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Åstrøm AN, Agdal ML, Sulo G. Exploring avoidance of dental care due to dental fear and economic burden -A cross-sectional study in a national sample of younger adults in Norway. Int J Dent Hyg 2024; 22:148-157. [PMID: 36524299 DOI: 10.1111/idh.12657] [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: 09/17/2021] [Revised: 09/13/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
AIM To assess the prevalence of dental avoidance due to dental fear and economic burden and its distribution by utilization of dental care and socio-behavioural characteristics. METHOD A sample of 9052 Norwegian adults aged 25-35 years was invited to participate, and 2551 completed electronic questionnaires regarding lifetime prevalence of dental avoidance due to fear and last year prevalence of dental avoidance due to economic burden. RESULTS Cancelled- and avoided ordering appointments due to fear amounted to 14.7% and 30.5%, respectively. Avoidance of dental visits due to cost was 37.7%. Frequency of cancelled appointments due to fear was 30% and 16.6% among participants attending dental care several times annually and seldom, respectively. Multiple logistic regression revealed that avoiding dental visits due to cost was less likely among participants with higher household income (OR 0.4, 95% CI 0.3-0.5) and more likely among participants with dental care need (OR 1.8, 95% CI 1.2-2.7). Cancelled and avoided appointments due to fear was most likely among those with need for dental care and lower education. Early unpleasant experience with dental care remained a covariate of avoidance behaviour due to fear. CONCLUSION 14.7%, 30.5%, and 37.7% confirmed cancelled appointments due to fear, avoided ordering appointments due to fear, and avoided visiting the dentist due to cost. Avoiding dental care due to fear and economic burden was more and less common among participants with respectively, frequent and seldom use of dental care. Dental avoidance behaviours were highest among socially disadvantaged groups, indicating a hole in the welfare state model that needs political consideration.
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Affiliation(s)
- Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
| | | | - Gerhard Sulo
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
- Division of Mental and Physical Health, Center for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway
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Goswami S, Tseveenjav B, Kaila M. Non-utilization of oral health services and associated factors among children and adolescents: an integrative review. Acta Odontol Scand 2023; 81:105-118. [PMID: 35841154 DOI: 10.1080/00016357.2022.2095020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To review publications exploring non-utilization of oral health services and to identify factors associated with non-utilization of oral health services among children and adolescents. MATERIALS AND METHODS An integrative review design was adopted. A search was conducted for research articles published during the period from 2000 to April 2021 in five databases, Medline via Ovid, Scopus, CINAHL, Cochrane Library and Web of Science. Inclusion criteria were original articles examining non-utilization of oral health services among 0-19 years old and studies published in peer-reviewed journals in English. Thematic analysis was undertaken to identify common themes. The Newcastle-Ottawa scale was used to evaluate the quality of the studies. RESULTS Twenty-one geographically diverse articles were included. Nineteen studies were cross-sectional, one was a prospective cohort and one a case-control study. Non-utilization of dental health services tended to be higher in children than adolescents. There were predisposing (age, gender, ethnicity, parent's level of education), enabling (family income, dental insurance) and need factors (subjective and objective oral health related parameters) that had been shown to be associated with non-utilization of dental services among children and adolescents. CONCLUSIONS This integrative review found predisposing, enabling and need factors to be associated with dental health service non-utilization.
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Affiliation(s)
- Shweta Goswami
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Battsetseg Tseveenjav
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,New Children's Hospital, Helsinki University Hospital, Helsinki, Finland.,Department of Maxillofacial Surgery, Päijät-Häme Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland
| | - Minna Kaila
- Clinicum, University of Helsinki, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
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Höglund M, Wårdh I, Shahnavaz S, Berterö C. Dental clinicians recognizing signs of dental anxiety: a grounded theory study. Acta Odontol Scand 2022:1-9. [DOI: 10.1080/00016357.2022.2154263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Markus Höglund
- Centre for Orofacial Medicine, Public Dental Service Östergötland, Linköping, Sweden
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Inger Wårdh
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Academic Center of Geriatric Dentistry, Stockholm, Sweden
- Department of Health Sciences, University of Karlstad, Karlstad, Sweden
| | - Shervin Shahnavaz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
- The Centre for Psychotherapy Education & Research, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Carina Berterö
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Patient-self-reported history of restraint among 17-year-olds: a retrospective study of records by non-specialist dentists in the public dental service in Hordaland, Norway. Eur Arch Paediatr Dent 2022; 23:475-484. [PMID: 35536447 PMCID: PMC9167190 DOI: 10.1007/s40368-022-00710-0] [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: 10/01/2021] [Accepted: 04/09/2022] [Indexed: 10/28/2022]
Abstract
PURPOSE The primary purposes were to examine dental records of Norwegian adolescents' with and without self-reported history of restraint for information about oral health (DMFT), total scheduled time in the Public Dental Service (PDS) (dental appointments, cancelled and missed appointments), and reluctant behaviour and/or dental fear and anxiety (DFA). Another purpose was to explore their dental records for information recorded by the dentist concerning the use of restraint. METHODS Data on patient-self-reported history of restraint and DFA were collected in a population-based cross-sectional survey of 17-year-olds in the PDS in Hordaland, Norway, 2019. Patients were divided into two groups: self-reported restraint group (N1 = 26) and self-reported non-restraint group (N2 = 200). Data on oral health and dental treatment, total scheduled time of the PDS, reluctant behaviour or DFA, and information on the use of restraint were extracted from the dental records written by non-specialist dentists using a pre-set protocol covering the period from 2002 to 2019. RESULTS A total of 206 dental records were analysed. Adolescents with self-reported history of restraint (n1 = 18) had higher DMFT and greater descriptions of reluctant behaviour and/or DFA, and total scheduled time compared with the self-reported non-restraint group (n2 = 188). The use of restraint was recorded in the dental records of one patient from the self-reported restraint group and in two patients from the self-reported non-restraint group. CONCLUSIONS The adolescents with self-reported history of restraint had higher DMFT, higher scheduled time attending the PDS, and had more descriptions of reluctant behaviour and/or signs of DFA compared with the self-reported non-restraint group. The patient records contained limited information concerning restraint, and there were significant discrepancies between patient-self-reported history of restraint and the recording of restraint by the dentist in the patients' records.
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Ab Mumin N, Yusof ZYM, Marhazlinda J, Obaidellah U. Exploring the opinions of secondary school students on the strengths and weaknesses of the school dental service in Selangor, Malaysia: a qualitative study. BMC Oral Health 2021; 21:394. [PMID: 34380484 PMCID: PMC8359023 DOI: 10.1186/s12903-021-01741-7] [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: 10/30/2020] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
Background The Malaysian School Dental Service (SDS) was introduced to provide systematic and comprehensive dental care to school students. The service encompasses promotive, preventive, and, curative dental care. This study aimed to undertake a process evaluation of the SDS based on the perspectives of government secondary school students in Selangor, Malaysia. Methods The study adopted a qualitative approach to explore the opinions of secondary school students on the SDS implementation in their schools. Data from focus group discussions involving Form Two (14-year-olds) and Form Four (16-year-olds) students from the selected schools were transcribed verbatim and coded using the NVivo software before framework method analysis was conducted. Results Among the strengths of the SDS were the convenience for students to undergo annual oral examination and dental treatment without having to visit dental clinics outside the school. The SDS also reduced possible financial burdens resulting from dental treatment costs, especially among students from low-income families. Furthermore, SDS helped to improve oral health awareness. However, the oral health education provided by the SDS personnel was deemed infrequent while the content and method of delivery were perceived to be less interesting. The poor attitude of the SDS personnel was also reported by the students. Conclusion The SDS provides effective and affordable dental care to secondary school students. However, the oral health promotion and education activities need to be improved to keep up with the evolving needs of the target audience. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01741-7.
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Affiliation(s)
- Nazirah Ab Mumin
- Department of Periodontology and Community Oral Health, Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, Malaysia.,Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | - Jamaludin Marhazlinda
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya (UM), Kuala Lumpur, Malaysia.
| | - Unaizah Obaidellah
- Department of Artificial Intelligence, Faculty of Computer Science & Information Technology, Universiti Malaya (UM), Kuala Lumpur, Malaysia
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Fägerstad A, Lundgren J, Arnrup K, Carlson E. Barriers and facilitators for adolescent girls to take on adult responsibility for dental care - a qualitative study. Int J Qual Stud Health Well-being 2019; 14:1678971. [PMID: 31608818 PMCID: PMC6807868 DOI: 10.1080/17482631.2019.1678971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2019] [Indexed: 11/03/2022] Open
Abstract
Purpose: This study aims to explore and describe experiences of the dental care system among adolescent dental patients with a recent history of missed dental appointments at public dental clinics (PDCs) in a Swedish county. Methods: Twelve adolescent girls participated in the study. Data were collected by individual, semi-structured, open-ended interviews and analysed with qualitative content analysis. Results: The study findings could be summed into the theme "Triggers for adolescent girls to take on or not take on adult responsibility for dental care". The experience of free dental care could be summarized in five main categories: Pain and discomfort; Attractive and healthy teeth; Feeling safe and secure; Taking on the responsibility; and Free of charge. These five categories consisted of 15 subcategories. Conclusions: The results of this study should increase the knowledge on how to meet and treat adolescent girls in dental care. Knowing what will happen during the dental visit was highlighted by the participants as decisive to whether or not they would attend their dental appointments. Therefore, we should as far as possible ensure that our patients feel safe at their dental visits and by trying to avoid painful treatments.
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Affiliation(s)
- Anida Fägerstad
- Public Dental Service, Region Örebro County, Örebro, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Jesper Lundgren
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Arnrup
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Eva Carlson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
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Höglund M, Bågesund M, Shahnavaz S, Wårdh I. Evaluation of the ability of dental clinicians to rate dental anxiety. Eur J Oral Sci 2019; 127:455-461. [PMID: 31317603 PMCID: PMC6790589 DOI: 10.1111/eos.12648] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 02/06/2023]
Abstract
The aim of this study was to evaluate the ability of dental clinicians to rate dental anxiety. A total of 104 clinicians from 24 public dental clinics in the Region of Östergötland, Sweden, examined 1,128 adult patients undergoing their regular dental examination. The patients rated their dental anxiety using the Modified Dental Anxiety Scale and a Visual Analogue Scale. After the examination, the clinicians rated the patients' levels of dental anxiety on a Visual Analogue Scale. The correlation (rs ) between the clinicians' and patients' ratings of dental anxiety was 0.45. Among highly dentally anxious patients, there was no correlation between clinicians' and patients' ratings. Dental clinicians rated dental anxiety lower than their patients did, especially if the patients were highly anxious. The ability of clinicians to rate dental anxiety was better when the clinician was older and the patient was older. There was an inverse association between clinicians' confidence and their ability to rate a patient's dental anxiety. In conclusion, clinicians are unsuccessful in identifying a dentally anxious patient without the concurrent use of patient self-assessment tools. A Visual Analogue Scale is a suitable screening tool in general practice for detection of dental anxiety.
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Affiliation(s)
- Markus Höglund
- Centre for Orofacial Medicine, Public Dental Service Östergötland, Linköping, Sweden.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Mats Bågesund
- Centre for Orthodontics and Paediatric Dentistry, Norrköping, Public Dental Service Östergötland, Sweden.,Division of Paediatrics, Department of Clinical and Experimental Medicine, Faculty of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Shervin Shahnavaz
- Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.,Department of Clinical Neuroscience, Centre for Psychotherapy Education and Research, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Inger Wårdh
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Academic Centre of Geriatric Dentistry, Stockholm, Sweden
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Vigu A, Stanciu D. When the fear of dentist is relevant for more than one's oral health. A structural equation model of dental fear, self-esteem, oral-health-related well-being, and general well-being. Patient Prefer Adherence 2019; 13:1229-1240. [PMID: 31413551 PMCID: PMC6663078 DOI: 10.2147/ppa.s209068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/21/2019] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To develop and test a complex model that captures the individuals' general well-being and the specific oral-health-related well-being. We were specifically interested, as a specific research question, if self-esteem, dental fear, and the oral health-related well-being are credible predictors for the general well-being. PATIENTS AND METHODS A one-time associative research design measured dental-specific anxiety, self-esteem, oral-health-related specific well-being, and general well-being in 281 participants, 3rd and 6th year dental students (M Age =22.59 years, SD Age =3.13; 55% females), which completed a battery of relevant questionnaires: the Dental Fear Survey, the Rosenberg Self-Image Scale, the short form of Oral Health Impact Profile, and the Flourishing Scale. The data were subject to structural equation modeling in order to validate potential pathways of influence hypothesized based on previous evidence from the literature. RESULTS We developed and tested a complex structural equations model, in which dental fear influences both the specific oral-health-related well-being and the persons' self-esteem. In turn, self-esteem mediates the influence pathways between dental fear and oral-health-specific well-being, on the one hand, and the overall well-being, on the other hand. CONCLUSION Our research contributes directly to strengthening the theoretical basis for future interdisciplinary research, by providing, first, a tested and replicable model that surpasses the simple correlation or prediction, and second, empirical evidence for the significant mutual interdependence between psychological experiences, eg, self-esteem, and the two main aspects of well-being, ie, specific and general. From a practical, clinical viewpoint, our research provides further insights and justification for the importance of educating the patient, on all levels, from the individual clinical practice to community programs and public oral health policies, with respect to the importance of oral health.
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Affiliation(s)
- Alexandra Vigu
- Department of Dental Materials and Ergonomics, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-napoca, Cluj-Napoca, Romania
| | - Dorin Stanciu
- Department of Psychology and Pedagogy, Technical University of Cluj-napoca, Cluj-Napoca, Romania
- Riley College of Education and Leadership (rcoel), Walden University, Minneapolis, USA
- Correspondence: Dorin StanciuDepartment of Psychology and Pedagogy, Technical University of Cluj-Napoca, 15 Constantin Daicoviciu Street, Tower Building, Room 205, Cluj-Napoca, RomaniaTel/Fax +40 26 440 1348Email
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