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Vitali FC, Mafra G, Santos PS, da Fonseca Roberti Garcia L, da Silveira Teixeira C. Patient-related predictors of post-operative pain following root canal treatment: A structural model analysis. Int Endod J 2024. [PMID: 39150401 DOI: 10.1111/iej.14137] [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: 04/16/2024] [Revised: 07/01/2024] [Accepted: 08/05/2024] [Indexed: 08/17/2024]
Abstract
AIM The pathways to post-operative pain are complex and encompass factors that extend beyond the treatment protocol employed. This study aimed to identify patient-related predictors of post-operative pain following root canal treatment. METHODOLOGY A total of 154 patients received a single-visit root canal treatment for asymptomatic necrotic mandibular molars. Before treatment, dental anxiety, dental fear and sense of coherence (SOC) were measured as predictors for each patient using validated questionnaires. Other measured predictors included gender, age, previous negative experiences at the dental offices and prior root canal treatment. Post-operative pain was assessed using the Numeric Rating Scale at multiple time-points over 30 days. Structural equation analysis was employed to evaluate the direct and indirect effects of patient-related predictors on a theoretical model of post-operative pain. The irrigant solution was also included in the model, as it was the only aspect that varied in the treatment protocol (sodium hypochlorite 2.5% and 8.25%). RESULTS Dental anxiety (coefficient 0.028; p < .01), dental fear (coefficient 0.007; p = .02) and irrigant solution (coefficient 0.004; p = .03) exerted a direct effect on post-operative pain. SOC exerted an indirect effect on post-operative (coefficient 0.006; p = .01) through dental anxiety and dental fear. Moreover, previous negative experiences (coefficient 0.048; p = .04) exerted an indirect effect on post-operative pain through dental anxiety. CONCLUSIONS Dental anxiety, dental fear, previous negative experiences and SOC are patient-related predictors of post-operative pain following root canal treatment. These factors should be taken into consideration in clinical practice, as patients with these characteristics may be at an increased risk of experiencing post-operative pain.
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Affiliation(s)
- Filipe Colombo Vitali
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Gabriel Mafra
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Pablo Silveira Santos
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
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Janik K, Niemczyk W, Peterek R, Rój R, Balicz A, Morawiec T. Computer-Controlled Local Anaesthesia Delivery efficacy - a literature review. Saudi Dent J 2024; 36:1066-1071. [PMID: 39176166 PMCID: PMC11338014 DOI: 10.1016/j.sdentj.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 08/24/2024] Open
Abstract
Minimising pain with effective local anaesthesia is an essential step towards improving the level of dentally anxious patients' comfort during dental treatment. It can be provided by many different techniques. One of them is using the Computer-Controlled Local Anaesthesia Delivery systems (CCLADs). This study was conducted to compare the efficacy of computerised anaesthesia with the conventional technique in terms of perceived pain. A database literature search was performed on PubMed, Cochrane Library and Google Scholar, covering up the period between 2015 and 2023. Only the studies comparing computerised anaesthesia technique with the use of conventional carpule were included. An overview of 20 relevant studies (n = 1347 subjects) was provided including pediatric patients, as well as the adults. The evaluated parameters were: pain, child's behaviour, heart rate, blood pressure, level of satisfaction, anxiety, further anaesthesia method preference, need for additional anaesthetic, as well as the duration of anaesthesia, measured by different scales, devices and questionnaires. The present literature review led the authors to the conclusion, that the use of CCLADs is significantly less painful than the traditional anaesthesia and it is a promising technique for helping patients deal with pain perception. However, it is advisable to conduct further research on the use of CCLAD.
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Affiliation(s)
- Katarzyna Janik
- Department of Oral Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
| | - Wojciech Niemczyk
- Department of Oral Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
| | - Robert Peterek
- Department of Oral Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
| | - Rafał Rój
- Department of Oral Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
| | - Agnieszka Balicz
- Department of Oral Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
| | - Tadeusz Morawiec
- Department of Oral Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
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Elfezary MT, Moteea ME, Abu Samadah MS, Waly AS. The implementation of conscious sedation by dental professionals in Egypt: an analytical cross-sectional study. Sci Rep 2024; 14:16502. [PMID: 39019966 PMCID: PMC11255333 DOI: 10.1038/s41598-024-66834-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/04/2024] [Indexed: 07/19/2024] Open
Abstract
Conscious sedation is widely considered one of the techniques most commonly used to manage anxiety in both children and adults during dental procedures. The application of procedural sedation exhibits considerable variation globally. The purpose of the study was to determine the prevalence of conscious sedation in the current situation in the dental healthcare sector in Egypt and to identify the factors influencing it. An online cross-sectional analytical survey, consisting of nine multiple choice questions, was distributed through the contact lists of national dentists and social media platforms. 163 respondents completed the survey. Regarding the use of conscious sedation, only 25 (15.3%),95% confidence interval (10-21) utilized it. The percentage of participants who used conscious sedation was higher among dentists practicing pediatric dental specialists (n = 19, 76%). Academic qualification correlates significantly with the practice of conscious sedation (P = 0.002), but this was not reflected in multiple logistic regression. Indeed, while conscious sedation is part of the dental study curriculum in Egypt, its application rate is relatively low compared to other countries. This discrepancy could be attributed to a variety of factors, including resource availability, lack of training, reflecting the need to develop strategies to improve the implementation of conscious sedation in Egyptian dental practices.
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Affiliation(s)
- Mohamed Taha Elfezary
- Department of Pediatric Dentistry, Faculty of Dentistry, Al-Azhar University, Assiut, Egypt.
| | - Mohamed Elsayed Moteea
- Department of Pediatric Dentistry, Faculty of Dentistry, Al-Azhar University, Assiut, Egypt
| | | | - Ahmed S Waly
- Department of Pediatric Dentistry, Faculty of Dentistry, Al-Azhar University, Assiut, Egypt
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Kildahl AN, Berggren T, Rønneberg A, Molnes CSY, Nordgarden H. A call for trauma-informed dental care for individuals with intellectual disabilities. SPECIAL CARE IN DENTISTRY 2024; 44:1126-1134. [PMID: 38192120 DOI: 10.1111/scd.12959] [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: 11/23/2023] [Revised: 12/20/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024]
Abstract
People with intellectual disabilities are at increased risk of dental anxiety and poor oral health. In addition, people with intellectual disabilities are at increased risk of potentially traumatic experiences, such as violence and sexual abuse, and appear to be more vulnerable to developing trauma-related disorders following such experiences. While psychological trauma is associated with poor oral health and dental anxiety in the general population, the potential link between dental anxiety, poor oral health and psychological trauma is yet to be explored in people with intellectual disabilities. In this conceptual paper, we provide an overview of recent findings concerning the relationships between oral health and intellectual disabilities, psychological trauma and intellectual disabilities, as well as between psychological trauma and oral health, and discuss the relevance of these findings related to dental care for people with intellectual disabilities. We conclude that psychological trauma is likely to contribute to dental anxiety and poor oral health also in people with intellectual disabilities. Implications include an urgent need for research exploring how trauma affects oral health and experiences of dental care for people with intellectual disabilities, as well as the importance of individualized and trauma-informed dental care for these individuals.
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Affiliation(s)
- Arvid Nikolai Kildahl
- Regional Section Mental Health, Intellectual Disabilities/Autism, Oslo University Hospital, Oslo, Norway
- NevSom - Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Oslo, Norway
| | - Tiril Berggren
- TAKO-Centre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway
| | | | | | - Hilde Nordgarden
- TAKO-Centre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway
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Czakert J, Kandil FI, Boujnah H, Tavakolian P, Blakeslee SB, Stritter W, Dommisch H, Seifert G. Scenting serenity: influence of essential-oil vaporization on dental anxiety - a cluster-randomized, controlled, single-blinded study (AROMA_dent). Sci Rep 2024; 14:14143. [PMID: 38898054 PMCID: PMC11187188 DOI: 10.1038/s41598-024-63657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The objective of this study was to analyze the effect of essential-oil vaporization on acute anxiety of patients in dental practices. Four dental practices used five weekly cycles of vaporization with each scent: Orange (Citrus sinensis), Swiss Pine (Pinus cembra), Good Mood (blended essential oils: Citrus sinensis, Citrus aurantifolia, Citrus limon, Osmanthus fragrance (5%)), Forest Walk (blended essential oils: Abies grandis, Pinus cembra, Myrtus communis c. t. 1,8-cineol, Abies alba, Citrus paradisi, Abies sibirica, Pseudotsuga menziesii, Vetiveria zizanoides), and water. Acute anxiety was the primary outcome (state-trait-anxiety inventory (STAI-S)). Secondary outcomes were trait anxiety (STAI-T), dental anxiety (Kleinknecht dental fear survey), and pain perception in treatment (numeric rating scale). Across all patients (n = 486), STAI-S was slightly higher in the control group (40.7 ± 11.6) than in the intervention groups (38.4 ± 10.5). Post-hoc analyses revealed that the effect is only robust for the subgroup of female patients (n = 296, p = 0.044). We also conducted a post-hoc additional analysis on a subpopulation with an increased level of STAI-T ≥ 42 (n = 131 patients). For this group the difference in acute anxiety between the control group (51.1 ± 11.9, n = 30) vs. the intervention groups (46.8 ± 9.6, n = 118) was significant (T = 4.39, p = 0.0379). The results of the study indicate a promising potential of essential-oil vaporization to alleviate dental anxiety, particularly in the subgroups of patients with a high level of trait anxiety, and particularly in female patients. The calming effects of the essential-oil vaporization were also highlighted by the anecdotical statements of the dental-practice staff. The anxiety-reducing role of essential-oil vaporization alone and as one part of combined techniques to counter DFA should be further explored using multi-perspective methodological approaches in research.
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Affiliation(s)
- Judith Czakert
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
| | - Farid I Kandil
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Hiba Boujnah
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Pantea Tavakolian
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Sarah B Blakeslee
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Dentistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
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Zhang D, Li S, Zhang R. Effects of dental anxiety and anesthesia on vital signs during tooth extraction. BMC Oral Health 2024; 24:632. [PMID: 38811912 PMCID: PMC11134746 DOI: 10.1186/s12903-024-04404-5] [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: 12/31/2023] [Accepted: 05/23/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Anxiety is common preceding tooth extraction; hence, it is crucial to identify patients with dental anxiety (DA) and to manage DA. This study assessed the level of DA and influencing factors in tooth extraction patients in a dental hospital in China and changes in their blood pressure (BP) and heart rate (HR) during the tooth-extraction procedure. METHODS The study was a cohort study. The Dental Anxiety Scale (DAS) was used to assess the level of DA of 120 patients before tooth extraction. A Demographics and Oral Health Self-Assessment Form was used to assess factors influencing DA. The correlations of DAS scores with HR and BP were measured. The effects of local anesthesia and general anesthesia on HR and BP were also compared using a Datex-Ohmeda anesthesia monitor to detect HR and BP continuously before and after anesthesia. Independent sample t-tests, OLS multiple regression model and one-way analysis of variance were applied to analysis the results. RESULTS Based on the DAS score, 12.5% of the participants were identified as suffering from DA. DA was related to age, gender, and the self-assessment of oral health. The DAS score was correlated with increased BP (P < 0.05). BP showed an overall upward trend after local anesthesia, while it was generally stable after general anesthesia. The systolic BP at 4 and 5 min and the HR at 2 and 4 min increased remarkably (P < 0.05) after local anesthesia compared with those before anesthesia. The HR and BP of patients under local anesthesia were generally higher than those of patients under general anesthesia were during the operation. CONCLUSIONS The prevalence of DA in adults was 12.5% in this study population. DA was related to gender, age, and the self-assessment of oral health. The score of DAS was correlated with BP. Compare to local anesthesia, general anesthesia can make the vital signs of tooth extraction patients more stable.
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Affiliation(s)
- Diya Zhang
- Dental Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, Zhejiang, China.
| | - Shenglai Li
- Department of Oral and Maxillofacial Surgery, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
| | - Rui Zhang
- Dongfang College, Zhejiang University of Finance and Economics, Hangzhou, China
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Wong NSM, Yeung AWK, McGrath CP, Leung YY. Adverse childhood experiences and dental anxiety among Chinese adults in Hong Kong: a cross-sectional study. Front Psychol 2024; 15:1372177. [PMID: 38840746 PMCID: PMC11150826 DOI: 10.3389/fpsyg.2024.1372177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction This study aimed to investigate the relationship between adverse childhood experiences (ACEs) and dental anxiety among Chinese adults in Hong Kong. Methods A cross-sectional survey was conducted at a university in Hong Kong. The recruiting period and data collection started in January 2023 and ended in June 2023. Participants completed an online questionnaire that assessed ACEs (using the Adverse Childhood Experiences International Questionnaire - ACE-IQ) and dental anxiety (using the Modified Dental Anxiety Scale - MDAS and Dental Fear Survey - DFS). The study examined the impacts of both cumulative (i.e., total number) and independent ACE components on dental anxiety. To explore the relationships between cumulative ACEs, individual ACE components and dental anxiety (MDAS and DFS score), Pearson correlations, linear regression and logistic regression were conducted. Results Significant associations were observed between ACEs and dental anxiety among 171 subjects. Cumulative ACEs were positively correlated with MDAS scores (r = 0.169, p = 0.027) and DFS scores (r = 0.253, p < 0.001). The odds of an individual having high dental anxiety increased by 26-43% for every additional increase in the number of ACEs. Individual types of ACEs, such as emotional and physical neglect, sexual abuse, and household substance abuse, significantly influenced the likelihood of having high dental anxiety. Discussion The results showed a positive association between ACEs and dental anxiety, highlighting the impact of ACEs on dental anxiety. Dental practitioners should consider inquiring about a patient's ACE history to develop personalized treatment plans.
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Affiliation(s)
- Natalie Sui Miu Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Colman Patrick McGrath
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Tunca Y, Kaya Y, Tunca M, Keskin S. Comparison of anxiety, pain, and quality of life in individuals with mild or moderate malocclusion between conventional fixed orthodontic treatment versus Invisalign: a randomised clinical trial. BMC Oral Health 2024; 24:576. [PMID: 38760747 PMCID: PMC11102135 DOI: 10.1186/s12903-024-04335-1] [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: 02/25/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND We evaluated anxiety, pain, and oral-health-related quality of life in individuals treated with conventional fixed appliances (Group A) and clear aligners (Group B) for moderate malocclusion during the initial phase of orthodontic treatment. METHODS Sixty individuals, separated into Group A (n = 30) and Group B (n = 30), were included in the study. They completed the Anxiety Levels, Oral Health Impact Profile-14, and Oral Health Related Quality of Life - United Kingdom/Surveys after the application of attachments on days 0 (T1), 10 (T10), and 20 (T20). Their pain levels were evaluated with the Visual Analogue Scale on days 0, 2, and 6 in the 2nd and 6th hours and on the 1st, 3rd, 7th, 14th, and 21st days. RESULTS Per the VAS questionnaire, pain levels in the 2nd hour, 6th hour, 1st day, and 3rd day were significantly lower in Group B than in Group A. In the OHIP-14 survey results, the comparison between Group A and Group B showed a significant difference only on the 1st day. The STAI and OHRQoL-UK survey results did not differ significantly between the groups. CONCLUSIONS We found no significant difference between the two groups in terms of anxiety levels, and pain among individuals in Group A was higher than in Group B only at the beginning of the treatment. No significant differences were observed in terms of individuals' quality of life. TRIAL REGISTRATION NCT06133296 (retrospectively registered)- Registration Date:15/11/2023.
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Affiliation(s)
- Yasemin Tunca
- Faculty of Dentistry, Department of Orthodontics, Van Yuzuncu Yil University, Van, 65080, Turkey
| | - Yesim Kaya
- Faculty of Dentistry, Department of Orthodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Murat Tunca
- Faculty of Dentistry, Department of Orthodontics, Van Yuzuncu Yil University, Van, 65080, Turkey.
| | - Sıddık Keskin
- Faculty of Medicine, Department of Biostatistics, Van Yuzuncu Yil University, Van, 65080, Turkey
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Samami M, Farrahi H, Alinia M. The relationship between dental anxiety and oral health literacy with oral health-related quality of life. BMC Oral Health 2024; 24:567. [PMID: 38745147 PMCID: PMC11094898 DOI: 10.1186/s12903-024-04359-7] [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: 03/03/2024] [Accepted: 05/09/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND AND AIM Dental anxiety is a prevalent issue in society, characterized by an uneasy sensation and anticipation of negative experiences in dental settings. In essence, dental anxiety, oral health literacy, and quality of life may have a relationship with each other, however, there is a shortage of evidence examining the interplay between these factors. Therefore, this study aimed to assess the relationship between dental anxiety and oral health literacy (OHL) with oral health-related quality of life (OHRQOL). METHODS This is an analytical cross-sectional study conducted on 155 patients referred to the Department of Oromaxillofacial Diseases. Three questionnaires consisting of dental anxiety scale, oral health impact profile- 14, and oral health literacy adult questionnaire were used to measure anxiety, health literacy, and the quality of life-related to oral health. Scores were recorded and analyzed by IBM SPSS 24 software using independent samples T-test and ANOVA. Besides, the confirmatory modeling through the goodness of fit index of the model was applied. RESULTS This study involved 155 participants, with a mean age of 38.44 ± 14 years. The majority were females, comprising 99 individuals (63.9%). In this study, 89 patients (57.4%) had dental anxiety. The mean OHL score in the examined participants was 9.88 ± 3.97. Both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on the OHRQOL. There was no significant difference in the mean OHRQOL among the three categories of OHL (p = 0.085). The confirmatory modeling showed that only the fourth (p = 0.065) and fifth (p = 0.146) questions of the OHL questionnaire had no significant effect on the total score of OHL. Besides, both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on OHRQOL. With an increase of one unit in anxiety, the OHRQOL score increases by 0.31 and for a one-unit increase in the OHL score, the OHRQOL score decreases by 0.66 units. CONCLUSION In conclusion, it seems that considering various dimensions of oral and dental health can help patients to have reduced psychological anxiety. Notably, further multicenter studies assessing diverse variables related to dental anxiety, OHL, and OHRQOL, and considering more comprehensive study designs with longitudinal follow-up could help provide insights into how changes in dental anxiety and OHL over time affect OHRQOL.
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Affiliation(s)
- Mohammad Samami
- Dental Sciences Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Hassan Farrahi
- Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Geddis-Regan A, Fisal ABA, Bird J, Fleischmann I, Mac Giolla Phadraig C. Experiences of dental behaviour support techniques: A qualitative systematic review. Community Dent Oral Epidemiol 2024. [PMID: 38680013 DOI: 10.1111/cdoe.12969] [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: 07/17/2023] [Revised: 03/27/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can provide unique insight into these experiences. AIM To explore and synthesize qualitative literature related to patient experience of dental behaviour support. METHODS A PROSPERO-registered systematic review of qualitative articles was undertaken. Studies were identified through MEDLINE, Embase and PsycINFO. Abstracts were screened by two reviewers and data were extracted to summarize the qualitative findings included within them. A thematic summary approach was used to synthesize the qualitative data identified. RESULTS Twenty-three studies were included. Studies primarily explored experiences of dental care of children by speaking to their parents (n = 16), particularly regarding paediatric dental general anaesthesia (DGA) (n = 8). Studies of adults' experiences of DBS (n = 7) covered a range of techniques. Nine studies explored broader dental care experiences and did not study specific DBS approaches. A thematic synthesis identified five themes applicable across the studies identified: Trust and the therapeutic alliance supporting effective care delivery; considered information sharing often alleviated anticipatory anxiety; control and autonomy-reduced anxieties; variations in the perceived treatment successes and failures of DBS techniques; and DBS techniques produced longer positive and negative impacts on patients beyond direct care provision. CONCLUSION Qualitative research has been under-utilized in research on DBS techniques. Care experiences of most DBS techniques outside of paediatric DGA are poorly understood. Building trust with patients and enabling autonomy appear to support positive patient-reported experiences of care.
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Affiliation(s)
| | - Aisyah Binti Ahmad Fisal
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - James Bird
- The Rotherham NHS Foundation Trust, Rotherham, UK
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | | | - Caoimhin Mac Giolla Phadraig
- Department of Child and Public Dental Health, Dublin Dental University Hospital, School of Dental Sciences, Trinity College Dublin, Dublin, Ireland
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11
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Slabšinskienė E, Radlinskaitė K, Kavaliauskienė A, Vasiliauskienė I, Zūbienė J, Saldūnaitė-Mikučionienė K, Zaborskis A. Do Subjects from Different Occupational Groups Experience Dental Fear and Anxiety Equally? MEDICINA (KAUNAS, LITHUANIA) 2024; 60:674. [PMID: 38674320 PMCID: PMC11051849 DOI: 10.3390/medicina60040674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. Materials and Methods: A cross-sectional study with 422 respondents from four occupational groups (physicians, teachers, industry workers, and artists) was carried out. A questionnaire on previous dental experience using the Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and Self-Esteem Scale was self-administered electronically. The data analysis involved descriptive statistics and structural equation modeling (SEM). Results: The DFA levels differed significantly across the occupational groups, with the lowest mean scores among physicians (DAS = 9.29 (SE 0.39); DFS-1 = 14.67 (0.63); DFS-2 = 33.94 (1.69)) and the highest mean scores among artists (DAS = 10.74 (0.38); DFS-1 = 17.19 (0.71); DFS-2 = 41.34 (1.92)). A significant impact of self-esteem on DFA was observed among physicians, teachers, and artists, but not among industry workers. Multi-group analysis with SEM revealed differences in the variable association (Chi-squared = 53.75; df = 21; p < 0.001), thus rejecting the hypothesis of the same mechanism underlying DFA across occupational groups. Conclusions: Individuals from various occupations experience DFA at different levels, and there are different mechanisms underlying their DFA. These findings can provide valuable insights for dental practitioners in developing tailored approaches to reduce the feeling of DFA of their patients.
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Affiliation(s)
- Eglė Slabšinskienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Karolina Radlinskaitė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Aistė Kavaliauskienė
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania;
| | - Ingrida Vasiliauskienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Jūratė Zūbienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Kristina Saldūnaitė-Mikučionienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Apolinaras Zaborskis
- Department of Preventive Medicine & Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania;
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Aardal V, Willumsen T, Evensen KB. Differences in anxiety, depression, and oral health-related quality of life among dental anxiety patients with and without reported abuse experience. Eur J Oral Sci 2024; 132:e12976. [PMID: 38305706 DOI: 10.1111/eos.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024]
Abstract
This study aimed to explore the differences in anxiety, depression, and oral health-related quality of life between people with dental anxiety who reported abuse experience (n = 60) and people with dental anxiety who did not report abuse experience (n = 97). Both groups attended a dental service focused on the treatment of dental anxiety intended for people with a history of physiological or psychological trauma, or odontophobia. The participants responded to a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), Oral Impacts on Daily Performance (OIDP), and the Index of Dental Anxiety and Fear (IDAF-4C+ ). The differences between groups were tested for statistical significance using Welch's T-tests, and linear regression was used to adjust for gender. The participants with reported abuse experience expressed greater psychological symptoms of anxiety and poorer oral health-related quality of life. The participants with reported abuse experience also expressed a higher fear of losing control, as well as feeling shame and disgust. This study shows that individuals with dental anxiety and a history of abuse may face more complex challenges than those with dental anxiety and no history of abuse.
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Affiliation(s)
- Vilde Aardal
- Oral Health Centre of Expertise in Rogaland, Stavanger, Norway
- Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024; 25:280-288. [PMID: 38690703 DOI: 10.5005/jp-journals-10024-3643] [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] [Indexed: 05/02/2024]
Abstract
AIM This study was undertaken with an aim to explore the influence of factors associated with anxiety and fear of dentistry on oral health behavior. MATERIALS AND METHODS A total of 84 patients aged 20-40 years visiting the dental institute for the management of gum diseases (gingivitis and periodontitis) and tooth decay (dental caries) were enrolled. Fear of dentistry and oral health behaviors were recorded employing a dental fear survey (DFS) and oral health behaviors checklist. Each of the 20-item scale of DFS was rated on a 5-point Likert scale. The oral health behavior checklist was based on oral hygiene habits, patterns of utilization of dental services, food habits, and use of tobacco products. Each of the 13-item checklist comprised a closed-ended statement with a high score corresponding to more positive oral health behavior. RESULTS Domains of dental fear (avoidance of dentistry, physiological arousal, and fear of specific stimuli) and total dental fear did not predict oral hygiene habits and nutritional preferences (p > 0.05). Physiological arousal was a positive predictor of utilization of dental services (p = 0.009) and oral health behavior (p = 0.042). Oral health behaviors were found to be positively correlated with three factors of DFS. CONCLUSION Anxiety and fear of dentistry are not found to influence personal preventive oral care with reference to oral hygiene habits. Avoidance of dentistry factor of DFS is positively correlated with oral health behavior. Dental fear and anxiety do not impact oral health behaviors adversely. CLINICAL SIGNIFICANCE In this era of youth and beauty, the utilization of professional dental care services is not affected by fear of invasive nature of dental procedures. Establishing the groundwork for knowledge regarding the scope of fear appeals in anxiety for dentistry may help to augment positive oral health behaviors for effective primary prevention of oral diseases. Interactions among personality characteristics, attitudes, emotions, and health behavior need further exploration. How to cite this article: Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024;25(3):280-288.
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Affiliation(s)
- Supriya
- Department of Psychology, Faculty of Behavioral Sciences, SGT University Gurugram, Haryana, India, Phone: +91 9821848374, e-mail: , Orcid: https://orcid.org/0009-0000-8224-9309
| | - Rajbir Singh
- Department of Psychology, Faculty of Behavioral Sciences, SGT University Gurugram, Haryana, India
| | - Amra Ahsan
- Department of Psychology, Faculty of Behavioral Sciences, SGT University Gurugram, Haryana, India
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Tanaka S, Karibe H, Kato Y, Okamoto A, Koeda M, Hama T. Comparison of Aversion to Visual Dental Stimuli Between Patients and Dentists: A Preliminary Study. Patient Prefer Adherence 2024; 18:623-633. [PMID: 38476588 PMCID: PMC10929565 DOI: 10.2147/ppa.s447526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose Fearful dental patients often cite various dental instruments or procedures as triggers for their dental fear. Thus, visual dental stimuli provoke anxiety. This preliminary study aimed to assess the level of aversion to visual stimuli in dental patients and compare it with that in dentists. Patients and Methods A total of 43 dental patients (25 women, 18 men; average age, 29.9 ± 13.3 years; patient group) and 13 dentists (4 women, 9 men; average age, 28.2 ± 2.0 years; dentist group) were included. All participants had previously undergone dental treatment. The dental fear level was assessed using the self-reported Dental Fear Survey (DFS). Thirty-two images associated with dental treatment were prepared and classified into three categories: dental instruments, dental procedures, and the dental environment. All participants rated their level of disgust toward each image on a visual analog scale with scores ranging from 0 to 100. Results In the patient group, the disgust ratings for tooth extraction, dental drilling, and local anesthesia were >60, which were significantly different from those in the dentist group (Mann-Whitney U-test, p<0.001, p=0.001, and p=0.001, respectively). The ranking order of the disgust ratings for the 32 images showed significant correlation between the patient and dentist groups (Spearman correlation coefficient, r=0.80, p<0.001). In the patient group, the disgust ratings for dental impressions and the interdental brush, dental light, and dental chair were significantly correlated with DFS scores (r=0.61, p<0.001; r=0.47, p=0.001; r=0.41, p=0.006; and r=0.40, p=0.008, respectively). Conclusion This study revealed that patients have more negative feelings toward invasive procedures than dentists. However, a significant correlation was identified between the ranking of aversion-provoking dental stimuli by patients and dentists. Furthermore, the level of aversion to several dental-related items that do not cause pain was correlated with the dental fear level.
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Affiliation(s)
- Satoshi Tanaka
- Department of Pediatric Dentistry, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Hiroyuki Karibe
- Department of Pediatric Dentistry, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Yuichi Kato
- Department of Pediatric Dentistry, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Ayuko Okamoto
- Department of Pediatric Dentistry, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Michihiko Koeda
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - Tomoko Hama
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Ehime, Japan
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15
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Heyman RE, Daly KA, Slep AMS, Wolff MS. Leveraging technology to increase the disseminability of evidence-based treatment of dental fear: An uncontrolled pilot study. J Public Health Dent 2024; 84:36-42. [PMID: 38114444 PMCID: PMC11173353 DOI: 10.1111/jphd.12598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/14/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence-based cognitive-behavioral treatments for dental fear (CBT-DF) exist, they have little impact on the millions who seek dental care annually because they are not disseminable (6 h of in-chair time, delivered only in person at a few sites). We developed a disseminable CBT-DF stepped-care treatment comprising (Step 1) a mobile-health application and, for those who remain fearful, (Step 2) a 1-h, one-on-one psychological treatment session that allows practice during exposure to the patient's most-feared stimuli. We hypothesized that the treatment would (a) be rated highly on usability and credibility and (b) result in clinically consequential (i.e., lowering fear into the 0-3 "no/low fear" zone) and statistically significant changes in global dental fear. METHOD Racially/ethnically diverse patients (N = 48) with moderate to severe dental fear were recruited; all completed Step 1, and n = 16 completed Step 2. RESULTS As hypothesized, users found the stepped-care treatment highly usable, credible, and helpful. Critically, this stepped-care approach produced reductions in patients' dental fear that were both clinically consequential (with half no longer fearful) and statistically significant (d = 1.11). CONCLUSIONS This usable, credible, stepped-care approach to dental fear treatment holds promise for liberating evidence-based CBT-DF from specialty clinics, allowing broad dissemination.
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Affiliation(s)
| | | | | | - Mark S. Wolff
- University of Pennsylvania School of Dental Medicine
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16
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Sun IG, Chu CH, Lo ECM, Duangthip D. Global prevalence of early childhood dental fear and anxiety: A systematic review and meta-analysis. J Dent 2024; 142:104841. [PMID: 38246307 DOI: 10.1016/j.jdent.2024.104841] [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: 11/16/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE The objective of this review is to determine the global prevalence of dental fear and anxiety (DFA) in early childhood and identify its related factors. METHODS The systematic review utilized three common English-language databases (PubMed, EMBASE, and Web of Science). Two independent researchers performed a systematic search to include observational studies on young children published from 2000 to 2023. They extracted information on prevalence of DFA, assessment tools used, study sites, respondents, and children's dental visit experiences. RESULTS A total of 2,895 studies were identified, and 25 studies met the inclusion criteria for analysis. The pooled prevalence of DFA among 2- to 6- year-old children was estimated to be 30 % (95 % CI=25, 36). Children without dental visit experience (OR=1.37, 95 % CI=1.18, 1.59) and children with caries experiences (OR=1.18, 95 % CI=1.09, 1.27) had higher odds of experiencing DFA compared to those with dental visit experience or caries-free status. The most commonly used assessment tools in the included studies were the Frankl Behaviour Rating Scale (32 %, 8/25), Children's Fear Survey Schedule-Dental Subscale (20 %, 5/25), and Dental Anxiety Question (20 %, 5/25). CONCLUSIONS This systematic review reveals that approximately one-third of young children globally experience DFA. Children who lack dental visit experience or have caries experiences are at increased risk of DFA. Clinicians can use this information to make informed decisions regarding dental care provision for young children. CLINICAL SIGNIFICANCE This study provides comprehensive information on the global prevalence of dental fear and anxiety and its associated factors in early childhood. The findings can assist clinicians in understanding and addressing DFA in their dental care approach for young children. REGISTRATION PROSPERO (CRD42023446464).
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Affiliation(s)
- Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; College of Dentistry, The Ohio State University, Columbus, OH, USA.
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17
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Galletti C, Lombardo C, LA Barbiera C, Boronat-Català M, Almiñana-Pastor PJ, Sala Fernàndez C, Ramírez-Sebastià A, Muscatello MR, Bruno A, Mento C. Dental anxiety, Quality of Life and body image: gender differences in Italian and Spanish population. Minerva Dent Oral Sci 2024; 73:14-19. [PMID: 37878239 DOI: 10.23736/s2724-6329.23.04820-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
BACKGROUND Dental anxiety is an excessive and irrational negative emotional state experienced by population; the dental anxiety is common throughout the lifespan and is an obstacle to improving oral health behaviors and outcomes. The aim of this study was to assess gender differences in dental anxiety and to investigate if oral health impacts patients' Quality of Life and the perception of their body image. METHODS The sample consisted of 366 subjects selected in Italy and Spain (January 2021-September 2021). For this study, data were gathered using Google Forms (Google LLC, Mountain View, CA, USA). Data were collected including the Dental Anxiety Scale (DAS), Oral Health Impact Profile (OHIP-14) questionnaires and Body Uneasiness Test. RESULTS Women showed higher scores than men for the dental anxiety. The regression analysis showed that gender, age, and Oral Health Impact are predictors of "dental anxiety." A borderline significance emerges for the independent variable body uneasiness. CONCLUSIONS The dental anxiety is widespread in the population, with a higher prevalence among women and increases with increasing age. It can negatively affect patients' Quality of Life, well-being, and self-esteem. These results underline the importance of addressing both individual and group strategies for preventing or treating dental anxiety.
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Affiliation(s)
- Cosimo Galletti
- School of Dentistry, Department of Integrated Dentistry, International University of Catalonia, San Cugat del Vallès, Barcelona, Spain
| | - Clara Lombardo
- Unit of Psychiatry, Polyclinic G. Martino University Hospital, Messina, Italy
| | | | - Montserrat Boronat-Català
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Pedro J Almiñana-Pastor
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Cristina Sala Fernàndez
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Anais Ramírez-Sebastià
- School of Dentistry, Department of Endodontic and Restorative Dentistry, International University of Catalonia, Sant Cugat del Vallès, Barcelona, Spain
| | - Maria Ra Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Carmela Mento
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy -
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Ferreira GF, Machado GGA, Roncolato VL, Bussadori SK, Motta LJ, Duran CCG, Fernandes KPS, Mesquita-Ferrari RA, Horliana ACRT. Use of photobiomodulation (880 nm) for anesthesia puncture pain reduction: A split-mouth case report. JOURNAL OF BIOPHOTONICS 2024; 17:e202300401. [PMID: 38031986 DOI: 10.1002/jbio.202300401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
The objective of this split-mouth case report is to evaluate the effect of photobiomodulation (PBM, 880 nm) on pain control during pterygomandibular puncture. A patient received anesthesia on both sides of the mouth in a randomized manner. On the right side, an 880-nm infrared laser was applied immediately before local anesthesia. On the left side, a sham laser was applied using the same technique. There was a 50% reduction in pain levels on the PBM-treated side compared to the PBM-sham side, as measured by the visual analog scale. Sensitivity tests revealed that anesthesia was more effective on the PBM side. There was no difference in blood pressure. This case report suggests that PBM (880 nm) before anesthesia may alleviate puncture pain associated with pterygomandibular anesthesia. Although these findings are based on a single case report, they can serve as the initial stepping stone for further randomized clinical trials.
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Affiliation(s)
| | | | | | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics-Medicine, Universidade Nove de Julho, UNINOVE, São Paulo, Brazil
- Postgraduate Program in Reabilitation Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics-Medicine, Universidade Nove de Julho, UNINOVE, São Paulo, Brazil
| | | | | | - Raquel Agnelli Mesquita-Ferrari
- Postgraduate Program in Biophotonics-Medicine, Universidade Nove de Julho, UNINOVE, São Paulo, Brazil
- Postgraduate Program in Reabilitation Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, Brazil
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Geers AL, Seligman LD, Pituch KA, Colagiuri B, Marusak HA, Rabinak CA, Turner N, Al-Ado SL, Nedley M. A study protocol testing pre-exposure dose and compound pre-exposure on the mechanisms of latent inhibition of dental fear. BMC Psychol 2024; 12:36. [PMID: 38238866 PMCID: PMC10797709 DOI: 10.1186/s40359-024-01527-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Dental stimuli can evoke fear after being paired - or conditioned - with aversive outcomes (e.g., pain). Pre-exposing the stimuli before conditioning can impair dental fear learning via a phenomenon known as latent inhibition. Theory suggests changes in expected relevance and attention are two mechanisms responsible for latent inhibition. In the proposed research, we test whether pre-exposure dose and degree of pre-exposure novelty potentiate changes in expected relevance and attention to a pre-exposed stimulus. We also assess if the manipulations alter latent inhibition and explore the possible moderating role of individual differences in pain sensitivity. METHODS Participants will be healthy individuals across a wide range of ages (6 to 35 years), from two study sites. Participants will undergo pre-exposure and conditioning followed by both a short-term and long-term test of learning, all in a novel virtual reality environment. The unconditioned stimulus will be a brief pressurized puff of air to a maxillary anterior tooth. Pre-exposure dose (low vs. high) and pre-exposure novelty (element stimulus vs. compound stimuli) will be between-subject factors, with stimulus type (pre-exposed to-be conditioned stimulus, a non-pre-exposed conditioned stimulus, and an unpaired control stimulus) and trial as within-subject factors. Pain sensitivity will be measured through self-report and a cold pressor test. It is hypothesized that a larger dose of pre-exposure and compound pre-exposure will potentiate the engagement of the target mechanisms and thereby result in greater latent inhibition in the form of reduced fear learning. Further, it is hypothesized that larger effects will be observed in participants with greater baseline pain sensitivity. DISCUSSION The proposed study will test whether pre-exposure dose and compound stimulus presentation change expected relevance and attention to the pre-exposed stimulus, and thereby enhance latent inhibition of dental fear. If found, the results will add to our theoretical understanding of the latent inhibition of dental fear and inform future interventions for dental phobia prevention.
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Affiliation(s)
- Andrew L Geers
- Department of Psychology, University of Toledo, Toledo, OH, 43606, USA.
| | - Laura D Seligman
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Keenan A Pituch
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Ben Colagiuri
- Department of Psychology, University of Sydney, Sydney, Australia
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA
| | | | - Natalie Turner
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Sena L Al-Ado
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Michael Nedley
- Department of Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
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Maeda CY, Serrano RV, Campos L, Palma LF, Marcucci M. Is there an association between head and neck cancer diagnosis and self-reported dental fear? A dual-center cross-sectional study. Natl J Maxillofac Surg 2024; 15:36-39. [PMID: 38690231 PMCID: PMC11057582 DOI: 10.4103/njms.njms_119_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 03/17/2023] [Accepted: 05/19/2023] [Indexed: 05/02/2024] Open
Abstract
Introduction Mental distress is highly reported in cancer patients, resulting in anxiety and depression most of the time. Both conditions, in turn, are recognized to be related to dental fear in adults; however, there are no studies on patients suffering from head and neck cancer. Thus, the present study aimed to investigate whether newly diagnosed patients with head and neck cancer are more prone to self-reported dental fear. Material and Methods This dual-center cross-sectional study was conducted with 25 healthy outpatients and 25 patients with a recent diagnosis of head and neck cancer, all requiring dental care. The patients were informed at the first appointment about their dental therapy planning and the Brazilian Portuguese Version of the Dental Fear Survey (DFS) questionnaire was then applied after appropriate instructions. Results The DFS total scores did not differ statistically between the groups (Mann-Whitney U test, P = 0,120) but the Cancer Group presented a slightly higher mean score (32.2 ± 10.0) than the Control Group (30.0 ± 14.2). Conclusion Within the limitations of this study, newly diagnosed patients with head and neck cancer and healthy individuals seem to experience similar self-reported dental fear.
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Affiliation(s)
- Claudia Y. Maeda
- Stomatology and Oral and Maxillofacial Surgery Center, Hospital Heliópolis, São Paulo - SP, Brazil
| | - Rafael V. Serrano
- Graduate Dentistry Program, Ibirapuera University, São Paulo - SP, Brazil
| | - Luana Campos
- Graduate Program in Implantology, University of Santo Amaro, São Paulo - SP, Brazil
| | - Luiz F. Palma
- Department of Pathology, Federal University of São Paulo, São Paulo - SP, Brazil
| | - Marcelo Marcucci
- Stomatology and Oral and Maxillofacial Surgery Center, Hospital Heliópolis, São Paulo - SP, Brazil
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Bowers RD, Hogden CT, Bartholomew OC, Qian F, Howe BJ. Survey investigation of articaine use in the United States. J Am Dent Assoc 2023; 154:1058-1066.e4. [PMID: 37777935 DOI: 10.1016/j.adaj.2023.08.005] [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: 02/06/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Local anesthesia is an essential component of dentistry, but there is limited quantifiable understanding of what techniques and local anesthetic solutions are used by practicing dentists. Use of the local anesthetic articaine has been highly debated in dentistry regarding its efficacy and risks for paresthesia. The aims of this study were to expand the knowledge of local anesthesia practices of dentists in the United States through a large-scale survey and associate potential influencing factors regarding articaine use specifically. METHODS The 23-item survey was sent to 10,340 practicing dentists in the United States, gathering demographic data and local anesthesia approaches and concerns. Statistical analysis consisted of descriptive, bivariate, and multivariate logistic regression analyses. RESULTS A total of 1,128 dentists completed the survey. Previous experience with articaine was reported by 97.6% of respondents, with 3.3% no longer using articaine. Sixty percent of respondents indicated using articaine for most local anesthetic injections administered. Multivariable regression analysis found those reporting to use articaine for all local anesthetic injections involving vasoconstrictors were more likely to be male (odds ratio, 1.59; P = .002) or general dentists (odds ratio, 1.63; P < .001). CONCLUSIONS Articaine has a perceived benefit to practitioners as most respondents reported using articaine as their primary local anesthetic. A practitioner's sex and type were found to affect the profile of use of articaine. PRACTICAL IMPLICATIONS Assembling evidenced-based local anesthesia practices would be beneficial to ensure US practitioners are more standardized in administering local anesthetics, particularly articaine, in the safest and most efficacious way.
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Lagarde M, Brunou J, Feijoo Yeckle K, Lemonier N, Pelissolo A, Pirnay P. Dental anxiety, a one-year evaluation. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:29-33. [PMID: 38040643 DOI: 10.3917/spub.hs1.2023.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Dental anxiety is the second most common reason for patients to forgo treatment in France. Based on this observation, the odontology and psychiatry departments of Henri Mondor hospital proposed a collaborative approach to help these patients. The aim of this study is to evaluate the results of this pilot project over one year. The patients appreciated the consultation, considering it a tool to help them be able to receive care. This consultation also resulted in 17 percent of patients being offered psychological care in order to treat other problems related to dental anxiety. The idea of a network of practitioners specialized in the treatment of these anxious patients is therefore proposed, the patients having emphasized that not having to re-explain their anxieties would be a relief.
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Affiliation(s)
- Marianne Lagarde
- Hôpital Albert-Chenevier, Groupe hôpitaux universitaires Henri-Mondor AP-HP, France
| | - Juliette Brunou
- Hôpital Albert-Chenevier, Groupe hôpitaux universitaires Henri-Mondor AP-HP, France
| | | | - Nicolas Lemonier
- Hôpital Albert-Chenevier, Groupe hôpitaux universitaires Henri-Mondor AP-HP, France
| | - Antoine Pelissolo
- Hôpital Albert-Chenevier, Groupe hôpitaux universitaires Henri-Mondor AP-HP, France
| | - Philippe Pirnay
- Hôpital Albert-Chenevier, Groupe hôpitaux universitaires Henri-Mondor AP-HP, France
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23
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Bantel D, Chmielewski WX, Brähler E, Stöbel-Richter Y, Zenger M, Berth H. Variables associated with oral health-related self-efficacy - results of a cross-sectional study. BMC Oral Health 2023; 23:939. [PMID: 38017511 PMCID: PMC10683143 DOI: 10.1186/s12903-023-03656-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/10/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Oral health-related self-efficacy (OH-SE) is pivotal for oral health and is associated with other oral-health related variables, such as dental fear and anxiety (DF/A) and dental hygiene behaviors (DHB). This study attempts to analyze associations between OH-SE and oral healthrelated variables in a German population to extend previous research by analyzing whether OH-SE can be predicted by these variables, as this might contribute to the development of treatment interventions. METHODS OH-SE, DF/A, oral health-related quality of life (OHRQoL), self-perceived dental condition, satisfaction with general health, DHB, and socioeconomic status were assessed as a part of the Saxon Longitudinal Study in an adult sample (n = 309, 56.3% female, all Saxon secondary school 8th graders in 1987). The associations of OH-SE with these variables were examined by means of correlation, multiple linear regression analyses, and group comparisons. Significance (p), standardized regression coefficients (β), and effect size (Cohen's d) were calculated. RESULTS The correlation analyses revealed increased OH-SE to be accompanied by low levels of DF/A, high levels of OHRQoL, high levels of self-perceived dental condition, increased satisfaction with general health and socioeconomic status (all r ≥ 0.142; all p ≤ 0.013). In the regression analysis, OH-SE was mainly predicted by self-perceived dental condition and satisfaction with general health (R2 = 0.157) as well as by daily frequency of toothbrushing, OHRQoL, and socioeconomic status on a trend-level basis. In the group comparisons OH-SE was lower in participants with moderate for manifest DF/A and higher in individuals with higher OHRQoL, better self-perceived dental condition, increased satisfaction with general health, increased daily frequency of toothbrushing, more dental appointments, and above-average socioeconomic status (trend level; all t ≥ 1.57; p ≤ 0.059). CONCLUSIONS In this cross-sectional study, high levels of OH-SE were mainly predicted by general health as well as self-perceived dental condition. It was also associated with decreased DF/A, increased DHB, higher OHRQoL, and higher socioeconomic status. Future research should analyze these associations in longitudinal designs to address whether interventions focusing on adherence to good DHB improve (dental) health and thus OH-SE. This might be a promising approach, particularly in relation to the treatment of DF/A.
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Affiliation(s)
- David Bantel
- Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neuroscience, Research Group Applied Medical Psychology and Medical Sociology, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Witold X Chmielewski
- Institute for Psychological Psychotherapy, University of Bochum, Bochum, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Leipzig, Germany
| | - Yve Stöbel-Richter
- Faculty of Managerial and Cultural Studies, University of Applied Sciences Zittau/Görlitz, Görlitz, Germany
| | - Markus Zenger
- Department of Applied Human Studies, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany
| | - Hendrik Berth
- Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neuroscience, Research Group Applied Medical Psychology and Medical Sociology, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
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24
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Oue K, Oda A, Shimizu Y, Takahashi T, Kamio H, Sasaki U, Imamura S, Imado E, Mukai A, Doi M, Sakuma M, Ono S, Aikawa T, Yoshida M. Efficacy and safety of remimazolam besilate for sedation in outpatients undergoing impacted third molar extraction: a prospective exploratory study. BMC Oral Health 2023; 23:774. [PMID: 37865761 PMCID: PMC10589926 DOI: 10.1186/s12903-023-03538-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Dental treatments often cause anxiety, fear, and stress in patients. Intravenous sedation is widely used to alleviate these concerns, and various agents are employed for sedation. However, it is important to find safer and more effective sedation agents, considering the adverse effects associated with current agents. This study aimed to investigate the efficacy and safety of remimazolam besilate (hereinafter called "remimazolam") and to determine the optimal dosages for sedation in outpatients undergoing dental procedures. METHODS Thirty-one outpatients aged 18-65 years scheduled for impacted third molar extraction were included in the study. Remimazolam was administered as a single dose of 0.05 mg/kg followed by a continuous infusion at a rate of 0.35 mg/kg/h, with the infusion rate adjusted to maintain a sedation level at a Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score of 2-4. The primary endpoint was the sedation success rate with remimazolam monotherapy, and the secondary endpoints included induction time, recovery time, time until discharge, remimazolam dose, respiratory and circulatory dynamics, and frequency of adverse events. RESULTS The sedation success rate with remimazolam monotherapy was 100%. The remimazolam induction dose was 0.08 (0.07-0.09) mg/kg, and the anesthesia induction time was 3.2 (2.6-3.9) min. The mean infusion rate of remimazolam during the procedure was 0.40 (0.38-0.42) mg/kg/h. The time from the end of remimazolam administration to awakening was 8.0 (6.7-9.3) min, and the time from the end of remimazolam administration to discharge was 14.0 (12.5-15.5) min. There were no significant respiratory or circulatory effects requiring intervention during sedation. CONCLUSIONS Continuous intravenous administration of remimazolam can achieve optimal sedation levels without significantly affecting respiratory or circulatory dynamics. The study also provided guidance on the appropriate dosage of remimazolam for achieving moderate sedation during dental procedures. Additionally, the study findings suggest that electroencephalogram monitoring can be a reliable indicator of the level of sedation during dental procedural sedation with remimazolam. TRIAL REGISTRATION The study was registered in the Japan Registry of Clinical Trials (No. jRCTs061220052) on 30/08/2022.
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Affiliation(s)
- Kana Oue
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan.
| | - Aya Oda
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Tamayo Takahashi
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Hisanobu Kamio
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Utaka Sasaki
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Serika Imamura
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Eiji Imado
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Akari Mukai
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Mitsuru Doi
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Miyuki Sakuma
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Shigehiro Ono
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Tomonao Aikawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
| | - Mitsuhiro Yoshida
- Division of Oral and Maxillofacial Surgery and Oral Medicine, Department of Dental Anesthesiology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Japan
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Heaton B, Bond JC, Bae J, Cozier Y. Perceived experiences of racism linked to dental fear and anxiety among Black women. Community Dent Oral Epidemiol 2023; 51:896-907. [PMID: 35964228 PMCID: PMC9925613 DOI: 10.1111/cdoe.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Dental fear and anxiety are known determinants of delaying or avoiding dental care and vary considerably based on factors such as age and gender. However, little is known about dental fear and anxiety in racial/ethnic minority populations, which bear a disproportionate burden of poor oral health outcomes. Structural and social pathways responsible for producing these disparities are also understudied. Experiences of racism over the lifecourse may contribute to poor oral health outcomes through a pathway of dental fear and anxiety. This paper aimed to evaluate perceived experiences with racism, dental fear and anxiety, and the utilization of dental services, in the Black Women's Health Study (BWHS), a United States-based prospective cohort. METHODS Analysis of prospective data obtained from a geographic subset of participants in the BWHS was conducted. In 2014, BWHS participants residing in Massachusetts responded to a mailed oral health questionnaire that included the Index of Dental Anxiety and Fear (IDAF-4C+) instrument (N = 484; 69% response rate). Previously collected demographic and health information, along with reported experiences of everyday and lifetime racism, obtained from national BWHS questionnaires between 1995 and 2009, were merged with the Massachusetts-based sub-sample. Associations between high dental anxiety (HDA) (mean IDAF-4C+ score ≥2.5 on the dental fear and anxiety module) and oral health outcomes and perceived racism and HDA were explored via prevalence ratios (PR) calculated using log-binomial regression models, including adjustment for potential confounders. RESULTS Reported exposures to everyday racism occurred weekly on average for the top 25% of the sample, while 13% of participants reported exposure to multiple (n = 3) experiences of unfair treatment due to their race over their lifetime. HDA was prevalent among 17.8% of the sample and was significantly associated with indicators of poor oral health status. High exposures to everyday and lifetime experiences of racism were positively associated with HDA (PR = 1.08; 95% CI: 0.90, 1.58 and PR = 1.72; 95% CI: 1.03, 2.88, respectively). CONCLUSIONS Significant associations between racism and HDA, and between HDA and poor oral health and reduced utilization of dental care were observed. Dental anxiety may be a pathway through which perceived experiences with racism may impact oral health outcomes.
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Affiliation(s)
- Brenda Heaton
- Department of Health Policy & Health, Services Research, Boston University, Henry M. Goldman School of Dental, Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston, University School of Public Health, Boston, Massachusetts, USA
| | - Julia C. Bond
- Department of Health Policy & Health, Services Research, Boston University, Henry M. Goldman School of Dental, Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston, University School of Public Health, Boston, Massachusetts, USA
| | - Jaeyoung Bae
- Department of Health Policy & Health, Services Research, Boston University, Henry M. Goldman School of Dental, Medicine, Boston, Massachusetts, USA
| | - Yvette Cozier
- Department of Epidemiology, Boston, University School of Public Health, Boston, Massachusetts, USA
- Slone Epidemiology Center, Boston, University, Boston, Massachusetts, USA
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26
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Winkler CH, Bjelopavlovic M, Lehmann KM, Petrowski K, Irmscher L, Berth H. Impact of Dental Anxiety on Dental Care Routine and Oral-Health-Related Quality of Life in a German Adult Population-A Cross-Sectional Study. J Clin Med 2023; 12:5291. [PMID: 37629334 PMCID: PMC10455740 DOI: 10.3390/jcm12165291] [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: 07/20/2023] [Revised: 08/09/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
The interaction between dental anxiety and the establishment of a consistent dental care routine has been an ongoing challenge. Unfortunately, there is limited available data concerning the detailed dental care practices of individuals with dental anxiety. Therefore, this study aims to explore how dental anxiety influences dental care habits and oral-health-related quality of life within an adult population. By utilizing the Dental Anxiety Scale (DAS) and the German Oral Health Impact Profile (OHIP-G5), we assessed their extent. To evaluate the differences, we performed analyses of variance (Anova), an independent t-test and rank correlation. The findings of this study unveil a significant correlation between elevated DAS scores and reduced frequency of tooth brushing; calculus removal and appointments for professional teeth cleaning. Interestingly; the use of dental floss and mouthwash solution as well as toothbrush hardness appeared to be not significantly affected by dental fear. Moreover, individuals with dental anxiety demonstrated a preference for manual toothbrushes over electric ones. In addition, higher DAS scores were found to be strongly associated with greater OHIP-G5 scores, thus leading to a substantial decline in overall oral health-related quality of life.
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Affiliation(s)
- Christian H. Winkler
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.W.); (K.M.L.)
| | - Monika Bjelopavlovic
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.W.); (K.M.L.)
| | - Karl M. Lehmann
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.W.); (K.M.L.)
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Duesbergweg 6, 55131 Mainz, Germany;
| | - Lisa Irmscher
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Medical Psychology and Medical Sociology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany (H.B.)
| | - Hendrik Berth
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Medical Psychology and Medical Sociology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany (H.B.)
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Chi SI. What is the gold standard of the dental anxiety scale? J Dent Anesth Pain Med 2023; 23:193-212. [PMID: 37559670 PMCID: PMC10407447 DOI: 10.17245/jdapm.2023.23.4.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
It is important to understand patients' anxiety and fear about dental treatment. A patient's anxiety can be quantified through a self-report questionnaire, and many related scales have been developed. In this review, I tried to find out which scale is most suitable for the patient's dental anxiety and fear evaluation by examining the contents of previously developed scales and comparing the strengths and weaknesses of each scale.
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Affiliation(s)
- Seong In Chi
- Department of Pediatric Dentistry, Sejong Dental Hospital, School of Dentistry, Dankook University, Sejong, Republic of Korea
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28
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Done AE, Preoteasa E, Preoteasa CT. Psychometric Assessment of the Romanian Version of the Index of Dental Anxiety and Fear (IDAF-4C +). Healthcare (Basel) 2023; 11:2129. [PMID: 37570370 PMCID: PMC10419272 DOI: 10.3390/healthcare11152129] [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: 06/12/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The goal of this study was to assess the validity of the Romanian version of the Index of Dental Anxiety and Fear (IDAF-4C+) questionnaire. MATERIALS AND METHODS This study was conducted on a convenience sample of past patients and their acquaintances through an online questionnaire administered on the Google Forms platform between May 2021 and September 2022. The sections of the survey were demographic characteristics, the dental anxiety scale questionnaire, the IDAF-4C+ questionnaire, a single question about dental fear, and previous dental treatments. RESULTS In total, 239 participants were included in the study, and the mean age was 37. The IDAF-4C questionnaire had good internal validity (Cronbach alpha was 0.945). The IDAF-4C had good convergent validity, and it was positively correlated with the dental anxiety scale (r = 0.825, p < 0.001) and the question about the fear of going to the dentist (r = 0.738, p < 0.001). The questionnaire had good reliability, and the intraclass correlation was 0.985. Lower levels of dental anxiety were associated with scaling, orthodontic treatment, and dental implants. A confirmatory factor analysis was conducted after the removal of the first question from the phobia module, and residual covariance was added between items four and nine of the stimulus module, showing a good fit for the retained questions of the IDAF-4C+, grouped by module. CONCLUSIONS The Romanian version of the IDAF-4C+ showed acceptable psychometric properties.
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Affiliation(s)
- Alexandra Elena Done
- Department of Scientific Research Methods-Ergonomics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Elena Preoteasa
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Cristina Teodora Preoteasa
- Department of Scientific Research Methods-Ergonomics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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Hauge MS, Willumsen T, Stora B. Changes in symptoms of anxiety, depression, and PTSD in an RCT-study of dentist-administered treatment of dental anxiety. BMC Oral Health 2023; 23:415. [PMID: 37349747 PMCID: PMC10288821 DOI: 10.1186/s12903-023-03061-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Educating dentists in treatment methods for dental anxiety would increase the patients' access to treatments that are important to their oral health. However, to avoid adverse effects on comorbid symptoms, involvement by a psychologist has been considered necessary. The objective of the present paper was to evaluate whether a dentist could implement systematized treatments for dental anxiety without an increase in comorbid symptoms of anxiety, depression or PTSD. METHODS A two-arm parallel randomised controlled trial was set in a general dental practice. Eighty-two patients with self-reported dental anxiety either completed treatment with dentist-administered cognitive behavioural therapy (D-CBT, n = 36), or received dental treatment while sedated with midazolam combined with the systemized communication technique "The Four Habits Model" (Four Habits/midazolam, n = 41). Dental anxiety and comorbid symptoms were measured pre-treatment (n = 96), post-treatment (n = 77) and one-year after treatment (n = 52). RESULTS An Intention-To-Treat analysis indicated reduced dental anxiety scores by the Modified Dental Anxiety Scale (median MDAS: 5.0 (-1,16)). The median scores on the Hospital Index of Anxiety and Depression (HADS-A/D) and the PTSD checklist for DSM-IV (PCL) were reduced as follows: HADS-A: 1 (-11, 11)/HADS-D: 0 (-7, 10)/PCL: 1 (-17,37). No between-group differences were found. CONCLUSIONS The study findings support that a general dental practitioner may treat dental anxiety with Four Habits/Midazolam or D-CBT without causing adverse effects on symptoms of anxiety, depression or PTSD. Establishing a best practice for treatment of patients with dental anxiety in general dental practice should be a shared ambition for clinicians, researchers, and educators. TRIAL REGISTRATION The trial was approved by REC (Norwegian regional committee for medical and health research ethics) with ID number 2017/97 in March 2017, and it is registered in clinicaltrials.gov 26/09/2017 with identifier: NCT03293342.
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Affiliation(s)
- Mariann Saanum Hauge
- Faculty of Dentistry, University of Oslo, Oslo, Norway.
- Oral Health Centre of Expertise, Rogaland, Stavanger, Norway.
| | | | - Bent Stora
- Oral Health Services Agder, Kristiansand, Norway
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Alansaari ABO, Tawfik A, Jaber MA, Khamis AH, Elameen EM. Prevalence and Socio-Demographic Correlates of Dental Anxiety among a Group of Adult Patients Attending Dental Outpatient Clinics: A Study from UAE. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6118. [PMID: 37372705 DOI: 10.3390/ijerph20126118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES The aims of this paper were twofold: first, to evaluate dental anxiety levels among patients undergoing oral surgery procedures; second, to assess how dental anxiety and fear are connected to age, gender, educational background, past traumatic experiences, and the frequency of dental appointments. METHODS A cross-sectional Likert-scale questionnaire survey was conducted to collect quantitative data from 206 patients at the Oral Surgery Clinics at Dubai Dental Clinics, Dubai, United Arab Emirates. The reliability and validity of the questionnaire were tested using Cronbach's alpha. The normality of the MDAS score was tested using the Kolmogorov-Smirnov test. The chi square and Kruskal-Wallis tests were used to determine the association between categorical variables. Descriptive statistics were used to describe continuous and categorical variables. The statistical significance was set at p-value ≤ 0.05. RESULTS The evaluation of the degree of dental anxiety among patients who visited the Dubai Dental clinics revealed that there was a considerably high level of moderate or high anxiety (72.3%). Tooth extraction and dental surgery procedures (95%), followed by local anesthetic injection in the gingiva (85%) and teeth drilling (70%), were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety (35%). There was no substantial difference in dental anxiety between male and female patients or among patients with different marital statuses. A total of 70% of patients preferred the tell-show-do method, whereas 65% chose communication strategies to reduce dental anxiety. CONCLUSIONS The evaluation of the degree of dental anxiety among patients who visited Dubai Dental clinics revealed that there was a considerably high level of anxiety. Tooth extraction and dental surgery procedures, followed by local anesthetic injection and teeth drilling, were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety. Despite the use of a modified anxiety scale and a large and representative sample of oral surgery patients, more research is necessary to investigate the impact of various factors on dental anxiety.
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Affiliation(s)
- Al Batool Omer Alansaari
- Hamdan Bin Mohammed College of Dental Medicine, MBRU, Dubai P.O. Box 505055, United Arab Emirates
| | - Abdelrahman Tawfik
- Hamdan Bin Mohammed College of Dental Medicine, MBRU, Dubai P.O. Box 505055, United Arab Emirates
| | - Mohamed A Jaber
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Amar Hassan Khamis
- Hamdan Bin Mohammed College of Dental Medicine, MBRU, Dubai P.O. Box 505055, United Arab Emirates
| | - Essra Mohamed Elameen
- Clinical Sciences Department, College of Medicine, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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Huff C. A Promising Tool For Overcoming Dental Anxiety. Health Aff (Millwood) 2023; 42:454-458. [PMID: 37011309 DOI: 10.1377/hlthaff.2022.01626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Researchers in Philadelphia, Pennsylvania, are testing a cognitive behavioral intervention with the aim of removing a common obstacle to dental care.
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Affiliation(s)
- Charlotte Huff
- This article is part of a series on transforming health systems published with support from The Robert Wood Johnson Foundation. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work, for commercial use, provided the original work is properly cited. See https://creativecommons.org/licenses/by/4.0/. Charlotte Huff is a medical and health policy journalist based in Fort Worth, Texas, who has written for Kaiser Health News, Nature, STAT, and Texas Monthly, among other publications. To access the author's disclosures, click on the Details tab of the article online
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Karam SA, Costa FDS, Peres KG, Peres MA, Barros FC, Bertoldi AD, Santos IS, Tovo L, Matijasevich A, B Menezes AM, Gonçalves H, Correa MB, Demarco FF. Two decades of socioeconomic inequalities in the prevalence of untreated dental caries in early childhood: Results from three birth cohorts in southern Brazil. Community Dent Oral Epidemiol 2023; 51:355-363. [PMID: 35362631 DOI: 10.1111/cdoe.12747] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/24/2022] [Accepted: 03/22/2022] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To estimate the socioeconomic disparities in untreated dental caries in early childhood according to socioeconomic characteristics in three birth cohorts in Southern Brazil. METHODS The socioeconomic data to this study were collected at the 48-month follow-up and oral health studies of 1993, 2004 and 2015 Pelotas birth cohort studies. The outcome was untreated dental caries in children aged 6 (1993 cohort), 5 (2004 cohort) and 4 years (2015 cohort), dichotomized into absence/presence. Analyses were stratified by maternal skin colour/race, maternal education and family income. For statistical purposes, the prevalence difference, relative risk and absolute and relative indices of health inequality (Slope Index of Inequality-SII and Concentration Index-CIX) were used. RESULTS The prevalence of untreated dental caries in primary dentition was 63.4%, 45.5% and 15.6%, in 1993, 2004 and 2015 cohorts, respectively. The prevalence of untreated dental caries was concentrated in the poorest quintile and lower maternal education group in both absolute (SII) and relative (CIX) measures of inequality, being characterized as a pro-poor event. A higher risk of untreated caries was found in the poorest quintile of family income compared with the richest quintile in the 1993 cohort (RR 1.44 [95% CI 1.05; 1.98]). That risk was higher considering the 2004 Cohort (RR 1.78 [95% CI 1.42; 2.23]) and 2015 cohort (RR 4.20 [95% CI 2.97; 5.94]) data. CONCLUSIONS Over the course of two decades, a higher prevalence of untreated dental caries is concentrated among the most socioeconomically deprived children.
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Affiliation(s)
- Sarah Arangurem Karam
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Center Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Center Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Fernando C Barros
- Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | | | - Iná S Santos
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Luciana Tovo
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Faculty of Medicine, Department of Preventive Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Ana M B Menezes
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Helen Gonçalves
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Flávio Fernando Demarco
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
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Aburas S, Pfaffeneder-Mantai F, Hofmann A, Meller O, Schneider B, Turhani D. Dentophobia and dental treatment: An umbrella review of the published literature. SPECIAL CARE IN DENTISTRY 2023; 43:163-173. [PMID: 35700448 DOI: 10.1111/scd.12749] [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: 01/25/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022]
Abstract
AIMS Dentophobia is a well-know kind of phobia and psychological problem in dentistry. Although patients might suffer from severe oral pain and have serious health complications, dentophobia is still posing a threat to oral healthcare and remains an unresolved worldwide phenomenon. According to estimates, up to 80% of the general population are affected by this condition. Dentophobia is an unpleasant problem with serious consequences not only for patients but also for dentists and the public health system in general. This umbrella review provides a comprehensive overview of the various aspects of dentophoia as addressed in the published literature, and the current level of knowledge concerning their treatment. METHODS AND RESULTS Based on 35 reviews of the published literature, addressing various aspects of dentophobia and published between 2008 and 2021, this umbrella review was written. The search was based on the PubMed and PsycINFO databases. The extraction was structured by open coding and each aspect of the subject analyzed according to Ritchie and Lewis. CONCLUSION We conclude that the evidence concerning the efficacy of the various interventions is still rather weak and there is an obvious need for further research, because of the yet and unresolved challenges and the lack of standardised guidelines to deal with patients with dentophobia.
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Affiliation(s)
- Sarmad Aburas
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
- Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Alina Hofmann
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Oliver Meller
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
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Stangvaltaite-Mouhat L, Stankeviciene I, Martinussen SSS, Sabataitis V, Sandjord C, Toresen I, Tryggestad MS, Puriene A, Johnsen JAK. Web-Based Interventions Reduced Dental Anxiety among Adults in Lithuania and Norway: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3343. [PMID: 36834035 PMCID: PMC9966357 DOI: 10.3390/ijerph20043343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Dental anxiety (DA) is a prevalent public health issue. However, there is a lack of self-administered DA interventions. The aim of this study was to evaluate the short-term effects of web-based interventions aiming to reduce DA in adults in two European countries. A pretest posttest design was used. Tailor-made websites were developed in Lithuania and Norway. Volunteers who self-reported DA were invited to participate. DA levels measured by the Modified Dental Anxiety Scale (MDAS) were assessed at baseline and after two weeks via online questionnaires. The interventions were completed by 34 participants in Lithuania and 35 participants in Norway. In Lithuania, the median posttest MDAS score (9.5, IQR 5.25) decreased compared to the median pretest MDAS score (14.5, IQR 8; Z value = -4.246, p < 0.001). The same was found in Norway-the median posttest MDAS score (12, IQR 9) was lower compared to the median pretest MDAS score (15, IQR 7; Z value = -3.818, p < 0.001). The present study demonstrated that two tailor-made web-based interventions had the potential to reduce dental anxiety levels when assessed in the short term in Lithuania and Norway. Studies with more controlled designs assessing long-term outcomes are needed to validate the results of this pilot study also in other cultures.
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Affiliation(s)
- Lina Stangvaltaite-Mouhat
- Oral Health Centre of Expertise in Eastern Norway, 0369 Oslo, Norway
- Institute of Dentistry, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | - Indre Stankeviciene
- Institute of Dentistry, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | | | - Vytautas Sabataitis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | - Camilla Sandjord
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsoe, Norway
| | - Ingrid Toresen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsoe, Norway
| | | | - Alina Puriene
- Institute of Dentistry, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | - Jan-Are Kolset Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsoe, Norway
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Kallio A, Suominen A, Tolvanen M, Rantavuori K, Jussila H, Karlsson L, Karlsson H, Lahti S. Concurrent changes in dental anxiety and smoking in parents of the FinnBrain Birth Cohort Study. Eur J Oral Sci 2023; 131:e12912. [PMID: 36599651 PMCID: PMC10107302 DOI: 10.1111/eos.12912] [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: 04/01/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023]
Abstract
We evaluated associations between changes in dental anxiety and tobacco use, adjusted for general anxiety and depressive symptoms. The FinnBrain Birth Cohort Study data, collected at gestational weeks 14 and 34 and at 3 months postpartum, were used. Questionnaires included the Modified Dental Anxiety Scale (MDAS), the Edinburgh Postnatal Depression Scale (EPDS), and the anxiety subscale of the Symptom Checklist-90 (SCL). Smoking was categorized as "stable non-smoking", "started smoking", "quit smoking", and "stable smoking". Changes in smoking and dental anxiety were evaluated "during pregnancy" (i.e., from gestational week 14 to gestational week 34) in 2442 women and 1346 men and "after pregnancy" (i.e., from gestational week 34 to 3 months postpartum) in 2008 women and 1095 men. Changes were evaluated in three smoking categories (stable non-smoking, fluctuating, and stable smoking), using data from all three time-points (1979 women and 1049 men). Modeling used repeated measures analysis of covariance. Stable smoking mothers had statistically significantly higher levels of dental anxiety (mean MDAS 12.3-12.6) than non-smoking mothers (mean MDAS 10.1-10.7) or mothers who smoked at some point during pregnancy (mean MDAS 10.8-11.5). A similar tendency was observed in fathers. However, no systematic change in dental anxiety by changes in smoking habits was observed. Those smoking during pregnancy and with high dental anxiety may need special support for smoking cessation.
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Affiliation(s)
- Anu Kallio
- Department of Community Dentistry, University of Turku, Turku, Finland.,City of Turku, Welfare Services Division, Oral and Dental Health Care, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics, University of Turku, Turku, Finland.,Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Heidi Jussila
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
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Aardal V, Evensen KB, Willumsen T, Hervik Bull V. The complexity of dental anxiety and its association with oral health-related quality of life: An exploratory study. Eur J Oral Sci 2023; 131:e12907. [PMID: 36418106 PMCID: PMC10099540 DOI: 10.1111/eos.12907] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022]
Abstract
This study aimed to explore the factors associated with oral health-related quality of life (OHRQoL) in a sample with high dental anxiety. Data were obtained from 107 patients attending a therapeutic treatment program for people who have experienced abuse and for those with dental phobia in Norway. Patients completed questionnaires, including the Index of Dental Anxiety and Fear, the Anxiety subscale of the Hospital Anxiety and Depression Scale, and the Oral Impacts on Daily Performance scale, measuring OHRQoL prior to treatment. The various measurement instruments were evaluated psychometrically, and the variables associated with OHRQoL were explored using hierarchical multiple regression. Symptoms of dental anxiety and general anxiety were high, while OHRQoL was poor. Dental anxiety, higher age, higher number of years since the last dental treatment, and higher general anxiety were discernibly associated with lower OHRQoL. The strongest association was found between general anxiety and OHRQoL. In conclusion, several factors were associated with OHRQoL in a sample with high dental anxiety, suggesting a complex picture of dental anxiety. When treating patients with high dental anxiety, dental practitioners should be aware that there may be factors complicating the therapeutic setting, such as general anxiety.
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Affiliation(s)
- Vilde Aardal
- Oral Health Centre of Expertise in Rogaland, Stavanger, Norway.,Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | | | - Tiril Willumsen
- Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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A Bibliometric Analysis on the Early Works of Dental Anxiety. Dent J (Basel) 2023; 11:dj11020036. [PMID: 36826181 PMCID: PMC9955892 DOI: 10.3390/dj11020036] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/20/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Dental anxiety has been a common phenomenon under investigation for decades. This report aimed to identify the historical roots of dental anxiety in the research literature. The literature database Web of Science Core Collection was searched to identify relevant papers on this theme. Cited reference analysis on the collected literature set was performed with CRExplorer, a dedicated bibliometric software. This analysis successfully identified the references dealing with dental anxiety in the late 1800s and early 1900s. They included essays that provided expert opinion on dental anxiety, reported semi-structured interviews to elucidate its underlying reasons, introduced psychometric scales to assess dental anxiety, and proposed theories and arguments from psychoanalytic aspects. Several references dealing with anxiety in general were also identified. To conclude, cited reference analysis was useful in revealing the historical origins of dental anxiety research. These cited references provided a concrete foundation to support subsequent dental anxiety research.
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Efficacy of Music Intervention for Dental Anxiety Disorders: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020209. [PMID: 36837411 PMCID: PMC9961880 DOI: 10.3390/medicina59020209] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/03/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
Objective To evaluate the effectiveness of music therapy for dental anxiety disorders. Methods In order to gather clinical randomized controlled trials comparing the effectiveness of music interventions to traditional oral manipulation in patients with dental anxiety disorders, computer searches of the electronic databases of Wanfang, CNKI, VIP, PubMed, Web of Science, ScienceDirect, Cochrane library, Scopus, and CINAHL were conducted. The search period covered from 23 December 2022, through to the development of the database. The Cochrane Handbook was used to assess the quality of the included literature, and two researchers independently conducted the literature screening and data extraction. Stata 17.0 and RevMan 5.3 were used to conduct the meta-analysis. Results The preoperative baseline levels of the music intervention group were similar to those of the control group (p > 0.05), according to the meta-analysis, and music intervention significantly decreased heart rate (I2 = 81.2%, WMD (95% CI): -7.33 (-10.07, -4.58), p < 0.0001), systolic blood pressure fluctuations (I2 = 85.6%, WMD (95% CI): -6.10(-9.25, 2.95), p < 0.0001), diastolic blood pressure (I2 = 79.7%, WMD (95% CI): -4.29(-6.57, -2.02), p < 0.0001) fluctuations, anxiety scores (I2 = 19.6%, WMD (95% CI): -9.04(-11.45, 6.63), p < 0.0001), and pain scores (I2 = 32.7%, WMD (95% CI): -7.64(-9.43, -5.85), p < 0.0001), as well as significantly lowered anxiety and pain levels and raised patients' cooperation rates (I2 = 0%, OR (95% CI): 3.03(1.24, 7.40), p = 0.02). Conclusions Music interventions are effective for dental anxiety disorders, but given the limitations of the study, more multicenter, large-sample, high-quality randomized controlled trials are needed to further validate the findings and obtain more objective and reliable clinical evidence.
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Alkuwaiti E, Alshubaili R, AlZahrani N, Khusheim S, AlMunif R, Alharbi N, Nazir M. Dental Anxiety Among Physicians: Relationship with Oral Problems, Dental Visits, and Socio-Demographic Factors. Patient Prefer Adherence 2023; 17:1107-1116. [PMID: 37113214 PMCID: PMC10126723 DOI: 10.2147/ppa.s406105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Purpose The purpose of study was to investigate dental anxiety (DA) and its relationship with oral health problems, dental visits, and socio-demographic factors among physicians. Patients and Methods This cross-sectional study was conducted on physicians working in Dhahran, Khobar, Dammam, and Qatif cities of the kingdom of Saudi Arabia. The study included physicians (general practitioners, residents, specialists, and consultants) working in the public and private sectors. Modified Dental Anxiety Scale and World Health Organization's Oral Health Questionnaire for Adults were used to evaluate DA, oral health problems, and dental attendance. Results The study included data from 355 participants with a mean age of 40.13 ± 10.45 years. There were 57.2% of non-Saudi and 42.8% of Saudi participants in the study. Bad dental experience in the previous dental visit was reported by 40% of participants, which was significantly related to DA (P = 0.002). Only 9.60% of participants had no DA, whereas 41.10% demonstrated low DA, 23.4% moderate DA, 18.9% high DA, and 7% extreme DA. Common oral problems included tooth sensitivity (65.40%), tooth cavities (45.90%), bleeding gums (43.10%), and bad breath (36.90%). More than half of participants (58.3%) visited the dentist during the last year and dental pain was the most common reason for dental visits (31.3%). Saudi participants demonstrated significantly increased DA than non-Saudis (P = 0.019). DA was significantly related to tooth sensitivity (P = 0.001), tooth cavities (P = 0.002), dry mouth (P = 0.044), and bad breath (P = 0.005). The participants with difficulty in biting foods (P > 0.001) and feeling embarrassed due to the appearance of teeth (P < 0.001) demonstrated significantly higher DA. Conclusion This sample of physicians showed a high prevalence of DA, oral problems, and dental visits due to pain. DA was significantly related to physicians' negative dental experience, tooth sensitivity, dental decay, dry mouth, and bad breath.
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Affiliation(s)
- Elaf Alkuwaiti
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Rand Alshubaili
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Nada AlZahrani
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Sarah Khusheim
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Raghad AlMunif
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Nawal Alharbi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Muhammad Nazir
- Department of Preventive Dental Science, College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
- Correspondence: Muhammad Nazir, Tel +966-543579615, Email
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Wong NSM, Yeung AWK, McGrath CP, Leung YY. Qualitative Evaluation of YouTube Videos on Dental Fear, Anxiety and Phobia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:750. [PMID: 36613071 PMCID: PMC9819845 DOI: 10.3390/ijerph20010750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
The aim of this study was to review the health information of dental fear-, dental anxiety-, and dental phobia-related videos on YouTube. The 100 most widely viewed videos for the keywords "dental fear", "dental anxiety", and "dental phobia" were chosen for evaluation. Out of the 300 videos, 145 videos met the inclusion criteria and were analyzed. It was found that most of them were produced by the professions, with a dentist delivering the key messages or with patients giving testimonials. Many etiological factors and symptoms were described. Many pharmacological and non-pharmacological interventions were recommended to the audience, such as sedation and distraction, respectively. However, there was a lack of information on the definition or diagnostic criteria of dental fear, dental anxiety, and dental phobia. Videos with high views had a higher ratio of misleading information. Videos with a dentist being the informant had a similar ratio of misleading information compared to other videos. Without adequate information on how to diagnose, it would be very difficult for the audience to determine if the video content was relevant or useful. The dental profession can work together with psychologists or psychiatrists to produce authoritative videos with accurate content.
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Affiliation(s)
- Natalie Sui Miu Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Andy Wai Kan Yeung
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Colman Patrick McGrath
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
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Yap AU, Kwan YY, Kok L, Lee XF, Lee DZR. Dental Environment and Practitioner Preferences of Southeast Asian Youths with Dental Fear/Anxiety. Int J Dent Hyg 2022; 20:671-677. [DOI: 10.1111/idh.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/03/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital
- Faculty of Dentistry National University Health System Singapore
- National Dental Research Institute Singapore National Dental Centre Singapore
- Duke‐NUS Medical School Singapore Health Services Singapore
- School of Health and Social Sciences Nanyang Polytechnic Singapore
| | - Yi Yan Kwan
- School of Health and Social Sciences Nanyang Polytechnic Singapore
| | - Li Kok
- School of Health and Social Sciences Nanyang Polytechnic Singapore
| | - Xin Fang Lee
- School of Health and Social Sciences Nanyang Polytechnic Singapore
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Wong NSM, Yeung AWK, Li KY, McGrath CP, Leung YY. Non-Pharmacological Interventions for Reducing Fear and Anxiety in Patients Undergoing Third Molar Extraction under Local Anesthesia: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811162. [PMID: 36141435 PMCID: PMC9517611 DOI: 10.3390/ijerph191811162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 05/17/2023]
Abstract
This report investigated the effectiveness of non-pharmacological interventions for reducing dental fear and anxiety in patients undergoing third molar extraction under local anesthesia. In November 2020, multiple electronic databases (Cochrane, EMBASE, MEDLINE, PsycInfo, PsycArticles, PubMed, and Web of Science) were searched for articles published in English. Inclusion criteria were randomized-controlled trials reporting the effectiveness of any non-pharmacological interventions in reducing fear or anxiety levels in patients with third molar extraction. A total of 3015 studies by electronic search and 2 studies by hand search were identified. After screening, 21 studies were eligible for systematic review. Seven studies were included in the meta-analysis. Study selection, data extraction, and quality assessment of the included studies were performed by two independent investigators. The anxiety levels after intervention in each study were pooled and meta-analyzed by the random-effect model. A significant reduction in anxiety level was observed in non-pharmacological intervention groups (SMD = -0.32; 95% CI -0.57 to -0.07; p = 0.01). Subgroup analyses showed that a significant anxiety reduction by non-pharmacological interventions could be demonstrated by pooled data from studies using psychometric assessments, but not from studies using physiological assessments. Non-pharmacological interventions appear to reduce fear and anxiety levels in patients undergoing third molar extraction under local anesthesia.
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Affiliation(s)
- Natalie Sui Miu Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Andy Wai Kan Yeung
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Kar Yan Li
- Clinical Research Centre, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Colman Patrick McGrath
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
- Correspondence:
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Rapp L, Madden S, Rode AV, Walsh LJ, Spallek H, Nguyen Q, Dau V, Woodfield P, Dao D, Zuaiter O, Habeb A, Hirst TR. Anesthetic-, irrigation- and pain-free dentistry? The case for a femtosecond laser enabled intraoral robotic device. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.976097] [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
By leveraging ultrashort pulse laser and micro-electromechanical systems (MEMS) technologies, we are developing a miniaturized intraoral dental robotic device that clamps onto teeth, is remotely controlled, and equipped with a focusing and scanning system to perform efficient, fast, and ultra-precise laser treatments of teeth and dental restorative materials. The device will be supported by a real-time monitoring system for visualization and diagnostic analysis with appropriate digital controls. It will liberate dentists from repetitive manual operations, physical strain and proximity to the patient's oro-pharyngal area that potentially contains infectious agents. The technology will provide patients with high-accuracy, minimally invasive and pain-free treatment. Unlike conventional lasers, femtosecond lasers can ablate all materials without generating heat, thus negating the need for water irrigation, allowing for a clear field of view, and lowering cross-infection hazards. Additionally, dentists can check, analyze, and perform precise cutting of tooth structure with automatic correction, reducing human error. Performing early-stage diagnosis and intervention remotely will be possible through units installed at schools, rural health centers and aged care facilities. Not only can the combination of femtosecond lasers, robotics and MEMS provide practical solutions to dentistry's enduring issues by allowing more precise, efficient, and predictable treatment, but it will also lead to improving the overall access to oral healthcare for communities at large.
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Dental fear and anxiety in Asian youths: response components and inducing stimuli. Clin Oral Investig 2022; 26:5953-5960. [PMID: 35639205 DOI: 10.1007/s00784-022-04555-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study estimated the prevalence of dental fear/anxiety (DFA) and phobia in Asian youths and investigated the fear/anxiety response components and triggers for those with DFA. MATERIALS AND METHODS A convenience sample of youths, aged 17 to 24 years old, was recruited from a local polytechnic. The Index of Dental Anxiety and Fear-4C + (IDAF-4C +) was employed to assess the occurrence of DFA (IDAF-4C) and phobia (IDAF-P) as well as to ascertain fear/anxiety-inducing stimuli (IDAF-S). Psychological distress was determined with the Patient Health Questionnaire-4 (PHQ-4). Sociodemographic, IDAF-4C + , dental attendance patterns, and PHQ-4 data were gathered electronically. Statistical analyses were conducted with chi-square, Kruskal-Wallis, and relevant post hoc tests (α = 0.05). RESULTS A total of 215 participants were enrolled (mean age of 18.9 ± 2.0 years; 87.4% women). Of these, 12.6/6.0% had moderate-to-high (MH)/high-to-extreme (HE) DFA and 0.9% experienced dental phobia. Significant differences in scores were observed between the HE/MH and no-to-moderate (NM) groups for all IDAF-4C components. Apart from the cost of dental treatment, IDAF-4S scores varied significantly among the three DFA groups. The two most highly rated DFA stimuli were painful/uncomfortable procedures and needles/injections for the HE group, while they were needles/injections and the cost of dental treatment for the MH and NM groups. CONCLUSIONS Moderate-to-extreme DFA existed in 18.6% of the Asian youths examined. The emotional and physiological components of the IDAF-4C appear to contribute more to the DFA response. Dental pain including needles/injections and the cost of dental treatment troubled Asian youths the most. CLINICAL RELEVANCE DFA is a common problem among Asian youths, and understanding its extent, nature, and triggers is central for effective interventions.
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Stein Duker LI, Grager M, Giffin W, Hikita N, Polido JC. The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042380. [PMID: 35206566 PMCID: PMC8872083 DOI: 10.3390/ijerph19042380] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 01/28/2023]
Abstract
Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.
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Affiliation(s)
- Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
- Correspondence:
| | | | - Willa Giffin
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - Natasha Hikita
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - José C. Polido
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
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