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Taheri AA, Parvizifard AA, Reisi S, Jafari M, Mohammadian Y, Heshmati K, Foroughi A, Eivazi M, Ghasemi M. Associations between the perception of dental pain and pain anxiety, mental pain, and dental anxiety in Iranian sample. Int J Psychiatry Med 2024; 59:34-49. [PMID: 37265197 DOI: 10.1177/00912174231180855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This study examined the perception of dental pain and its relationship to pain anxiety, dental anxiety, and mental pain. METHODS This cross-sectional study was conducted on 328 patients referred to dental clinics in Kermanshah (Iran) from 2020 to 2021. The instruments used in this study included scales assessing pain anxiety, dental anxiety, mental pain, and pain perception. RESULTS There was a significant relationship (p = .001) between pain perception with dental anxiety (r = .38), pain anxiety (r = .45), and mental pain (r = .25). CONCLUSION Psychological factors are associated with the perception of dental pain. Given the importance of dental care to overall health, psychological interventions may help to reduce the perception of dental pain and fear of seeing dentists in Iran.
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Affiliation(s)
- Amir Abbas Taheri
- Department of Rehabilitation Counseling, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Ali Akbar Parvizifard
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajjad Reisi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Jafari
- Department of Psychology, University of Mohaghegh Ardebili, Ardebil, Iran
| | - Yokhabe Mohammadian
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Khatereh Heshmati
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aliakbar Foroughi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoome Eivazi
- Department of periodontics, school of dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ghasemi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alansaari ABO, Tawfik A, Jaber MA, Khamis AH, Elameen EM. Prevalence and Socio-Demographic Correlates of Dental Anxiety among a Group of Adult Patients Attending Dental Outpatient Clinics: A Study from UAE. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6118. [PMID: 37372705 DOI: 10.3390/ijerph20126118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES The aims of this paper were twofold: first, to evaluate dental anxiety levels among patients undergoing oral surgery procedures; second, to assess how dental anxiety and fear are connected to age, gender, educational background, past traumatic experiences, and the frequency of dental appointments. METHODS A cross-sectional Likert-scale questionnaire survey was conducted to collect quantitative data from 206 patients at the Oral Surgery Clinics at Dubai Dental Clinics, Dubai, United Arab Emirates. The reliability and validity of the questionnaire were tested using Cronbach's alpha. The normality of the MDAS score was tested using the Kolmogorov-Smirnov test. The chi square and Kruskal-Wallis tests were used to determine the association between categorical variables. Descriptive statistics were used to describe continuous and categorical variables. The statistical significance was set at p-value ≤ 0.05. RESULTS The evaluation of the degree of dental anxiety among patients who visited the Dubai Dental clinics revealed that there was a considerably high level of moderate or high anxiety (72.3%). Tooth extraction and dental surgery procedures (95%), followed by local anesthetic injection in the gingiva (85%) and teeth drilling (70%), were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety (35%). There was no substantial difference in dental anxiety between male and female patients or among patients with different marital statuses. A total of 70% of patients preferred the tell-show-do method, whereas 65% chose communication strategies to reduce dental anxiety. CONCLUSIONS The evaluation of the degree of dental anxiety among patients who visited Dubai Dental clinics revealed that there was a considerably high level of anxiety. Tooth extraction and dental surgery procedures, followed by local anesthetic injection and teeth drilling, were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety. Despite the use of a modified anxiety scale and a large and representative sample of oral surgery patients, more research is necessary to investigate the impact of various factors on dental anxiety.
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Affiliation(s)
- Al Batool Omer Alansaari
- Hamdan Bin Mohammed College of Dental Medicine, MBRU, Dubai P.O. Box 505055, United Arab Emirates
| | - Abdelrahman Tawfik
- Hamdan Bin Mohammed College of Dental Medicine, MBRU, Dubai P.O. Box 505055, United Arab Emirates
| | - Mohamed A Jaber
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Amar Hassan Khamis
- Hamdan Bin Mohammed College of Dental Medicine, MBRU, Dubai P.O. Box 505055, United Arab Emirates
| | - Essra Mohamed Elameen
- Clinical Sciences Department, College of Medicine, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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Saba Z, Katirci G. Relationship between dental anxiety levels and oral health among dental patients in Turkey: a cross-sectional study. BMC Oral Health 2023; 23:328. [PMID: 37231452 DOI: 10.1186/s12903-023-03041-8] [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: 03/08/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study aimed to determine the relationship between dental anxiety and oral health in adult patients who applied to the Department of Restorative Dentistry at the Faculty of Dentistry at Suleyman Demirel University. METHODS The study included 500 subjects. The dental anxiety levels of the patients were determined using a modified dental anxiety scale (MDAS). Information on sociodemographic details, oral hygiene and nutritional habits were recorded. Intraoral examinations of the subjects were performed. Caries prevalence of individuals was determined using the decayed, missing or filled teeth (DMFT) and decayed, missing, or filled surfaces (DMFS) indices. Gingival health was evaluated using the gingival index (GI). Statistical analyses were performed using the Mann-Whitney U, Kruskal-Wallis and Chi-square tests and Spearman correlation analysis. RESULTS The ages of the 276 female and 224 male participants ranged from 18-84 years. The median MDAS value was 9.00. The median DMFT and DMFS values were 10.00 and 23.00, respectively. The median MDAS values of women were higher than those of men. Individuals who postponed their appointment had a higher MDAS median value than those who did not (Mann-Whitney U test, p < 0.05). No statistically significant correlation was found between dental anxiety level (MDAS) and GI, DMFT and DMFS index scores (Spearman correlation analysis, p > 0.05). CONCLUSION The MDAS values of individuals who did not remember the reason for their dental visit were higher than those who visited the dentist for routine control. Based on the findings of this study, further research on the relationship between dental anxiety and oral health is necessary to determine the factors that pose a risk for dental anxiety and to ensure the regular benefits of dental services.
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Affiliation(s)
- Zafer Saba
- Restorative Dentistry Specialist, Private Dentist, Bursa, Turkey
| | - Gunseli Katirci
- Faculty of Dentistry, Department of Restorative Dentistry, Suleyman Demirel University, Isparta, Turkey.
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Evensen KB, Bull VH. Oral health in prison: an integrative review. Int J Prison Health 2023; 19:251-269. [PMID: 38899622 DOI: 10.1108/ijph-08-2021-0081] [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: 11/17/2022]
Abstract
PURPOSE Prisoners' oral health is an often overseen, yet important aspect of the general health of prisoners. To develop effective measures to improve the situation, it is important to get an overview of existing research. The purpose of this study is to examine and analyse existing research on oral health of prisoners and provide a thorough understanding of prisoners' oral health and related factors. DESIGN/METHODOLOGY/APPROACH Due to relatively few scientific papers on prisoners' oral health, an integrative review was chosen. Integrative reviews allow for the inclusion of diverse methodologies. A literature search was conducted, followed by an assessment of the quality of the studies by using the Mixed Methods Appraisal Tool. Thematic analysis was used to analyse the studies. FINDINGS The few studies addressing European prisoners' oral health in the last 21 years differ in design and methodology. The results from this review indicate that prisoners' oral health is a complex phenomenon and should be understood from both individual and organisational perspectives. More research is needed to bridge the gap in the literature on prisoners' oral health. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first literature review on European prisoners' oral health.
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Gussgard AM, Carlstedt K, Meirik M. Intraoral clinical examinations of pediatric patients with anticipatory anxiety and situational fear facilitated by therapy dog assistance: A pilot RCT. Clin Exp Dent Res 2023; 9:122-133. [PMID: 36259429 PMCID: PMC9932233 DOI: 10.1002/cre2.679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE To evaluate whether the presence of a certified therapy dog specially trained for working in a dental setting may facilitate dental care of anxious pediatric patients. METHODS The Norwegian Regional Committee for Medical and Health Research Ethics approved a randomized cross-over trial with a study sample of n = 16 children aged between 6 and 12 years. The trial was registered on clinicaltrials.gov. Pediatric patients referred to specialist care at the Public Dental Service Competence Center of Northern Norway (TkNN) because of anxiety were invited to partake in the trial. Study participants met twice for an intraoral examination by a specialist pediatric dentist. Per random allocation, a therapy dog team was present in the clinic operatory during the clinical examination on the first or the second visit. The primary outcome was the assessment of patient compliance during the intraoral examination (yes/no). Secondary outcomes were measurements of child satisfaction and anxiety using the CFSS-DS scale (Dental subscale of Children's Fear Survey Schedule) completed by a parent/guardian. Supplementary outcomes were salivary cortisol level, heart rate variability, and skin conductance. RESULTS Ten boys and six girls (mean age 8.5) were recruited. All completed both clinical visits and demonstrated full compliance while undergoing a dental examination. All study participants and guardians reported great satisfaction. The salivary cortisol level reduction during the clinical examination on the first visit decreased by 30% in the presence of the therapy dog and 20% without, while the decrease during the clinical examination on the second visit was 29% in the presence of the therapy dog and 3% without. Within the limitations of the experimental setup, the electrophysiological measurements were unreliable in the current study population. CONCLUSION Dog-assisted therapy in a dental care setting appears to have a positive effect on children with dental anxiety or children that avoid dental care.
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Affiliation(s)
- Anne M. Gussgard
- Department of Clinical DentistryUiT The Arctic University of NorwayTromsoNorway
| | - Kerstin Carlstedt
- Department of Clinical DentistryUiT The Arctic University of NorwayTromsoNorway
| | - Malin Meirik
- The Uppsala University Hospital, Sweden, Child, and Adolescent Psychiatric ServicesUppsalaSweden
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Aarvik RS, Svendsen EJ, Agdal ML. Held still or pressured to receive dental treatment: self-reported histories of children and adolescents treated by non-specialist dentists in Hordaland, Norway. Eur Arch Paediatr Dent 2022; 23:609-618. [PMID: 35763246 PMCID: PMC9338127 DOI: 10.1007/s40368-022-00724-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/03/2022] [Indexed: 12/19/2022]
Abstract
Aim This study aimed to estimate the prevalence of a self-reported history of restraint in children and adolescents when receiving dental care by non-specialist dentists and to assess differences in dental fear and anxiety (DFA), intra-oral injection fear, and trust in dentists between patients with and without a self-reported history of restraint. Methods An electronic cross-sectional survey was distributed to all 9 years old (n = 6686) and 17 years old (n = 6327) in the Public Dental Service in Hordaland County, Norway, in 2019. For statistical evaluation, we generated descriptive statistics and Mann–Whitney U tests. Results The response rate ranged between 43.5 and 59.9% for the different questions. The prevalence of a self-reported history of being held still against one’s will during dental treatment and pressured to undergo dental treatment against one’s will was 3.6% and 5.1%, respectively. In general, these patients reported higher DFA, and higher intra-oral injection fear compared with those without such histories of restraint. Patients who had reported being held still against their will during dental treatment had significantly higher distrust in dentists than those who did not report restraint (p < 0.001). Conclusion To feel pressured to receive dental treatment and to be held still against one’s will overlap with the concepts of psychological and physical restraint. Patients with a self-reported history of restraint recorded significant differences in DFA, intra-oral injection fear, and trust in dentists compared to those who did not report restraint. Future studies should explore the role that restraint may play in relation to a patient’s DFA, intra-oral injection fear, and trust in dentists.
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Affiliation(s)
- R S Aarvik
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway. .,Oral Health Centre of Expertise in Western Norway, Bergen, Norway.
| | - E J Svendsen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - M L Agdal
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
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Hauge MS, Stora B, Willumsen T. Dental anxiety treatment by a dentist in primary care: A 1-year follow-up study. Eur J Oral Sci 2022; 130:e12872. [PMID: 35569119 PMCID: PMC9540184 DOI: 10.1111/eos.12872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/29/2022] [Indexed: 11/28/2022]
Abstract
In an earlier randomized controlled trial of dental anxiety treatments (n = 96) we compared the effects of dentist‐administered cognitive behavioural therapy (D‐CBT) and dental treatment supplemented with the Four Habits communication model plus midazolam sedation. Both treatments, applied in a general dental practice, were associated with a clinically relevant decrease in dental anxiety. In this follow‐up study, 52 of the 82 treatment completers responded to an online questionnaire 1 year post‐treatment. Reduction in dental anxiety persisted for both treatment groups. From baseline to 1 year post‐treatment the Modified Dental Anxiety Scale was reduced by 7.8 [SD: 4.4; Cohen's d effect size: 1.2 (CI: 0.8–1.7)] and 7.8 [SD: 4.2; Cohen's d: 1.4 (0.9–1.8)] in the D‐CBT and Four Habits/midazolam groups, respectively. Most patients (74% for D‐CBT, 80% for Four Habits/midazolam) continued with dental treatment. Nine patients in the D‐CBT and seven in the Four Habits/midazolam groups received additional CBT treatment from a psychologist/dentist team. Both methods tested should be accessible to interested dentists who receive adequate training. Effective first‐line treatments for dental anxiety in general dental practice can generate more accessible care pathways for patients with dental anxiety. Evidence‐based dental anxiety treatment programmes should be included in the dental curriculum and established as best practice for dentists.
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Affiliation(s)
- Mariann Saanum Hauge
- Faculty of Dentistry, University, of Oslo, Oslo, Norway.,Oral Health Centre of Expertise, Rogaland, Stavanger, Norway
| | - Bent Stora
- Oral Health Services Agder, Kristiansand, Norway
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Nydell Helkimo A, Rolander B, Koch G. Dental fear in school children and young adults attending public dental health care: prevalence and relationship to gender, oral disease and dental treatment; trends over 40 years. BMC Oral Health 2022; 22:146. [PMID: 35473601 PMCID: PMC9044703 DOI: 10.1186/s12903-022-02166-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/08/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To study prevalence of dental fear and the relationship to gender, oral disease and dental treatment between 1973 and 2013 in school children and young adults attending public dental health care. Methods Every ten years from 1973 to 2013 random samples of about 100 individuals in each of the age groups 10, 15 and 20 years took part in a repeated cross-sectional study based on clinical parameters and a questionnaire. Dental fear was estimated by the question: “What do you feel at the prospect of an appointment with a dentist?”. 75–99% of the samples answered the question. Agreement to at least one of the alternative answers: ill at ease, frightened and sick defined dental fear. Frightened and/or sick indicated severe dental fear. The prevalence of caries, gingivitis and number of filled tooth surfaces were calculated. Chi-square tests were used to show differences in proportions between groups and linear regression to show trends over time. Results Prevalence of dental fear declined in all age groups over time. In the 20-year olds dental fear was found in 29% of the sample and severe dental fear in 12% of girls and 5% of boys in 2013. Individuals with dental fear had higher mean caries prevalence and number of filled tooth surfaces compared with individuals without dental fear. Conclusions This 40-year time trend study showed a reduction in dental fear prevalence in school children and young adults offered regular public dental health care based on prevention and a psychological approach.
The prevalence of dental fear was still high in 2013 despite a significant decline in caries during the study period. Further improvements in the psychological approach when treating children are thus needed.
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Affiliation(s)
- Anna Nydell Helkimo
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden.
| | - Bo Rolander
- Futurum, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.,Department of Behavioral Science and Social Work, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Göran Koch
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden
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Bryne E, Hean SCPD, Evensen KB, Bull VH. Exploring the contexts, mechanisms and outcomes of a torture, abuse and dental anxiety service in Norway: a realist evaluation. BMC Health Serv Res 2022; 22:533. [PMID: 35459239 PMCID: PMC9026053 DOI: 10.1186/s12913-022-07913-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/06/2022] [Indexed: 11/29/2022] Open
Abstract
Background Torture, abuse and dental anxiety (TADA) are often precursors to developing a pathological relationship with dental care due to elevated anxiety. Consequently, patients who suffer from one or more of these tend to avoid dental services. This could leave them with severe tooth decay, which could affect their general and psychosocial health. Norwegian dental services have implemented the TADA service to specifically alleviate dental anxiety and restore oral health for the TADA patient group. However, the service has not been evaluated, and there is a need to understand how and why this service works, for whom, under what circumstances. Therefore, this study aimed to develop theories on how the service’s structure alleviates dental anxiety and restores these patients’ oral health. Although developed in a Norwegian context, these theories may be applicable to other national and international contexts. Methods This realist evaluation comprised multiple sequential methods of service and policy documents (n = 13), followed by interviews with service developers (n = 12). Results The analysis suggests that, by subsidising the TADA service, the Norwegian state has removed financial barriers for patients. This has improved their access to the service and, hence, their service uptake. National guidelines on service delivery are perceived as open to interpretation, and can hereby meet the needs of a heterogeneous patient group. The services have become tailored according to the available regional resources and heterogeneous needs of the patient population. A perceived lack of explicit national leadership and cooperative practices has resulted in regional service teams becoming self-reliant and insular. While this has led to cohesion within each regional service, it is not conducive to interservice collaborations. Lastly, the complexity of migration processes and poor dissemination practices is presumed to be the cause of the lack of recruitment of torture survivors to the service. Conclusions Policy documents and service developers described the TADA service as a hybrid bottom-up/top-down service that allows teams to practise discretion and tailor their approach to meet individual needs. Being free of charge has improved access to the service by vulnerable groups, but the service still struggles to reach torture survivors.
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Affiliation(s)
- Emilie Bryne
- Oral Health Centre of Expertise Rogaland, Torgveien 21 B, 4016, Stavanger, Norway.
| | | | | | - Vibeke Hervik Bull
- Oral Health Centre of Expertise Rogaland, Torgveien 21 B, 4016, Stavanger, Norway
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Stein Duker LI, Grager M, Giffin W, Hikita N, Polido JC. The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042380. [PMID: 35206566 PMCID: PMC8872083 DOI: 10.3390/ijerph19042380] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 01/28/2023]
Abstract
Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.
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Affiliation(s)
- Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
- Correspondence:
| | | | - Willa Giffin
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - Natasha Hikita
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - José C. Polido
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
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11
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Wide U, Hakeberg M. Treatment of Dental Anxiety and Phobia-Diagnostic Criteria and Conceptual Model of Behavioural Treatment. Dent J (Basel) 2021; 9:153. [PMID: 34940050 PMCID: PMC8700242 DOI: 10.3390/dj9120153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
Dental anxiety and dental phobia are still prevalent among adult individuals and should be considered a dental public health issue. Dental anxiety/phobia is often described as a vicious cycle where avoidance of dental care, poor oral health, and psychosocial effects are common features, often escalating over time. Treatment should include therapy for dental anxiety/phobia and oral diseases. This paper discusses aetiology, prevalence, and diagnosis of dental anxiety/phobia and, in detail, presents a conceptual treatment model at the Dental Fears Research and Treatment Center in Gothenburg, Sweden. In addition, based on systematic reviews, evidence-based treatment for dental anxiety is revealed including the interdisciplinary approach between psychology and dentistry.
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Affiliation(s)
- Ulla Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden;
- Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden;
- Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden
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12
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Ahmad P, Chaudhary A, Asif JA, AlSagob EI, Alkahtany MF, Almadi KH, AlMubarak A, Abduljabbar T, Vohra F. Risk analysis of factors in clinical anxiety among undergraduate and postgraduate students in dentistry. Work 2021; 71:177-186. [PMID: 34924411 DOI: 10.3233/wor-205093] [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: 11/15/2022] Open
Abstract
BACKGROUND When anxiety is persistent among dental students, the consequence could be poor academic performance, ill health, lack of empathy, and exhaustion. OBJECTIVE This study aimed to determine the level of anxiety along with anxiety-provoking factors among clinical dental students. METHODS This study included dental undergraduate and postgraduate clinical students from a public university. A modified version of the self-administered Moss and McManus questionnaire, which consisted of 50 items, was utilized to evaluate the levels of anxiety. The results were analyzed using SPSS ® version 24. The significance level was set at p < 0.05. RESULTS Within 180 participants, 140 (77.77%) were undergraduate students, while 40 (22.22%) were postgraduate dental students. Overall, the top clinical anxiety-provoking factor included failure to pass the final examination, whereas the least clinical anxiety-provoking element was communicating with the opposite gender. Significant differences existed among male and female participants in the seven anxiety-provoking factors among the participants namely dealing with elderly patients, fail to pass finals, arresting post-extraction bleeding, patients asking difficult questions, fear of accidental pulp exposure, dealing with a child or non-cooperative patient, and fear of taking an incorrect impression. Postgraduate students showed lower anxiety scores in various clinical tasks as compared to undergraduate students. CONCLUSIONS Postgraduate dental students share largely the same perspectives with undergraduate dental students on the clinical anxiety-provoking situations with slight variations. Being the future healthcare providers, dental students must learn techniques to help them manage their dental anxiety and fear as well as deal with anxiety related to treating patients.
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Affiliation(s)
- Paras Ahmad
- Oral Medicine Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Ahmad Chaudhary
- Department of Dental Public Health, School ofDental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Jawaad A Asif
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Eman I AlSagob
- Preventive Dental Sciences Department, Community Dentistry Division, College of Dentistry, Princess Nourahbint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mazen F Alkahtany
- Department of Restorative Dental Science, Divisionof Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Khalid H Almadi
- Department of Restorative Dental Science, Divisionof Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman AlMubarak
- Department of Periodontics andCommunity Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of ProstheticDental Science, College of Dentistry, King Saud University; ResearchChair for Biological Research in Dental Health, College ofDentistry, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of ProstheticDental Science, College of Dentistry, King Saud University; ResearchChair for Biological Research in Dental Health, College ofDentistry, Riyadh, Saudi Arabia
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A Short Form of the Children's Experiences of Dental Anxiety Measure (CEDAM): Validation and Evaluation of the CEDAM-8. Dent J (Basel) 2021; 9:dj9060071. [PMID: 34203658 PMCID: PMC8232249 DOI: 10.3390/dj9060071] [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: 05/10/2021] [Revised: 05/26/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022] Open
Abstract
Background: The Children’s Experiences of Dental Anxiety Measure (CEDAM-14) is a child-centred measure of dental anxiety which assesses a range of behaviours, thoughts and feelings/physical symptoms related to dental anxiety. A short form of the CEDAM-14, which places less time burden on patients and clinicians, could promote the feasibility and applicability of the CEDAM in clinical settings. The aim of the study was to develop a short version of the CEDAM that can be used to assess children’s dental anxiety in clinical practice. Methods: A short version of the CEDAM was developed using a combination of item impact and regression methods. Measurement properties including floor/ceiling effects, variance, criterion validity, construct validity and internal consistency was calculated for the short form. Results: An eight-item CEDAM short form was developed (CEDAM-8) that had good psychometric properties, was significantly correlated with the CEDAM measure (r = 0.90; p < 0.01), had minimal floor and ceiling effects (3.5% and 1.2%, respectively) and was sensitive to change. Conclusion: The CEDAM-8 is a useful assessment tool for clinicians that is easy and quick to administer and could help to understand children’s experiences of dental anxiety and changes in anxiety over time and following intervention.
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14
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The Prevalence of Dental Anxiety Associated with Pain among Chinese Adult Patients in Guangzhou. Pain Res Manag 2021; 2021:7992580. [PMID: 34234884 PMCID: PMC8216828 DOI: 10.1155/2021/7992580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 12/19/2022]
Abstract
Background Anxious people appear to exaggerate the severity of aversive experiences such as anxiety and pain. Anxiety towards dental procedures is a common difficulty that may be experienced by dental patients all over the world. The goal of the study is to find out the prevalence of dental anxiety and its associated factors in Chinese adult patients. Methods A cross-sectional study was conducted on 183 dental adult patients whose age ranged from 18 to 70 years. Demographic details, first and most recent dental visits with experience, the MDAS, and the Visual Analogue Scale for Anxiety (VAS-A) were obtained. Data were analyzed by frequency analysis, chi-square test, and Spearman correlation test. Results Most of the respondents were female (68.9%) and 30-45 years age group. The mean total score for dental anxiety on the MDAS was 13.63 (3.1). 80.3% of participants suffered from moderate or high dental anxiety. Age must show a strong association with dental anxiety among the participants (p=0.011). The first dental visit experience, the frequency of the dental visit, most recent dental experience, length of time since the most recent dental visit, and postponement of the dental visit are strongly associated with the MDAS score (p=0.001). Conclusions The MDAS score exhibits that Chinese adult patients have significant dental anxiety and phobia. Identifying patients with dental anxiety as soon as possible is essential to providing better dental care.
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Hauge MS, Stora B, Vassend O, Hoffart A, Willumsen T. Dentist-administered cognitive behavioural therapy versus four habits/midazolam: An RCT study of dental anxiety treatment in primary dental care. Eur J Oral Sci 2021; 129:e12794. [PMID: 33960536 DOI: 10.1111/eos.12794] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/01/2021] [Indexed: 01/07/2023]
Abstract
The study aimed to test the effectiveness of cognitive behavioural therapy (CBT) administered by a general dental practitioner (GDP) in a general dental practice. In a two-arm parallel randomised controlled trial, the experimental group received a short dentist-administered CBT-intervention (D-CBT). A best-practice control group (FHM) received dental treatment during sedation with midazolam combined with an evidence-based communication model (The Four Habits Model). Ninety-six patients with self-reported dental anxiety were allocated to the treatment arms at a 1:1 ratio. Modified Dental Anxiety Scale (MDAS) scores spanned from 12 to 25, and 82 patients (85%) had a score of 19 or more, indicating severe dental anxiety. In both treatment arms, scores on MDAS and Index of Dental Anxiety and Fear (IDAF-4C) decreased significantly, but no differences were found between treatment arms. Mean reductions were: MDAS scores: -6.6 (SD = 0.5); IDAF-4C scores: -1.0 (SD = 1.1). In conclusion, local GDPs in general dental practices with proper competence have the ability for early detection of dental anxiety and, with the use of a manual-based D-CBT or FHM treatment, GDPs could offer efficient first-line treatment suitable for dental anxiety of varying severities.
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Affiliation(s)
- Mariann Saanum Hauge
- Faculty of Dentistry, University of Oslo, Oslo, Norway.,Oral Health Centre of Expertise, Stavanger, Norway
| | - Bent Stora
- Oral Health Services Agder, Kristiansand, Norway
| | - Olav Vassend
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Institute, Modum Bad Psychiatric Hospital, Vikersund, Norway
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Silveira ER, Cademartori MG, Schuch HS, Armfield JA, Demarco FF. Estimated prevalence of dental fear in adults: A systematic review and meta-analysis. J Dent 2021; 108:103632. [PMID: 33711405 DOI: 10.1016/j.jdent.2021.103632] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To systematically review the literature about: 'What is the global estimated prevalence of dental fear in adults?'. DATA/SOURCES Inclusion criteria were observational population-based studies reporting the prevalence or raw data of dental fear in adults (>18 years). Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library and Web of Science) were searched without language restrictions up to March 2020. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. Risk of bias was performed using the Joanna Briggs Critical Appraisal Checklist for Prevalence and Incidence studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed. STUDY SELECTION The search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. Three studies presented low risk of bias and 28 studies presented high risk of bias. A total of 72,577 individuals 18 years of age or older composed the sample of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 15.3 % (95 %CI 10.2-21.2), 12.4 % (95 %CI 9.5-15.6) and 3.3 % (95 %CI 0.9-7.1), respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instruments used to measure dental fear also affected its prevalence. CONCLUSIONS Dental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women. CLINICAL SIGNIFICANCE Evidence suggests fear negatively impacts dental care pattern, clinical and subjective oral health conditions. A better knowledge of the global prevalence and the factors associated with this problem will allow that prevention or even behavior modulation strategies of the fearful individual's in dental setting being carried out.
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Affiliation(s)
- Ethieli Rodrigues Silveira
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Mariana Gonzalez Cademartori
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Helena Silveira Schuch
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Jason A Armfield
- Australian Centre for Precision Health, University of South Australia, Adelaide, 101 Currie St, Adelaide, SA, 5001, Australia.
| | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil; Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, 1160, Marechal Deodoro Street, 96020-220, Brazil.
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17
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Grisolia BM, Dos Santos APP, Dhyppolito IM, Buchanan H, Hill K, Oliveira BH. Prevalence of dental anxiety in children and adolescents globally: A systematic review with meta-analyses. Int J Paediatr Dent 2021; 31:168-183. [PMID: 33245591 DOI: 10.1111/ipd.12712] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/23/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dental anxiety (DA) negatively impacts oral health-related quality of life, and patients with DA usually require more dental treatment time. AIM To describe the global prevalence of DA in children and adolescents and to examine the influence of individual factors (age, sex, and caries experience) and variables related to DA measurement on pooled prevalence. DESIGN Systematic review with meta-analyses of observational studies published between 1985 and 2020 (PROSPERO CRD42014013879). RESULTS Searches yielded 1207 unique records; 224 full-text articles were screened, and 50 studies were used in the qualitative and quantitative synthesis. No study was considered as having high methodological quality according to 'The Joanna Briggs Institute assessment tool'. Overall pooled DA prevalence was 23.9% (95% CI 20.4, 27.3). Pooled prevalence in preschoolers, schoolchildren, and adolescents was as follows: 36.5% (95% CI 23.8, 49.2), 25.8% (95% CI 19.5, 32.1), and 13.3% (95% CI 9.5, 17.0), respectively. DA was significantly more prevalent in preschool children (one study) and schoolchildren (two studies) with caries experience and in female adolescents (one study). The scale used for DA assessment was shown to influence pooled prevalence in preschoolers and adolescents. CONCLUSION DA is a frequent problem in 3- to 18-year-olds worldwide, more prevalent in schoolchildren and preschool children than in adolescents.
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Affiliation(s)
- Barbara Monteiro Grisolia
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University - UERJ, Rio de Janeiro, Brazil
| | - Ana Paula Pires Dos Santos
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University - UERJ, Rio de Janeiro, Brazil
| | - Izabel Monteiro Dhyppolito
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University - UERJ, Rio de Janeiro, Brazil
| | - Heather Buchanan
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Kirsty Hill
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - Branca Heloisa Oliveira
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University - UERJ, Rio de Janeiro, Brazil
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Nydell Helkimo A, Rolander B, Koch G. Attitudes to dental visits in a child population attending public dental health care in Jönköping, Sweden-trends over 40 years. Eur Arch Paediatr Dent 2020; 22:351-360. [PMID: 32860617 DOI: 10.1007/s40368-020-00552-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/31/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To study attitudes to dental visits in a child population attending public dental health care between 1973 and 2013. METHODS Random samples of individuals aged 3, 5, 10, 15 and 20 years took part in cross-sectional studies based on clinical parameters and a questionnaire, all repeated every 10 years using the same study design. One question related to dental attitude; "What do you feel at the prospect of an appointment with a dentist?". The affirmative answers were full of expectation, unaffected, ill at ease, frightened and sick, representing positive, neutral and negative attitudes. During the same 40-year period, a dental health care system based on prevention and regular dental appointments was reinforced. RESULTS In preschool children, the most pronounced change was an increase in the number of children reporting full of expectation during the study period. In 10-, 15- and 20-year-olds, there was an increase in unaffected and a decrease in ill at ease over time. A reduction in frightened was only seen in the 20-year-olds. CONCLUSIONS Despite a simultaneous dramatic decline in caries and a reduced need for operative dental treatment, the dental attitudes were fairly constant during the 40-year period. The moderate shifts to more positive or neutral dental attitudes were merely seen during the first 10 or 20 years. After this, the changes in answers were limited. This leads to the assumption that factors other than dental treatment experiences have an impact on dental attitudes in children.
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Affiliation(s)
- A Nydell Helkimo
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden.
| | - B Rolander
- Futurum, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
- Department of Behavioral Science and Social Work, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - G Koch
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden
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