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Hughes S, Davies L, Monaghan U, Stennett M. Implementation of a CBT-based dental anxiety management pathway for patients with learning disabilities. Br Dent J 2024; 237:40-44. [PMID: 38997369 DOI: 10.1038/s41415-024-7557-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 07/14/2024]
Abstract
Dental anxiety is a common phenomenon in the general population and may be more prevalent in people with learning disabilities. There is growing interest in the use of cognitive behaviour therapy (CBT) approaches, including within dental anxiety management. However, relatively little is known regarding the application of CBT approaches in dental anxiety management for patients with learning disabilities. This paper outlines details of the implementation of a CBT-based dental anxiety pathway for patients with learning disabilities treated in a special care dental service in England. The pathway is modelled on the utilisation of skills from the dental team (dental nurses and dentists) to deliver a combination of talking sessions, desensitisation and positive affirmation in five distinct stages. Early feedback from service users following implementation of this pathway indicates successful acceptance of dental care with a decreased use of sedative adjuncts.
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Affiliation(s)
- Sadie Hughes
- Consultant in Special Care Dentistry, Hertfordshire Special Care Dental Service, Hertfordshire Community NHS Trust, Cheshunt Community Hospital, King Arthur Court, Cheshunt, Hertfordshire, EN8 8XN, UK.
| | - Lisa Davies
- Senior Dental Nurse and Lead Sedation Nurse, Hertfordshire Special Care Dental Service, Hertfordshire Community NHS Trust, Cheshunt Community Hospital, King Arthur Court, Cheshunt, Hertfordshire, EN8 8XN, UK
| | - Una Monaghan
- Clinical Director Hertfordshire Special Care Dental Service, Associate Medical Director Hertfordshire Community NHS Trust, Cheshunt Community Hospital, King Arthur Court, Cheshunt, Hertfordshire, EN8 8XN, UK
| | - Michelle Stennett
- Senior Dental Officer, Hertfordshire Special Care Dental Service, Hertfordshire Community NHS Trust, Cheshunt Community Hospital, King Arthur Court, Cheshunt, Hertfordshire, EN8 8XN, UK
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Slabšinskienė E, Radlinskaitė K, Kavaliauskienė A, Vasiliauskienė I, Zūbienė J, Saldūnaitė-Mikučionienė K, Zaborskis A. Do Subjects from Different Occupational Groups Experience Dental Fear and Anxiety Equally? MEDICINA (KAUNAS, LITHUANIA) 2024; 60:674. [PMID: 38674320 PMCID: PMC11051849 DOI: 10.3390/medicina60040674] [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: 02/26/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. Materials and Methods: A cross-sectional study with 422 respondents from four occupational groups (physicians, teachers, industry workers, and artists) was carried out. A questionnaire on previous dental experience using the Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and Self-Esteem Scale was self-administered electronically. The data analysis involved descriptive statistics and structural equation modeling (SEM). Results: The DFA levels differed significantly across the occupational groups, with the lowest mean scores among physicians (DAS = 9.29 (SE 0.39); DFS-1 = 14.67 (0.63); DFS-2 = 33.94 (1.69)) and the highest mean scores among artists (DAS = 10.74 (0.38); DFS-1 = 17.19 (0.71); DFS-2 = 41.34 (1.92)). A significant impact of self-esteem on DFA was observed among physicians, teachers, and artists, but not among industry workers. Multi-group analysis with SEM revealed differences in the variable association (Chi-squared = 53.75; df = 21; p < 0.001), thus rejecting the hypothesis of the same mechanism underlying DFA across occupational groups. Conclusions: Individuals from various occupations experience DFA at different levels, and there are different mechanisms underlying their DFA. These findings can provide valuable insights for dental practitioners in developing tailored approaches to reduce the feeling of DFA of their patients.
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Affiliation(s)
- Eglė Slabšinskienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Karolina Radlinskaitė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Aistė Kavaliauskienė
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania;
| | - Ingrida Vasiliauskienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Jūratė Zūbienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Kristina Saldūnaitė-Mikučionienė
- Department of Oral Health and Paediatric Dentistry, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (K.R.); (I.V.); (J.Z.); (K.S.-M.)
| | - Apolinaras Zaborskis
- Department of Preventive Medicine & Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania;
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Flink H, Hedenbjörk-Lager A, Liljeström S, Nohlert E, Tegelberg Å. Identification of caries-active individuals in longitudinal data a methodological study using a national registry. Acta Odontol Scand 2024; 83:70-75. [PMID: 37831434 PMCID: PMC11302634 DOI: 10.1080/00016357.2023.2265474] [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: 04/13/2023] [Revised: 09/07/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE The aim was to identify caries active individuals among adults by using a trajectory model of longitudinal data from the Swedish national registry (SKaPa) and comparing them with published data from the Dunedin cohort. MATERIALS AND METHODS Data from two different age groups (30- and 40-year-olds) followed for 10 years were retrieved from SKaPa and were compared with published longitudinal birth-cohort data from the Dunedin study. Using the trajectory model, the subjects were divided into three different trajectories according to their caries development over time (i.e. high, 15%; moderate, 45%; low, 40%). RESULTS Caries experience, as measured by mean decayed, missing, and filled surfaces (DMFS) index, revealed significant differences among the three trajectories in both age groups. The patterns were similar to those observed in the Dunedin cohort. The mean increase in DMFS during the 10-year follow-up period from SKaPa was significantly higher for the high trajectories in both age groups compared with the moderate and low trajectories. CONCLUSIONS The method using three trajectories for presentation of caries experience over time, may be a useful tool to identify subjects with different disease activities. Identification of subjects in the high caries experience trajectory may increase the possibility to explore and evaluate more effective caries prevention for this group in the future.
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Affiliation(s)
- Håkan Flink
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden.
| | | | - Simon Liljeström
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden
| | - Eva Nohlert
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden
| | - Åke Tegelberg
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden
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Rhee SH, Kweon YS, Won DO, Lee SW, Seo KS. Identification of an effective and safe bolus dose and lockout time for patient-controlled sedation (PCS) using dexmedetomidine in dental treatments: a randomized clinical trial. J Dent Anesth Pain Med 2024; 24:19-35. [PMID: 38362260 PMCID: PMC10864709 DOI: 10.17245/jdapm.2024.24.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
Background This study investigated a safe and effective bolus dose and lockout time for patient-controlled sedation (PCS) with dexmedetomidine for dental treatments. The depth of sedation, vital signs, and patient satisfaction were investigated to demonstrate safety. Methods Thirty patients requiring dental scaling were enrolled and randomly divided into three groups based on bolus doses and lockout times: group 1 (low dose group, bolus dose 0.05 µg/kg, 1-minute lockout time), group 2 (middle dose group, 0.1 µg/kg, 1-minute), and group 3 (high dose group, 0.2 µg/kg, 3-minute) (n = 10 each). ECG, pulse, oxygen saturation, blood pressure, end-tidal CO2, respiratory rate, and bispectral index scores (BIS) were measured and recorded. The study was conducted in two stages: the first involved sedation without dental treatment and the second included sedation with dental scaling. Patients were instructed to press the drug demand button every 10 s, and the process of falling asleep and waking up was repeated 1-5 times. In the second stage, during dental scaling, patients were instructed to press the drug demand button. Loss of responsiveness (LOR) was defined as failure to respond to auditory stimuli six times, determining sleep onset. Patient and dentist satisfaction were assessed before and after experimentation. Results Thirty patients (22 males) participated in the study. Scaling was performed in 29 patients after excluding one who experienced dizziness during the first stage. The average number of drug administrations until first LOR was significantly lower in group 3 (2.8 times) than groups 1 and 2 (8.0 and 6.5 times, respectively). The time taken to reach the LOR showed no difference between groups. During the second stage, the average time required to reach the LOR during scaling was 583.4 seconds. The effect site concentrations (Ce) was significantly lower in group 1 than groups 2 and 3. In the participant survey on PCS, 8/10 in group 3 reported partial memory loss, whereas 17/20 in groups 1 and 2 recalled the procedure fully or partially. Conclusion PCS with dexmedetomidine can provide a rapid onset of sedation, safe vital sign management, and minimal side effects, thus facilitating smooth dental sedation.
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Affiliation(s)
- Seung-Hyun Rhee
- Department of Dental Anesthesiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Young-Seok Kweon
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Dong-Ok Won
- Department of Artificial Intelligence Convergence, Hallym University, Chuncheon, Republic of Korea
| | - Seong-Whan Lee
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Kwang-Suk Seo
- Department of Dental Anesthesiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Zhuge J, Zheng D, Li X, Nie X, Liu J, Liu R. Parental preferences for the procedural sedation of children in dentistry: a discrete choice experiment. Front Pediatr 2023; 11:1132413. [PMID: 38116578 PMCID: PMC10728602 DOI: 10.3389/fped.2023.1132413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/16/2023] [Indexed: 12/21/2023] Open
Abstract
Purpose The aim of this study was to explore parental preferences for the procedural sedation of children in dentistry through a discrete choice experiment (DCE) to inform clinical decisions and oral health management. Methods Based on literature reviews, interviews with parents of pediatric dental patients, and expert consultation, six attributes, including fasting time, recovery time, sedative administration routes, adverse reactions, sedation depth and procedure cost, were incorporated into the DCE questionnaire. The DCE questionnaire collected data on parental preferences for pediatric dental sedation treatment from June to August 2022. A conditional logit model was used to analyze preference and willingness to pay (WTP) for each attribute and its level. Subgroup analyses assessing the impact of parents' dental anxiety on procedural sedation preferences were also conducted using conditional logit models. Results A total of 186 valid questionnaires were gathered. Parents' preferences for fewer adverse reactions, a milder sedation depth, lower out-of-pocket cost, shorter fasting and recovery times and administration by inhalation were significantly associated with their choice of sedation model. The conditional logit model showed that parents were most interested in treatments with no adverse reactions (0% vs. 15%) (Coef, 1.033; 95% CI, 0.833-1.233), followed by those providing minimal sedation (vs. deep sedation) (Coef, 0.609; 95% CI, 0.448-0.769). Moreover, the relative importance of adverse reactions and fasting time was higher among anxious than nonanxious parents. The study found a WTP threshold of ¥1,538 for reducing adverse reactions (15% to 0%). The WTP threshold for the best sedation procedure scenario (no fasting requirement, 10 min recovery time, administration by inhalation, 0% adverse reaction incidence and minimal sedation) was ¥3,830. Conclusion Reducing the adverse reactions and depth of sedation are predominant considerations for parents regarding procedural sedation in pediatric dentistry, followed by lower cost, shorter fasting and recovery times and inhalation sedation. Parents with dental anxiety had a stronger preference for options with a lower incidence of adverse reactions and shorter fasting time than parents without dental anxiety. This discovery is helpful for doctors and can promote collaborative decision-making among parents and doctors.
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Affiliation(s)
- Jinru Zhuge
- Department of Anesthesiology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongyue Zheng
- Department of Nursing, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xingwang Li
- Department of Anesthesiology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xin Nie
- Department of Stomatology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiefan Liu
- Department of Stomatology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ruohai Liu
- Department of Anesthesiology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
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Taqi M, Zaidi SJA, Javaid J, Alam Z, Saleem A, Khan SA. Patient perceptions and experiences of dental fear of different dental specialties: a mixed-method study. BMC Oral Health 2023; 23:884. [PMID: 37981667 PMCID: PMC10659037 DOI: 10.1186/s12903-023-03626-3] [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: 06/02/2023] [Accepted: 11/05/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVE The primary objective of this study was to validate an Urdu translation of Kleinknecht's Dental Fear Survey (DFS) for use in Pakistan and to explore which items contribute the most to the variance in dental fear scores based on patient perceptions and lived experiences during dental care. METHODOLOGY This mixed-method study was conducted at Dow Dental Hospital from February 2022 to June 2022. For quantitative analysis, a total of 273 participants were enrolled through convenience sampling. After obtaining signed consent, participants were asked to self-report their dental fear. In-depth interviews with 25 patients displaying moderate to high dental fear were conducted to clarify the elements of dental fear scores through the lens of individual perceptions and experiences. RESULTS The prevalence of moderate dental fear was significantly higher among female participants than males. The mean dental fear score was higher among females (39.47 ± 14.23) as compared to males (30.83 ± 10.50). Most of the female participants reported an increase in breathing rate and heartbeat during dental treatment. The highest mean fear score was reported by participants who underwent oral surgical treatment (42.98 ± 14.21), followed by participants who received restorative care (36.20 ± 12.60). Approaching the dentist's office was the significant factor that contributed the most to the variance in dental fear scores. Four themes were generated through the content analysis of the interviews: physical reactions to dental procedures, perceptions and fears about surgical and restorative procedures, and gender and environmental factors in dental fear and interaction with dentists. CONCLUSION The Urdu translation of DFS is a reliable and valid instrument for assessing dental fears in Pakistan based on the findings of this study. Patients perceive surgical and restorative procedures as unpleasant and threatening. It was noted that "the heart beats faster" and "the breathing rate increases." were the top two physiological responses.
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Affiliation(s)
- Muhammad Taqi
- Department of Community Dentistry, Dow Dental College, Dow University of health sciences Karachi, Karachi, Pakistan
| | - Syed Jaffar Abbas Zaidi
- Department of Oral Biology, Dow Dental College, Dow University of health sciences Karachi, Karachi, Sindh 74200, Pakistan.
| | - Javaria Javaid
- Department of Community Dentistry, Dow Dental College, Dow University of health sciences Karachi, Karachi, Pakistan
| | - Zainab Alam
- Department of Community Dentistry, Dow Dental College, Dow University of health sciences Karachi, Karachi, Pakistan
| | - Aimen Saleem
- Department of Community Dentistry, Dow Dental College, Dow University of health sciences Karachi, Karachi, Pakistan
| | - Sadia Asghar Khan
- Department of Community Dentistry, Dow Dental College, Dow University of health sciences Karachi, Karachi, Pakistan
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Abdulla R, Murray A, Seeballuck C, Heffernan A. Top tips for the management of the dentally anxious patient in general practice. Br Dent J 2023; 235:166-169. [PMID: 37563375 DOI: 10.1038/s41415-023-6199-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Affiliation(s)
- Ranj Abdulla
- DCT 1, Dundee Dental Hospital and Research School, Dundee, UK.
| | - Aisling Murray
- General Dental Practitioner, Navan, Republic of Ireland.
| | - Clement Seeballuck
- Lecturer in Paediatric Dentistry, Dundee Dental Hospital and Research School, Dundee, UK.
| | - Abigail Heffernan
- Consultant in Special Care Dentistry, Dundee Dental Hospital and Research School, Dundee, UK.
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Alharbi A, Humphris G, Freeman R. The Associations among Dental Anxiety, Self-Esteem, and Oral Health-Related Quality of Life in Children: A Cross-Sectional Study. Dent J (Basel) 2023; 11:179. [PMID: 37504245 PMCID: PMC10378345 DOI: 10.3390/dj11070179] [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: 04/15/2023] [Revised: 06/28/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The current evidence on the relationships among child oral health-related quality of life, dental anxiety, and self-esteem indicates that we need to investigate these relationships to improve our understanding of the associations. Therefore, the current research aimed to enhance this evidence and provide an overview of the participating children's oral-health-related quality of life (as measured by the CPQ8-10), self-esteem (as measured by the Coopersmith SEI-SF), and dental anxiety (as measured by the CFSS_DS) and how these child-related outcome measures interacted and were related to one another. METHOD A cross-sectional survey was conducted on a random sample of school children (n = 1900) aged 8 to 10 years. The questionnaire was collected through validated self-report measures: dental anxiety, COHRQoL, and self-esteem. Structural equation modelling (SEM) was used to test the strength of the association of our model to explore the relationships among these three psychological constructs. The moderating effects of age, gender, location, and the educational board were analysed for their possible influence on these relationships. RESULTS Significant relationships between COHRQoL and child dental anxiety and between COHRQoL and SE were detected. The relationship subscale between COHRQoL and child dental anxiety was 0.24, (p < 0.001). A stronger correlation between COHRQoL, and SE was found, with B = -0.77, (p < 0.001). Although the association between CDA and SE was small, it was statistically significant (p = 0.03). These findings provide some important background information for designing effective educational programs for children.
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Affiliation(s)
- Amjad Alharbi
- DHSRU, Dundee Dental School and Hospital, University of Dundee, Dundee DD1 4HN, UK
- College of Dentistry, Qassim University, Buraydah 51452, Saudi Arabia
| | - Gerry Humphris
- DHSRU, Dundee Dental School and Hospital, University of Dundee, Dundee DD1 4HN, UK
- Health Psychology, School of Medicine, University of St Andrews, Edinburgh KY16 9AJ, UK
| | - Ruth Freeman
- DHSRU, Dundee Dental School and Hospital, University of Dundee, Dundee DD1 4HN, UK
- Public Health, NHS Tayside, Dundee DD2 1UB, UK
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Clow J, Northstone K, Hardwick C, Dermont M, Dudding T. Are childhood oral health behaviours and experiences associated with dental anxiety in adolescence? Int J Paediatr Dent 2023; 33:372-381. [PMID: 36756729 PMCID: PMC10947280 DOI: 10.1111/ipd.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/22/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Dental anxiety is associated with untreated dental caries. Understanding which childhood behaviours or experiences have the strongest association with later dental anxiety may help focus preventive strategies, subsequently limiting the burden of dental caries and anxiety. AIM The aim of this study was to explore whether behaviours and experiences during childhood were associated with adolescent dental anxiety. DESIGN Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Multivariable logistic regression was used to explore associations between adolescent dental anxiety and childhood behaviours and experiences. 1791 participants answered questions about oral health behaviours and experiences at 8 years of age and dental anxiety questions aged 17 years. RESULTS Children with experience of invasive dental treatment were more likely to have dental anxiety at 17 years of age than those who had not experienced dental treatment (OR 1.63; 95% CI: 1.12, 2.37; p = .011). Irregular dental attenders in childhood had over three times the odds of dental anxiety by adolescence, compared with regular attenders (OR 3.67 95% CI: 1.52, 8.88; p = .004). CONCLUSIONS Adolescent dental anxiety is associated with invasive treatment and irregular dental attendance in childhood. A history of irregular attendance or invasive treatment may serve as a useful predictor when considering dental anxiety in young adult patients. Early preventive care supports good attendance and oral health. These actions may have secondary effects of reducing future dental anxiety.
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Affiliation(s)
- Jennifer Clow
- Dental Public Health, Defence Primary Healthcare (Dental), HQ Defence Medical Services GroupLichfieldUK
| | - Kate Northstone
- Population Health Sciences, Bristol School of MedicineUniversity of BristolBristolUK
| | - Constance Hardwick
- National Institute for Health and Care Research ACF, Dental Core Trainee, Bristol Dental SchoolUniversity of BristolBristolUK
| | - Mark Dermont
- Head of Defence Public Health Unit, Consultant in Public Health, Defence Public Health Unit, Headquarters Defence Medical Services GroupLichfieldUK
| | - Tom Dudding
- National Institute for Health and Care Research ACF Restorative Dentistry, Honorary LecturerBristol Dental School, University of BristolBristolUK
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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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Does a New Modification of the Two-Step Injection Technique for Inferior Alveolar Nerve Block Reduce Pain Compared to the Conventional Technique? A Randomized Clinical Trial. Int J Dent 2023; 2023:5922663. [PMID: 36969376 PMCID: PMC10038732 DOI: 10.1155/2023/5922663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/20/2023] Open
Abstract
Background. The ability to control pain is an essential part of dental procedures and the need for optimal pain control and reduction of discomfort is the primary concern of every dentist. This study aims to compare the pain and vital signs during inferior alveolar nerve block between conventional and a new modification of the two-step injection techniques. Methods. In this institutional single-blind randomized clinical trial, attendees of dental school at Mazandaran University of Medical Sciences from February to May 2022 were included. Inclusion criteria were 20–60 years old and healthy (ASA1) individuals who were willing to participate in this study. Individuals who were taking medications affecting their understanding of pain and patients with active infections at the injection site were excluded. These individuals were divided into two groups. First, superficial anesthesia was performed and afterward, conventional and two-step injection techniques were performed. For the two-step injection method, 6 mm of the needle was injected into the mucosa and one-third of the local anesthetic solution was released from the computer-controlled injection toolkit. Afterward, a 25 mm 30-gauge needle was reinserted into the previous hole delivering the remaining local anesthetic. The pain during injection was measured by a patient-reported numerical rating scale (NRS). Moreover, vital signs were monitored immediately before and after the injection. Kolmogorov–Smirnov test, Mann–Whitney U test, independent T-test, and Fisher’s exact χ2 test were performed for statistical analysis (α = 0.05). Results. This study involved 32 adults aged between 20 and 50 years old with 1 : 1 female/male sex distribution. The pain score was significantly higher in the conventional injection technique compared to the two-step injection technique in all sex and age groups. There were no significant differences in vital signs between the conventional and two-step injection techniques. There was no significant difference in the mean pain scores of females and males, regardless of their injection techniques. Conclusion. Utilizing the two-step injection technique in patients for inferior alveolar block reduces pain during injection without altering patients’ vital signs significantly. This trial is registered with IRCT20220106053646N1.
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Hashemipour MA, Mohammadi F, Kamyabi H. Investigate the role of positive and negative memories from dentistry in the anxiety of dental patients in Kerman, Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:427. [PMID: 36824078 PMCID: PMC9942161 DOI: 10.4103/jehp.jehp_1436_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/29/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND AIM Several research works show that anxiety is more common in women, low-income classes, and middle-aged and elderly populations. The present study aimed to investigate the role of positive and negative memories in patients' anxiety referred to the dental clinics, offices, and schools of Kerman, Iran, in 2018-2019. MATERIALS AND METHODS In this cross-sectional, descriptive, analytical study, the participants were selected among individuals referred to the dental offices, schools, and clinics of Kerman, Iran. In this study, 500 questionnaires were distributed among the participants (based on census method), and of these, 482 of which were reviewed (response rate = 96.4%). The questionnaire used in this study contained four categories of questions, including demographic information, general questions about dentistry, Corah's Dental Anxiety Scale, and Autobiographical Memory Questionnaire. Analysis of variance, t-test, and Chi-square test were used to analyze. RESULTS Overall, 281 participants were female, and 201 were male. Based on the findings, dental visits were enjoyable and pleasant experiences for 154 participants, and 165 patients were anxious while the dentist prepared for a restorative treatment. This study showed that people with negative memories had more anxiety. Anxiety was also significantly associated with positive memories, higher education, and gender (female) (P < 0.05). Also, the most negative memories of dental treatments were associated with increased anxiety about dental treatments in adults (P < 0.05), while positive memories did not have a relationship any with decreased anxiety (P > 0.05). CONCLUSION The most negative memories of dental treatments were associated with increased anxiety about dental treatments in adults, while positive memories did not have any expected inverse relationship with anxiety.
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Affiliation(s)
- Maryam Alsadat Hashemipour
- Professor of Oral Medicine, Department of Oral Medicine, Dental School, Kerman of University of Medical Sciences, Kerman, Iran, Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran, Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Farideh Mohammadi
- Private Practice, Dental School, Kerman of University of Medical Sciences, Kerman, Iran
| | - Homa Kamyabi
- General Dentist, Dental School, Kerman University of Medical Sciences, Kerman, Iran
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Alsibai E, Bshara N, Alzoubi H, Alsabek L. Assessing an active distracting technique during primary mandibular molar pulpotomy (randomized controlled trial). Clin Exp Dent Res 2022; 9:283-289. [PMID: 36478192 PMCID: PMC10098273 DOI: 10.1002/cre2.702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/13/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This study aims to evaluate the effectiveness of two different distraction techniques (Audio Video Distraction/Video Game Distraction) in the management of anxious pediatric patients during dental treatment. MATERIALS AND METHODS One hundred and five children were randomly divided into three groups; Group A: active distraction using video games on a tablet device and wireless joystick (VG). Group B: passive distraction using video on tablet, and wireless headphones (AV). Group C (Control group): basic behavior guidance technique Tell Show Do was used (C). The children were selected from the department of pediatric dentistry at the Faculty of Dentistry, Damascus University, who required pulpotomy in primary mandibular molars. All children were assessed by: Simplified Wong-Baker FACES for pain scale (self-report), and "HOUPT" Behavior Rating Scale for Overall Behavior (non-self-report), at the end of treatment. RESULTS One hundred and five children completed the study (57 boys and 48 girls) aged between 6 and 10 years (mean age of 7.4 years). The active distraction (VG) group was superior to the passive distraction (AV) group and the control group (C) on the pain scale with statistically significant differences as appeared in Simplified Wong-Baker Scale (p = .000), The active distraction (VG) group was superior to the control group (C) in overall behavior as appeared in HOUPT scale (p = .041), but it was no statistically significant differences between (VG) group and (AV) group in overall behavior (p = .605). With the use of Bluetooth technology and wireless devices, the workspace was comfortable for the dentist and did not interfere with the movement of his hands. CONCLUSION Positive distraction with video games by wireless joystick displayed on the portable tablet on the dental chair was the best technique for reducing dental anxiety and reported pain in school children (6-10 years) and was better than negative distraction by video cartoons on the tablet device.
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Affiliation(s)
- Ekram Alsibai
- Department of Pediatric Dentistry, Faculty of Dentistry Damascus University Damascus Syria
| | - Nada Bshara
- Department of Pediatric Dentistry, Faculty of Dentistry Damascus University Damascus Syria
| | - Hasan Alzoubi
- Department of Pediatric Dentistry, Faculty of Dentistry Damascus University Damascus Syria
| | - Laith Alsabek
- Department of Pediatric Dentistry, Faculty of Dentistry Damascus University Damascus Syria
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Ichihashi T, Goto A, Myagmar-Ochir E, Haruyama Y, Muto T, Kobashi G. Association between the interval of worksite dental check-ups and dental and medical expenditures: a single-site, 12-year follow-up study in Japan. BMJ Open 2022; 12:e063658. [PMID: 36223958 PMCID: PMC9562720 DOI: 10.1136/bmjopen-2022-063658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The purpose of this study was to identify the effective intervals of worksite dental check-ups to reduce cumulative dental expenditures (CDEs) and cumulative medical expenditures (CMEs), based on 12 years of follow-up dental check-ups. SETTING, DESIGN AND PARTICIPANTS A longitudinal study was conducted between 2002 and 2014 fiscal years. A total of 2691 full-time employees (2099 males and 592 females) aged 20-59 years in a manufacturing company in Japan were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES Based on the follow-up of 12-year dental check-ups, the interval of dental check-ups visits was classified into the following categories: 'Once per year' as the regular group, 'At least once per 2 years' as the subregular group and others as the irregular group. CDEs and CMEs per capita were examined by the three groups of dental check-ups interval after adjustment for sex, age, occupation and total CMEs at baseline. For sensitivity analysis, decayed teeth, missing teeth and Community Periodontal Index were added as adjustment factors. RESULTS Compared with the irregular group, the pooled CDEs (including dental check-ups fee) per capita in the subregular group (OR 0.91, 95% CI 0.85 to 0.98) and regular group (OR 0.87, 95% CI 0.81 to 0.93) were significantly lower overall. The younger adults in the subregular group and younger-aged and middle-aged adults in the regular group had significantly lower CDEs. Sensitivity analysis confirmed these findings. CONCLUSIONS Our findings suggest that regular and subregular worksite dental check-ups were related to reduction of CDEs. It is important to promote a yearly interval between dental check-ups.
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Affiliation(s)
- Toru Ichihashi
- Lion Foundation for Dental Health, Sumida-ku, Tokyo, Japan
- Department of Public Health, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Ayae Goto
- Lion Foundation for Dental Health, Sumida-ku, Tokyo, Japan
| | | | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Takashi Muto
- Department of Public Health, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
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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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Crowe HL, Woolley SM. Dental students' experience of conscious sedation: A qualitative review of student reflections. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:197-205. [PMID: 33838059 DOI: 10.1111/eje.12688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/06/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The UK General Dental Council (GDC) requires dental graduates to competently identify, manage and refer patients with dental pain and anxiety. This study aimed to explore sedation training experience quantitatively and qualitatively through individual reflective logs. MATERIALS & METHODS A single-centred mixed-methods evaluation of teaching, within a UK university conscious sedation department. Fourth-year dental students undertook lectures and supervised clinical sessions following the undergraduate curriculum. Patient attendance patterns, individual experience and group experience were analysed descriptively. Reflective log sheets were analysed by Thematic Framework Analysis. RESULTS Seventy-two students participated. Of 153 booked patients, 79 (51.6%) attended of which 74 (48.4%) were treated by undergraduates. The mean performed inhalation sedation and intravenous sedation cases per student were 1 and 0.8, respectively. Three students (4%) assisted only. Group experience varied. Three themes arose from reflections: consolidation of theory and learning; confidence through experience; and responding to challenges. DISCUSSION Whilst experience quotas were not met, GDC requirements for increasing students' knowledge and confidence within CS were met. Practical experience enhanced learning. "Hands-on" experience was most valuable for self-reported confidence but learning by proxy also aided development. Students recognised challenges, but not the implications for themselves or their career. Strategies to reduce barriers to experience require research. CONCLUSION Whilst variable, all students were provided learning opportunities. Physical experience gave the greatest confidence. Opportunities afforded by the undergraduate curriculum allowed students to learn and develop through consolidation of theory, response to challenges and ultimately the gaining of confidence.
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Magnitude and Determinants of Dental Anxiety among Adult Patients Attending Public Dental Clinics in Dar-Es-Salaam, Tanzania. Int J Dent 2021; 2021:9965204. [PMID: 34046065 PMCID: PMC8128540 DOI: 10.1155/2021/9965204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/28/2021] [Accepted: 05/03/2021] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION It is estimated that, about 40% of the population suffer from dental anxiety. Dental anxiety is considered to be complex and multifactorial with a wide range of provoking factors which may be patient, provider, or environment-related. AIM This study aimed to assess the magnitude and determinants of dental anxiety among adult patients attending public dental clinics in Dar es Salaam, Tanzania. Methodology. This was a descriptive cross-sectional study carried out in 4 public hospitals in Dar es Salaam, Tanzania. It included 300 adult patients who had dental caries, periodontal diseases, or dental trauma. Data were collected using a self-administered Modified Dental Anxiety Scale (MDAS) questionnaire. Data were analyzed using the SPSS computer software version 23. A one-way Analysis of Variance (ANOVA) was used to assess the association between variables, and the significance level was set at p < 0.05. RESULTS The mean age of participants was 32.18 years (±11.06 SD) with a male-to-female ratio of 1 : 1.43. The means MDAS score was 12.84 ± 4.99. Tooth extraction had the highest mean MDAS score. The majority (261, 87%) of participants had mild-to-severe anxiety. The most common (72.2%) anxiety-provoking factor was an unsympathetic dentist; others included unawareness of the procedure to be carried out (58.3%) and the presence of apprehensive patients (52.0%). The level of anxiety was found to be statistically significantly associated (p < 0.05) with young age [p=0.009, AOR 3.06 (95% CI, 1.32, 7.09), female patients [p < 0.001, AOR 4.45 (95% CI, 2.05, 9.70)], and a higher education level [p < 0.05, AOR 2.32 (95% CI, 1.03, 5.25)]. CONCLUSION The prevalence of dental anxiety was high among the participants of this study. Female gender, young age, and a higher level of education constituted determinants of dental anxiety. An unsympathetic practitioner, unawareness of the procedure, and presence of apprehensive patients were the common anxiety-provoking factors.
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Edwards D, Ramsey R, Breeze J. How should we manage severe anxiety towards dental treatment in UK service personnel? BMJ Mil Health 2021; 169:277-279. [PMID: 33547190 DOI: 10.1136/bmjmilitary-2020-001701] [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: 10/26/2020] [Revised: 12/30/2020] [Accepted: 01/14/2021] [Indexed: 11/03/2022]
Abstract
Anxiety towards dental treatment is a significant barrier towards care within the United Kingdom Armed Forces. Avoidance of dental treatment results in morbidity, and severe dental infections can lead to systemic disease, which in turn may require hospitalisation. Of greater concern are deployed phobic patients who may develop dental pathology or suffer dental trauma and will likely require evacuation to the UK or a suitable host nation. This has considerable financial implications and in a war setting may place everyone in the evacuation chain at greater risk especially considering that it is not possible to manage these patients in Role 1 or 2 environments. Managing anxiety using either sedation or a general anaesthetic as a long-term management strategy for anxious military patients is simply not practical. This is reflected by current Defence policy stating that service personnel who are unable to tolerate treatment under local anaesthetic (LA) alone should be medically downgraded. However, the situation should ideally be addressed at the time of first recruitment. Currently, despite regulations recommending that potential new military recruits who cannot tolerate routine dentistry under LA should be medically discharged, in reality the subjectivity of such an assessment means this rarely happens. We would instead recommend that following identification of dental phobic recruits in initial training, they be placed in a holding platoon while methods to address their anxiety are explored. This would potentially avoid them entering military service and ultimately being discharged.
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Affiliation(s)
| | - R Ramsey
- Defence Centre for Rehabilitative Dentistry, Royal Army Dental Corps, Aldershot, Hampshire, UK
| | - J Breeze
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.,Department of Bioengineering, Imperial College London, London, UK
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Minimum intervention oral healthcare for people with dental phobia: a patient management pathway. Br Dent J 2020; 229:417-424. [PMID: 33037361 PMCID: PMC7546148 DOI: 10.1038/s41415-020-2178-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/10/2020] [Indexed: 11/30/2022]
Abstract
Dental phobia is relatively common among adults and often associated with poorer oral health as a consequence of delaying dental treatment until advanced disease has caused intolerable symptoms. The increased rates of active disease may also have an impact on oral health-related quality of life (OHR QoL). Minimum intervention oral healthcare (MIOC) combines four key domains: detection and diagnosis, prevention and control of oral disease, minimally invasive (MI) operative interventions and review/recall. Team delivery and patient-focused care are the underpinning tenets to these four domains. The MIOC approach offers advantages to both patients with dental phobia and the oral healthcare team involved in their long-term management. This paper presents an adaptation of MIOC for patients with dental phobia, which is founded on a comprehensive assessment approach followed by the provision of dental care with behavioural management techniques in combination with conscious sedation. This approach has the potential to provide a comprehensive personalised patient management pathway for delivering better oral health for this vulnerable patient group in a primary care setting. People with dental phobia often present with a poorer oral health status which compromises their oral health-related quality of life. An outline of the application of the minimum intervention oral healthcare (MIOC) framework for patients with dental phobia is described, which has the potential to be particularly beneficial for the oral healthcare of this group of patients. An assessment tool is presented which provides an overview of important points for a practitioner to consider when assessing patients with dental phobia using MIOC.
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20
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Al Rawahi SH, Asimakopoulou K, Masood M, Al Bulushi NM, Al Yaqoobi KH, Newton JT. The Psychological Models of Health-related Behavior in Understanding Sugars Intake in Adults: A Review. Oman Med J 2020; 35:e114. [PMID: 32308991 PMCID: PMC7151060 DOI: 10.5001/omj.2020.32] [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: 12/29/2018] [Accepted: 04/30/2019] [Indexed: 12/19/2022] Open
Abstract
Free sugars intake plays a major role in dental caries formation and other general health issues such as obesity. Therefore, interventions, which assist individuals or populations in the control of their free sugars intake, are of central importance in caries prevention strategies. There is good evidence that behavioral interventions benefit from a foundation in conceptual theories of behavior change founded on empirical data. In this review, we discuss the future application of seven theories, including six common psychological theories in predicting and developing interventions to reduce free sugars intake related to dental caries among adults. For each model, we summarize its key features and the data derived from its application in general and oral health settings and make recommendations for future research. We searched Medline, PsycINFO, Global Health, PubMed, and Embase databases to identify items dealing with dental caries, adults, sugars intake, and six psychological theories. These included the Transtheoretical Model of Change, Theory of Planned Behavior, Social Cognitive Theory, Information-Motivation-Behavioral Skills model, PRIME Theory, and Behavior Change Wheel theories. We searched literature published in the last 10 years, and priority was given to systematic reviews and randomized control trials. Although there is extensive literature on the application of the six psychological theories, there is a gap in knowledge about their effectiveness in reducing free sugars intake related to dental caries among adults. There is a need for better-designed trials of interventions based on the clear operationalization of psychological constructs to reduce sugars intake among the adult population.
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Affiliation(s)
| | - Koula Asimakopoulou
- Department of Population and Patient Health, Dental Institute, King’s College London, London, UK
| | - Mohd Masood
- Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Melbourne, Australia
| | | | | | - Jonathon Timothy Newton
- Department of Population and Patient Health, Dental Institute, King’s College London, London, UK
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Suresh A, Karuna YM, Natarajan S, Maimoona TM, Shenoy S, Nayak AP, Rao AP, Shrikrishna SB. Assessing the behavior management problems during the first dental visit of preschool children using a doll placement test. J Indian Soc Pedod Prev Dent 2020; 38:41-47. [PMID: 32174628 DOI: 10.4103/jisppd.jisppd_206_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Assessing dental anxiety as a predictor of the likely behavior of the child in the dental operatory is of paramount importance for a clinician to render quality care. AIM This study aims to correlate the dental anxiety of preschool children as shown during the doll placement test with that of their behavioral patterns during the first dental visit. SETTINGS AND DESIGN This cross-sectional study was conducted between the ages of 3-7 years. MATERIALS AND METHODS During their first dental visit, the background variables were elicited from parent/guardian at the reception desk. Later at the play area, the child was given a set of dolls representing dentist, child, and mother to place them in a model dental office having a dental chair. The child was then taken for the initial oral examination, during which the behavior of the child was rated using Frankl's Behavior Rating Scale. The data collected were analyzed using Chi-square test and binary regression analysis. RESULTS The observed association between the doll placement pattern and the behavior of the patient during dental treatment was statistically significant (P < 0.001). The binary regression analysis showed that the child's unpleasant previous medical and parent's unpleasant dental experiences had higher odds favoring uncooperative behavior (46.63 and 41.93, respectively). CONCLUSIONS The child's behavior on the dental chair is associated with the doll placement pattern, which is also influenced by experiences of the child during his/her encounter with the medical doctor and previous dental experiences of their parents.
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Affiliation(s)
- Akhil Suresh
- Former Under Graduate Student, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Y M Karuna
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Srikant Natarajan
- Department of Oral Pathology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - T M Maimoona
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Savitha Shenoy
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anupama P Nayak
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashwin P Rao
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Suprabha B Shrikrishna
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Gajendragadkar K, Bhate K, Jagtap B, S N S, Kshirsagar K, Magoo S. Making inferior alveolar nerve block more comfortable via computer-controlled local anesthetic delivery: A prospective clinical study. J Dent Anesth Pain Med 2019; 19:135-141. [PMID: 31338419 PMCID: PMC6620535 DOI: 10.17245/jdapm.2019.19.3.135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/16/2019] [Accepted: 06/17/2019] [Indexed: 02/01/2023] Open
Abstract
Background The fear of needle insertion and pain during anesthesia is a source of patient dissatisfaction in dentistry. Inferior alveolar nerve block (IANB) remains the most common type of block and is in itself painful. Computer-controlled local anesthetic delivery (CCLAD) has been proven to reduce the pain associated with injection of anesthetics in various blocks. However, the efficacy of CCLAD for IANB in adults remains unknown. Methods Sixty-four adult patients requiring bilateral IANB were selected and divided into two groups: group A (50 patients receiving IANB via CCLAD) and group B (50 patients receiving IANB using a conventional cartridge syringe). Pain perception and patient comfort were assessed using the visual analog scale and the 5-point semantic scale, respectively. Results The pain perception was compared between the two groups using the Mann-Whitney U-test, and the P value was 0.003. The patient comfort was also compared using the same test, and the P value was 0.484. Conclusion A significant difference was observed in the pain perception of the patients during CCLAD. The patient comfort was grossly equal for both techniques.
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Affiliation(s)
- Kunal Gajendragadkar
- Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Kalyani Bhate
- Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Bhagyashree Jagtap
- Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Santhoshkumar S N
- Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Kapil Kshirsagar
- Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Surabhi Magoo
- Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pune, India
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Kamel AF, Al-Harbi A, Al-Otaibi F, Al-Qahtani F, Al-Garni A. Dental anxiety at Riyadh Elm University Clinics. SAUDI JOURNAL OF ORAL SCIENCES 2019. [DOI: 10.4103/sjos.sjoralsci_33_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dental attendance after treatment under dental general analgesia (DGA): a data-based follow-up study. Eur Arch Paediatr Dent 2018; 20:27-32. [PMID: 30382523 DOI: 10.1007/s40368-018-0381-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 10/15/2018] [Indexed: 12/12/2022]
Abstract
AIMS To investigate dental attendance of patients in different age groups after dental general analgesia (DGA) and procedures performed on these patients during the DGA and in dental care after the DGA during the follow-up period of almost 3 years. METHODS The study population consisted of 66 patients who were treated under DGA at a municipal health centre in Oulu, Finland between September 2010 and June 2011. The electronic patient files of the DGA patients were accessible for data collection for the follow-up period of nearly 3 years. The statistical analyses included Chi square tests and logistic regression modelling. RESULTS Approximately every sixth (14.9%) dental visit was missed or cancelled and nearly half (43.9%) of the studied subjects had at least one missed or cancelled appointment. The factors increasing the risk of missed or cancelled appointments and dental avoidance were endodontic treatment (OR 3.62), need of more than five dental restorations (OR 3.47), tooth extractions due to caries (OR 2.22), and male gender (OR 1.80). A total of 45.5% of the patients received non-invasive procedures. CONCLUSIONS Patients who need DGA are evidently risk patients considering dental attendance. Nearly half of the patients in this study had non-attended or cancelled appointments. DGA patients' need of treatment after DGA is extensive, even comparable to the amount of procedures generally performed under DGA. The quality or amount of preventive procedures do not appear to be at the required level to reduce the number of non-attended appointments.
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Heidari E, Banerjee A, Newton T. Survey of treatment policies under conscious sedation at centres dealing with people with high levels of dental anxiety across the United Kingdom. Br Dent J 2018; 224:632-6. [DOI: 10.1038/sj.bdj.2018.265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 11/09/2022]
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Inequalities in preventive and restorative dental services in England, Wales and Northern Ireland. Br Dent J 2018; 221:235-9. [PMID: 27608576 DOI: 10.1038/sj.bdj.2016.641] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/09/2022]
Abstract
Aims The objective of this study is to assess socioeconomic inequalities in the use of selected dental procedures.Methods Data is from the Adult Dental Health Survey 2009, a nationally representative cross-sectional survey of England, Northern Ireland and Wales. Overall, 6,279 participants were included in the analysis. Occupational classification and education were used to assess variations in the use of preventive, restorative services and tooth extraction using a series of logistic regression models, adjusting for age, sex, ethnicity, DMFT, self-reported oral health, dental visits and country.Results There were clear socioeconomic variations in the utilisation of preventive and restorative services. In the fully adjusted model those with no educational qualification were less likely to report ever having preventive services than those with a degree (OR 0.48, 95%CI: 0.36,0.65). Similarly, individuals in routine/manual occupation were significantly less likely to report ever having preventive services than those in managerial/professional occupation (OR 0.58, 95%CI: 0.46,0.74) in the fully adjusted model.Conclusion The findings imply that despite relatively equitable access and higher use of dental services in UK, the least educated and those at the bottom of social hierarchy are less likely to have preventive and restorative dental services.
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Ibrahim H, Lyons KM, Armfield JM, Thomson WM. Performance of the Index of Dental Anxiety and Fear in a population-based sample of adults. Aust Dent J 2017; 62:478-484. [DOI: 10.1111/adj.12541] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- H Ibrahim
- Sir John Walsh Research Institute; Faculty of Dentistry; The University of Otago; Dunedin New Zealand
| | - KM Lyons
- Sir John Walsh Research Institute; Faculty of Dentistry; The University of Otago; Dunedin New Zealand
| | - JM Armfield
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide South Australia Australia
| | - WM Thomson
- Sir John Walsh Research Institute; Faculty of Dentistry; The University of Otago; Dunedin New Zealand
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Anthonappa RP, Ashley PF, Bonetti DL, Lombardo G, Riley P. Non‐pharmacological interventions for managing dental anxiety in children. Cochrane Database Syst Rev 2017; 2017:CD012676. [PMCID: PMC6481904 DOI: 10.1002/14651858.cd012676] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to assess the effectiveness of non‐pharmacological interventions for reducing dental anxiety in children.
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Affiliation(s)
- Robert P Anthonappa
- University of Western AustraliaSchool of DentistryFaculty of Medicine, Dentistry and Health Sciences17 Monash AvenueNedlandsAustraliaWA 6009
| | - Paul F Ashley
- UCL Eastman Dental InstituteUnit of Paediatric Dentistry, Department of Craniofacial Growth and Development256 Grays Inn RoadLondonUKWC1X 8LD
| | - Debbie L Bonetti
- University of DundeeSchool of DentistryFrankland Building, Small's WyndDundeeUKDD1 4HN
| | - Guido Lombardo
- University of PerugiaDipartimento di Scienze Chirurgiche, Radiologiche e OdontostomatologicheOspedale S. Maria della Misericordia ‐ S. Andrea delle FrattePerugiaItaly06156
| | - Philip Riley
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
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Doganer YC, Aydogan U, Yesil HU, Rohrer JE, Williams MD, Agerter DC. Does the trait anxiety affect the dental fear? Braz Oral Res 2017; 31:e36. [PMID: 28513787 DOI: 10.1590/1807-3107bor-2017.vol31.0036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 04/05/2017] [Indexed: 12/11/2022] Open
Abstract
The aims of the present study were to evaluate possible associations between trait anxiety, dental fear and the predictors of these interactions including demographic characteristics and dental history of patients applied to the dental care center in Ankara, Turkey. A sample of 607 participants (mean age: 21.02 ± 2.32) responded to a Turkish version of the Modified Dental Fear Survey (MDFS), the State-Trait Anxiety Inventory (STAI-T) and a questionnaire regarding previous negative dental experience. Multiple logistic regression analysis was used to identify the association between dental fear and the independent variables including trait anxiety, age groups, education level, dental visit frequency, experience and the source of dental knowledge. There was a trend for increasing in trait anxiety scores with greater levels of dental fear in a medium level of the dental fear group (OR = 1.055, 95%CI [1.025-1.086]; p < 0.001) and in a high level of the dental fear group (OR = 1.090 [1.057-1.124]; p < 0.001). Comparing to the low level of dental fear group; participants of medium dental fear level intended more likely to go to the dentist when they have a complaint instead of regularly going (odds ratio; OR = 3.177, 95%CI [1.304-7.741]; p = 0.011). Participants of high dental fear level tended to be less likely to have experienced no problem (OR = 0.476, 95%CI [0.284-0.795]; p = 0.005) than the low level of the dental fear group. We strongly indicate that higher dental fear scores have a predisposition of having high trait anxiety scores. Unpleasant dental experiences increased the risk for high dental fear levels. Patients with dental fear tended only to visit a dentist when necessary, avoiding regular visits.
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Affiliation(s)
- Yusuf Cetin Doganer
- National Defense University, Turkish Military Academy, Primary Care Examination Center, Ankara, Turkey
| | - Umit Aydogan
- University of Health Sciences, Gulhane Medical Faculty, Department of Family Medicine, Ankara, Turkey
| | - Hande Ucler Yesil
- Diskapi Yildirim Beyazit Training and Research Hospital, Oral Health and Dental Treatment Center, Ankara, Turkey
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The oral health of individuals with dental phobia: a multivariate analysis of the Adult Dental Health Survey, 2009. Br Dent J 2017; 222:595-604. [DOI: 10.1038/sj.bdj.2017.361] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/09/2022]
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Oliveira MA, Vale MP, Bendo CB, Paiva SM, Serra-Negra JM. Influence of negative dental experiences in childhood on the development of dental fear in adulthood: a case-control study. J Oral Rehabil 2017; 44:434-441. [PMID: 28386938 DOI: 10.1111/joor.12513] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2017] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the factors associated with high dental fear among Brazilian university students, especially the effect of a negative dental experience in childhood. This paired case-control study was conducted at the Universidade Federal de Minas Gerais in Brazil. Dental, psychology and mathematics students were divided into cases (high fear) and controls (low fear), defined by cluster analysis, according to the items of the Dental Fear Survey (DFS). Cases (n = 65) and controls (n = 260) participants were paired (1:4) by gender, undergraduate course and social vulnerability. The students self-reported the DFS and a questionnaire about oral health. Descriptive analysis, bivariate and multivariate conditional logistic regression were used as statistical tests with a significance level of 5%. The multivariate model showed that students who reported negative dental experiences in childhood (OR = 2·97; 95% CI: 1·44-6·14), toothache in the last 12 months (OR = 11·31; 95% CI: 4·79-26·68), discomfort during dental treatment (OR = 5·36; 95% CI: 2·53-11·36) and poor self-evaluation of oral health (OR = 3·82; 95% CI: 1·61-8·11) were more likely to have high dental fear. Negative dental experiences in childhood influence dental fear in adulthood. Oral health education should be addressed among university students to reduce dental fear.
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Affiliation(s)
- M A Oliveira
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - M P Vale
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - C B Bendo
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - S M Paiva
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - J M Serra-Negra
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte, Minas Gerais, Brazil
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Khan S, Hamedy R, Lei Y, Ogawa RS, White SN. Anxiety Related to Nonsurgical Root Canal Treatment: A Systematic Review. J Endod 2016; 42:1726-1736. [DOI: 10.1016/j.joen.2016.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/06/2016] [Accepted: 08/09/2016] [Indexed: 02/07/2023]
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Guentsch A, Stier C, Raschke GF, Peisker A, Fahmy MD, Kuepper H, Schueler I. Oral health and dental anxiety in a German practice-based sample. Clin Oral Investig 2016; 21:1675-1680. [PMID: 27596605 DOI: 10.1007/s00784-016-1951-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/30/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Does dental anxiety have an effect on dental and periodontal health? METHODS Survey data was collected from n = 200 adults (53 % females, average age 49 years) in a cross-sectional study. Dental anxiety was measured with the modified dental anxiety scale (MDAS, score 1-5, the greater the score, the greater the anxiety). Clinical parameters including probing depth (PD), clinical attachment level (CAL), plaque index (SLI), and bleeding on probing (BoP) as well as the DMFT index were recorded and statistically analyzed. RESULTS Rating of dental anxiety was higher in women than in men (65 vs 35 %). Subjects with higher MDAS values visited the dentist less frequently (p = 0.001) and had more decay (DT 6.7 ± 4.2 vs 1.7 ± 2.4; p < 0.001) but fewer filled teeth than subjects with lower ratings of dental anxiety (FT 7.1 ± 4.5 vs 9.8 ± 5.7; p = 0.042). There were no differences in PD or CAL between subjects with or without dental anxiety, while patients with higher MDAS value showed significantly more BoP (50 ± 19 vs 34 ± 20 %; p = 0.002) than patients with low MDAS scores (no or low dental anxiety). CONCLUSIONS Patients with higher ratings of dental anxiety had significantly more caries experience and gingivitis. Therefore, dental anxiety is associated with negative effect on dental and periodontal health. CLINICAL RELEVANCE Identifying patients with high dental anxiety and helping to manage this anxiety has important implications to improve oral health in adults. The MDAS appears to be an easy and efficient tool that can be used to identify patients with dental anxiety in dental practices.
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Affiliation(s)
- Arndt Guentsch
- Department of Surgical Sciences, Marquette University School of Dentistry, P.O. Box 1881, Milwaukee, WI, 53201-1881, USA. .,Department of Prosthetic Dentistry, Jena University Hospital, Jena, Germany.
| | - Christiane Stier
- Department of Prosthetic Dentistry, Jena University Hospital, Jena, Germany
| | - Gregor F Raschke
- Department of Cranio-Maxillofacial and Plastic Surgery, Jena University Hospital, Jena, Germany
| | - André Peisker
- Department of Cranio-Maxillofacial and Plastic Surgery, Jena University Hospital, Jena, Germany
| | - Mina D Fahmy
- Department of Surgical Sciences, Marquette University School of Dentistry, P.O. Box 1881, Milwaukee, WI, 53201-1881, USA
| | - Harald Kuepper
- Department of Prosthetic Dentistry, Jena University Hospital, Jena, Germany
| | - Ina Schueler
- Department of Preventive Dentistry and Paediatric Dentistry, Jena University Hospital, Jena, Germany
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Raghav K, Van Wijk AJ, Abdullah F, Islam MN, Bernatchez M, De Jongh A. Efficacy of virtual reality exposure therapy for treatment of dental phobia: a randomized control trial. BMC Oral Health 2016; 16:25. [PMID: 26920573 PMCID: PMC4769551 DOI: 10.1186/s12903-016-0186-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/22/2016] [Indexed: 11/13/2022] Open
Abstract
Background Virtual Reality Exposure Therapy (VRET) is found to be a promising and a viable alternative for in vivo exposure in the treatment of specific phobias. However, its usefulness for treating dental phobia is unexplored. The aims of the present study are to determine: (a) the efficacy of VRET versus informational pamphlet (IP) control group in terms of dental trait and state anxiety reductions at 1 week, 3 months and 6 months follow-up (b) the real-time physiological arousal [heart rate (HR)] of VRET group participants during and following therapy (c) the relation between subjective (presence) and objective (HR) measures during VRET. Methods This study is a single blind, randomized controlled trial with two parallel arms in which participants will be allocated to VRET or IP with a ratio of 1:1. Thirty participants (18-50 years) meeting the Phobia Checklist criteria of dental phobia will undergo block randomization with allocation concealment. The primary outcome measures include participants’ dental trait anxiety (Modified Dental Anxiety Scale and Dental Fear Survey) and state anxiety (Visual Analogue Scale) measured at baseline (T0), at intervention (T1), 1-week (T2), 3 months (T3) and 6 months (T4) follow-up. A behavior test will be conducted before and after the intervention. The secondary outcome measures are real-time evaluation of HR and VR (Virtual Reality) experience (presence, realism, nausea) during and following the VRET intervention respectively. The data will be analyzed using intention-to-treat and per-protocol analysis. Discussion This study uses novel non-invasive VRET, which may provide a possible alternative treatment for dental anxiety and phobia. Trial registration number ISRCTN25824611, Date of registration: 26 October 2015.
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Affiliation(s)
- Kumar Raghav
- Department of Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 LA, Amsterdam, The Netherlands. .,Faculty of Dentistry, SEGi University, No:9 Jalan Teknologi, Kotadamansara, PJU-5, Petalingjaya-47810, Selangor, Malaysia.
| | - A J Van Wijk
- Department of Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 LA, Amsterdam, The Netherlands
| | - Fawzia Abdullah
- Faculty of Dentistry, SEGi University, No:9 Jalan Teknologi, Kotadamansara, PJU-5, Petalingjaya-47810, Selangor, Malaysia
| | - Md Nurul Islam
- Faculty of Dentistry, SEGi University, No:9 Jalan Teknologi, Kotadamansara, PJU-5, Petalingjaya-47810, Selangor, Malaysia
| | | | - Ad De Jongh
- Department of Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 LA, Amsterdam, The Netherlands.,School of Health Sciences of Salford University, Manchester, UK
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Heidari E, Banerjee A, Newton JT. Oral health status of non-phobic and dentally phobic individuals; a secondary analysis of the 2009 Adult Dental Health Survey. Br Dent J 2015; 219:E9. [DOI: 10.1038/sj.bdj.2015.853] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 11/09/2022]
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Determining Cut-Off Points for the Dental Fear Survey. ScientificWorldJournal 2015; 2015:983564. [PMID: 26491721 PMCID: PMC4602336 DOI: 10.1155/2015/983564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/13/2015] [Indexed: 12/27/2022] Open
Abstract
Objective. To determine a high fear cut-off point score for the Dental Fear Survey (DFS) using a single-item self-report questionnaire. Methods. The DFS, a 20-item questionnaire assessing fear of dental treatment, was completed by 1,256 participants with a mean age of 22.3 years (SD = 5.1). Another self-report questionnaire was used to collect data on previous dental experiences. A high fear cut-off point score was determined by calculating the receiver operating characteristic (ROC) curve for the DFS. Descriptive statistics and multinomial logistic regression were calculated; a significance level of p < 0.05 was used for all tests. Results. The ROC curve indicated that a DFS score ≥53 corresponds to a sensitivity of 88.9% and a specificity of 92.5%. Most participants (n = 895; 71.5%) reported no fear of going to the dentist. There was significant association between DFS score and fear assessed with the question “Are you fearful of going to the dentist?” (p < 0.001). Conclusion. A cut-off point of 53 on the DFS total score represents the best compromise between sensitivity and specificity and can be used to predict high dental fear.
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Abstract
High levels of dental caries, challenging child behavior, and parent expectations support a need for sedation in pediatric dentistry. This paper reviews modern developments in pediatric sedation with a focus on implementing techniques to enhance success and patient safety. In recent years, sedation for dental procedures has been implicated in a disproportionate number of cases that resulted in death or permanent neurologic damage. The youngest children and those with more complicated medical backgrounds appear to be at greatest risk. To reduce complications, practitioners and regulatory bodies have supported a renewed focus on health care quality and safety. Implementation of high fidelity simulation training and improvements in patient monitoring, including end-tidal carbon dioxide, are becoming recognized as a new standard for sedated patients in dental offices and health care facilities. Safe and appropriate case selection and appropriate dosing for overweight children is also paramount. Oral sedation has been the mainstay of pediatric dental sedation; however, today practitioners are administering modern drugs in new ways with high levels of success. Employing contemporary transmucosal administration devices increases patient acceptance and sedation predictability. While recently there have been many positive developments in sedation technology, it is now thought that medications used in sedation and anesthesia may have adverse effects on the developing brain. The evidence for this is not definitive, but we suggest that practitioners recognize this developing area and counsel patients accordingly. Finally, there is a clear trend of increased use of ambulatory anesthesia services for pediatric dentistry. Today, parents and practitioners have become accustomed to children receiving general anesthesia in the outpatient setting. As a result of these changes, it is possible that dental providers will abandon the practice of personally administering large amounts of sedation to patients, and focus instead on careful case selection for lighter in-office sedation techniques.
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Affiliation(s)
- Travis M Nelson
- Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA
| | - Zheng Xu
- Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA
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Farhad Mollashahi N. Adult dental patients with avoidance behaviours. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2015; 4:e23547. [PMID: 25821752 PMCID: PMC4360539 DOI: 10.5812/ijhrba.23547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 09/28/2014] [Accepted: 10/09/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Narges Farhad Mollashahi
- Department of Endodontics, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, IR Iran
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Kim MJ, Noh H, Oh HY. Efficiency of professional tooth brushing before ultrasonic scaling. Int J Dent Hyg 2015; 13:125-31. [DOI: 10.1111/idh.12127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- MJ Kim
- Boa Dental Clinic; Seoul Republic of Korea
| | - H Noh
- Department of Dental Hygiene; Wonju College of Medicine; Yonsei University; Wonju-si Kangwon-do Republic of Korea
| | - HY Oh
- Department of Dental Hygiene; Suwon Sceince College; Hwaseong-si Gyeonggi-do Republic of Korea
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Dental Fear Survey: a cross-sectional study evaluating the psychometric properties of the Brazilian Portuguese version. ScientificWorldJournal 2014; 2014:725323. [PMID: 25184153 PMCID: PMC4144391 DOI: 10.1155/2014/725323] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/15/2014] [Accepted: 07/22/2014] [Indexed: 12/14/2022] Open
Abstract
Objective. The aim of this study was to evaluate the psychometric properties of the Brazilian version of the Dental Fear Survey (DFS), previously translated to the Brazilian Portuguese language and validated. Methods. A cross-sectional study with 1,256 undergraduates from the city of Belo Horizonte, Brazil, was carried out. The DFS and a questionnaire about previous dental experiences were self-administered. Data analysis involved descriptive statistics, principal components analysis (PCA), confirmatory factor analysis (CFA), internal consistency and test-retest reliability, and construct, discriminant, and convergent validity. Results. PCA identified a three-factor structure. CFA confirmed the multidimensionality of the Brazilian version of the DFS. A modified model of the Brazilian version of the DFS fits better than the hypothesized model. The Cronbach's alpha coefficient for the total DFS scale was 0.95. Conclusion. The DFS demonstrated acceptable construct validity, convergent validity, and discriminant validity. These results supported the reliability and validity of the DFS among Brazilian undergraduates.
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Wiener RC, Sambamoorthi U, Jurevic RJ. Dental utilization of active duty/previous active duty US military: a cross-sectional analysis of the 2010 Behavior and Risk Surveillance Survey. ACTA ACUST UNITED AC 2014; 1. [PMID: 26086028 PMCID: PMC4466546 DOI: 10.13070/rs.en.1.888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction The purpose of this study is to understand dental utilization of 1) individuals serving/having served in active duty in the U.S. military as compared with the general public and 2) individuals who are currently serving as compared with individuals who are no longer active duty, but have been in active duty within the previous year. Methods The Behavior and Risk Surveillance Survey, 2010, was used in cross-sectional analyses to determine the comparisons. Chi square and multivariable logistic regression analyses were applied. Results 70.7% of participants who had served/currently serving had a dental visit within the previous 12 months; 69.9% of the general public reported a dental visit (p = 0.0265). 69.8% of participants who had served/currently serving had a dental hygiene visit within the previous 12 months and 68.1% of the general public reported a dental hygiene visit (p <0.0001). The adjusted odds ratio (AOR) for participants who had served/currently serving vs. the general public was 1.10 (95% Confidence Interval [CI] 1.05, 1.16; p<0.0001) for dental visits and 1.11 (95%CI 1.05, 1.17; p<0.0001) for dental hygiene visits. Conclusion Participants who are serving or have served were more likely to have any dental visit and dental hygiene visit than the general public; but the results were not substantively important.
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Affiliation(s)
- R Constance Wiener
- Dental Practice and Rural Health, School of Dentistry, Department of Epidemiology, School of Public Health, West Virginia University, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center, USA
| | - Richard J Jurevic
- Department of Oral Medicine, School of Dentistry, West Virginia University, USA
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Tanja-Dijkstra K, Pahl S, White MP, Andrade J, May J, Stone RJ, Bruce M, Mills I, Auvray M, Gabe R, Moles DR. Can virtual nature improve patient experiences and memories of dental treatment? A study protocol for a randomized controlled trial. Trials 2014; 15:90. [PMID: 24655569 PMCID: PMC3978097 DOI: 10.1186/1745-6215-15-90] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 03/11/2014] [Indexed: 12/14/2022] Open
Abstract
Background Dental anxiety and anxiety-related avoidance of dental care create significant problems for patients and the dental profession. Distraction interventions are used in daily medical practice to help patients cope with unpleasant procedures. There is evidence that exposure to natural scenery is beneficial for patients and that the use of virtual reality (VR) distraction is more effective than other distraction interventions, such as watching television. The main aim of this randomized controlled trial is to determine whether the use of VR during dental treatment can improve the overall dental experience and recollections of treatment for patients, breaking the negative cycle of memories of anxiety leading to further anxiety, and avoidance of future dental appointments. Additionally, the aim is to test whether VR benefits dental patients with all levels of dental anxiety or whether it could be especially beneficial for patients suffering from higher levels of dental anxiety. The third aim is to test whether the content of the VR distraction can make a difference for its effectiveness by comparing two types of virtual environments, a natural environment and an urban environment. Methods/design The effectiveness of VR distraction will be examined in patients 18 years or older who are scheduled to undergo dental treatment for fillings and/or extractions, with a maximum length of 30 minutes. Patients will be randomly allocated into one of three groups. The first group will be exposed to a VR of a natural environment. The second group will be exposed to a VR of an urban environment. A third group consists of patients who receive standard care (control group). Primary outcomes relate to patients’ memories of the dental treatment one week after treatment: (a) remembered pain, (b) intrusive thoughts and (c) vividness of memories. Other measures of interest are the dental experience, the treatment experience and the VR experience. Trial registration Current Controlled Trials ISRCTN41442806
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Affiliation(s)
| | | | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
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Wanyonyi K, Radford D, Gallagher J. The relationship between access to and use of dental services following expansion of a primary care service to embrace dental team training. Public Health 2013; 127:1028-33. [DOI: 10.1016/j.puhe.2013.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 04/03/2013] [Accepted: 08/15/2013] [Indexed: 11/30/2022]
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Self-reported causes for referral to dental treatment under general anaesthesia (DGA): a cross-sectional survey. Eur Arch Paediatr Dent 2013; 15:105-12. [DOI: 10.1007/s40368-013-0071-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 07/13/2013] [Indexed: 12/13/2022]
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Abstract
Dental anxiety and fear are common and potentially problematic, both for the patient and for the dental team in managing such patients. Furthermore, dental fear still presents a major barrier to the uptake of dental treatment. This article will take as its premise an assumption that anxiety manifests at different levels and that consequently management of dental anxiety involves both assessment and proportionate intervention. Methods for undertaking both assessment and management are outlined.
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Oliveira MA, Bendo CB, Ferreira MC, Paiva SM, Vale MP, Serra-Negra JM. Association between childhood dental experiences and dental fear among dental, psychology and mathematics undergraduates in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:4676-87. [PMID: 23247225 PMCID: PMC3546783 DOI: 10.3390/ijerph9124676] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 12/11/2012] [Accepted: 12/11/2012] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to evaluate the association between childhood dental experiences and dental fear in adulthood among dentistry, psychology and mathematics undergraduate students. A cross-sectional study of 1,256 students from the city of Belo Horizonte, Brazil, was performed. Students responded to the Brazilian version of the Dental Fear Survey (DFS) and a questionnaire regarding previous dental experiences. Both the DFS and the questionnaire were self-administered. Association was tested using descriptive, bivariate and multivariate linear regression analysis, with a 5% significance level. Dentistry undergraduates reported lower scores than psychology (p < 0.001) and mathematics undergraduates (p < 0.05) for all three dimensions of the DFS. Negative dental experiences in childhood was associated with dimensions of Avoidance (B = 2.70, p < 0.001), Physiological arousal (B = 1.42, p < 0.001) and Fears of specific stimuli/situations (B = 3.44, p < 0.001). The reason for first visit to dentist was associated with dimensions of Physiological arousal (B = 0.76, p < 0.01) and Fears of specific stimuli/situations (B = 1.29, p < 0.01). Dentists should be encouraged to evaluate the dental fear of their patients before treatment. The DFS has been found to be an effective instrument for this purpose.
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Affiliation(s)
- Maurício A. Oliveira
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha Campus, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte-MG, 31270-901, Brazil; E-Mails: (M.A.O.); (C.B.B.); (S.M.P.); (M.P.V.)
| | - Cristiane B. Bendo
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha Campus, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte-MG, 31270-901, Brazil; E-Mails: (M.A.O.); (C.B.B.); (S.M.P.); (M.P.V.)
| | - Meire C. Ferreira
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Diamantina-MG, 39100-000, Brazil; E-Mail:
| | - Saul M. Paiva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha Campus, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte-MG, 31270-901, Brazil; E-Mails: (M.A.O.); (C.B.B.); (S.M.P.); (M.P.V.)
| | - Miriam P. Vale
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha Campus, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte-MG, 31270-901, Brazil; E-Mails: (M.A.O.); (C.B.B.); (S.M.P.); (M.P.V.)
| | - Júnia M. Serra-Negra
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha Campus, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte-MG, 31270-901, Brazil; E-Mails: (M.A.O.); (C.B.B.); (S.M.P.); (M.P.V.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +55-31-3409-2433; Fax: +55-31-3409-2472
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Khademi AA, Saatchi M, Minaiyan M, Rostamizadeh N, Sharafi F. Effect of Preoperative Alprazolam on the Success of Inferior Alveolar Nerve Block for Teeth with Irreversible Pulpitis. J Endod 2012; 38:1337-9. [DOI: 10.1016/j.joen.2012.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 06/02/2012] [Accepted: 06/04/2012] [Indexed: 11/29/2022]
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Wright A, Humphris G, Wanyonyi KL, Freeman R. Using the verona coding definitions of emotional sequences (VR-CoDES) and health provider responses (VR-CoDES-P) in the dental context. PATIENT EDUCATION AND COUNSELING 2012; 89:205-208. [PMID: 22694894 DOI: 10.1016/j.pec.2012.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/09/2012] [Accepted: 05/13/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To show if cues, concerns and provider responses (defined in VR-CoDES and VR-CoDES-P manuals) are present, can be reliably coded and require additional advice for adoption in a dental context. METHODS Thirteen patients in a dental practice setting were videoed with either their dentist or hygienist and dental nurse present in routine treatment sessions. All utterances were coded using the Verona systems: VR-CoDES and the VR-CoDES-P. Rates of cue, concerns and provider responses described and reliability tested. RESULTS The VR-CoDES and VR-CoDES-P were successfully applied in the dental context. The intra-rater ICCs for the detection of cues and concerns and provider response were acceptable and above 0.75. A similar satisfactory result was found for the inter-rater reliability. CONCLUSION The VR-CoDES and the VR-CoDES-P are applicable in the dental setting with minor supporting guidelines and show evidence of reliable coding. PRACTICE IMPLICATIONS The VR-CoDES and the VR-CoDES-P may be helpful tools for analysing patient cues and concerns and the dental professionals' responses in the dental context.
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Affiliation(s)
- Alice Wright
- Medical School, University of St Andrews, North Haugh, St Andrews, Fife, UK
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Assessment of dental fear and anxiety levels in eating disorder patients undergoing minor oral surgery. J Oral Maxillofac Surg 2011; 69:2078-85. [PMID: 21496999 DOI: 10.1016/j.joms.2010.12.050] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2010] [Accepted: 12/28/2010] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the levels of dental fear and anxiety in women with eating disorders (EDs) scheduled for oral surgery. PATIENTS AND METHODS A total of 61 patients with EDs, an identical number of age-, gender-, and education-matched healthy controls, and 2 consecutive, randomly selected, clinical and nonclinical samples each consisting of 220 female subjects were included in the present study. The participants completed the demographic and clinical forms, as well as the modified dental anxiety scale (MDAS) and dental fear survey (DFS) before the surgical procedure. RESULTS The mean scores of the MDAS and DFS for the study population correlated negatively with age and positively with a previous unpleasant experience related to dentistry (P < .01 for both). Patients with EDs had significantly greater mean scores on the MDAS than the clinical and nonclinical groups (P < .05 for both). Their mean scores on the DFS were significantly greater than those for the nonclinical participants (P < .05). A significant difference was found in the DFS subscale "fear of specific situations and stimuli" compared with the healthy matched controls and clinical and nonclinical subjects (P < .05 for all). CONCLUSION The results of our study have shown that patients with EDs can be more sensitive to the auditory, visual, and contact stimuli of the oral surgery procedures under local anesthesia. They also had greater levels of dental fear and anxiety than routine clinical patients and randomly selected subjects from a nonclinical environment.
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Boyle CA, Newton T, Heaton LJ, Afzali S, Milgrom P. What happens after referral for sedation? Br Dent J 2010; 208:E22; discussion 524-5. [PMID: 20512107 DOI: 10.1038/sj.bdj.2010.502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2010] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To follow up 100 referrals to the sedation clinic, examining dental anxiety and background of patients, and to assess how many patients attended for treatment planning, initial treatment and how many completed treatment, and describe the characteristics of each. For those who attended for initial treatment, to investigate which type of sedation they received and the level of clinician they saw. DESIGN Descriptive, cross-sectional survey and review of case notes. SUBJECTS AND METHODS Subjects were 100 consecutive new patients to the Department of Sedation and Special Care Dentistry at Guy's and St Thomas NHS Foundation Trust. The notes were analysed by an experienced member of staff (CAB) and data entered into an Excel spreadsheet and an SPSS data file created. These data were merged with a dataset containing their responses to the initial questionnaire and medical history for analysis. RESULTS Of the 100 patients initially referred, 72 attended the treatment planning session, 66 of the 72 (92%) attended for initial dental treatment, and 33 of 66 (50%) completed treatment. Dental Fear Survey (DFS) scores were related to attendance at the initial treatment visit but not to completion of treatment. Only 33 of 100 referred patients completed treatment. CONCLUSIONS Attendance for treatment planning and initial treatment was high. Attendance is related to fear and mental health. Overall completion of treatment from referral was 33%.
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Affiliation(s)
- C A Boyle
- Department of Sedation and Special Care Dentistry, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Floor 26, Tower Wing, London, SE1 9RT, UK.
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