Non-institutionalized elderly dental patients in Israel: socio-demographics, health concerns, and dental anxiety

Dental anxiety in adults in Bulgaria

The anxiety experienced by some patients before or during dental visits poses a problem for patients and the dental practitioners alike. Some people consider them a stressful experience which manifests itself as anxiety, fear and even phobia and results in avoidance of proper dental care. The dental anxiety, dental fear and dental phobia stand out against the background of general anxiety. The aim of the present study was to investigate dental anxiety in Bulgaria by means of a self-assessment scale.

MATERIAL AND METHODS

The self-assessment Dental Anxiety Scale (DAS), developed by N Corah, was used in the form of a questionnaire containing questions about the gender, age, education and occupation of respondents. Subjects were 746 adults aged 18-82 years living in urban areas. Individual and group interviews were conducted directly with them.

RESULTS

The respondents with moderate dental anxiety were the most of all subjects (35.5%, DAS score: 9-12 points), followed by the anxiety-free subjects (34.6%, 4-8 points). The third most numerous group was the high anxiety group (18.2%, 13-14 points), followed by the subjects with severe anxiety (11.7%, 15-20 points). The mean score was 10.26 +/- 0.14. We found a statistically significant correlation between anxiety, age (P < 0.05), education (P < 0.05) and type of labour (manual or mental labour) (P < 0.01). No significant difference was found between anxiety and sex (P > 0.05).

CONCLUSIONS

The percentage of people scoring high on dental anxiety (DAS 13-20) in Bulgaria (29.9%) is considerably higher than that in some European and North American countries. The present study is the first in Bulgaria on dental anxiety. Further studies are needed to reveal other factors related to dental anxiety.

Dental caries risk indicators among Australian Aboriginal young adults

OBJECTIVES

To determine dental caries risk indicators among a birth cohort of Australian Aboriginal young adults (n=442).

METHODS

Data were from the Aboriginal Birth Cohort study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Models representing demographic, socioeconomic, behavioural, dental service utilization and clinical oral health variables were tested using multivariate regression.

RESULTS

The percent DT>0 was 72.9 (95% CI 68.7-77.1), mean DT was 4.19 (95% CI 3.8-4.6), percent DMFT>0 was 77.4 (95% CI 73.5-81.3) and mean DMFT was 4.84 (95% CI 4.4-5.3). After controlling for other covariates, risk indicators for percent DT>0 included soft drink consumption every day or a few times a week (PR 1.25, 95% CI 1.08-1.45), not consuming milk every day or a few times a week (PR 1.16, 95% CI 1.04-1.30) and sweet consumption every day or a few times a week (PR 1.18, 95% CI 1.04-1.33). Risk indicators for mean DT included sweet consumption every day or a few times a week (B=1.14, 95% CI 0.27-2.02), nonownership of a toothbrush (B=0.91, 95% CI 0.10-1.87) and presence of plaque (B=2.46, 95% CI 0.96-3.96). Those with 4 +  occupants in their house the previous night had 1.2 times the prevalence of having DMFT>0 than their counterparts with less household occupants (95% CI 1.01-1.49). Percent DMFT>0 was also associated with consumption of soft drink every day or a few times a week (PR 1.18, 95% CI 1.04-1.34) and consumption of sweets every day or a few times a week (PR 1.23, 95% CI 1.10-1.37). Mean DMFT was higher among those who consumed sweets every day or a few times a week (B = 0.13, 95% CI 0.05-0.22) and who had dental anxiety (B=0.10, 95% CI 0.01-0.19).

CONCLUSIONS

In an Australian Aboriginal young adult cohort, risk indicators for dental caries included social determinants such as household size, dietary behaviours such as regular consumption of soft drink and sweets, dental behaviour such as nonownership of a toothbrush and dental anxiety.

Factors affecting dental anxiety and beliefs in an Indian population

The purpose of this study was to describe the possible factors that may affect dental anxiety and beliefs and to validate and test the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and a Modified Dental Beliefs Scale (MDBS) among the patients attending a university dental clinic in India. A cross-sectional study design was used. A total of 482 general dental patients attending a university dental clinic returned completed forms of the Indian translations of the MDAS and MDBS. General information about the age, sex, occupation and educational qualifications of the respondents as well as information about past dental experiences was also collected. All the statistical analysis was carried out by the spss (version 10) statistical software package. The Indian translations of the MDAS and the MDBS were found to be internally reliable with a Cronbach's alpha of 0.78 and 0.85, respectively. Validity was demonstrated by a statistically significant correlation between the MDAS and the MDBS scores with the correlation coefficient of 0.47. Age was also inversely related to dental anxiety. Anxiety scores were higher among the less educated patients. Those who had a prior unpleasant dental experience showed higher dental anxiety and more negative dental beliefs. The data obtained in this study provided strong evidence for the psychometric properties of the Indian version of the MDAS and the MDBS.

A behavioural approach in the treatment of elderly patients: a new philosophy

Complete denture prosthodontists are very well aware of the influence of psychological factors in the success of their treatment. Recently, a number of authors tried to ascertain some psychosocial criteria in the predictability of patients' satisfaction. Although special attention was paid to concerns of socio-demographic and educational status, it was demonstrated that there is little relationship between quality of dentures and patients' satisfaction, nor a relationship between satisfaction and anatomical conditions. The purpose of this paper is to give a better understanding of the behavioural problems of this treatment and offer some solutions. Educational programmes should be influenced by behavioural problems in the management of the elderly patient.

Immediate or transitional complete dentures: gerodontic considerations

Ageing society is a worldwide phenomenon, especially in western countries, were the proportion of the aged population reaches about 20%. Of this group about 50% constitute what is termed the old-old frail persons who suffer drastic physiological changes which exacerbate difficulties in classic dental and prosthetic treatments. Epidemiological surveys point out that many of the elderly present with about 12-14 teeth with bad periodontal conditions that should be extracted. As a result, special strategies have to be elaborated to give an appropriate solution to specific medical and prosthetic conditions. Transitional procedures are necessary to assure the smooth change between removable partial dentures and complete dentures. Even when implant supported dentures are planed this transition period is necessary. Clinical decision making is crucial to avoid stress to these medically compromised patients.