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Gasparro R, Di Spirito F, Cangiano M, De Benedictis A, Sammartino P, Sammartino G, Bochicchio V, Maldonato NM, Scandurra C. A Cross-Sectional Study on Cognitive Vulnerability Patterns in Dental Anxiety: The Italian Validation of the Dental Fear Maintenance Questionnaire (DFMQ). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2298. [PMID: 36767665 PMCID: PMC9915921 DOI: 10.3390/ijerph20032298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Dental anxiety is a crucial problem for dentistry because it may represent a significant risk to oral health. Within the framework of the Cognitive Vulnerability Model (CVM), which sheds light on the cognitive vulnerability patterns that may cause dental anxiety, this study aimed to assess the psychometric characteristics of the Italian version of the Dental Fear Maintenance Questionnaire (DFMQ). The DFMQ is a 32-item questionnaire that assesses four cognitive vulnerability patterns, i.e., dangerousness, disgust, unpredictability, and uncontrollability. In a sample of 200 dental patients who had accessed public-university-hospital dental surgery, this study assessed the model fit of the DFMQ and different types of validity (i.e., predictive, convergent, construct, and discriminant validity). In addition, potential differences between DFMQ dimensions were assessed based on gender (men vs. women) and age ranges. All indicators of cognitive vulnerability were significantly associated with high dental anxiety when each variable was included independently. In contrast, when the DFMQ subscales were considered together, only unpredictability and uncontrollability were found to be associated with high dental anxiety. Women had higher scores for unpredictability, uncontrollability, and general dangerousness than men. In addition, older patients had higher scores for some vulnerability cognitive patterns than younger patients. This study provides Italian dentists and researchers with a valid questionnaire to assess cognitive factors associated with dental anxiety.
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Affiliation(s)
- Roberta Gasparro
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Federica Di Spirito
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy
| | - Mario Cangiano
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Arianna De Benedictis
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Pasquale Sammartino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Gilberto Sammartino
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, 87036 Cosenza, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Cristiano Scandurra
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
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Heaton LJ, Leroux BG, Ramsay DS. Development and Testing of an Interpretational Bias Measure of Dental Anxiety. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.871039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
ObjectivesWe hypothesized that individuals with dental care-related anxiety and fear would interpret ambiguous dental situations more negatively than non-anxious individuals. The objectives of these studies were to develop and test a Measure of Dental Anxiety Interpretational Bias (MoDAIB).MethodsIn the development phase, participants completing an online survey provided qualitative and quantitative assessments of dental scenarios that could be interpreted in either positive or negative ways. Scenarios producing the greatest difference in visual analog (VAS) scores between individuals with high vs. low dental anxiety as measured by the Modified Dental Anxiety Scale (MDAS) were included in the MoDAIB. In the testing phase, participants completed an online survey including the newly developed MoDAIB and dental anxiety measures.ResultsIn the development phase, participants (N = 355; 65.6% female) high in dental anxiety (MDAS ≥ 19) gave significantly higher (i.e., more negative) VAS scores to all the dental scenarios than did those low in dental anxiety (p's < 0.05). In the testing phase, the MoDAIB was significantly and positively correlated with the MDAS (r = 0.68, p < 0.001), meaning that those who were high in dental anxiety selected negative interpretations of ambiguous dental scenarios significantly more often than did individuals low in dental anxiety (p's <0.05). The MoDAIB showed good content validity and test-retest reliability.ConclusionsIndividuals high in dental anxiety interpret ambiguous dental situations more negatively than do less anxious individuals. Understanding individuals' interpretational styles may help dental providers avoid miscommunications. Interventions that train dentally anxious patients to consider more positive interpretations may reduce dental anxiety and should be investigated.
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AlMuhaish L, AlArfaj A, AlGhannam M, AlMutiri H, Abuhassan S, Asiri A, Nazir MA. Dental Anxiety Screening and Management Practices in Dental Practice in Eastern Province, Saudi Arabia. Patient Prefer Adherence 2022; 16:3429-3439. [PMID: 36601029 PMCID: PMC9807122 DOI: 10.2147/ppa.s393399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/22/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The purpose of the study was to investigate dental anxiety (DA) screening and management practices among dental professionals in Saudi Arabia. The study also evaluated correlation between patients' self-reported DA and dentists' ratings of patients' DA. PARTICIPANTS AND METHODS This cross-sectional observational study included dentist/patient pairs (N = 279) from the Eastern Province of Saudi Arabia. The dentists responded to a questionnaire about their DA screening and management practices and they evaluated patients' DA using the visual analogue scale (VAS). In addition, patients responded to the Modified Dental Anxiety Scale (MDAS) to measure their DA. RESULTS About 15.1% of dentists reported using a published scale for screening DA in dental practice and Corah's Dental Anxiety Scale and Dental Fear Survey were their main scales. However, 69.2% reported directly asking their patients about DA. The use of DA management technique was reported by 89.6% of the dentists. Approximately half of the participants (53%) reported receiving DA training in their undergraduate dentistry programs and 65.2% expressed their interest in continuing education courses related to DA. In multiple logistic regression analysis, statistically significant factors associated with DA screening practice included gender (AOR = 0.46, P = 0.037), place of work (AOR = 3.68, P = 0.039), and interest in continuing education courses (AOR = 3.21, P = 0.015). Monthly income (AOR = 0.20, P = 0.029) and directly asking patient about DA (AOR = 6.15, P = 0.025) were significant factors associated with management of patients with DA. The study also showed a significant but weak correlation between DA evaluated by the dentists and DA reported by the patients (rho = 0.185, P = 0.002). CONCLUSION The present study showed a low prevalence of DA screening practices among dentists. Dentists' rating of patients' DA weakly correlated with patients' self-reported DA.
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Affiliation(s)
- Luba AlMuhaish
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - AlHanoof AlArfaj
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Maha AlGhannam
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hadeel AlMutiri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sarah Abuhassan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amal Asiri
- Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Ashraf Nazir
- Department of Preventive Dental Sciences, College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Correspondence: Muhammad Ashraf Nazir, Tel +966-543569615, Email
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Scandurra C, Gasparro R, Dolce P, Bochicchio V, Muzii B, Sammartino G, Marenzi G, Maldonato NM. The role of cognitive and non-cognitive factors in dental anxiety: A mediation model. Eur J Oral Sci 2021; 129:e12793. [PMID: 33945646 PMCID: PMC8453836 DOI: 10.1111/eos.12793] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022]
Abstract
Dental anxiety is a crucial problem for dentistry because it may represent a significant risk to oral health. Different factors, whether non‐cognitive (e.g., traumatic dental events) or cognitive (e.g., the patient's subjective perceptions), may cause dental anxiety. However, previous studies have assessed these factors as independent predictors of dental anxiety, without providing any exploration of potential mediational pathways. The current study assessed the role of certain cognitive dimensions (i.e., the dentist's perceived professionalism and communicational attitudes, and the patient's perceived lack of control) as mediators between traumatic dental events and dental anxiety. The sample comprised 253 patients who had accessed a public university hospital dental surgery. The mediation analysis used a structural equation modeling. Traumatic dental events were positively associated with dental anxiety but, among the cognitive factors, only lack of control was. Furthermore, lack of control mediated the relationship between traumatic dental events and dental anxiety, although this mediation was only partial. This study sheds light on the mechanisms through which non‐cognitive and cognitive factors may affect dental anxiety. The clinical implications for dental practice, in terms of improving the psychological well‐being of patients, are discussed.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Roberta Gasparro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Napoli, Italy
| | | | - Benedetta Muzii
- Department of Humanistic Studies, University of Naples Federico II, Napoli, Italy
| | - Gilberto Sammartino
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Gaetano Marenzi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
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The Italian Validation of the Level of Exposure-Dental Experiences Questionnaire. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10031143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The aim of this monocentric cross-sectional study was to evaluate the psychometric characteristics of the Italian version of the Level of Exposure-Dental Experiences Questionnaire (LOE-DEQ) in an Italian sample of 253 dental patients ranging from 18–80 years of age. The LOE-DEQ assesses 16 potential dental distressing experiences and 7 general traumatic life events through 4 subscales: (1) dentists’ behaviour and patients’ emotions (DBPE); (2) distressing dental procedures (DDP); (3) other distressing dental events (ODDE); and (4) general traumatic events (GTE). Confirmatory factor analysis showed that the original 4-factor model had adequate fit to the data obtained from the Italian sample. Criterion validity was partially confirmed as only DBPE and DDP positively correlated with dental anxiety. Similarly, convergent validity was also partially confirmed as DBPE, DDP, and ODDE correlated with negative beliefs towards the dentist and the dental treatment. Discriminant validity was fully confirmed, as all correlations were below 0.60. Finally, DDP was the factor most associated with high dental anxiety. This study offers evidence of the reliability and validity of the LOE-DEQ in the Italian context, providing Italian researchers and dentists with a tool to assess dental and general distressing experiences in dental patients.
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