentally anxious (DAS > or = 13). DAS scores were associated with numerous socio-demographic factors (P < 0.01), self-reported oral health status (P < 0.01) and dental service (P < 0.01) factors. A series of regression analyses revealed that dental anxiety was a significant predictor of a number of behavioural and oral health outcomes. CONCLUSION One in eight older people in Britain are dentally anxious and this is associated with their use of services and oral health status (self-reported).
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Affiliation(s)
- R Bedi
- National Centre for Transcultural Oral Health, Eastman Dental Institute for Oral Health Care Sciences, University College London, 256 Gray's Inn Road, London WC1X 8LD.
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Hägglin C, Berggren U, Hakeberg M, Hällstrom T, Bengtsson C. Variations in dental anxiety among middle-aged and elderly women in Sweden: a longitudinal study between 1968 and 1996. J Dent Res 1999; 78:1655-61. [PMID: 10520971 DOI: 10.1177/00220345990780101101] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cross-sectional studies have shown that older individuals are significantly less dentally anxious than younger ones. However, research has not been able to show if this is a cohort effect or an effect of fear declining with age. If it is a cohort effect, dental anxiety among the elderly may pose a greater-than-expected problem for the providers of dental services. With the exception of longitudinal studies in children and a three-year follow-up on adults, no truly longitudinal epidemiological studies concerning dental anxiety have been performed. The aim of this project was to investigate how dental anxiety changes with aging. In a longitudinal population study of women in Göteborg, Sweden, starting in 1968, 1462 women aged 38 to 54 participated. A representative subsample of 778 women took part in a psychiatric examination where an investigation of dental anxiety was included. The same questions were also included when these women were re-examined in 1974, 1992, and 1996. Three hundred seventy-five women were still eligible for investigation in 1996. In 1968-69, 48 (12.8%) of the participating women assessed themselves as "very afraid" or "terrified" when visiting the dentist, and in 1996 the frequency was 21 (5.6%) among the same women. In 1968-69, 180 women (48%) reported no dental anxiety when visiting the dentist, and 28 years later the frequency was 230 (61%). In the three youngest age groups, dental anxiety decreased significantly (p < 0.001) over the 28-year period. Older compared with younger women reported significantly less dental anxiety, and this was an age effect rather than a cohort effect. Thus, this longitudinal study supported the hypothesis that dental fear, like many other general and specific phobias, declines with age.
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Affiliation(s)
- C Hägglin
- Department of Endodontology & Oral Diagnosis, Faculty of Odontology, Göteborg University, Sweden
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Thomson WM, Poulton RG, Kruger E, Davies S, Brown RH, Silva PA. Changes in self-reported dental anxiety in New Zealand adolescents from ages 15 to 18 years. J Dent Res 1997; 76:1287-91. [PMID: 9168862 DOI: 10.1177/00220345970760060801] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Little is understood of the natural history of dental anxiety. The aim of this study was to examine three-year changes in self-reported dental anxiety among adolescent participants in the Dunedin Multidisciplinary Health and Development Study. Dental anxiety was estimated at ages 15 and 18 by means of the Corah Dental Anxiety Scale (DAS). A DAS score of 13+ defined high dental anxiety. Participants were assigned to one of four dental-anxiety study groups (Chronic, Incident, Remitted, or Never) on the basis of changes in reported level of anxiety from ages 15 to 18. Results are reported for the 691 participants who completed the DAS at both ages. The sample's overall dental anxiety score decreased significantly from age 15 (mean, 8.79) to 18 (8.52) (paired t test, t = 2.37; P < 0.05). The Chronic and Never groups had small negative DAS increments, the Incident group showed a substantial positive increment, and the Remitted group recorded an even larger negative increment. Multivariate analysis showed that the DAS score at age 15 was the sole predictor of the change in DAS score for the Chronic and Remitted groups, and was a co-predictor for the Incident and Never groups. An episodic dental visiting pattern was a strong predictor of a positive change in DAS score for the Incident group; and for the Never group, a higher DMFS score at age 15 predicted a positive change in DAS score at 18, but being female was predictive of a decrement. This study indicates lower stability of dental anxiety in late adolescence than has been reported from other age groups.
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Affiliation(s)
- W M Thomson
- Department of Community Dental Health, School of Dentistry, University of Otago, Dunedin, New Zealand
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Holtzman JM, Berg RG, Mann J, Berkey DB. The relationship of age and gender to fear and anxiety in response to dental care. SPECIAL CARE IN DENTISTRY 1997; 17:82-7. [PMID: 9582708 DOI: 10.1111/j.1754-4505.1997.tb00873.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The apparent association in the published literature of gender and age with dental fear and anxiety is far from consistent or universal. A random, age-stratified telephone survey of 398 adults was performed in a US metropolitan area: Denver, Colorado. Information collected included Kleinknecht's Dental Fear Survey (DFS). In addition to total DFS scores, values were also calculated for the sums of the five DFS physiologic response items (PATRESP) and 12 DFS fear-producing stimulus items (DENTSTIM). Tests for reliability of these three scales were performed (alpha = 0.804 to 0.936). In this sample population, significant age and gender differences were noted. In general, fear and anxiety decreased in importance with increased respondent age, with the largest difference noted between the 40-50 and 60-69 age groups. Increased fear and anxiety were most apparent among younger females (20-30 and 40-50) as compared with older females (60 and older). However, among males, the summary variable for physiologic response to fear and anxiety did not appear to be age-related. Among the oldest respondents (ages 70+), 12.2% did report a "major" response to muscle tension when in the dental chair. Females reported more fear of some stimuli associated with dental care (e.g., "feeling the drill in the mouth") than did males.
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Affiliation(s)
- J M Holtzman
- Department of General and Hospital Dentistry, UMDNJ New Jersey Dental School, Newark 07103-2400, USA
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