1
|
Knuutila J, Lahti S, Sipilä K, Tolvanen M. Associations between pain-related temporomandibular disorders and dental anxiety at 46 years of age in the Northern Finland Birth Cohort 1966. Acta Odontol Scand 2023; 81:633-640. [PMID: 37466375 DOI: 10.1080/00016357.2023.2236229] [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: 02/08/2023] [Revised: 06/07/2023] [Accepted: 07/08/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES The aims were (1) to study the association between dental anxiety (DA) and temporomandibular disorders (TMDs) and whether subgroups formed differ in psychological symptoms and pain sensitivity in the Northern Finland Birth Cohort 1966 and (2) to confirm the factor structure of the Hopkins Symptom Checklist-25 assessing psychological symptoms. MATERIALS AND METHODS Data were acquired using questionnaires and clinical examinations at age 46 years (n = 1889). Dental anxiety was assessed with Modified Dental Anxiety Scale (MDAS). Pain-related TMD (myalgia, arthralgia) were assessed according to modified diagnostic criteria for temporomandibular disorders. Pressure pain threshold and tolerance were measured with an algometer. Explanatory factor analysis revealed three factors, named 'depression', 'anxiety' and 'distress'. RESULTS Those with high DA and myalgia and/or arthralgia reported higher depression (mean = 1.52), anxiety (mean = 1.61) and distress (mean = 2.06) scores, and lower pressure pain threshold (mean = 496 kPa) and tolerance (mean = 741 kPa) values than those with only DA (1.22; 1.56; 1.84; 613; 875), TMD (1.21; 1.39; 1.83; 600; 908) or neither (1.12; 1.29; 1.58; 707; 1006), respectively. CONCLUSIONS Patients with DA and/or myalgia/arthralgia have similar profiles regarding pain sensitivity and psychological symptoms, the burden being highest among those with DA and a TMD diagnosis.
Collapse
Affiliation(s)
- Jarno Knuutila
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
- Center for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Kirsi Sipilä
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | | |
Collapse
|
2
|
Lafebre-Carrasco MF, Arroyo-Menéndez M, Lozano-Paniagua D, Parrón-Carreño T, Nievas-Soriano BJ. Social and Preventive Factors That Explain Oral Health among Pregnant Women in the Canton of Cuenca, Ecuador. Healthcare (Basel) 2023; 11:2664. [PMID: 37830702 PMCID: PMC10572668 DOI: 10.3390/healthcare11192664] [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: 09/04/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
(1) Background: pregnant women in underprivileged areas may face challenges that affect their oral health. The analysis of these issues such as toothaches or cavities, among others could be crucial for them. However, no studies have been conducted in Cuenca, Ecuador. Thus, this study aimed to create a model explaining how social factors and healthy habits impact oral health in Cuenca, Ecuador. (2) Methods: An observational study was performed using a questionnaire developed from scratch. Principal component factor analysis was performed to calculate the oral disease index based on the oral health issues reported by women during pregnancy. (3) Results: 1971 women participated in the research. In total, 88% reported at least one oral health problem, with cavities (34%) and bleeding gums (33%) as the most prevalent. The rate of preventive visits and frequent brushing were the two variables that most impacted the oral disease index. The consumption of sweets, age, and the belief that visiting the dentist harms their unborn child were also important factors. However, income, education, and ethnic background showed little to no effect. (4) Conclusions: The most beneficial determinants of oral health factors in pregnant women in Cuenca, Ecuador, are preventive dentist visits, frequent brushing, and a contained consumption of sweets. The main harmful factors are age and the misconception that dental visits can harm their unborn child. Surprisingly, income, education, and ethnic background have little effect. This study can be replicated in other countries and cultures.
Collapse
Affiliation(s)
| | - Millán Arroyo-Menéndez
- Department of Sociology: Theory and Methodology, Faculty of Political Science and Sociology, Member of TRANSOC Research Institute, Complutense University of Madrid, 28223 Madrid, Spain;
| | - David Lozano-Paniagua
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (T.P.-C.); (B.J.N.-S.)
| | - Tesifón Parrón-Carreño
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (T.P.-C.); (B.J.N.-S.)
| | - Bruno José Nievas-Soriano
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (T.P.-C.); (B.J.N.-S.)
| |
Collapse
|
3
|
Kallio A, Suominen A, Tolvanen M, Rantavuori K, Jussila H, Karlsson L, Karlsson H, Lahti S. Concurrent changes in dental anxiety and smoking in parents of the FinnBrain Birth Cohort Study. Eur J Oral Sci 2023; 131:e12912. [PMID: 36599651 PMCID: PMC10107302 DOI: 10.1111/eos.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023]
Abstract
We evaluated associations between changes in dental anxiety and tobacco use, adjusted for general anxiety and depressive symptoms. The FinnBrain Birth Cohort Study data, collected at gestational weeks 14 and 34 and at 3 months postpartum, were used. Questionnaires included the Modified Dental Anxiety Scale (MDAS), the Edinburgh Postnatal Depression Scale (EPDS), and the anxiety subscale of the Symptom Checklist-90 (SCL). Smoking was categorized as "stable non-smoking", "started smoking", "quit smoking", and "stable smoking". Changes in smoking and dental anxiety were evaluated "during pregnancy" (i.e., from gestational week 14 to gestational week 34) in 2442 women and 1346 men and "after pregnancy" (i.e., from gestational week 34 to 3 months postpartum) in 2008 women and 1095 men. Changes were evaluated in three smoking categories (stable non-smoking, fluctuating, and stable smoking), using data from all three time-points (1979 women and 1049 men). Modeling used repeated measures analysis of covariance. Stable smoking mothers had statistically significantly higher levels of dental anxiety (mean MDAS 12.3-12.6) than non-smoking mothers (mean MDAS 10.1-10.7) or mothers who smoked at some point during pregnancy (mean MDAS 10.8-11.5). A similar tendency was observed in fathers. However, no systematic change in dental anxiety by changes in smoking habits was observed. Those smoking during pregnancy and with high dental anxiety may need special support for smoking cessation.
Collapse
Affiliation(s)
- Anu Kallio
- Department of Community Dentistry, University of Turku, Turku, Finland.,City of Turku, Welfare Services Division, Oral and Dental Health Care, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics, University of Turku, Turku, Finland.,Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Heidi Jussila
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| |
Collapse
|
4
|
Sorunke ME, Onigbinde OO, Oyapero A, Coker OA. Self-Reported Periodontal Disease and its Association with Dental Anxiety in Lagos, Nigeria. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
5
|
Karukivi M, Suominen A, Scheinin NM, Li R, Ahrnberg H, Rantavuori K, Karlsson H, Karlsson L, Lahti S. Gender-specific associations between the dimensions of alexithymia personality trait and dental anxiety in parents of the FinnBrain Birth Cohort Study. Eur J Oral Sci 2021; 130:e12830. [PMID: 34761432 DOI: 10.1111/eos.12830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/05/2021] [Indexed: 12/30/2022]
Abstract
We evaluated gender-specific associations of two dimensions of dental anxiety (anticipatory and treatment-related dental anxiety) with three dimensions of alexithymia: difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. The sample comprised 2558 parents from the general population participating in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale and alexithymia with the 20-item Toronto Alexithymia Scale. Associations between dental anxiety and alexithymia dimensions were modelled using linear regression analysis adjusting for general anxiety and depressive symptoms, age, and education. Structural equation modeling assessed their interrelationships. In women, anticipatory dental anxiety was associated only with difficulty in identifying feelings, but treatment-related dental anxiety was associated with difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. In men, anticipatory dental anxiety was associated with only externally oriented thinking, whereas treatment-related dental anxiety was associated with difficulty in describing feelings, and with externally oriented thinking. Structural equation modelling showed that difficulty in identifying feelings was associated with anticipatory and treatment-related dental anxiety in women, whereas in men, only difficulty in describing feelings was associated with both types of dental anxiety. Anticipatory and treatment-related dental anxiety have different associations with alexithymia dimensions.
Collapse
Affiliation(s)
- Max Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Noora M Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Hanna Ahrnberg
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Satu Lahti
- Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Community Dentistry, University of Turku, Turku, Finland
| |
Collapse
|
6
|
Palo K, Tolvanen M, Karlsson H, Karlsson L, Lahti S. Is the oral health-related quality of life associated with quality of life among pregnant Finnish families: a cross-sectional study. Acta Odontol Scand 2021; 79:523-527. [PMID: 33823739 DOI: 10.1080/00016357.2021.1906441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objectives of this study was to find out if oral health-related quality of life and its dimensions (OHRQoL) are associated with overall quality of life (QoL) among mothers and fathers during pregnancy and whether these two constructs were associated within the family sharing the same living environment. MATERIAL AND METHODS The data (mothers n = 2580, fathers n = 1467) for this cross-sectional data study were collected from the FinnBrain Birth Cohort study during 2011-2015. OHRQoL was measured using a 14-item Oral Health Impact Profile (OHIP-14) questionnaire and QoL by using the WHOQoL-Bref questionnaire. Spearman correlation coefficients were used to assess the statistical significance of the associations. RESULTS OHRQoL was weakly associated at the individual level with the overall QoL (mothers r = 0.21, fathers r = 0.22, p < 0.001), but the correlations within families were low for QoL and OHRQoL. CONCLUSIONS Our findings suggest that overall QoL is a different construct than OHRQoL though slightly overlapping.
Collapse
Affiliation(s)
- Katri Palo
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
- Dental Care, Primary Health Care, Social and Health Services, City of Vaasa, Finland
| | - Mimmi Tolvanen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Hasse Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| |
Collapse
|
7
|
Hair Cortisol Concentrations Are Associated with Dental Anxiety during Pregnancy. Dent J (Basel) 2021; 9:dj9040042. [PMID: 33920415 PMCID: PMC8069593 DOI: 10.3390/dj9040042] [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: 02/15/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/31/2022] Open
Abstract
Dental anxiety (DA) and hair cortisol concentrations (HCC) are associated with psychological symptoms and vary during pregnancy. We aimed to examine the association between HCC and DA at two points of pregnancy. Participants were pregnant mothers (n = 533) drawn from the FinnBrain Birth Cohort Study donating a hair sample at gestational week (gwk) 24 (n = 442) and/or at delivery (n = 176) and completed questionnaires on DA. Two groups, HCC1 and HCC2, treated as separate in the analyses, were formed according to the hair sample donation time i.e., gwk24 and delivery. 85 subjects were included in both groups. MDAS, EPDS, and SCL-90 were used to measure DA, depressive and anxiety symptoms, respectively, at gwk14 for the HCC1 group and gwk34 for the HCC2 group. The association between DA and HCC was studied with a binary logistic regression model, adjusted for anxiety and depressive symptoms, age, BMI, and smoking status. Individuals with high DA had lower HCC levels at gwk24 (OR = 0.548; 95% CI = 0.35–0.86; p = 0.009), but the association was not statistically significant at the delivery (OR = 0.611; 95% CI = 0.28–1.33; p = 0.216). The independent association between HCC and DA in pregnant women suggests that long-term cortisol levels could play a role in the endogenous etiology of DA. Further studies are however, needed.
Collapse
|
8
|
Hagqvist O, Tolvanen M, Rantavuori K, Karlsson L, Karlsson H, Lahti S. Changes in dental fear and its relations to anxiety and depression in the FinnBrain Birth Cohort Study. Eur J Oral Sci 2020; 128:429-435. [PMID: 32875623 DOI: 10.1111/eos.12736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 12/30/2022]
Abstract
This study aimed to: (i) evaluate short-term changes in dental fear during a 9-month period among women and men, and (ii) evaluate whether the course and magnitude of changes in dental fear were associated with changes in depression and anxiety. The longitudinal data of the FinnBrain Birth Cohort Study were used. Out of 3808 women and 2623 men, 1984 women and 1082 men filled in the Modified Dental Anxiety Scale (MDAS) at gestational weeks 14 and 34, and 3 months after childbirth. Other questionnaires used were the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Symptom Checklist-90. All scales were analyzed as sum scores. The MDAS was also trichotomized to assess the stability of dental fear. Statistical significances of the changes in dental fear, depression, and general anxiety were evaluated using repeated-measures Friedman tests. Correlation coefficients were used to describe the associations between measures (Spearman) and their changes (Pearson). Dental fear more often increased than decreased, but for the majority it was stable. On average, dental fear, depression, and anxiety symptoms correlated throughout the study. The correlations tended to be stronger with depressive symptoms. However, the relationships between changes in dental fear, depression, and anxiety were not systematic.
Collapse
Affiliation(s)
- Outi Hagqvist
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Kari Rantavuori
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Satu Lahti
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| |
Collapse
|
9
|
Fernandez-Aguilar J, Guillén I, Sanz MT, Jovani-Sancho M. Patient's pre-operative dental anxiety is related to diastolic blood pressure and the need for post-surgical analgesia. Sci Rep 2020; 10:9170. [PMID: 32513987 PMCID: PMC7280201 DOI: 10.1038/s41598-020-66068-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 05/14/2020] [Indexed: 11/25/2022] Open
Abstract
In order to study the relationship of the patient’s anxiety level from Corah’s Dental Anxiety Scale (DAS) vs different physiological parameters: pre and post-operative blood pressure, and pre and post-operative heart rates, and subsequently, relate the results to the patient’s post-operative anti-inflammatory analgesic need, 185 patients requiring a simple dental extraction were recruited. They filled out the DAS in the waiting room prior to their procedure and once in the examination room, their preoperative blood pressure and heart rate was measured. Once the dental extraction had been completed, their blood pressure and heart rate were measured again. Before leaving the clinic, the patient was given an analgesic form in which they had to indicate whether or not they had required analgesia after the procedure. Diastolic blood pressure (DBP) showed statistically significant differences between pre-operative and post-operative (P = 0.001). DAS was related with pre-operative diastolic blood pressure (pre-DBP) (P = 0.001) and post-operative diastolic blood pressure (post-DBP) as well as pre-operative heart rate (pre-HR) (P = 0.027) and post-operative heart rate (post-HR) (P = 0.013). Patients with high levels of DAS tend to take more Ibuprofen 400 mg (P = 0.038). The different levels of anxiety will determine what type of anti-inflammatory analgesia the patient will take, if necessary.
Collapse
Affiliation(s)
- Javier Fernandez-Aguilar
- Dentistry Department, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, 46115, Alfara del Patriarca, Valencia, Spain
| | - Isabel Guillén
- Pharmacy Department, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, 46115, Alfara del Patriarca, Valencia, Spain
| | - María T Sanz
- Didactics of Mathematics Department, University of Valencia, Valencia, 46022, Spain
| | - Mar Jovani-Sancho
- Dentistry Department, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, 46115, Alfara del Patriarca, Valencia, Spain.
| |
Collapse
|
10
|
Jussila H, Ekholm E, Pajulo M. A New Parental Mentalization Focused Ultrasound Intervention for Substance Using Pregnant Women. Effect on Self-reported Prenatal Mental Health, Attachment and Mentalization in a Randomized and Controlled Trial. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00205-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractThe effect of a novel mentalization-based parenting intervention was explored on prenatal self-reported mentalization (P-PRFQ), attachment (MFAS), depression (EPDS) and anxiety (STAI) among women with substance use problems. The participants were 90 pregnant women referred to obstetric outpatient care due to recent or current substance use and randomized into intervention (n = 46) and control (n = 44) groups. The intervention group received three interactive 4D ultrasound sessions and a week-by-week pregnancy diary. The control condition was constituted of treatment-as-usual in obstetric care. Unfortunately, the efficacy of the intervention on maternal prenatal mental health, attachment, and parental mentalization was not substantiated. The negative results may be related to the small sample size, the patient-reported outcomes, or insufficient efficacy within this high-risk group. In the context of high psychosocial risks and follow-up by Child Welfare Services, the patient-reported outcomes may have underestimated prenatal adversity. The role of the research context, methodology, and possible sources of bias in the outcome assessment are discussed.The trial registration number in the ClinicalTrials.gov: NCT03413631
Collapse
|
11
|
Lahti SM, Tolvanen MM, Humphris G, Freeman R, Rantavuori K, Karlsson L, Karlsson H. Association of depression and anxiety with different aspects of dental anxiety in pregnant mothers and their partners. Community Dent Oral Epidemiol 2019; 48:137-142. [PMID: 31809556 DOI: 10.1111/cdoe.12511] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/06/2019] [Accepted: 11/18/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim was to confirm the factor structure of Modified Dental Anxiety Scale (MDAS) and to investigate whether the association of these factors with general anxiety and depression varied across gender. METHODS The FinnBrain Birth Cohort Study (www.finnbrain.fi) data from the first collection point at gestational week 14 were used. Of the invited participants (n = 5790), 3808 (66%) expectant mothers and 2623 fathers or other partners of the mother agreed to participate, and 3095 (81.3%) mothers and 2011 (76.7%) fathers returned the self-report questionnaire. Dental anxiety was measured with the MDAS, general anxiety symptoms with Symptom Checklist-90 (anxiety subscale) and depressive symptoms with the Edinburgh Postnatal Depression Scale. Multiple group confirmatory factor analysis (MGCFA) was conducted to test the equivalence of the factor structure and multiple group SEM (MGSEM) to test the configural invariance (unconstrained model) and metric invariance (structural weights model), across genders. RESULTS Of those consenting, 3022 (98%) women and 1935 (96%) men answered the MDAS. The MGCFA indicated good convergent validity for the two-factor model for MDAS, but somewhat low discriminant validity (factors demonstrated 72% shared variance). The MDAS items loaded clearly higher for the assigned factor than to the other factor (differences in loadings >0.2), indicating that the 2-factor model has merit. According to the final MGSEM model, anxiety symptoms were directly related to anticipatory dental anxiety, but not to treatment-related dental anxiety. CONCLUSIONS When assessing dental anxiety with MDAS, considering also its two factors may help clinicians in understanding the nature of patient's dental anxiety.
Collapse
Affiliation(s)
- Satu M Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Mimmi M Tolvanen
- Department of Community Dentistry, University of Turku, Turku, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Gerald Humphris
- Division of Populations and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK
| | - Ruth Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
| | - Kari Rantavuori
- Department of Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| |
Collapse
|
12
|
Zhang X, Wang B, Qiao S, Gu Y, Shi J, Lai H. A study on the prevalence of dental anxiety, pain perception, and their interrelationship in Chinese patients with oral implant surgery. Clin Implant Dent Relat Res 2019; 21:428-435. [PMID: 31025495 DOI: 10.1111/cid.12779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Xiao Zhang
- Department of Oral and Maxillo‐facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| | - Bei Wang
- Department of Oral and Maxillo‐facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| | - Shi‐Chong Qiao
- Department of Oral and Maxillo‐facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| | - Ying‐Xin Gu
- Department of Oral and Maxillo‐facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| | - Jun‐Yu Shi
- Department of Oral and Maxillo‐facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| | - Hong‐Chang Lai
- Department of Oral and Maxillo‐facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| |
Collapse
|
13
|
Kankaanpää R, Auvinen J, Rantavuori K, Jokelainen J, Karppinen J, Lahti S. Pressure pain sensitivity is associated with dental fear in adults in middle age: Findings from the Northern Finland 1966 birth cohort study. Community Dent Oral Epidemiol 2018; 47:193-200. [DOI: 10.1111/cdoe.12443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Rami Kankaanpää
- Department of Community Dentistry University of Turku Turku Finland
- Oral and Maxillofacial Deceases Tampere University Hospital Tampere Finland
- Oral Health Services City of Tampere Tampere Finland
| | - Juha Auvinen
- Center for Life Course Health Research University of Oulu Oulu Finland
- Unit of Primary Care Oulu University Hospital Oulu Finland
- Medical Research Center Oulu University of Oulu Oulu University Hospital OuluFinland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics University of Turku Turku Finland
| | - Jari Jokelainen
- Center for Life Course Health Research University of Oulu Oulu Finland
- Unit of Primary Care Oulu University Hospital Oulu Finland
- Medical Research Center Oulu University of Oulu Oulu University Hospital OuluFinland
| | - Jaro Karppinen
- Center for Life Course Health Research University of Oulu Oulu Finland
- Medical Research Center Oulu University of Oulu Oulu University Hospital OuluFinland
- Finnish Institute of Occupational Health Oulu Finland
| | - Satu Lahti
- Department of Community Dentistry University of Turku Turku Finland
- Turku Clinical Research Centre Turku University Hospital Turku Finland
| |
Collapse
|
14
|
Psychometric Properties of the Spanish Version of the Pregnancy Related Anxiety Questionnaire (PRAQ). SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E64. [PMID: 30501656 DOI: 10.1017/sjp.2018.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although pregnancy increases the vulnerability to anxiety, no specific assessment instruments are usually used to detect it. The objective of this study was to adapt the Pregnancy Related Anxiety Questionnaire (PRAQ) to Spanish population, as well as analyze its validity and reliability. A sample of 367 nulliparous pregnant women with a normal risk status filled in a socio-demographic and obstetric-gynaecological questionnaire, the PRAQ, the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). After performing a factorial analysis, a five-factor model that explains 53.1% of the variance was obtained. Estimates of internal consistency reliability were adequate (range = .78 to .93) for the five factors included in the final confirmatory factor analysis, and for the total scale (.97). Significant correlation among PRAQ, EPDS, and STAI was found (p < .001). The 85th percentile (score 234 or more) was used as a cut-off point to identify those women with high pregnancy-specific anxiety. In accordance with the results obtained, the PRAQ can be considered a useful screening tool to evaluate pregnancy-related anxiety among the Spanish population.
Collapse
|
15
|
Hagqvist O, Tolvanen M, Rantavuori K, Karlsson L, Karlsson H, Lahti S. Short‐term longitudinal changes in adult dental fear. Eur J Oral Sci 2018; 126:300-306. [DOI: 10.1111/eos.12531] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Outi Hagqvist
- FinnBrain Birth Cohort Study Turku Brain and Mind Center Institute of Clinical Medicine University of Turku Turku Finland
- Department of Community Dentistry Institute of Dentistry University of Turku Turku Finland
| | - Mimmi Tolvanen
- FinnBrain Birth Cohort Study Turku Brain and Mind Center Institute of Clinical Medicine University of Turku Turku Finland
- Department of Community Dentistry Institute of Dentistry University of Turku Turku Finland
| | - Kari Rantavuori
- Department of Orthodontics Institute of Dentistry University of Turku Turku Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study Turku Brain and Mind Center Institute of Clinical Medicine University of Turku Turku Finland
- Department of Child Psychiatry Turku University Hospital University of Turku Turku Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study Turku Brain and Mind Center Institute of Clinical Medicine University of Turku Turku Finland
- Department of Psychiatry Turku University Hospital University of Turku Turku Finland
| | - Satu Lahti
- FinnBrain Birth Cohort Study Turku Brain and Mind Center Institute of Clinical Medicine University of Turku Turku Finland
- Department of Community Dentistry Institute of Dentistry University of Turku Turku Finland
| |
Collapse
|
16
|
Drachev SN, Brenn T, Trovik TA. Prevalence of and factors associated with dental anxiety among medical and dental students of the Northern State Medical University, Arkhangelsk, North-West Russia. Int J Circumpolar Health 2018; 77:1454786. [PMID: 29564967 PMCID: PMC5912187 DOI: 10.1080/22423982.2018.1454786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objective was to assess the prevalence of and factors associated with dental anxiety (DA) in medical and dental students in North-West Russia. This cross-sectional study included 422 medical and 285 dental undergraduate Russian students aged 18–25 years from the Northern State Medical University in Arkhangelsk. Corah’s Dental Anxiety Scale (DAS) was applied to measure DA. Information on socio-demographic and socioeconomic factors, oral health behaviour and general and oral health was obtained from a structured, self-administered questionnaire. A clinical examination was performed to assess caries experience, Simplified Oral Hygiene Index, and Gingival Index. DAS score ≥13 was found in 13.7% and 2.2% of medical and dental students, respectively. Female sex (incidence rate ratio [IRR] = 1.11, p = 0.013), lower education of mother (IRR = 1.13, p = 0.001), and poor self-assessed oral health (IRR = 1.15, p < 0.001) were associated with DA in medical students. Corresponding factors in dental students were female sex (IRR = 1.16, p = 0.001), irregular dental visits (IRR = 1.19, p = 0.001), infrequent tooth-brushing (IRR = 1.17, p = 0.007), pain in mouth (IRR = 1.09, p = 0.031) and number of missing teeth (IRR = 1.13, p = 0.007). The prevalence of high DA was lower in dental students than in medical students. DA was associated with sex, mother’s education, poor oral health behaviour and self-assessed and clinically assessed oral health.
Collapse
Affiliation(s)
- Sergei N Drachev
- a Department of Community Medicine, Faculty of Health Sciences , UiT The Arctic University of Norway , Tromsø , Norway.,b International School of Public Health , Northern State Medical University , Arkhangelsk , Russia
| | - Tormod Brenn
- a Department of Community Medicine, Faculty of Health Sciences , UiT The Arctic University of Norway , Tromsø , Norway
| | - Tordis A Trovik
- a Department of Community Medicine, Faculty of Health Sciences , UiT The Arctic University of Norway , Tromsø , Norway
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Tolvanen M, Puijola K, Armfield JM, Lahti S. Translation and validation of the Finnish version of index of dental anxiety and fear (IDAF-4C +) among dental students. BMC Oral Health 2017; 17:85. [PMID: 28525993 PMCID: PMC5438555 DOI: 10.1186/s12903-017-0375-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental fear accounts for 41% of the non-habitual dental attendance such as visiting only when in pain among adult Finns. Dentists should be able to recognize patients in risk for irregular attendance due to dental fear and measure their fear with valid and reliable instrument that capture the multidimensionality of dental fear. The study's aim was to translate the Index of Dental Anxiety and Fear (IDAF-4C+) into Finnish and test its reliability and validity. METHODS The study population consisted of dental students in a Finnish university (n = 202). The IDAF-4C+ was back-and forward translated by experts as well as a native English translator, blinded to the original version. Reliability was assessed using Cronbach's alpha. Validity of the IDAF-4C+ was assessed against the Modified Dental Anxiety Scale (MDAS) using Spearman correlation coefficients and through the use of Exploratory factor analysis (EFA) and between genders using Mann-Whitney U tests. RESULTS The reliability of the IDAF-4C+ was good, the Cronbach's alpha being 0.88. The IDAF-4C+ and MDAS and their subscales were correlated, with coefficients varying between 0.34 and 0.85. Correlations were stronger with the emotional and physiological components of the IDAF-4C+. EFA revealed one factor explaining 51.7% of the common variance (eigenvalue = 4.6). Women tended to have slightly higher mean scores than men (1.49 vs. 1.36, p = 0.247). CONCLUSIONS The translation and localization of the Finnish version of the IDAF-4C+ can be considered as providing some evidence of the validity and reliability of the scale. It adds to previously used measures as it considers also the behavioral, cognitive and physiological dimension involved in dental fear.
Collapse
Affiliation(s)
- Mimmi Tolvanen
- Department of Community Dentistry, Institute of Dentistry, FI-20014 University of Turku, Turku, Finland.,FinnBrain Study Group, Department of Psychiatry and Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Katri Puijola
- Department of Community Dentistry, Institute of Dentistry, FI-20014 University of Turku, Turku, Finland
| | - Jason M Armfield
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, 5005, Australia
| | - Satu Lahti
- Department of Community Dentistry, Institute of Dentistry, FI-20014 University of Turku, Turku, Finland. .,Turku Clinical Research Center, Turku University Hospital, Turku, Finland.
| |
Collapse
|
19
|
Leach LS, Poyser C, Cooklin AR, Giallo R. Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review. J Affect Disord 2016; 190:675-686. [PMID: 26590515 DOI: 10.1016/j.jad.2015.09.063] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/21/2015] [Accepted: 09/28/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Men's experiences of anxiety within the perinatal period can adversely impact themselves, their partner and infant. However, we know little about the prevalence and course of men's anxiety across the perinatal period. The current review is one of the first to systematically review the published literature. METHODS Five databases (PubMed, PsycINFO, Cochrane, SCOPUS, and Web of Science) were searched to identify relevant papers published prior to April 2015. The literature search identified articles with data for expectant fathers (prenatal period) and/or fathers of an infant aged between 0 and 1 (postnatal period). The following data were extracted: (a) anxiety disorder prevalence (diagnostic clinical interviews), (b) 'high' anxiety symptom prevalence (above thresholds/cut-points on anxiety symptom scales) and (c) mean anxiety levels (anxiety symptom scales). Initially, 537 unique papers were identified. Subsequently, 43 papers met criteria for inclusion in the review. RESULTS Prevalence rates for 'any' anxiety disorder (as defined by either diagnostic clinical interviews or above cut-points on symptom scales) ranged between 4.1% and 16.0% during the prenatal period and 2.4-18.0% during the postnatal period. The data reviewed suggest the course of anxiety across the perinatal period is fairly stable with potential decreases postpartum. LIMITATIONS Wide variation in study measurement and methodology makes synthesis of individual findings difficult. Anxiety is highly comorbid with depression, and thus measures of mixed anxiety/depression might better capture the overall burden of mental illness. CONCLUSIONS Anxiety disorders are common for men during the perinatal period. Both partners should be included in discussions and interventions focused on obstetric care and parent mental health during the perinatal period.
Collapse
Affiliation(s)
- Liana S Leach
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia.
| | - Carmel Poyser
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
| | | | - Rebecca Giallo
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia
| |
Collapse
|
20
|
Luoto A, Tolvanen M, Rantavuori K, Pohjola V, Karlsson L, Lahti S. Individual changes in dental fear among children and parents: a longitudinal study. Acta Odontol Scand 2014; 72:942-7. [PMID: 24922091 DOI: 10.3109/00016357.2014.923582] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim was to study longitudinal changes in dental fear among children and one of their parents separately for girls, boys, mothers and fathers over a 3.5-year period. MATERIALS AND METHODS 11-12-year-old children in Pori, Finland (n = 1691) and one of their parents were invited to participate in this longitudinal study. Dental fear was measured in 2001, 2003 and 2005 when the children were 11-12, 13-14 and 15-16-years-old, respectively. The participants were asked if they were afraid of dental care (1 = 'not afraid', 2 = 'slightly afraid', 3 = 'afraid to some degree', 4 = 'quite afraid', 5 = 'very afraid' and 6 = 'I don't know'). The participants' gender was also registered. Mean values of the change scores were studied. Prevalence and incidence of dental fear and changes in dichotomized dental fear (responses 4-5 = high dental fear and responses 1-3 = low dental fear) were studied using cross-tabulations and Cochran's Q test. RESULTS Overall, the prevalence of dental fear slightly increased and female preponderance in dental fear became more evident during the follow-up. Of the mothers and children with high dental fear at the baseline, 24% and 56%, respectively, reported not to be fearful at the end of the follow-up. CONCLUSIONS Dental fear seems to be more stable in adulthood than in childhood. Thus, it might be better to intervene in dental fear during childhood rather than during adulthood.
Collapse
Affiliation(s)
- Anni Luoto
- Department of Community Dentistry, Institute of Dentistry, University of Turku , Turku , Finland
| | | | | | | | | | | |
Collapse
|