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Chapman HR, Kirby-Turner N, Moghaddam N. The hidden psychological cost of lack of access to dental care. Br Dent J 2024; 237:253-254. [PMID: 39179823 DOI: 10.1038/s41415-024-7720-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 08/26/2024]
Abstract
This opinion piece highlights the hidden psychological and other costs of the lack of access to dental care.
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Affiliation(s)
- Helen R Chapman
- Visiting Fellow, School of Psychology, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, UK.
| | | | - Nima Moghaddam
- Research Clinical Psychologist/Associate Professor, School of Psychology, University of Lincoln, Brayford, Pool, Lincoln, LN6 7TS, UK
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2
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Mohd Khairuddin AN, Bogale B, Kang J, Gallagher JE. Impact of dental visiting patterns on oral health: A systematic review of longitudinal studies. BDJ Open 2024; 10:18. [PMID: 38448428 PMCID: PMC10917741 DOI: 10.1038/s41405-024-00195-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024] Open
Abstract
AIM To systematically review longitudinal studies investigating the impact of dental visiting patterns on oral health across the life course. METHODS Five databases (MEDLINE, Embase, Scopus, Web of Science, CINAHL) were searched up to March 2023. Results were screened based on eligibility criteria in a two-stage process: title and abstract, and full-text review. A backward search of reference lists and a forward search of citations of the included papers was also conducted. The quality of the included papers was assessed using the Newcastle-Ottawa Scale. Key study information was extracted and a narrative synthesis of the findings was performed. RESULTS Eleven papers from five longitudinal studies in five countries (Australia, Brazil, China, New Zealand, Sweden) met the inclusion criteria. Studies of moderate to high quality consistently reported that regular dental attendance was associated with having less dental caries experience, fewer missing teeth and better oral health-related quality of life. Inconsistent findings were observed for decayed teeth, and no association was found for periodontal condition. CONCLUSIONS This review highlights an association between regular dental visiting pattern and improved oral health, notably less dental caries experience and better oral health-related quality of life. Dental attendance emerges as an important predictor of oral health across the life course, underscoring the importance of routine dental care. REGISTRATION INFORMATION The PROSPERO registration number is CRD42023396380.
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Affiliation(s)
- Aina Najwa Mohd Khairuddin
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Birke Bogale
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
- Department of Dental and Maxillofacial Surgery, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Jing Kang
- Oral Clinical Research Unit, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | - Jennifer E Gallagher
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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3
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Poulton R, Caspi A, Moffitt TE. Fear and anxiety: Lessons learned from the Dunedin longitudinal study. Neurosci Biobehav Rev 2023; 148:105118. [PMID: 36871678 DOI: 10.1016/j.neubiorev.2023.105118] [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: 12/21/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/06/2023]
Abstract
Four related lines of research on anxiety were reviewed from the 'Dunedin Study', an investigation of a representative longitudinal birth cohort of 50-years duration, with 94% retention at the last follow-up. Findings include: (i) Childhood fears deemed evolutionarily-relevant may have different pathways and/or mechanisms underlying their emergence when compared to evolutionarilyneutral fears. (ii) Sequential comorbidity both inside and external to the family of disorders is the rule not the exception, highlighting the importance of developmental history. (iii) The developmental relationship between GAD and MDE is more symmetric that previously assumed, with equal numbers of persons having GAD preceding MDE and MDE preceding GAD. (iv) PTSD in adulthood is influenced by a broad range of childhood risk factors, sequential comorbidity is near universal, and both high-stress life events and mental-disorder history influence the development of PTSD. The implications for epidemiology, nosology, the importance of developmental history, and prevention/treatment options are considered.
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Affiliation(s)
- Richie Poulton
- Department of Psychology and Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, 9016 Dunedin, New Zealand.
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Marshman Z, Rodd H, Fairhurst C, Porritt J, Dawett B, Day P, Innes N, Vernazza C, Newton T, Ronaldson S, Cross L, Ross J, Baker SR, Hewitt C, Torgerson D, Ainsworth H. The CALM trial protocol: a randomised controlled trial of a guided self-help cognitive behavioural therapy intervention to reduce dental anxiety in children. Trials 2023; 24:15. [PMID: 36609355 PMCID: PMC9817252 DOI: 10.1186/s13063-022-07046-6] [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: 11/10/2022] [Accepted: 12/20/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Globally, around 13% of children experience dental anxiety (DA). This group of patients frequently miss dental appointments, have greater reliance on treatment under general anaesthesia (GA) and have poorer oral health-related quality of life (OHRQoL) than their non-dentally anxious peers. Recently, a low-intensity cognitive behavioural therapy (CBT)-based, self-help approach has been recommended for management of childhood anxiety disorders. A feasibility study conducted in secondary care found this guided self-help CBT resource reduced DA and a randomised controlled trial was recommended. The present study aims to establish the clinical and cost-effectiveness of a guided self-help CBT intervention to reduce DA in children attending primary dental care sites compared to usual care. METHODS This 4-year randomised controlled trial will involve 600 children (aged 9-16 years) and their parent/carers in 30 UK primary dental care sites. At least two dental professionals will participate in each site. They will be assigned, using random allocation, to receive the CBT training and deliver the intervention or to deliver usual care. Children with DA attending these sites, in need of treatment, will be randomly allocated to be treated either by the intervention (CBT) or control (usual care) dental professional. Children will complete questionnaires relating to DA, OHRQoL and HRQoL before treatment, immediately after treatment completion and 12 months post-randomisation. Attendance, need for sedation/GA and costs of the two different approaches will be compared. The primary outcome, DA, will be measured using the Modified Child Dental Anxiety Scale. Scores will be compared between groups using a linear mixed model. DISCUSSION Treating dentally anxious patients can be challenging and costly. Consequently, these children are frequently referred to specialist services for pharmacological interventions. Longer waiting times and greater travel distances may then compound existing healthcare inequalities. This research will investigate whether the intervention has the potential to reduce DA and improve oral health outcomes in children over their life-course, as well as upskilling primary dental healthcare professionals to better manage this patient group. TRIAL REGISTRATION This clinical trial has been registered with an international registry and has been allocated an International Standard Randomised Controlled Trial Number (ISRCTN27579420).
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Affiliation(s)
- Zoe Marshman
- grid.11835.3e0000 0004 1936 9262School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Helen Rodd
- grid.11835.3e0000 0004 1936 9262School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Caroline Fairhurst
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Jenny Porritt
- grid.5884.10000 0001 0303 540XCentre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Bhupinder Dawett
- grid.11835.3e0000 0004 1936 9262School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Peter Day
- grid.9909.90000 0004 1936 8403 Leeds Dental Institute, University of Leeds, Leeds, UK
| | - Nicola Innes
- grid.5600.30000 0001 0807 5670School of Dentistry, Cardiff University, Cardiff, UK
| | - Christopher Vernazza
- grid.1006.70000 0001 0462 7212School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Tim Newton
- grid.13097.3c0000 0001 2322 6764Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - Sarah Ronaldson
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Liz Cross
- grid.11835.3e0000 0004 1936 9262School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Jennie Ross
- Richmond Dental Care, 427-429 Richmond Road, Sheffield, UK
| | - Sarah R. Baker
- grid.11835.3e0000 0004 1936 9262School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Catherine Hewitt
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - David Torgerson
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Hannah Ainsworth
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
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Halvari AEM, Halvari H, Deci EL. The Roles of Patients' Authenticity and Accepting External Influence, and Clinicians' Treatment Styles in Predicting Patients' Dental Anxiety and Avoidance of Dental Appointments. EUROPES JOURNAL OF PSYCHOLOGY 2021; 16:45-61. [PMID: 33680169 PMCID: PMC7913025 DOI: 10.5964/ejop.v16i1.1664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 06/18/2019] [Indexed: 11/28/2022]
Abstract
A substantial proportion of adults suffer from high dental anxiety, which is related to poor oral health and functioning. Using authenticity theory and self-determination theory, we applied a model testing two moderated mediation hypotheses: (i) the negative indirect association between authenticity and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of autonomy support; and (ii) the indirect positive association between accepting external influence and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of controllingness. Participants (N = 208) responded to a survey with validated questionnaires. The model with hypotheses were tested using Structural Equation Modeling (SEM) in LISREL and Conditional Process Modeling (moderated mediation). The results supported our hypotheses. The SEM model tested was found to fit the data well. Patient’s personality and dental clinic treatment environments predicted 38% of the variance in dental anxiety, which explained 38% of avoidance of treatment.
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Affiliation(s)
- Anne Elisabeth Münster Halvari
- Faculty of Dentistry, Department of Dental Hygienist Education, University of Oslo, Oslo, Norway.,Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Bakkenteigen, Norway
| | - Hallgeir Halvari
- Department of Business, Marketing and Law, University of South-Eastern Norway, Hønefoss, Norway
| | - Edward L Deci
- Department of Business, Marketing and Law, University of South-Eastern Norway, Hønefoss, Norway.,Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA.,Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
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6
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Vanhee T, Lachiri F, Van Den Steen E, Bottenberg P, Vanden Abbeele A. Child behaviour during dental care under nitrous oxide sedation: a cohort study using two different gas distribution systems. Eur Arch Paediatr Dent 2020; 22:409-415. [PMID: 33067760 PMCID: PMC7567415 DOI: 10.1007/s40368-020-00569-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/21/2020] [Indexed: 12/28/2022]
Abstract
Purpose Conscious sedation by inhalation of a mixture of nitrous oxide and oxygen (CS) is a technique used in dental care for anxious, handicapped or uncooperative patients. The very special objective of this cohort study is to compare the behaviour of young patients during dental care under CS in two hospitals using different gas distribution systems. Methods Young patients were divided into four categories: young child (YC), phobic anxiety (PA), mental disorder (MD), occasional indication (OI). Differences in behaviour scale at various time points according to the sedation system used were established and compared using Mann–Whitney tests. Results This study showed that there is no difference in behaviour during dental care in YC after sedation. In PA, a significant difference in behaviour is only observed during local anaesthesia (p = 0.024). Conclusion No significant differences detected in children’s behaviour under conscious sedation using different gas administration systems. The delicate stage of local anaesthesia in PA patients can be facilitated with repeated sessions of dental care under conscious sedation. Electronic supplementary material The online version of this article (10.1007/s40368-020-00569-z) contains supplementary material, which is available to authorised users.
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Affiliation(s)
- T Vanhee
- Department of Operative and Paediatric Dentistry, Université Libre de Bruxelles, Brussels, Belgium.
| | - F Lachiri
- Oral Health Research Group, Vrije Universiteit Brussel, Route de Lennik, CP 622 808, 1070, Brussels, Belgium
| | - E Van Den Steen
- Oral Health Research Group, Vrije Universiteit Brussel, Route de Lennik, CP 622 808, 1070, Brussels, Belgium
| | - P Bottenberg
- Oral Health Research Group, Vrije Universiteit Brussel, Route de Lennik, CP 622 808, 1070, Brussels, Belgium
| | - A Vanden Abbeele
- Department of Operative and Paediatric Dentistry, Université Libre de Bruxelles, Brussels, Belgium
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Hong C, Broadbent J, Thomson W, Poulton R. The Dunedin Multidisciplinary Health and Development Study: Oral health findings and their implications. J R Soc N Z 2020; 50:35-46. [PMID: 32226196 PMCID: PMC7100605 DOI: 10.1080/03036758.2020.1716816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
Longitudinal research is needed to better understand the natural history of oral conditions and long-term health and social outcomes. Oral health data has been collected periodically in the Dunedin Multidisciplinary Health and Development Study for over 40 years. To date, 70+ peer-review articles on the Study's oral health-related findings have been published, providing insight into the natural history of oral conditions, risk factors, impacts on quality of life, and disparities in oral health. Some of these report new findings, while others build upon the existing body of evidence. This paper provides an overview of these findings and reflects on their public health implications and policy utility in New Zealand.
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Affiliation(s)
- C.L. Hong
- Department of Oral Sciences, University of Otago
| | | | - W.M. Thomson
- Department of Oral Sciences, University of Otago
| | - R. Poulton
- Department of Psychology, University of Otago
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Halvari AEM, Halvari H, Deci EL, Williams GC. Motivation and anxiety for dental treatment and dental attendance: The roles of the locus of causality personality and treatment styles. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2019. [DOI: 10.1111/jasp.12645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Hallgeir Halvari
- Department of Business, Marketing and Law University of South‐Eastern Norway Hønefoss Norway
| | - Edward L. Deci
- Department of Business, Marketing and Law University of South‐Eastern Norway Hønefoss Norway
- Department of Clinical and Social Sciences in Psychology University of Rochester Rochester NY USA
- Institute for Positive Psychology and Education, Australian Catholic University Strathfield NSW Australia
| | - Geoffrey C. Williams
- Department of Clinical and Social Sciences in Psychology University of Rochester Rochester NY USA
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Abstract
Introduction A high percentage of people with dental phobia have poor oral health. This may be the result of delayed treatment or differences in care planning by the oral health care team.Aim This study sought to determine the effect, if any, of dental phobia and complexity of dental care on the proposed care plan devised by clinicians for patients.Design An experimental analogue study with independent variables of the presence of phobia and complexity of treatment need. Dependent variables included frequency of care planning elements such as periodontal treatment, prevention, restorations, root canal treatment, extraction and provision of crowns, bridges and prostheses.Participants Seventy-nine UK-based dental practitioners.Analysis The association between the case status (phobic versus non-phobic, simple versus complex) and the outcome variables were assessed using a chi-square test for association. Logistic regression analyses were also used to determine the predictors of care planning elements.Results There were no differences in care planning for phobic and non-phobic patients. Complexity of treatment need had significant effects on advanced periodontal treatment, restorations anterior and posterior, root canal treatment, provision of crowns, and extractions.Conclusions Care planning is influenced by patients' dental needs and not their phobic status.
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10
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Coxon JD, Hosey MT, Newton JT. The oral health of dentally phobic 12- and 15-year-olds: a descriptive analysis of the 2013 Child Dental Health Survey. Br Dent J 2019; 226:595-599. [PMID: 31028328 DOI: 10.1038/s41415-019-0196-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction Dental anxiety has been shown to be related to poorer oral health. Limited data exist exploring the relationship between oral health status and dental anxiety in non-clinical populations in children.Aim To compare the oral health of phobic and non-phobic children aged 12 and 15 years.Design Secondary analysis of data from 12-year-old and 15-year-old children in the Child Dental Health Survey 2013.Materials and methods Participants were grouped into non-phobic and phobic groups, depending on their self-reported dental anxiety (MDAS). Descriptive analyses compared the two groups on social demographic factors, clinical status, self-reported oral health status, oral health-related behaviours and oral health impact.Results A total of 601 children were classed as dentally phobic with 4,144 classed as non-phobic. Dental phobic children were more likely to be female, had more active decay and untreated dental disease, and rated their dental health as poorer. Phobic children were more likely to report that their oral health had a negative effect on their everyday life. This group were less likely to brush their teeth regularly or attend the dentist for check-ups.Conclusions Dentally phobic children have more dental disease and express greater impact on their everyday life.
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Affiliation(s)
- James D Coxon
- Faculty of Dentistry, Oral & Craniofacial Sciences King's College London, London, UK.
| | - Marie-Therese Hosey
- Paediatric Dentistry Centre of Oral Clinical and Translational Science Faculty of Dentistry, Oral & Craniofacial Sciences King's College London, London, UK
| | - J Tim Newton
- Faculty of Dentistry, Oral & Craniofacial Sciences King's College London, London, UK
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McNeil DW, Randall CL, Cohen LL, Crout RJ, Weyant RJ, Neiswanger K, Marazita ML. Transmission of dental fear from parent to adolescent in an Appalachian sample in the USA. Int J Paediatr Dent 2019; 29:720-727. [PMID: 31328316 PMCID: PMC6785362 DOI: 10.1111/ipd.12564] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 07/02/2019] [Accepted: 07/16/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dental fear/anxiety is associated with numerous negative outcomes. State dental fear is known to be transmitted from parents to their children in the dental setting, but it is not known how trait fear/anxiety might be shared between parents and offspring long term, and especially for adolescents. AIM This study aimed to: (a) compare dental fear levels of adolescents and their parents; (b) predict adolescent dental fear based on demographic variables, fear of pain, and parental dental fear; and, (c) determine relative contributions of mothers' and fathers' dental fear to adolescent fear. DESIGN In this cross-sectional study, the Dental Fear Survey and Fear of Pain Questionnaire-9 were administered to 350 adolescents (age range 11-17) and 515 of their parents, with t test and ANOVA used to calculate between-group differences; multiple linear regression was used to predict adolescent fear from parent fear. RESULTS Adolescents' dental fear was predicted by their own fear of pain and their parents' dental fear, but not their parents' fear of pain nor their own age or gender. When considered together, fathers' but not mothers' dental fear predicted adolescents' dental fear. CONCLUSIONS Parents' fears/anxieties about dentistry are associated with adolescents' dental fear in a manner suggestive of intergenerational transmission.
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Affiliation(s)
- Daniel W. McNeil
- Clinical Professor, Department of Dental Practice & Rural Health;,Professor, Department of Psychology, Eberly Distinguished Professor, Eberly College of Arts and Sciences, West Virginia University, Center for Oral Health Research in Appalachia
| | - Cameron L. Randall
- Department of Oral Health Sciences, University of Washington School of Dentistry, Center for Oral Health Research in Appalachia
| | | | - Richard J. Crout
- Department of Periodontics, School of Dentistry, West Virginia University, Center for Oral Health Research in Appalachia
| | - Robert. J. Weyant
- Department of Dental Public Health and Information Management, School of Dental Medicine, University of Pittsburgh, Center for Oral Health Research in Appalachia
| | - Katherine Neiswanger
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Center for Oral Health Research in Appalachia
| | - Mary L. Marazita
- Director, Center for Craniofacial and Dental Genetics, and Professor, Department of Oral Biology, School of Dental Medicine; Professor, Department of Human Genetics, Graduate School of Public Health; and Professor, Clinical and Translational Science and Department of Psychiatry University of Pittsburgh, Center for Oral Health Research in Appalachia
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12
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Bernabé E, Lie SA, Mastrovito B, Sannevik J, Astrom AN. Childhood negative dental experiences and tooth loss in later life: A 25-year longitudinal study in Sweden. J Dent 2019; 89:103198. [DOI: 10.1016/j.jdent.2019.103198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/31/2019] [Accepted: 09/07/2019] [Indexed: 12/20/2022] Open
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AlMaummar M, AlThabit HO, Pani S. The impact of dental treatment and age on salivary cortisol and alpha-amylase levels of patients with varying degrees of dental anxiety. BMC Oral Health 2019; 19:211. [PMID: 31492133 PMCID: PMC6731601 DOI: 10.1186/s12903-019-0901-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 08/27/2019] [Indexed: 12/15/2022] Open
Abstract
Background The purpose of this study was to assess the salivary cortisol and salivary alpha-amylase levels in children aged between 6 and 9 years, 3 months and 1 year after the successful completion of dental treatment through either pharmacological or non-pharmacological behavior management techniques. Methods A total of 1567 patients aged between 6 and 9 years who had completed dental treatment were screened. A total of 703 patients who were caries free at the end of 3 months were classified based on Frankl behavior score and administered the Arabic version of the Children’s Fear Survey Schedule- Dental Subscale (CFSS-DS) and accordingly allocated to one of three groups; (Phobic Patients, Anxious Patients, Control Group). A total of 183 patients met the inclusion criteria and were followed up for 1 year. A total of 151 patients completed the study. Patients’ heart rate on recall, salivary cortisol and salivary amylase were compared between the groups. Results The results of the study showed that amylase and cortisol levels had a significant association with the level of dental fear. The phobic patients had the highest levels of salivary amylase and salivary cortisol levels with no significant associations observed with either heart rate or extent of dental treatment. Control and anxious patients had significantly lower amylase levels when compared to phobic patients. There was no significant difference between the salivary cortisol levels of anxious and phobic patients. These findings were replicated on 1-year recall. Conclusions Within the limitations of this study we can conclude that salivary amylase is an indicator of of acute stress that can differentiate between anxiety and dental fear; while salivary cortisol appears to be a marker of long-term stress that lacks the sensitivity to differentiate between the two.
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Affiliation(s)
| | - Huda Othman AlThabit
- Resident in Pediatric Dentistry, Saudi Board in Pediatric Dentistry, Riyadh, Saudi Arabia
| | - Sharat Pani
- Room No 1012, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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14
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Chen HY, Yang H, Chi HJ, Chen HM. Parasympathetic effect of deep pressure input on third molar extraction in adolescents. J Formos Med Assoc 2019; 118:1317-1324. [PMID: 31204146 DOI: 10.1016/j.jfma.2019.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUD/PURPOSE Deep pressure input is used to normalize physiological arousal due to stress. Third molar extraction is an invasive dental procedure with high stress for the patient, and an alleviation strategy is rarely applied during tooth extraction. In the present study, we investigated the effects of deep pressure input on autonomic responses during the procedures of third molar extraction in healthy adolescents. METHODS A randomized controlled crossover design was used for adolescents who were allocated to experimental and control groups that received intervention with or without deep pressure input, respectively. Autonomic indicators, namely the heart rate, percentage of low-frequency heart rate variability (LF-HRV), percentage of high-frequency heart rate variability (HF-HRV), and low-frequency/high-frequency heart rate variability ratio (LF/HF-HRV), were assessed at the baseline, during molar extraction, and in the posttreatment phase. RESULTS The results indicated that third molar extraction caused significant autonomic parameter changes in both groups; however, differential response patterns were observed between two groups. In particular, application of deep pressure input in the experimental group was associated with higher HF-HRV and lower LF/HF-HRV during third molar extraction compared with those in the control group. CONCLUSION LF/HF-HRV measurement revealed balanced sympathovagal activation in response to deep pressure application. The present study suggests that the application of deep pressure alters the response of HF-HRV and facilitate maintaining sympathovagal balance during third molar extraction.
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Affiliation(s)
- Hsin-Yung Chen
- Department of Occupational Therapy & Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurology and Dementia Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsiang Yang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Huang-Ju Chi
- Department of Neurology and Dementia Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsin-Ming Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, National Taiwan University, Taipei, Taiwan.
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15
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Liinavuori A, Tolvanen M, Pohjola V, Lahti S. Longitudinal interrelationships between dental fear and dental attendance among adult Finns in 2000‐2011. Community Dent Oral Epidemiol 2019; 47:309-315. [DOI: 10.1111/cdoe.12458] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Arja Liinavuori
- Department of Community DentistryUniversity of Turku Turku Finland
- Social and Health Services Kirkkonummi Finland
| | - Mimmi Tolvanen
- Department of Community DentistryUniversity of Turku Turku Finland
| | - Vesa Pohjola
- Faculty of MedicineDepartment of Community DentistryUniversity of Oulu Oulu Finland
- Medical Research CenterOulu University Hospital Oulu Finland
| | - Satu Lahti
- Department of Community DentistryUniversity of Turku Turku Finland
- Turku Clinical Research CentreTurku University Hospital Turku Finland
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Strieder AP, Oliveira TM, Rios D, Cruvinel AFP, Cruvinel T. Is there a relationship of negative oral health beliefs with dental fear and anxiety regarding diverse dental patient groups? A systematic review and meta-analysis. Clin Oral Investig 2019; 23:3613-3621. [PMID: 30612241 DOI: 10.1007/s00784-018-2786-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/18/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to critically appraise the evidence on the relationship of oral health beliefs with dental fear and anxiety in distinct patient groups. MATERIALS AND METHODS Observational studies were retrieved by Cochrane, Embase Search, Portal BVS, Clinical Trials, Ovid, Open Gray, PubMed, Scopus, and Web of Science, and they were manually checked for the inclusion of additional articles of interest. The assessment of quality of studies was performed by the application of three different versions of the Newcastle-Ottawa Scale, for cohort, case-control, and cross-sectional studies. Only studies with low or unclear/moderate risk of bias contributed to meta-analyses, regarding the analysis of random effects of mean differences of dental beliefs scores between dental fear/anxiety and control groups, and the correlation of dental beliefs with dental fear and anxiety measures. RESULTS Of 276 articles initially retrieved, 10 were included in the systematic review, while only 6 studies with unclear/moderate risk of bias were considered in meta-analyses. The mean difference of dental beliefs effects was higher in patients with dental fear and anxiety compared to controls (1.20; 95% CI 0.27-2.14; P = 0.01). Additionally, a moderate positive correlation was observed between dental beliefs and dental fear measures (r = 0.54, 95% CI 0.47-0.60;P< 0.001). CONCLUSIONS Based on these results, the presence of negative health beliefs is directly related to the increase of dental fear and anxiety; however, these findings are supported in studies with unclear/moderate risk of bias. CLINICAL RELEVANCE Dental fear and anxiety is an important obstacle for the access of dental treatment and patient-dentist relationship, leading to inadequate oral health levels.
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Affiliation(s)
- Anna Paola Strieder
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Thaís Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Agnes Fátima Pereira Cruvinel
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Rodovia SC 484 - Km 02, Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil.
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Pani S, AlMaummar M, Althabit H. The impact of dental anxiety on the salivary cortisol and alpha-amylase levels of children undergoing dental treatment. SAUDI JOURNAL OF ORAL SCIENCES 2019. [DOI: 10.4103/sjos.sjoralsci_54_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nermo H, Willumsen T, Johnsen JAK. Changes in dental anxiety among 15- to 21-year-olds. A 2-year longitudinal analysis based on the Tromsø study: Fit futures. Community Dent Oral Epidemiol 2018; 47:127-133. [PMID: 30408210 DOI: 10.1111/cdoe.12434] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/10/2018] [Accepted: 10/14/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Identify predictive variables related to the development and continuation of high dental anxiety among young people over 2 years and assess differences between youth experiencing increased, decreased or unchanged dental anxiety scores over time. METHODS An observational panel study of 15- to 21-year-old people in Tromsø and Balsfjord region followed students from their first to their last year of upper secondary school (2010/11-2012/13). Logistic regression was used to estimate odds ratios and their 95% confidence intervals (CI) of possible predictive variables assessed at baseline when using dental anxiety score from the second wave as a dichotomous dependent variable. Variables measured at baseline: Sex, Dental Caries Experiences (DMFS index), Dental Anxiety (Corah's Dental Anxiety Scale/DAS), Psychological Distress (Hopkins Symptom Checklist/HSCL-10), Avoidance of dental treatment, Pain Estimation at the dentist and motivational questions related to tooth brushing and caries (Self and Social Motivation). Wilcoxon signed-rank tests and Kruskal-Wallis tests were used to test whether changes in DAS score between waves were associated with changes in Pain Estimation between waves and HSCL-10 scores at baseline. RESULTS Hopkins Symptom Checklist, DMFS and DAS scores at baseline predicted high dental anxiety scores after 2 years. Sex, motivation related to oral hygiene and avoidance due to fear at baseline did not contribute significantly to our model. DMFS and HSCL-10 were higher among young people who reported a substantial change in DAS score (2.0 > Interquartile range/IQR), irrespective of the direction of change. Pain Estimation changed consistently with a change in DAS score. CONCLUSION Mental health symptoms, pre-existing dental anxiety and dental health status are important contributors to the development of dental anxiety in youth. Estimations of pain at the dentist are central when it comes to changes in dental anxiety over time in this study.
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Affiliation(s)
- Hege Nermo
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway.,Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tiril Willumsen
- Department of Pediatric Dentistry and Behavioural Science, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Carter AE, AlShwaimi E, Boschen M, Carter G, George R. Influence of culture change on the perception of fear and anxiety pathways in Endodontics: A pilot proof of concept study. AUST ENDOD J 2018; 45:20-25. [PMID: 29336506 DOI: 10.1111/aej.12253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2017] [Indexed: 12/28/2022]
Abstract
This study assessed the influence of cultural changes (known as acculturation) on pathways of fear and anxiety in Endodontics. A purposive sampling technique identified patients of Saudi Arabian descent living in Australia and Saudi Arabia. Only patients with root canal fillings (or treatment planned for endodontic treatment) were included. Patients with intellectual disabilities, surgical root therapy, and aged under 20 were excluded. Consenting patients attending the dental clinics of University of Griffith University, Australia and University of Dammam, Saudi Arabia completed the "My Endodontic Fear Questionnaire." Three hundred and twenty-four patients (21-75 years) were included, 90% of participants reported more than one pathway. Australian Saudi Arabians mainly utilised vicarious pathway (94.9%), whilst Saudi Arabians utilised the verbal threat (93.5%) and parental pathway (78.3%). This study highlights the possible role of acculturation on the perception of fear and anxiety in Endodontics; however, further research with other ethnic groups is essential to enhance our understanding.
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Affiliation(s)
- Ava Elizabeth Carter
- School of Dentistry, Griffith University, Southport, Gold Coast, Queensland, Australia
| | - Emad AlShwaimi
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - Mark Boschen
- School of Applied Psychology, Griffith University, Southport, Gold Coast, Queensland, Australia
| | - Geoffery Carter
- School of Human Education and Resources, Griffith University, Southport, Gold Coast, Queensland, Australia
| | - Roy George
- School of Dentistry, Griffith University, Southport, Gold Coast, Queensland, Australia
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Armfield JM, Crego A, Schuch HS, Luzzi L. The role of cognitions in short-term temporal changes in dental fear among Australian adults. J Public Health Dent 2017; 78:32-40. [PMID: 28771737 DOI: 10.1111/jphd.12232] [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: 09/16/2016] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine if temporal changes in dental fear over a 4-month period are predicted by changed cognitive vulnerability-related perceptions of going to the dentist. METHODS Australian adults (n = 484) completed mailed questionnaires at baseline and follow-up, containing measures of dental fear, cognitive vulnerability-related perceptions, dental services received, and possible aversive experiences during the study period. Change in dental fear was the main outcome measure, categorized as decreased (Fear- ), unchanged (Fear0 ), and increased (Fear+ ). RESULTS Across the study period, 15.5 percent of people had Fear- , 73.4 percent had Fear0 , and 11.1 percent had Fear+ . In a multinomial logistic regression, after controlling for participant gender, income, time since last dental visit at baseline, dental fear at baseline and experiencing an aversive event, increased vulnerability-related perceptions were significantly associated with Fear+ (OR = 2.83, P < 0.001) while decreased vulnerability-related perceptions were associated with Fear- (OR = 0.17, P < 0.001). CONCLUSIONS This study found, across a relatively short 4-month period, that increased vulnerability-related perceptions of visiting the dentist predicted increased dental fear while decreased vulnerability-related perceptions predicted decreased dental fear. More appropriate study designs, such as longitudinal designs, and longer follow-up periods are needed to determine the possible causal nature of these associations.
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Affiliation(s)
- Jason M Armfield
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia
| | - Antonio Crego
- Department of Psychology, Madrid Open University, Collado-Villalba, Spain
| | - Helena S Schuch
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia
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Ibrahim H, Lyons KM, Armfield JM, Thomson WM. Performance of the Index of Dental Anxiety and Fear in a population-based sample of adults. Aust Dent J 2017; 62:478-484. [DOI: 10.1111/adj.12541] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- H Ibrahim
- Sir John Walsh Research Institute; Faculty of Dentistry; The University of Otago; Dunedin New Zealand
| | - KM Lyons
- Sir John Walsh Research Institute; Faculty of Dentistry; The University of Otago; Dunedin New Zealand
| | - JM Armfield
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide South Australia Australia
| | - WM Thomson
- Sir John Walsh Research Institute; Faculty of Dentistry; The University of Otago; Dunedin New Zealand
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Anthonappa RP, Ashley PF, Bonetti DL, Lombardo G, Riley P. Non‐pharmacological interventions for managing dental anxiety in children. Cochrane Database Syst Rev 2017; 2017:CD012676. [PMCID: PMC6481904 DOI: 10.1002/14651858.cd012676] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to assess the effectiveness of non‐pharmacological interventions for reducing dental anxiety in children.
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Affiliation(s)
- Robert P Anthonappa
- University of Western AustraliaSchool of DentistryFaculty of Medicine, Dentistry and Health Sciences17 Monash AvenueNedlandsAustraliaWA 6009
| | - Paul F Ashley
- UCL Eastman Dental InstituteUnit of Paediatric Dentistry, Department of Craniofacial Growth and Development256 Grays Inn RoadLondonUKWC1X 8LD
| | - Debbie L Bonetti
- University of DundeeSchool of DentistryFrankland Building, Small's WyndDundeeUKDD1 4HN
| | - Guido Lombardo
- University of PerugiaDipartimento di Scienze Chirurgiche, Radiologiche e OdontostomatologicheOspedale S. Maria della Misericordia ‐ S. Andrea delle FrattePerugiaItaly06156
| | - Philip Riley
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
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24
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The oral health of individuals with dental phobia: a multivariate analysis of the Adult Dental Health Survey, 2009. Br Dent J 2017; 222:595-604. [DOI: 10.1038/sj.bdj.2017.361] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/09/2022]
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Arrow P, Klobas E. Minimal intervention dentistry for early childhood caries and child dental anxiety: a randomized controlled trial. Aust Dent J 2017; 62:200-207. [DOI: 10.1111/adj.12492] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2016] [Indexed: 12/19/2022]
Affiliation(s)
- P Arrow
- Western Australian Department of Health and Dental Health Service; Perth Western Australia Australia
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide South Australia Australia
| | - E Klobas
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide South Australia Australia
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Porritt J, Rodd H, Morgan A, Williams C, Gupta E, Kirby J, Creswell C, Newton T, Stevens K, Baker S, Prasad S, Marshman Z. Development and Testing of a Cognitive Behavioral Therapy Resource for Children's Dental Anxiety. JDR Clin Trans Res 2017; 2:23-37. [PMID: 28879243 PMCID: PMC5576043 DOI: 10.1177/2380084416673798] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for dental anxiety; however, access to therapy is limited. The current study aimed to develop a self-help CBT resource for reducing dental anxiety in children, and to assess the feasibility of conducting a trial to evaluate the treatment efficacy and cost-effectiveness of such an intervention. A mixed methods design was employed. Within phase 1, a qualitative "person-based" approach informed the development of the self-help CBT resource. This also employed guidelines for the development and evaluation of complex interventions. Within phase 2, children, aged between 9 and 16 y, who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital, were invited to use the CBT resource. Children completed questionnaires, which assessed their dental anxiety and health-related quality of life (HRQoL) prior to and following their use of the resource. Recruitment and completion rates were recorded. Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/carers and dental professionals. For this analysis, the authors adhered to the Mixed Methods Appraisal Tool criteria. There were 24 families and 25 dental professionals participating in the development and qualitative evaluation of the CBT resource for children with dental anxiety. A total of 56 children agreed to trial the CBT resource (66% response rate) and 48 of these children completed the study (86% completion rate). There was a significant reduction in dental anxiety (mean score difference = 7.7, t = 7.9, df = 45, P < 0.001, Cohen's d ES = 1.2) and an increase in HRQoL following the use of the CBT resource (mean score difference = -0.03, t = 2.14, df = 46, P < 0.05, Cohen's d ES = 0.3). The self-help approach had high levels of acceptability to stakeholders. These findings provide preliminary evidence for the effectiveness and acceptability of the resource in reducing dental anxiety in children and support the further evaluation of this approach in a randomized control trial. Knowledge Transfer Statement: This study details the development of a guided self-help Cognitive Behavioral Therapy resource for the management of dental anxiety in children and provides preliminary evidence for the feasibility and acceptability of this approach with children aged between 9 and 16 y. The results of this study will inform the design of a definitive trial to examine the treatment- and cost-effectiveness of the resource for reducing dental anxiety in children.
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Affiliation(s)
- J. Porritt
- Department of Psychology, Sociology, and Politics, Sheffield Hallam University, Collegiate Crescent, Sheffield, UK
| | - H. Rodd
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - A. Morgan
- Paediatric Dentistry Department, Charles Clifford Dental Hospital, Sheffield, UK
| | - C. Williams
- Institute of Health and Wellbeing, Mental Health and Wellbeing, University of Glasgow, Administration Building, Gartnavel Royal Hospital, Glasgow, UK
| | - E. Gupta
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - J. Kirby
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - C. Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights, Reading, Berkshire, UK
| | - T. Newton
- Oral Health Services Research & Dental Public Health, King’s College London, Denmark Hill Campus, Caldecot Road, London, UK
| | - K. Stevens
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, UK
| | - S. Baker
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - S. Prasad
- Derbyshire Community Health Services, Long Eaton Dental Clinic, UK
| | - Z. Marshman
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
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Sharma A, Kumar D, Anand A, Mittal V, Singh A, Aggarwal N. Factors predicting Behavior Management Problems during Initial Dental Examination in Children Aged 2 to 8 Years. Int J Clin Pediatr Dent 2017; 10:5-9. [PMID: 28377646 PMCID: PMC5360794 DOI: 10.5005/jp-journals-10005-1397] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/04/2016] [Indexed: 11/30/2022] Open
Abstract
AIM The aim of the present study was to identify the various background variables and its influence on behavior management problems (BMP) in children. MATERIALS AND METHODS The study included 165 children aged 2 to 8 years. During the initial dental visit, an experienced operator obtained each child's background variables from accompanying guardians using a standardized questionnaire. Children's dental behavior was rated by Frankel behavior rating scale. The behavior was then analyzed in relation to the answers of the questionnaire, and a logistic regression model was used to determine the power of the variables, separately or combined, to predict BMP. RESULTS The logistic regression analysis considering differences in background variables between children with negative or positive behavior. Four variables turned out to be as predictors: Age, the guardian's expectation of the child's behavior at the dental examination, the child's anxiety when meeting unfamiliar people, and the presence and absence of toothache. CONCLUSION The present study concluded that by means of simple questionnaire BMP in children may be expected if one of these attributes is found. CLINICAL SIGNIFICANCE Information on the origin of dental fear and uncooperative behavior in a child patient prior to treatment process may help the pediatric dentist plan appropriate behavior management and treatment strategy. HOW TO CITE THIS ARTICLE Sharma A, Kumar D, Anand A, Mittal V, Singh A, Aggarwal N. Factors predicting Behavior Management Problems during Initial Dental Examination in Children Aged 2 to 8 Years. Int J Clin Pediatr Dent 2017;10(1):5-9.
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Affiliation(s)
- Arun Sharma
- Professor and Head, Department of Pedodontics and Preventive Dentistry, People’s College of Dental Sciences and Research Centre, People’s University, Bhopal, Madhya Pradesh, India
| | - Dipanshu Kumar
- Reader, Department of Pedodontics and Preventive Dentistry Institute of Dental Studies & Technologies, Ghaziabad, Uttar Pradesh, India
| | - Ashish Anand
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry Institute of Dental Studies & Technologies, Ghaziabad, Uttar Pradesh, India
| | - Vipula Mittal
- Consultant, Department of Prosthodontics, Dental Life Clinic, CGHS Dispensary, New Delhi, India
| | - Aparna Singh
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Institute of Dental Studies & Technologies, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Aggarwal
- Professor and Head, Department of Pedodontics and Preventive Dentistry Institute of Dental Studies & Technologies, Ghaziabad, Uttar Pradesh, India
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Opendak M, Sullivan RM. Unique neurobiology during the sensitive period for attachment produces distinctive infant trauma processing. Eur J Psychotraumatol 2016; 7:31276. [PMID: 27837581 PMCID: PMC5106868 DOI: 10.3402/ejpt.v7.31276] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 06/28/2016] [Accepted: 07/31/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Trauma has neurobehavioral effects when experienced at any stage of development, but trauma experienced in early life has unique neurobehavioral outcomes related to later life psychiatric sequelae. Recent evidence has further highlighted the context of infant trauma as a critical variable in determining its immediate and enduring consequences. Trauma experienced from an attachment figure, such as occurs in cases of caregiver child maltreatment, is particularly detrimental. METHODS Using data primarily from rodent models, we review the literature on the interaction between trauma and attachment in early life, which highlights the role of the caregiver's presence in engagement of attachment brain circuitry and suppressing threat processing by the amygdala. We then consider how trauma with and without the caregiver produces long-term changes in emotionality and behavior, and suggest that these experiences initiate distinct pathways to pathology. RESULTS Together these data suggest that infant trauma processing and its enduring effects are impacted by both the immaturity of brain areas for processing trauma and the unique functioning of the early-life brain, which is biased toward processing information within the attachment circuitry. CONCLUSION An understanding of developmental differences in trauma processing as well as the critical role of the caregiver in further altering early life brain processing of trauma is important for developing age-relevant treatment and interventions.
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Affiliation(s)
- Maya Opendak
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA;
| | - Regina M Sullivan
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
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Heidari E, Banerjee A, Newton JT. Oral health status of non-phobic and dentally phobic individuals; a secondary analysis of the 2009 Adult Dental Health Survey. Br Dent J 2015; 219:E9. [DOI: 10.1038/sj.bdj.2015.853] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 11/09/2022]
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Carter AE, Carter G, Boschen M, AlShwaimi E, George R. Ethnicity and Pathways of Fear in Endodontics. J Endod 2015; 41:1437-40. [DOI: 10.1016/j.joen.2015.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/24/2015] [Accepted: 04/19/2015] [Indexed: 12/17/2022]
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Inter-rater agreement between children's self-reported and parents' proxy-reported dental anxiety. Br Dent J 2015; 218:E6. [DOI: 10.1038/sj.bdj.2015.98] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/08/2022]
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Dental fear in children: the role of previous negative dental experiences. Clin Oral Investig 2014; 19:745-51. [PMID: 25502504 DOI: 10.1007/s00784-014-1380-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/25/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aims of this study were to determine the potential main sources of anxiety in children visiting the dental office and to examine whether negative experiences influence the development of dental fear. METHODS Six hundred six subjects from the same pediatric dental office were consecutively invited to participate in the study (303 children/303 parents). An adapted version of the Wong-Baker FACES Pain Rating Scale and Corah's Dental Anxiety Scale were used to rate anxiety in children and parents. Clinical variables were collected by the same experienced pediatric dentist, with a view to determining their potential influence upon the development of fears. Descriptive statistics (mean, standard deviation), along with the Mann-Whitney U test, were used to determine the association between clinical variables and anxiety levels. Correlations were established using the Spearman coefficient (r) (p < 0.05). RESULTS No statistical differences were observed in anxiety levels with respect to patient gender (p > 0.05). Greater anxiety levels were observed in 4- and 5-year-old children (n = 56/55, respectively), with a negative correlation between age and anxiety level (r = -0.176; p = 0.002) and between parent anxiety level and patient age (r = -0.154; p = 0.007). A strong positive correlation was found between the anxiety levels of the parents and children (r = 0.954; p < 0.001). In addition, a moderate positive correlation was found between elevated anxiety levels in children (r = 0.381; p < 0.001) and parents (r = 0.454; p < .001) and the number of previous treatments in other dental offices. CONCLUSIONS Dental fear in children is strongly associated with inadequate dental management, causing anxiety levels to increase in both the children and parents.
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Rantavuori K, Sihvonen A, Tolvanen M, Lahti S. The significance of previous invasive and orthodontic treatment experiences on children's dental fear. Eur J Orthod 2014; 36:409-13. [DOI: 10.1093/ejo/cjt062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Gordon D, Heimberg RG, Tellez M, Ismail AI. A critical review of approaches to the treatment of dental anxiety in adults. J Anxiety Disord 2013; 27:365-78. [PMID: 23746494 DOI: 10.1016/j.janxdis.2013.04.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
Dental anxiety and specific phobia of dental procedures are prevalent conditions that can result in substantial distress and oral health impairment. This paper critically reviews 22 randomized treatment trials aimed at reducing dental anxiety and avoidance in adults, published in peer-reviewed journals between 1974 and 2012. The following treatment techniques are reviewed: various forms of cognitive-behavioral therapy (CBT), relaxation training, benzodiazepine premedication, music distraction, hypnotherapy, acupuncture, nitrous oxide sedation, and the use of lavender oil scent. CBT delivered in a variety of formats, including one-session treatment, has the most evidence for its efficacy. Cognitive techniques, relaxation, and techniques to increase patients' sense of control over dental care are also efficacious but perform best when combined with repeated, graduated exposure. Other interventions require further study in randomized trials before conclusions about their efficacy are warranted. Limitations of the extant outcome research and implications for future treatment and research are discussed.
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Affiliation(s)
- Dina Gordon
- Adult Anxiety Clinic, Department of Psychology, Temple University, Philadelphia, PA 19122, USA.
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Bernson JM, Elfström ML, Hakeberg M. Dental coping strategies, general anxiety, and depression among adult patients with dental anxiety but with different dental-attendance patterns. Eur J Oral Sci 2013; 121:270-6. [PMID: 23659261 DOI: 10.1111/eos.12039] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2013] [Indexed: 12/29/2022]
Abstract
The aim of the present study was to investigate dental coping strategies, general anxiety, and depression in relation to regularity of dental treatment among persons with either regular dental care or phobic avoidance, whilst controlling for sociodemographic factors. Psychometric questionnaires on dental anxiety, dental coping strategies, general anxiety, and depression were delivered to 263 adult patients with dental phobic avoidance behavior who were seeking help from a specialized dental fear clinic and to 141 adult patients with dental anxiety who were receiving regular dental care from various public dental clinics. The results showed that the levels of dental and general anxiety and of depression were significantly higher among irregular attendees compared with regular attendees. Irregular attendees admitted fewer adaptive coping strategies. Predictive of irregular dental care were gender, dental anxiety, general anxiety, and the nonuse of the coping strategy 'optimism'. This study further confirms earlier preliminary results that the use of optimistic thinking is predictive for regular dental attendance habits and that male gender is a risk factor for irregular attendance. Moreover, this study adds that a high level of general anxiety indicates a higher risk for irregular dental care.
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Affiliation(s)
- Jenny M Bernson
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Klaassen MA, Veerkamp JSJ, Hoogstraten J. Changes in children’s dental fear: a longitudinal study. Eur Arch Paediatr Dent 2012; 9 Suppl 1:29-35. [DOI: 10.1007/bf03262653] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Porritt J, Marshman Z, Rodd HD. Understanding children's dental anxiety and psychological approaches to its reduction. Int J Paediatr Dent 2012; 22:397-405. [PMID: 22221141 DOI: 10.1111/j.1365-263x.2011.01208.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dental anxiety is a common problem, which can affect people of all ages, but appears to develop mostly in childhood and adolescence. Childhood dental anxiety is not only distressing for the child and their family but is also associated with poor oral health outcomes and an increased reliance on costly specialist dental services. AIM This article will consider the prevalence, development, and implications of children's dental anxiety. It will also discuss the opportunities for and challenges of psychological approaches such as cognitive behavioural therapy aimed at the reduction of dental anxiety in children.
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Affiliation(s)
- Jenny Porritt
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Bernson JM, Elfström ML, Hakeberg M. Adaptive coping strategies among adults with dental fear. Further development of a new version of the Dental Coping Strategy Questionnaire. Acta Odontol Scand 2012; 70:414-20. [PMID: 22126426 DOI: 10.3109/00016357.2011.634830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to further develop and investigate a newly constructed 15-item questionnaire on strategies for coping with dental treatment, used by fearful adult patients undergoing regular dental care and those with phobic avoidance. MATERIALS AND METHODS The dental coping strategy questionnaire (DCSQ-15) was distributed to 77 individuals with dental phobic avoidance and 94 fearful patients undergoing regular dental care. Previous analyses of a 20-item coping questionnaire (DCSQ-20) revealed that 2 of 4 identified factors predicted regularity or phobic avoidance of dental care. However, one of these factors was considered related to catastrophizing thoughts and not to coping strategies and it was therefore removed in the present study. RESULTS The reduced 15-item questionnaire was analyzed to identify its factor structure and a 5-factor solution was found. The five factors were labeled (i) 'self-efficacy', (ii) 'self-distraction', (iii) 'distancing', (iv) 'praying' and (v) 'optimism'. The factors of 'praying' and 'optimism' correlated significantly with dental anxiety and were assessed significantly higher and lower respectively, among individuals with phobic avoidance. A logistic regression analysis revealed that 'optimism', together with gender and dental anxiety, was predictive of the regularity or phobic avoidance of dental care.
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Affiliation(s)
- Jenny M Bernson
- The Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden.
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Tottenham N. Human amygdala development in the absence of species-expected caregiving. Dev Psychobiol 2012; 54:598-611. [PMID: 22714586 DOI: 10.1002/dev.20531] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 01/07/2011] [Indexed: 11/10/2022]
Abstract
In altricial species, like the human, caregiver presence is necessary for typical emotional development. Children who have been raised in institutional care early in life experience caregiver deprivation and are at significantly elevated risk for emotional difficulties. The current manuscript examines the non-human and human literatures on amygdala development following caregiver deprivation and presents an argument that in the absence of the species-expected caregiver presence, human amygdala development exhibits rapid development and perhaps premature engagement that results in some of the emotional phenotypes observed following early institutional care.
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Affiliation(s)
- Nim Tottenham
- Department of Psychology, University of California, Los Angeles, PO Box 951563, Los Angeles, CA 90095, USA.
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Carrillo-Diaz M, Crego A, Armfield JM, Romero-Maroto M. Assessing the relative efficacy of cognitive and non-cognitive factors as predictors of dental anxiety. Eur J Oral Sci 2012; 120:82-8. [DOI: 10.1111/j.1600-0722.2011.00924.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Carrillo-Díaz M, Crego A, Armfield JM, Romero M. Self-assessed oral health, cognitive vulnerability and dental anxiety in children: testing a mediational model. Community Dent Oral Epidemiol 2011; 40:8-16. [DOI: 10.1111/j.1600-0528.2011.00646.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Bernson JM, Hallberg LRM, Elfström ML, Hakeberg M. ‘Making dental care possible - a mutual affair’. A grounded theory relating to adult patients with dental fear and regular dental treatment. Eur J Oral Sci 2011; 119:373-80. [DOI: 10.1111/j.1600-0722.2011.00845.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hennequin M, Collado V, Faulks D, Koscielny S, Onody P, Nicolas E. A clinical trial of efficacy and safety of inhalation sedation with a 50% nitrous oxide/oxygen premix (Kalinox™) in general practice. Clin Oral Investig 2011; 16:633-42. [DOI: 10.1007/s00784-011-0550-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 03/16/2011] [Indexed: 11/30/2022]
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Milgrom P, Newton JT, Boyle C, Heaton LJ, Donaldson N. The effects of dental anxiety and irregular attendance on referral for dental treatment under sedation within the National Health Service in London. Community Dent Oral Epidemiol 2011; 38:453-9. [PMID: 20545723 DOI: 10.1111/j.1600-0528.2010.00552.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate whether the relationship between dental anxiety and referral for treatment under sedation is explained by attendance patterns and oral health. METHODS Structural Equation Modeling was used on the covariance matrix of the covariates to test hypothesized inter-relationships. Subsequently, we modeled the probability of referral for treatment under sedation with a multiple logistic regression taking into account inter-relationships between the independent variables. RESULTS A direct significant association of referral with dental anxiety and attendance patterns was detected, but not with oral health status. However, oral health and anxiety were highly correlated. Also signaled were correlations between age and education and between gender and bad past experience. CONCLUSION Referral for treatment under sedation appears to be motivated by both fear and irregular patterns of attendance. Coupled with behavioral treatments to address dental fear and attendance, sedation can be an important part of comprehensive care where curative treatments are long or unpleasant for patients.
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Affiliation(s)
- Peter Milgrom
- Dental Fears Research Clinic, University of Washington, Seattle, WA 98195-7475, USA.
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Nicolas E, Bessadet M, Collado V, Carrasco P, Rogerleroi V, Hennequin M. Factors affecting dental fear in French children aged 5-12 years. Int J Paediatr Dent 2010; 20:366-73. [PMID: 20545790 DOI: 10.1111/j.1365-263x.2010.01054.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND While dental anxiety is often correlated with prior negative dental experience, prevention of dental anxiety should in theory include early exposure to the dental setting. OBJECTIVE We set out to evaluate factors affecting dental fear in French children. METHODS Dental fear was evaluated using a visual analogue scale (DF-VAS) in a group of 1303 French children (681 boys and 622 girls) aged 5-11 years (mean: 8.12 years, SD: 1.42 years). Indicators of caries and oral hygiene were evaluated on dental examination. Indicators of well-being related to oral health, dental experience, and oral health education were collected via a structured interview. RESULTS Dental fear was scored low in 75.7% (DF-VAS 0-3), moderate in 16.7% (DF-VAS 4-6), and high in 7.6% (DF-VAS 7-10). DF-VAS decreased statistically with experience of a prior dental visit. Children who had at least one decayed tooth presented a higher level of dental fear than those with no decay, while children with fillings were significantly less anxious than those without previous dental care. CONCLUSIONS This study shows that for children aged 5-12 years, prior experience of the dental setting can act as a positive component of dental fear.
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Affiliation(s)
- Emmanuel Nicolas
- CHU Clermont-Ferrand, Service d'Odontologie, Hôtel-Dieu, F-63000 Clermont-Ferrand, France
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Themessl-Huber M, Freeman R, Humphris G, MacGillivray S, Terzi N. Empirical evidence of the relationship between parental and child dental fear: a structured review and meta-analysis. Int J Paediatr Dent 2010; 20:83-101. [PMID: 20384823 DOI: 10.1111/j.1365-263x.2009.00998.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The relationship between parental and child dental fear has been studied for over a century. During this time, the concept of dental fear as well as methodological approaches to studying dental fear in children have evolved considerably. AIM To provide an overview of the published empirical evidence on the link between parental and child dental fear. DESIGN A structured literature review and meta-analysis. RESULTS Forty-three experimental studies from across the six continents were included in the review. The studies ranged widely with respect to research design, methods used, age of children included, and the reported link between parental and child dental fear. The majority of studies confirmed a relationship between parental and child dental fear. This relationship is most evident in children aged 8 and under. A meta-analysis of the available data also confirmed an association between parental and child dental fear. CONCLUSION The narrative synthesis as well as the meta-analysis demonstrate a significant relationship between parental and child dental fear, particularly in children 8 years and younger.
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Affiliation(s)
- Markus Themessl-Huber
- Department of Behavioural and Social Sciences, CQUniversity, Rockhampton, Qld, Australia.
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Thomson WM, Broadbent JM, Locker D, Poulton R. Trajectories of dental anxiety in a birth cohort. Community Dent Oral Epidemiol 2009; 37:209-19. [PMID: 19508269 DOI: 10.1111/j.1600-0528.2009.00473.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine predictors of dental anxiety trajectories in a longitudinal study of New Zealanders. METHODS Prospective study of a complete birth cohort born in 1972/73 in Dunedin, New Zealand, with dental anxiety scale (DAS) scores and dental utilization determined at ages 15, 18, 26 and 32 years. Personality traits were assessed at a superfactor and (more fine-grained) subscale level via the Multidimensional Personality Questionnaire at age 18 years. Group-based trajectory analysis was used to identify dental anxiety trajectories. RESULTS DAS scores from at least three assessments were available for 828 participants. Six dental anxiety trajectories were observed: stable nonanxious low (39.6%); stable nonanxious medium (37.9%); recovery (1.6%); adult-onset anxious (7.7%); stable anxious (7.2%) and adolescent-onset anxious (5.9%). Multivariate analysis showed that males and those with higher DMFS at age 15 years were more likely to be in the stable nonanxious low trajectory group. Membership of the stable nonanxious medium group was predicted by the dental caries experience at age 15 years. Participants who had lost one or more teeth between ages 26 and 32 years had almost twice the relative risk for membership of the adult-onset anxious group. Personality traits predicted group membership. Specifically, high scorers (via median split) on the 'stress reaction' subscale had over twice the risk of being in the stable anxious group; low scorers on the traditionalism subscale were more likely to be members of the recovery trajectory group; and high scorers on the 'social closeness' subscale had half the risk of being in the stable anxious group. Dental caries experience at age 5 years was also a predictor for the stable anxious group. Membership of the late-adolescent-onset anxious group was predicted by higher dental caries experience by age 15 years, but none of the other predictors was significant. CONCLUSION Six discrete trajectories of dental anxiety have been observed. Some trajectories (totalling more than 90% of the cohort) had clear associations with external influences, but others were more strongly associated with characteristics such as personality traits. A mix of both influences was observed with only the stable anxious dental anxiety trajectory.
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Affiliation(s)
- W M Thomson
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
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Tickle M, Jones C, Buchannan K, Milsom KM, Blinkhorn AS, Humphris GM. A prospective study of dental anxiety in a cohort of children followed from 5 to 9 years of age. Int J Paediatr Dent 2009; 19:225-32. [PMID: 19486376 DOI: 10.1111/j.1365-263x.2009.00976.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND The development of dental anxiety in children is poorly understood. AIMS The aims of this study were to measure changes in dental anxiety over time and to examine the relationship between anxiety, dental care, and other factors. DESIGN A prospective cohort study of children in the north-west of England followed from 5 to 9 years of age. The participants were clinically examined and their parents completed the same questionnaire at 5 and 9 years. RESULTS The majority (54.3%N = 38) of participants who were anxious at 5 years were no longer anxious at 9 years, but a large proportion of children who were anxious at 5 remained anxious at 9 years of age (45.7%N = 32). During the follow-up period, a larger proportion of children developed anxiety (11.7%N = 85) than the proportion of children who were reported as being anxious at baseline (8.8%N = 70). At 9 years of age, dental anxiety was significantly associated with girls; parental anxiety; a history of extraction; and irregular, asymptomatic dental visiting. These factors were also significantly associated with dental anxiety at 5 years old. CONCLUSIONS Dental anxiety was cumulative in the study population over time, and its development influenced by multiple variables. Results suggest that adverse conditioning and vicarious learning are both important in the development of this condition.
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Affiliation(s)
- Martin Tickle
- Oral Health Unit, National Primary Care R&D Centre, University of Manchester, Manchester, UK.
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Bernson JM, Elfström ML, Berggren U. Self-reported dental coping strategies among fearful adult patients: preliminary enquiry explorations. Eur J Oral Sci 2007; 115:484-90. [DOI: 10.1111/j.1600-0722.2007.00496.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
This chapter provides a review of recent empirical developments, current controversies, and areas in need of further research in relation to factors that are common as well as specific to the etiology and maintenance of panic disorder, phobias, and generalized anxiety disorder. The relative contribution of broad risk factors to these disorders is discussed, including temperament, genetics, biological influences, cognition, and familial variables. In addition, the role that specific learning experiences play in relation to each disorder is reviewed. In an overarching hierarchical model, it is proposed that generalized anxiety disorder, and to some extent panic disorder, loads most heavily on broad underlying factors, whereas specific life history contributes most strongly to circumscribed phobias.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology, University of California, Los Angeles, California 90095, USA.
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