The Prevalence of Dental Anxiety Associated with Pain among Chinese Adult Patients in Guangzhou

The psychosocial background of dental care avoidance: A qualitative study

INTRODUCTION

Dental care avoidance affects individuals' oral health status. There is limited literature examining the context of dental avoidance behavior.

AIM

The aim of the study is to examine attitudes toward dental care services among adults.

METHODS

Overall, 16 patients participated in semi-structured interviews. The interviews were analyzed using inductive thematic analysis. Through independent reviews of the themes that comprise the patients' experience, a consensus was established among the researchers.

RESULTS

Ten major themes were identified that encapsulate patients' attitudes toward dental care attendance: Effect of environment and equipment, Fear and anesthesia, Procrastination, Dissatisfaction with the dental care system, Expectations of dentists, Quality of dental care, Edentulousness and social status, Financial involvement, Aesthetics, and Dentists' behavior. Compliance with oral health maintenance can be enhanced by specific training for professionals and dentistry students and by fine tuning the dental care system.

CONCLUSIONS

This is the first comprehensive study in Hungary investigating attitudes among dentist patients toward dental care. The results suggest that there are many factors that may affect dental care attendance. Thus, these findings make a potentially fundamental contribution to the improvement of dental care and support practitioners in enriching their understanding of dental avoidance behavior.

Computer-Controlled Local Anaesthesia Delivery efficacy - a literature review

Minimising pain with effective local anaesthesia is an essential step towards improving the level of dentally anxious patients' comfort during dental treatment. It can be provided by many different techniques. One of them is using the Computer-Controlled Local Anaesthesia Delivery systems (CCLADs). This study was conducted to compare the efficacy of computerised anaesthesia with the conventional technique in terms of perceived pain. A database literature search was performed on PubMed, Cochrane Library and Google Scholar, covering up the period between 2015 and 2023. Only the studies comparing computerised anaesthesia technique with the use of conventional carpule were included. An overview of 20 relevant studies (n = 1347 subjects) was provided including pediatric patients, as well as the adults. The evaluated parameters were: pain, child's behaviour, heart rate, blood pressure, level of satisfaction, anxiety, further anaesthesia method preference, need for additional anaesthetic, as well as the duration of anaesthesia, measured by different scales, devices and questionnaires. The present literature review led the authors to the conclusion, that the use of CCLADs is significantly less painful than the traditional anaesthesia and it is a promising technique for helping patients deal with pain perception. However, it is advisable to conduct further research on the use of CCLAD.

Effect of Photobiomodulation on the Depth of Local Anesthesia during Endodontic Treatment of Teeth with Symptomatic Irreversible Pulpitis

AIM

To determine whether photobiomodulation (PBM) therapy could increase the depth of analgesia during endodontic therapy of teeth affected with symptomatic irreversible pulpitis.

MATERIALS AND METHODS

Forty-nine patients with symptomatic irreversible pulpitis were randomized into two groups. In the laser group, before administering anesthesia, the lower molars' crowns were continuously treated with a diode laser (980 nm) for 20 s with a low-level laser tip in the buccal aspect close to the gingival margin. While the teeth of the second group who was blinded to the type of treatment received placebo treatment wherein the laser device was switched off. The visual analogue scale (VAS) was used to assess pain in both groups before the endodontic procedure, during dentin cutting, and at dropping pulp, wherein, the success was defined as no or mild pain. The Chi-square and independent sample t-tests were used to assess the data.

RESULTS

During dentin cutting and pulp dropping, the group receiving the laser therapy presented with less mean pain score than the placebo group which was statistically significant. Additionally, it was observed that the need for supplementary injection was less frequent in the laser-treated group than in the placebo group (p = 0.01).

CONCLUSION

The irradiation by diode laser (980 nm) prior to administration of local anesthesia appears to be useful in minimizing discomfort and additional injection during root canal therapy (RCT).

CLINICAL SIGNIFICANCE

Pain management is essential for providing the best possible treatment to patients before, during, and after endodontic therapy. Adequate pain control during treatment also aids in reducing postoperative discomfort. This implies the need for additional methods to reduce discomfort during endodontic treatment; hence, adjuncts are crucial to achieving this goal. Photobiomodulation may be used as an adjuvant to reduce discomfort and supplementary injections during RCT.

Prevalence of dental anxiety among adults in China: a Meta-analysis

OBJECTIVES

This study aimed to systematically evaluate the prevalence of dental anxiety in Chinese adults and to provide references for decision making on oral healthcare.

METHODS

We searched PubMed, Web of Science, Ebsco, Embase, The Cochrane Library, WanFang Data, CNKI, and VIP database to collect cross-sectional studies on dental anxiety in Chinese adults from the establishment of the databases to 30 September 2022. After literature screening, data extraction, and evaluation of the risk of bias in the included studies by two researchers independently, R 4.0.4 software was used to perform a Meta-analysis.

RESULTS

A total of 39 studies were included, including 24 309 subjects. Meta-analysis showed that the prevalence of dental anxiety in Chinese adults was 35.39% [95%CI (31.31%, 40.01%)]. Subgroup analysis showed that the prevalence rates of male and female adults were 32.92% and 44.78%, respectively. The prevalence rates of adults aged 16-39,40-59, ≥60 were 49.37%, 47.13%, and 37.41%, respectively. The prevalence rates of mild, moderate, and severe patients were 13.81%, 15.15%, and 9.24%, respectively. The prevalence rates of adults with elementary school and below, middle school, and university and above education levels were 33.81%, 35.84%, and 36.24%, respectively. The prevalence rates were 39.45% and 45.90% in adults with and without dental-treatment history, respectively. The prevalence rates of adults surveyed in dental and non-dental clinics were 27.10% and 39.31%, respectively.

CONCLUSIONS

The prevalence of dental anxiety in Chinese adults was relatively high, primarily moderate anxiety, and it was more likely to occur in women, young people, and groups with no history of dental treatment. Early intervention should be performed for adults with dental anxiety to improve their awareness of oral healthcare and treatment compliance and thus to promote the oral-health level of adults in China.

Dentophobia-latent Component Factor Analysis of Dental Concerns Assessment Scale

BACKGROUND: Dentophobia (DF) is unreasonable, irrational, excessive, and socially limiting fear of specific situations related to dental care. The condition is part of the ultimate and pathological cluster of dental anxiety. AIM: Objectives of the present study are: (1) Identification of latent factors in the psychological manifestation of dental fear, anxiety, and phobia and (2) comparison of these factors with the degree of manifestation of the psychological construct and gender differences. METHODS: A cross-sectional online-based survey was conducted. The primary sociological information is collected through a direct individual survey including 32 items divided into four sections. Statistical data processing includes descriptive statistics, non-parametric hypothesis tests, exploratory and confirmatory factor analysis for detection and verification of latent factors, internal validity analysis. DISCUSSION: The presence of a latent factor conditionally describing “pain related fear” is a possible reason for the overlap of DF with other panic disorders related to medical care described in the literature. A study performed for a wider and diverse population sample would produce more credible findings from which to draw more accurate conclusions. CONCLUSION: This study provides a better understanding of how to identify patients who are prone to, or already suffer from dental anxiety and allows dentists and health-care professionals to provide better health. The analysis of this study discovered a significant difference between latent factors from the construct encompassing the pain related fear and social fear.

Dental fear and anxiety in Asian youths: response components and inducing stimuli

OBJECTIVES

This study estimated the prevalence of dental fear/anxiety (DFA) and phobia in Asian youths and investigated the fear/anxiety response components and triggers for those with DFA.

MATERIALS AND METHODS

A convenience sample of youths, aged 17 to 24 years old, was recruited from a local polytechnic. The Index of Dental Anxiety and Fear-4C + (IDAF-4C +) was employed to assess the occurrence of DFA (IDAF-4C) and phobia (IDAF-P) as well as to ascertain fear/anxiety-inducing stimuli (IDAF-S). Psychological distress was determined with the Patient Health Questionnaire-4 (PHQ-4). Sociodemographic, IDAF-4C + , dental attendance patterns, and PHQ-4 data were gathered electronically. Statistical analyses were conducted with chi-square, Kruskal-Wallis, and relevant post hoc tests (α = 0.05).

RESULTS

A total of 215 participants were enrolled (mean age of 18.9 ± 2.0 years; 87.4% women). Of these, 12.6/6.0% had moderate-to-high (MH)/high-to-extreme (HE) DFA and 0.9% experienced dental phobia. Significant differences in scores were observed between the HE/MH and no-to-moderate (NM) groups for all IDAF-4C components. Apart from the cost of dental treatment, IDAF-4S scores varied significantly among the three DFA groups. The two most highly rated DFA stimuli were painful/uncomfortable procedures and needles/injections for the HE group, while they were needles/injections and the cost of dental treatment for the MH and NM groups.

CONCLUSIONS

Moderate-to-extreme DFA existed in 18.6% of the Asian youths examined. The emotional and physiological components of the IDAF-4C appear to contribute more to the DFA response. Dental pain including needles/injections and the cost of dental treatment troubled Asian youths the most.

CLINICAL RELEVANCE

DFA is a common problem among Asian youths, and understanding its extent, nature, and triggers is central for effective interventions.

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model

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.

Comparison of Dental Anxiety While Visiting Dental Clinics before and after Getting Vaccinated in Midst of COVID-19 Pandemic

Vaccination is critical to control the rate of coronavirus transmission and infectivity. Dental practices are a high-risk area for contracting coronavirus; this fact generates psychological disturbances amongst patients. In this study, we aimed to assess the levels of anxiety of patients while visiting dental practices before and after getting vaccinated. This cross-sectional study was carried out between March and December 2021. An electronic survey was distributed among the vaccinated individuals who visited dental clinics before and after getting vaccinated. The survey consisted of the following four parts: demographic characteristics, questions related to coronavirus, and anxiety scores before and after getting vaccinated. SPSS-25 was used to perform the statistical analysis, where paired t-test was used to compare the anxiety scores, and Mann–Whitney U test to assess the association of gender with anxiety scores. A p-value of ≤0.05 was considered to be statistically significant. A total of 400 vaccinated individuals participated in this study, with a response rate of 88.23%. The majority of the respondents (71.0%) did not test positive for coronavirus. More than half of the participants (54.0%) reported to not be suffering from any coronavirus-related symptoms. About 100 (25.0%) of the individuals stated that dental clinics are an environment in which there is a high risk of contracting coronavirus. In regards to the comparison of the mean MDAS scores of the participants before and after getting vaccinated, a significant difference (p = 0.001) was found. Vaccination has been recommended for all eligible individuals to control the transmission and infectivity of coronavirus. Vaccinations have decreased the dental anxiety of patients while visiting dental clinics. However, the protective measures are still valid and should be followed, regardless of the vaccination status.