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Yamada T, Kuwano S, Ebisu S, Hayashi M. Effect of age-related extended high frequency hearing loss on the subjective impressions of dental drill noise. Sci Rep 2024; 14:15655. [PMID: 38977724 PMCID: PMC11231262 DOI: 10.1038/s41598-024-65429-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/20/2024] [Indexed: 07/10/2024] Open
Abstract
Fear and anxiety among patients are sometimes evoked in dental clinics due to the sound of dental drills. This study aimed to explore the impact of age-related hearing loss in the extended high frequency (EHF) range above 8 kHz on individuals' subjective discomfort towards dental drill noise. After measuring pure-tone audiometric thresholds at both conventional and extended high frequencies, we used a psychoacoustic approach to evaluate subjective impressions of four dental drill sound stimuli, which featured varying frequency components, in 62 participants (aged 12-67 years). We found a significant decrease in hearing sensitivity within the EHF range as age increased, with notable differences in hearing thresholds at 14 kHz between teenage and older adults exceeding 65 dB. Furthermore, significant differences were observed between younger and older (above 40 years) participants in the subjective impressions of dental drill noise, emphasizing age as a critical factor in the perception of high frequency components. Consequently, age may influence the unpleasantness of dental drilling noise. Compared to older individuals, young participants may exhibit increased fear of dental procedures owing to physiological factors. These results underscore the need for age-appropriate noise control strategies in dental clinics to mitigate anxiety and improve patient comfort.
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Affiliation(s)
- Tomomi Yamada
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, 565-0871, Japan.
| | | | - Shigeyuki Ebisu
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, 565-0871, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, 565-0871, Japan
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2
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Cobo Vázquez CM, Gasco MC. Dental treatments under sedation-analgesia in patients who are unable to collaborate: a prospective observational study. J Dent Anesth Pain Med 2024; 24:173-185. [PMID: 38840648 PMCID: PMC11148414 DOI: 10.17245/jdapm.2024.24.3.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/21/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Excessive fear of dental procedures leads to disruptive behavior during dental examinations and treatments. Dental examinations and treatments of these patients usually require additional techniques, such as sedation. The most commonly used techniques are inhalation of nitrous oxide, infusion of propofol with fentanyl, and premedication and infusion of midazolam. Methods A prospective observational epidemiological study was conducted on patients who required sedoanalgesia techniques for dental exploration and procedures. The reasons for the inability of patients to cooperate (excessive fear or intellectual disability), age, sex, weight, systemic pathology, oral pathology, treatment performed, time of intervention, anesthetic technique performed, and occurrence of complications were recorded. Results In total, 218 patients were studied. Sixty-five patients came for fear of dental treatment and 153 for presenting with a diagnosis of intellectual disability and not collaborating in the treatment with local anesthesia. The average age of all patients was 30.54 ± 17.30 years. The most frequent oral pathologies found in patients with excessive fear were tartar (6.8%) and wisdom teeth (6.4%), followed by missing teeth (5%). In patients with disabilities, a combination of tartar and cavities appeared most frequently (41.3%), followed by cavities (15.6%). The most frequently used sedoanalgesia technique was the infusion of propofol with fentanyl in both groups of patients, followed by nitrous oxide. Conclusion The combination of propofol and fentanyl was the most frequently used alternative in patients who were unable to collaborate because of intellectual disability or carry out longer or more complex treatments. Inhaled nitrous oxide and midazolam were the sedative techniques of choice for simpler oral treatments, such as tartrectomies, shallow obturations, and shorter interventions, or in younger patients.
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Affiliation(s)
- Carlos M. Cobo Vázquez
- Department of Clinical Specialities, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
- Department of Dentistry and Stomatology, Gregorio Marañón University General Hospital, Madrid, Spain
| | - Mⷶ Carmen Gasco
- Department of Pharmacology, Complutense University of Madrid, Madrid, Spain
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3
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Chua JMC, Hong CHL, Sim YF, Choe RW, Dhillon IK, Hu S. Temperament and past behaviour can predict behaviour success for nitrous oxide sedation. Int J Paediatr Dent 2024. [PMID: 38730269 DOI: 10.1111/ipd.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND There is currently insufficient evidence on potential predictors of a child's behaviour with nitrous oxide (N2O) sedation. AIM To examine the association between a child's temperament and behavioural outcomes during dental treatment with N2O sedation, and the child's perception to N2O sedation. DESIGN At the first visit (dental treatment visit), temperament was assessed using the Child Behaviour Questionnaire-Short Form and behaviour was assessed by an independent rater using the Venham Behaviour Rating Scale. At the second visit, the child's experience with N2O sedation was elicited. RESULTS Seventy-two healthy children aged between 36 and 95 months were recruited. Planned dental treatment was completed in 84.7% of the subjects. Venham behaviour success <3 and Venham behaviour success <1 were achieved in 73.6% and 33.3%, respectively. The temperament domain of effortful control was associated with Venham behaviour score (ρ = -0.266, p = .024) and Venham behaviour success <1 (OR = 3.506, 95% CI = 1.328-9.259, p = .011). Baseline Frankl behaviour score was significantly associated with all behavioural outcomes. Venham behaviour success <3 was significantly associated with a child reporting to have enjoyed the dental treatment visit (p = .026). CONCLUSION Effortful control and baseline behaviour were associated with behavioural outcomes of N2O sedation and can be used to predict a child's behaviour.
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Affiliation(s)
| | | | - Yu Fan Sim
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Ruth Wei Choe
- National University Centre for Oral Health, National University Health System, Singapore, Singapore
| | | | - Shijia Hu
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Sun IG, Chu CH, Lo ECM, Duangthip D. Global prevalence of early childhood dental fear and anxiety: A systematic review and meta-analysis. J Dent 2024; 142:104841. [PMID: 38246307 DOI: 10.1016/j.jdent.2024.104841] [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: 11/16/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE The objective of this review is to determine the global prevalence of dental fear and anxiety (DFA) in early childhood and identify its related factors. METHODS The systematic review utilized three common English-language databases (PubMed, EMBASE, and Web of Science). Two independent researchers performed a systematic search to include observational studies on young children published from 2000 to 2023. They extracted information on prevalence of DFA, assessment tools used, study sites, respondents, and children's dental visit experiences. RESULTS A total of 2,895 studies were identified, and 25 studies met the inclusion criteria for analysis. The pooled prevalence of DFA among 2- to 6- year-old children was estimated to be 30 % (95 % CI=25, 36). Children without dental visit experience (OR=1.37, 95 % CI=1.18, 1.59) and children with caries experiences (OR=1.18, 95 % CI=1.09, 1.27) had higher odds of experiencing DFA compared to those with dental visit experience or caries-free status. The most commonly used assessment tools in the included studies were the Frankl Behaviour Rating Scale (32 %, 8/25), Children's Fear Survey Schedule-Dental Subscale (20 %, 5/25), and Dental Anxiety Question (20 %, 5/25). CONCLUSIONS This systematic review reveals that approximately one-third of young children globally experience DFA. Children who lack dental visit experience or have caries experiences are at increased risk of DFA. Clinicians can use this information to make informed decisions regarding dental care provision for young children. CLINICAL SIGNIFICANCE This study provides comprehensive information on the global prevalence of dental fear and anxiety and its associated factors in early childhood. The findings can assist clinicians in understanding and addressing DFA in their dental care approach for young children. REGISTRATION PROSPERO (CRD42023446464).
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Affiliation(s)
- Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; College of Dentistry, The Ohio State University, Columbus, OH, USA.
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5
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Ghaffar RSA, Sheikh M, Kidwai M, Sanaullah A, Salman M, Ilyas A, Ahmed N, Lal A. Impact of high-speed handpiece noise-induced dental anxiety on heart rate: analyzing experienced and non-experienced patients - a comparative study. BMC Oral Health 2024; 24:265. [PMID: 38389070 PMCID: PMC10885409 DOI: 10.1186/s12903-024-04017-y] [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: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Dental anxiety is very much common among the patients and could be due to different factors like the behavior of the dentist, past experiences, Needle phobia, or word of mouth from other patients. According to recent studies, a strong association between sound and anxiety has been found, so this observational study has been conducted to find out the link between the activation of anxiety with the sound of a handpiece between experienced patients, who have already gone through the dental treatments and non-experienced patients. METHODS Total of 297 participants were part of this study. These participants were divided into 2 groups according to the experienced and non-experienced dental patients. The researcher first filled out the CORAH Dental Anxiety Scale (DAS) form to mark the anxiety level of the patients, and then noted the readings of the heart rate in 3 intervals which were before during, and after the treatment with the pulse oximeter. Later the data was analysed using the SPSS independent t-test. RESULTS Results show that patients in group 1 who have gone through the dental treatment before were less anxious and had a lesser effect on their heart rate than the patient who were having the treatment for the first time who were in group 2. Another interesting factor was noticed that in both the groups female were found to be more anxious than male participants. Participants with younger age were found to be more anxious than older age patient in both groups CONCLUSIONS: The sound of the handpiece can provoke anxiety in the patient, affecting the heart and increasing the heart rate. Participants who were experienced were found to be less anxious than the participants who were inexperienced.
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Affiliation(s)
| | - Mahnoor Sheikh
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Muneeza Kidwai
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Anas Sanaullah
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | | | - Anum Ilyas
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Abhishek Lal
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
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Margraf-Stiksrud J, Pieper K. Assessment of Dental Anxiety in Children: Reliability and Validity of the Questionnaire to Assess Dental Anxiety in Children (QADA-C). Dent J (Basel) 2024; 12:23. [PMID: 38392227 PMCID: PMC10887742 DOI: 10.3390/dj12020023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
This study presents a measure to assess dental anxiety in children. To gain a better understanding of children's fear and anxiety in the dental setting, instruments to gather data with high quality are necessary and missing, especially in the German language. Based upon the facet approach, the Questionnaire to Assess Dental Anxiety in Children (QADA-C) includes items concerning anxiety reactions in thinking, behavior, and feelings in the form of short statements. The item formulation was adapted for children of the target age (9-11 years), and items were presented with pictures of dental situations. Item and reliability analyses in a sample of 1019 children showed the good quality of the instrument (Cronbach's alpha = 0.89), and the validity indicators revealed its ability to differentiate high-anxiety, low-anxiety, and non-anxious children with an overall sum score. This score was proven to correlate with oral health criteria (decayed/missing/filled teeth, oral health behavior, oral health knowledge). Its easy administration and appropriateness for children make the questionnaire applicable in the dental office for clinical purposes as well as in research contexts.
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Affiliation(s)
| | - Klaus Pieper
- Center for Dentistry, Oral and Maxillofacial Medicine, Philipps-University, 35039 Marburg, Germany
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Jervøe-Storm PM, Peters LP, Bekes K, Fricke M, Jepsen S. Evaluation of Children's Anxiety Level in Relation to a Dental Visit/Treatment and Their Parents' Dental Fear. J Clin Med 2023; 12:6691. [PMID: 37892828 PMCID: PMC10607096 DOI: 10.3390/jcm12206691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/15/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
The patients' fear of the dentist plays an important role in the everyday life of a dentist. The anxiety level of children in relation to dental treatment/visits and to their parents' dental fear was evaluated in three different centers. Assessments of a modified CFSS-DS (mCFSS-DS) were performed by questionnaire with 60 children and their parents. Children's dmft/DMFT scores, age and gender were evaluated in relation to the parents' perception of their child's anxiety levels. For statistical evaluation, Kruskal-Wallis and Wilcoxon tests as well as Spearman's correlation coefficient (Spearman) were used. The significance level was set at 0.05. There were no significant differences regarding children's mCFSS-DS between the three centers (p = 0.398, Kruskal-Wallis). The parents' mCFSS-DS scores correlated significantly with their children's mCFSS-DS scores (p = 0.004, Spearman). However, the mean mCFSS-DS score of the children was significantly higher than the mean score of parents' perception of their child's anxiety (p = 0.000, Wilcoxon). The age of the child had an influence on the mCFSS-DS score (p = 0.02, Kruskal-Wallis) but neither the children's gender (p = 0.170, Kruskal-Wallis), nor the dmft/DMFT showed an impact (p < 0.725, Spearman). Although a positive correlation was found between the results of the children's and parents' questionnaire, many parents underestimated the anxiety level of their children.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
| | | | - Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria;
| | - Miriam Fricke
- Independent Researcher, Glogauer Straße 28, 53117 Bonn, Germany;
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
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Chen SC, Chen CY, Shen SJ, Tsai YF, Ko YC, Chuang LC, Lin JR, Tsai HI. Application of Bispectral Index System (BIS) Monitor to Ambulatory Pediatric Dental Patients under Intravenous Deep Sedation. Diagnostics (Basel) 2023; 13:diagnostics13101789. [PMID: 37238272 DOI: 10.3390/diagnostics13101789] [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: 04/17/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Purpose Intravenous sedation has been well accepted to allow dental restoration in uncooperative children while avoiding aspiration and laryngospasm; however, intravenous anesthetics such as propofol may lead to undesired effects such as respiratory depression and delayed recovery. The use of the bispectral index system (BIS), a monitoring system reflective of the hypnotic state, is con-troversial in the reduction in the risk of respiratory adverse events (RAEs), recovery time, the in-travenous drug dosage, and post-procedural events. The aim of the study is to evaluate whether BIS is advantageous in pediatric dental procedures. Methods A total of 206 cases, aged 2-8 years, receiving dental procedures under deep sedation with propofol using target-controlled infusion (TCI) technique were enrolled in the study. BIS level was not monitored in 93 children whereas it was for 113 children, among which BIS values were maintained between 50-65. Physiological variables and adverse events were recorded. Statistical analysis was conducted using Chi-square, Mann Whitney U, Independent Samples t and Wilcoxon signed tests, with a p value of <0.05 considered to be statistically significant. Results Although no statistical significance in the post-discharge events and total amount of propofol used was observed, a clear significance was identified in periprocedural adverse events (hypoxia, apnea, and recurrent cough, all p value < 0.05) and discharge time (63.4 ± 23.2 vs. 74.5 ± 24.0 min, p value < 0.001) between these two groups. Conclusions The application of BIS in combination with TCI may be beneficial for young children undergoing deep sedation for dental procedures.
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Affiliation(s)
- Shih-Chia Chen
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
| | - Chun-Yu Chen
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan 333, Taiwan
| | - Shih-Jyun Shen
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Yung-Fong Tsai
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan 333, Taiwan
| | - Yu-Chen Ko
- Department of Anesthesiology, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi 613, Taiwan
| | - Li-Chuan Chuang
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei 112, Taiwan
- Graduate Institute of Craniofacial and Dental Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Jr-Rung Lin
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Clinical Informatics and Medical Statistics Research Center (CIMS) and Graduate Institute of Clinical Medical Sciences, Department of Biomedical Sciences, Gung Gung University, Taoyuan 333, Taiwan
| | - Hsin-I Tsai
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan 333, Taiwan
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Huff C. A Promising Tool For Overcoming Dental Anxiety. Health Aff (Millwood) 2023; 42:454-458. [PMID: 37011309 DOI: 10.1377/hlthaff.2022.01626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Researchers in Philadelphia, Pennsylvania, are testing a cognitive behavioral intervention with the aim of removing a common obstacle to dental care.
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Affiliation(s)
- Charlotte Huff
- This article is part of a series on transforming health systems published with support from The Robert Wood Johnson Foundation. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work, for commercial use, provided the original work is properly cited. See https://creativecommons.org/licenses/by/4.0/. Charlotte Huff is a medical and health policy journalist based in Fort Worth, Texas, who has written for Kaiser Health News, Nature, STAT, and Texas Monthly, among other publications. To access the author's disclosures, click on the Details tab of the article online
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Hadler-Olsen S, Steinnes J, Nermo H, Sjögren A, Hadler-Olsen E. Pain, discomfort, and functional impairment after extraction of primary teeth in children with palatally displaced canines - a randomized control trial comparing extraction of the primary canine versus extraction of the primary canine and the primary first molar. Acta Odontol Scand 2023; 81:158-163. [PMID: 35943761 DOI: 10.1080/00016357.2022.2108493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
CONCLUSION Primary canines and first molars can be extracted in a way that is associated with relatively low levels of pain and discomfort during and after the procedures. Double extractions induced more pain and discomfort than single extractions, which should be accounted for in the treatment planning. MATERIAL AND METHODS Twenty-eight children, aged 9.5-14 years with displaced permanent maxillary canines were randomly assigned for extraction of the primary canine only or the primary canine and the primary first molar. Pain and discomfort were rated on visual analogue scales, and influence on daily activities was assessed by a questionnaire that has been previously tested for reliability and validity. Differences between groups were assessed by independent samples t-tests, Mann-Whitney U-tests or the Fisher's exact test. OBJECTIVE To assess pain, discomfort, and functional impairment in children experiencing extraction of primary canine or primary canine and primary first molar as an interceptive treatment for palatally displaced permanent canines. RESULTS Tooth extraction was associated with low levels of pain and discomfort on a group level. Extraction of both the canine and the first molar was associated with significantly more pain and discomfort than was the extraction of the canine only. Extractions were associated with chewing problems among one-third to half of the children, otherwise, few children reported any jaw impairment after extraction.
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Affiliation(s)
- Sigurd Hadler-Olsen
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway
| | - Jeanett Steinnes
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway
| | - Hege Nermo
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway
| | - Anders Sjögren
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Elin Hadler-Olsen
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway.,Department of Medical Biology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø Norway
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11
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Aardal V, Evensen KB, Willumsen T, Hervik Bull V. The complexity of dental anxiety and its association with oral health-related quality of life: An exploratory study. Eur J Oral Sci 2023; 131:e12907. [PMID: 36418106 PMCID: PMC10099540 DOI: 10.1111/eos.12907] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022]
Abstract
This study aimed to explore the factors associated with oral health-related quality of life (OHRQoL) in a sample with high dental anxiety. Data were obtained from 107 patients attending a therapeutic treatment program for people who have experienced abuse and for those with dental phobia in Norway. Patients completed questionnaires, including the Index of Dental Anxiety and Fear, the Anxiety subscale of the Hospital Anxiety and Depression Scale, and the Oral Impacts on Daily Performance scale, measuring OHRQoL prior to treatment. The various measurement instruments were evaluated psychometrically, and the variables associated with OHRQoL were explored using hierarchical multiple regression. Symptoms of dental anxiety and general anxiety were high, while OHRQoL was poor. Dental anxiety, higher age, higher number of years since the last dental treatment, and higher general anxiety were discernibly associated with lower OHRQoL. The strongest association was found between general anxiety and OHRQoL. In conclusion, several factors were associated with OHRQoL in a sample with high dental anxiety, suggesting a complex picture of dental anxiety. When treating patients with high dental anxiety, dental practitioners should be aware that there may be factors complicating the therapeutic setting, such as general anxiety.
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Affiliation(s)
- Vilde Aardal
- Oral Health Centre of Expertise in Rogaland, Stavanger, Norway.,Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | | | - Tiril Willumsen
- Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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12
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Management of fear and anxiety in dental treatments: a systematic review and meta-analysis of randomized controlled trials. Odontology 2023; 111:20-32. [PMID: 35536282 DOI: 10.1007/s10266-022-00711-x] [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: 12/21/2021] [Accepted: 04/15/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This systematic review was to compare the effects of interventions for the management of fear and anxiety for dental treatments. METHODS This research project was applied to PubMed, CENTRAL, Web of Science, Cochrane library databases. The last search was run on March 31st, 2021. A list of references of relevant articles and previous reviews were checked. Qualitative and quantitative analyses were performed. RESULTS A total of 20 eligible randomized controlled trials were included, and 969 participations in experimental group and 892 participations in the control group were involved. Anxiety levels decreased more in intervention groups than in control groups (Z = 3.47, P = 0.0005, SMD = - 0.62, 95% CI - 0.98 to - 0.27). For adults, there was statistical difference between experimental and control groups [Z = 2.14, P = 0.03, 95% CI - 0.54 (- 1.03, - 0.04)], while there was not no such statistical difference in children and adolescents [Z = 1.62, P = 0.11, 95% CI - 0.60 (- 1.32, 0.13)]. Patients experienced a significant decrease in anxiety level using sedation drugs [Z = 2.44, P = 0.01, 95% CI - 0.61 (- 1.10, - 0.12)] and audio-visual distractions [Z = 3.1, P = 0.002, 95% CI - 0.86 (- 1.40, - 0.32)]. For the informative intervention groups, patients did not show significant difference than control groups [Z = 1.22, P = 0.22, 95% CI - 0.55 (- 1.43, 0. 33)]. There was no statistical difference in vital signs [Z = 1.39, P = 0.16, 95% CI - 0.25 (- 0.61, 0.10)] and pain levels [Z = 0.69, P = 0.49; SMD = - 0.06, 95% CI (0.27, 0.11)] between intervention and control groups. CONCLUSIONS Interventions should be used in managing anxiety and fear for dental treatment. It might be effective for anxiety alleviating for adults, but there was a low certainty of evidence that interventions could reduce anxiety level in children and adolescents. Sedation drugs and audio-visual distractions might be useful for managing dental fear and anxiety. Pain levels and vital signs could not be improved form our study. High-quality randomized clinical trials are required for further study.
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Modabber M, Campbell KM, McMurtry CM, Taddio A, Dempster LJ. Children's Perceptions of Dental Experiences and Ways to Improve Them. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111657. [PMID: 36360385 PMCID: PMC9688229 DOI: 10.3390/children9111657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/17/2022] [Accepted: 10/28/2022] [Indexed: 01/25/2023]
Abstract
This qualitative study explored children's perceptions of their dental experiences and their acceptability of the CARD™ (Comfort, Ask, Relax, Distract) system, adapted for the dental setting as a means to mitigate dental fear and anxiety (DFA). A purposive sample of 12 participants (7 males) aged 8-12 years receiving dental care at the Paediatric Dental Clinic, University of Toronto, was recruited. Virtual one-on-one interviews were augmented with visual aids. Participants were oriented to and asked about their perceptions of various dental procedures. Data were deductively analyzed, according to the Person-Centered Care framework (PCC). Four themes were identified: establishing a therapeutic relationship, shared power and responsibility, getting to know the person and empowering the person. Children emphasized the importance of clinic staff attributes and communication skills. They expressed a desire to engage more actively in their own care and highlighted the positive influence of pre-operative education and preparation. Participants found the CARD™ system to facilitate opportunities for self-advocacy in their dental care.
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Affiliation(s)
- Melika Modabber
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1X3, Canada
| | - Karen M. Campbell
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1X3, Canada
| | - C. Meghan McMurtry
- Department of Psychology, The University of Guelph, Guelph, ON N1G 2W1, Canada
- McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
- The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Correspondence:
| | - Laura J. Dempster
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1X3, Canada
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Çarıkçıoğlu B. Impact of parental dental anxiety on the oral health-related quality of life of preschool children without negative dental experience. Arch Pediatr 2022; 29:566-572. [DOI: 10.1016/j.arcped.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 04/19/2022] [Accepted: 06/18/2022] [Indexed: 11/06/2022]
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Como DH, Floríndez-Cox LI, Stein Duker LI, Polido JC, Jones BP, Lawlor M, Cermak SA. Oral Care Knowledge, Attitudes, and Practices of Black/African American Caregivers of Autistic Children and Non-Autistic Children. CHILDREN 2022; 9:children9091417. [PMID: 36138725 PMCID: PMC9498287 DOI: 10.3390/children9091417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
Oral health is a vital component of overall health. Children from underserved, minoritized populations (i.e., Black/African Americans, autistic children) are at even greater risk for experiencing oral health disparities. This study aims to illuminate the oral health knowledge, attitudes, and practices of Black/African American caregivers of autistic and non-autistic children. Black/African American caregivers of children (4-to-14 years) on the autism spectrum (n = 65) or not on the autism spectrum (n = 60), participated in a survey, with input from literature reviews, interviews, previous research, and reviews by experts. Caregivers demonstrated basic knowledge of oral health with significantly lower scores for caregivers of autistic children. Caregivers care about oral health and would like to increase their knowledge. Significant differences in oral care practices were found between the autistic and non-autistic groups. Caregivers reported they can access dental services with relative ease, including finding their child a dentist, scheduling a dental appointment, and accessing transportation (personal or public) to attend the visit. Black/African American caregivers of autistic children and children without autism seem to have foundational knowledge about oral health and basic practices; however, they are interested in learning more. Therefore, tailored oral health education programs may help mitigate oral health disparities for Black/African American families.
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Affiliation(s)
- Dominique H. Como
- 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
- Correspondence:
| | - Lucía I. Floríndez-Cox
- Nursing Research and Performance Improvement Department, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - 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
| | - Jose C. Polido
- USC Herman Ostrow School of Dentistry, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
- Division of Dentistry, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Brandi P. Jones
- USC Race & Equity Center, University of Southern California, Los Angeles, CA 90089, USA
- Rossier School of Education, University of Southern California, Los Angeles, CA 90089, USA
| | - Mary Lawlor
- 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
| | - Sharon A. Cermak
- 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
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Yap AU, Kwan YY, Kok L, Lee XF, Lee DZR. Dental Environment and Practitioner Preferences of Southeast Asian Youths with Dental Fear/Anxiety. Int J Dent Hyg 2022; 20:671-677. [DOI: 10.1111/idh.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/03/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital
- Faculty of Dentistry National University Health System Singapore
- National Dental Research Institute Singapore National Dental Centre Singapore
- Duke‐NUS Medical School Singapore Health Services Singapore
- School of Health and Social Sciences Nanyang Polytechnic Singapore
| | - Yi Yan Kwan
- School of Health and Social Sciences Nanyang Polytechnic Singapore
| | - Li Kok
- School of Health and Social Sciences Nanyang Polytechnic Singapore
| | - Xin Fang Lee
- School of Health and Social Sciences Nanyang Polytechnic Singapore
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Dempsy Chengappa M, Prashanth A. Evaluation of efficacy of computer-controlled local anaesthetic delivery system vs traditional injection system for minor pediatric surgical procedures in children. Med J Armed Forces India 2022; 78:S89-S95. [PMID: 36147427 PMCID: PMC9485760 DOI: 10.1016/j.mjafi.2020.08.010] [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: 04/06/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022] Open
Abstract
Background One of the biggest barriers to successful delivery of quality dental care to paediatric patients is fear related to injection of local anaesthetic. This study aimed to evaluate the efficacy of a computer-controlled local anaesthetic delivery (CCLAD) system when compared with a traditional anaesthetic injection. The two systems were compared with respect to reducing pain-related fear and anxiety. Methods Eighty children in the age group between 6 and 13 yrs requiring minor paediatric dental procedures on both sides of the dental arch were administered local anaesthesia using a CCLAD system and traditional injection system in two consecutive treatment sessions. The anxiety and fear related to the injection before and after the procedure was evaluated using Children's Fear Survey Schedule - Dental Subscale (CFSS-DS). The pain perception was evaluated using Wong-Bakers pain scale. Results The percentage wise distribution of pain rating as filled out by the subjects after being administered the local anaesthesia using CCLAD system, and the conventional injection system showed that pain levels experienced by the subjects was lower with the CCLAD injection system than with the conventional injection system. The comparison of CCLAD and conventional groups pretest and post-test CFSS-DS scores showed significantly lower values for CCLAD group indicating lower anxiety levels. Conclusion This study showed that the CCLAD system could be an useful alternative in administration of local anaesthesia. However, its effectiveness could be tested when used in highly anxious children. The disadvantages of CCLAD systems is that it requires a longer time during administration and cost.
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The Effect of Dental Treatments in Caries Management on Stress and Salivary Protein Levels. J Clin Med 2022; 11:jcm11154350. [PMID: 35893440 PMCID: PMC9332813 DOI: 10.3390/jcm11154350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/18/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023] Open
Abstract
A great burden is put on healthcare systems by dental caries and understanding patients’ treatment needs is of utmost importance. The aim of this pre−post study was to assess dental anxiety and the psychological stress induced by two different types of dental treatment (prophylaxis and cavity preparation), by combining psychometric evaluations with salivary biomarkers, in a group of 28 schoolchildren presenting in a university clinic. Pre- and post-treatment unstimulated whole saliva was collected and levels of cortisol, alpha-amylase (sAA) and total protein content were measured. The State−Trait Anxiety Inventory for Children and the Frankl Behaviour Rating Scale (FBRS) were applied. Statistical analysis was performed using the Stata/IC 16 (StataCorp) programme. All salivary parameters showed strong positive correlations between pre- and post-treatment levels. Post-treatment, salivary cortisol decreased (p = 0.008, paired t-test), sAA did not change significantly (p = 0.572, sign test), while the sAA/cortisol ratio (AOC) increased (p = 0.036, sign test). There were no correlations between state and trait anxiety levels. State anxiety scores registered significantly higher values for children with an FBRS score of 3 compared with a score of 4 (p < 0.001, unpaired t-test). The post-treatment decrease in the salivary cortisol level was higher for prophylaxis compared with the cavity preparation group (p = 0.024, t-test). These results demonstrate that sAA and cortisol levels are altered differently by psychological stress induced by two different types of dental treatment.
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Steenen SA, Zeegers MA, van Wijk AJ, Al-Zubaidi S, Jethu-Ramkrishan M, Loddin A, de Lange J, de Jongh A. Dentist Empathic Accuracy Is Associated With Patient-Reported Reassurance. Int Dent J 2022; 73:101-107. [PMID: 35896426 PMCID: PMC9875228 DOI: 10.1016/j.identj.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/02/2022] [Accepted: 06/15/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES The aim of this work was to determine dentists' ability to accurately estimate patients' anxiety level during dental treatment (ie, "empathic accuracy") and to determine the strength of the association between empathic accuracy and patient-reported reassurance. METHODS A cross-sectional study was conducted amongst 177 adult patients who underwent different invasive dental procedures (ie, extractions or procedures requiring injections and drilling) performed by 10 different dentists from 3 dental offices in the Netherlands. Patients reported their anxiety level during treatment and the extent to which they felt reassured by the dentist using a visual analogue scale (VAS). Simultaneously, the dentists estimated patients' anxiety level. Empathic accuracy was calculated as an absolute difference between patient-reported anxiety (100-point VAS) and dentist estimation of anxiety (100-point VAS). RESULTS Agreement between dentists' assessment of patients' anxiety and patient-reported anxiety proved good, intraclass correlation coefficient (177) = 0.63; 95% confidence interval [CI], 0.53-0.71. A small to medium-sized positive correlation, r (177) = 0.15; 95% CI, 0.00-0.29, was found between dentists' empathic accuracy and patient-reported reassurance. A negative correlation was found between empathic accuracy and patients' anxiety scores, r (177) = -0.23; 95% CI, -0.38 to -0.09. CONCLUSIONS Given that greater empathic accuracy was associated with higher patient-reported reassurance during treatment, training young dental professionals in empathic accuracy might help patients feel reassured. Importantly, our results also suggest that with elevated levels of patient anxiety it is increasingly challenging for dentists to recognise this emotion, and thus support the patient in anoptimal manner.
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Affiliation(s)
- Serge A. Steenen
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands,Corresponding author. Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, Location AMC, Meibergdreef 9, 1105 AZ, Room D2-240, Amsterdam, The Netherlands.
| | - Moniek A.J. Zeegers
- Department of Psychology, Mondium GGz, Clinical Health Center, Beesd, The Netherlands
| | - Arjen J. van Wijk
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Saif Al-Zubaidi
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Minakshi Jethu-Ramkrishan
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Aida Loddin
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ad de Jongh
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Institute of Health and Society, University of Worcester, Worcester, UK,School of Psychology, Queen's University, Belfast, Northern Ireland
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Patient and Caregiver Perceptions of Animal Assisted Activity in Orthodontics. Animals (Basel) 2022; 12:ani12141862. [PMID: 35883412 PMCID: PMC9312150 DOI: 10.3390/ani12141862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/22/2022] Open
Abstract
Simple Summary Dental anxiety impacts a significant fraction of children and adults, leading to lifelong avoidance of the dentist and increased emergency dental care. Animal-assisted activity (AAA) is widely used in medicine to reduce anxiety and pain, with promise in dentistry. However, dentistry has been slow to adopt AAA, with a state dental board banning therapy animals in dental clinics due to patient concerns over dog safety, allergies, and cleanliness. Our goal was to determine how orthodontic patients and their caregivers viewed canine therapists in dental clinics to see whether AAA would be welcomed by most families. (No dog therapy occurred as part of this study, so the efficacy of AAA for dental anxiety management was not evaluated). Orthodontic patients and parents/caregivers were asked to fill out a survey about their dental anxiety and their desire for and concerns regarding therapy animals in dental clinics. More than a third of patients had moderate or greater anxiety related to dental care. A vast majority of participants believed that therapy dogs would make dental experiences more enjoyable and reduce fear, with a small minority raising concerns about cleanliness, allergies, and safety. Among patients and caregivers, there is broad acceptance and desire for AAA in dental and orthodontic settings. Future research should be aimed at determining how AAA can improve the experiences of dental patients. Abstract Dental anxiety affects up to 21% of children and 80% of adults and is associated with lifelong dental avoidance. Animal assisted activity (AAA) is widely used to reduce anxiety and pain in medical settings and has promise in dentistry. The primary objective of this study was to evaluate caregiver and patient perceptions of canine AAA in orthodontics. A cross-sectional survey consisting of pre-tested and validated questions was conducted (n = 800) including orthodontic patients (n = 352 minors, n = 204 adults) and parents/caregivers (n = 244) attending university orthodontic clinics. In this study, AAA and dog therapy were not used or tested for dental anxiety management. More than a third of orthodontic patients (37%) had moderate or greater anxiety related to care. Participants believed that therapy animals would make dental experiences more enjoyable (75%) and reduce anxiety (82%). There was little to no concern expressed regarding cleanliness (83%), allergies (81%), and safety (89%) with a therapy animal in dental settings. Almost half of the participants would preferentially select an orthodontic office offering AAA. In light of the COVID-19 pandemic, we assessed whether perceptions of AAA changed before and after the shutdown of dental offices, with no significant differences. Across patients and caregivers, the responses support the use of AAA in orthodontic settings with minimal concerns.
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Hassan BH, Abd El Moniem MM, Dawood SS, Alsultan AA, Abdelhafez AI, Elsakhy NM. Dental Anxiety and Oral-Health-Related Quality of Life among Rural Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137643. [PMID: 35805302 PMCID: PMC9265705 DOI: 10.3390/ijerph19137643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 12/10/2022]
Abstract
Aim: This study aimed to investigate the association between dental anxiety (DA) and oral-health-related quality of life (OHRQoL) among rural community-dwelling older adults. Methods: A cross-sectional descriptive study was conducted among 390 rural community-dwelling older adults attending outpatient clinics of the Damanhur National Medical Institute during the year 2021. Three instruments were used: a demographic and clinical data structured interview schedule, Modified Dental Anxiety Scale (MDAS), and the Oral Health Impact Profile (OHIP-5) questionnaire. All statistical analyses were considered significant at a p-value of ≤0.001. Results: The main results showed that the prevalence of DA among participants was 90.5%, and 66.9% of the studied elderly population were either extremely (phobic) or very anxious. Moreover, a significant association was found between older adults’ DA and their OHRQoL (p ˂ 0.001). Conclusions: It was concluded that DA represents a common problem among rural community-dwelling older adults and is a predictor for poor OHRQoL. Raising community awareness about the importance of oral health and implementing measures to avoid DA through specialized community campaigns is recommended, particularly in rural areas.
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Affiliation(s)
- Bothaina Hussein Hassan
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
- Department of Gerontological Nursing, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt; (M.M.A.E.M.); (S.S.D.)
- Correspondence: or
| | - Maha Mohammed Abd El Moniem
- Department of Gerontological Nursing, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt; (M.M.A.E.M.); (S.S.D.)
| | - Shaimaa Samir Dawood
- Department of Gerontological Nursing, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt; (M.M.A.E.M.); (S.S.D.)
| | | | - Amal Ismael Abdelhafez
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
- Department of Critical Care & Emergency Nursing, Faculty of Nursing, Assiut University, Asyut 71717, Egypt
| | - Nancy Mahmoud Elsakhy
- Department of Gerontological Nursing, Faculty of Nursing, Matrouh University, Marsa Matrouh 51511, Egypt;
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22
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Dental fear and anxiety in Asian youths: response components and inducing stimuli. Clin Oral Investig 2022; 26:5953-5960. [PMID: 35639205 DOI: 10.1007/s00784-022-04555-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
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.
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Alhasan H, Samara A, Bamashmous N, Sabbagh HJ. Behavioral Modification of an Uncooperative Preschool Child with Sickle Beta Thalassemia Disease in a Dental Clinic: A Case Report. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background:
Treating medically compromised pediatric patients with dental anxiety can be challenging, especially when general anesthesia and sedation are not an option. This paper reported a case of an uncooperative preschool child who was medically compromised and presented in the dental clinic with Severe-Early-Childhood-Caries (S-ECC). The dental behavior management of such a case was not previously discussed in the literature.
Case Presentation:
This paper explains the dental management and behavior modification carried out for a 5-year-old male child who was diagnosed with sickle beta thalassemia disease (Sβ-thalassemia), S-ECC, had a negative dental behavior, and was successfully and efficiently treated under a dental setting. The patient presented with his mother, who was concerned about her child’s decayed teeth and sought dental treatment as soon as possible to avoid any risk of infection. Dental examination revealed multiple dental caries and high caries risk. The patient’s behavior can be classified as definitely negative with high level of anxiety. The mother showed permissive parenting and the father exerted an authoritative parenting style. Dental management focused mainly on child behavioral modification via utilizing the difference between the parenting styles. Middle way of treatment, the child showed behavioral improvement, which was progressing toward the end of the treatment. Teeth were successfully restored with composite and metal crowns.
Conclusion:
With several behavior management techniques and understanding the parenting styles, the patient's behavior improved, and the treatment plan was successfully used on a dental chair without the need for more advanced management under general anesthesia.
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Sekiya T, Sugimoto K, Kubota A, Tsuchihashi N, Oishi A, Yoshida N. Assessment of psychological changes in young children during dental treatment: Analysis of the autonomic nervous activity and electroencephalogram. Int J Paediatr Dent 2022; 32:418-427. [PMID: 34558749 DOI: 10.1111/ipd.12921] [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] [Received: 03/30/2021] [Revised: 08/12/2021] [Accepted: 09/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Understanding the emotional changes in children during dental treatment is necessary for providing stress-free care. AIM To objectively assess the stress associated with dental treatment in children, based on the autonomic nervous activity and the electroencephalogram (EEG). DESIGN Twenty-two children aged 4-9 years were recruited from outpatients of a paediatric clinic. Electrocardiogram and EEG were recorded throughout the treatment to analyze the autonomic nervous activities and the powers of brain waves, respectively. Changes in these measurements during each treatment process were evaluated in two age groups: 4-6 years and 6-9 years. RESULTS Elevations in sympathetic activities accompanied by decreased parasympathetic activities induced by stress were observed during rubber dam setting (RD) in the age group of 4-6 years and during infiltration anesthesia (IA), RD, and cavity preparation with a dental turbine (CP-T) in the age group of 6-9 years. Stress-related beta wave increments in EEG were observed during IA and CP-T in the age group of 6-9 years but not in the age group of 4-6 years. CONCLUSION Monitoring the autonomic nervous activities during treatments is useful in assessing stresses in a wide age of young children, whereas EEG monitoring is applicable only to children older than 6 years.
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Affiliation(s)
- Taki Sekiya
- Department of Paediatric Dentistry/Special Needs Dentistry, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kumiko Sugimoto
- Department of Oral Health Care Education, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayako Kubota
- Department of Oral Health Care Education, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Natsumi Tsuchihashi
- Department of Paediatric Dentistry/Special Needs Dentistry, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Oishi
- Department of Paediatric Dentistry/Special Needs Dentistry, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naomi Yoshida
- Department of Oral Health Care Education, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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25
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Nydell Helkimo A, Rolander B, Koch G. Dental fear in school children and young adults attending public dental health care: prevalence and relationship to gender, oral disease and dental treatment; trends over 40 years. BMC Oral Health 2022; 22:146. [PMID: 35473601 PMCID: PMC9044703 DOI: 10.1186/s12903-022-02166-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/08/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To study prevalence of dental fear and the relationship to gender, oral disease and dental treatment between 1973 and 2013 in school children and young adults attending public dental health care. Methods Every ten years from 1973 to 2013 random samples of about 100 individuals in each of the age groups 10, 15 and 20 years took part in a repeated cross-sectional study based on clinical parameters and a questionnaire. Dental fear was estimated by the question: “What do you feel at the prospect of an appointment with a dentist?”. 75–99% of the samples answered the question. Agreement to at least one of the alternative answers: ill at ease, frightened and sick defined dental fear. Frightened and/or sick indicated severe dental fear. The prevalence of caries, gingivitis and number of filled tooth surfaces were calculated. Chi-square tests were used to show differences in proportions between groups and linear regression to show trends over time. Results Prevalence of dental fear declined in all age groups over time. In the 20-year olds dental fear was found in 29% of the sample and severe dental fear in 12% of girls and 5% of boys in 2013. Individuals with dental fear had higher mean caries prevalence and number of filled tooth surfaces compared with individuals without dental fear. Conclusions This 40-year time trend study showed a reduction in dental fear prevalence in school children and young adults offered regular public dental health care based on prevention and a psychological approach.
The prevalence of dental fear was still high in 2013 despite a significant decline in caries during the study period. Further improvements in the psychological approach when treating children are thus needed.
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Affiliation(s)
- Anna Nydell Helkimo
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden.
| | - Bo Rolander
- Futurum, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.,Department of Behavioral Science and Social Work, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Göran Koch
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden
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Sandom F, Hearnshaw S, Grant S, Williams L, Brocklehurst P. The in-practice prevention programme: an example of flexible commissioning from Yorkshire and the Humber. Br Dent J 2022:10.1038/s41415-022-4140-y. [PMID: 35383286 PMCID: PMC8982659 DOI: 10.1038/s41415-022-4140-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022]
Abstract
Introduction An In-Practice Prevention (IPP) programme was developed by the Local Dental Network in the North Yorkshire and the Humber area in England in response to an oral health needs assessment. The underpinning logic model drew on a flexible commissioning approach and aimed to incentivise dental teams with NHS contracts to promote the delivery of prevention. This used care pathways that involved the whole dental team and was cost-neutral.Aim The programme was evaluated using realist methodology to identify 'what works, in which circumstances, how and for who?'.Design Realist evaluations are explanatory in nature and attempt to understand the factors that appear to influence the success (or not) of an intervention, rather than demonstrating causality.Methods and results Following a review of the pertinent literature, semi-structured interviews and focus groups, five theory areas were considered to be critical to the delivery of IPP. In order of stated priority, these were: 1) clinical leadership; 2) 'skill mix'; 3) financial incentives; 4) institutional logic/practice culture; and 5) behaviour change.Conclusion The results appear to show that clinically-led programmes could offer value to dental commissioners within a flexible commissioning model, although this would need to be further tested using an experiment design.
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Affiliation(s)
- Fiona Sandom
- School of Health Sciences, Bangor University, UK
| | | | - Siobhan Grant
- Public Health England, North Yorkshire and the Humber Area, UK
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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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Bucur SM, Moraru A, Adamovits B, Bud ES, Olteanu CD, Vaida LL. Psychometric Properties of Scared-C Scale in a Romanian Community Sample and Its Future Utility for Dental Practice. CHILDREN (BASEL, SWITZERLAND) 2022; 9:34. [PMID: 35053660 PMCID: PMC8774149 DOI: 10.3390/children9010034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/18/2021] [Accepted: 12/29/2021] [Indexed: 12/13/2022]
Abstract
The psychological management of children and adolescents in need of pedodontics or orthodontic treatments continues to be an essential objective in dental activity because along with the accuracy of the techniques that are used, anxiety reduction, and knowledge of how to approach the patient are necessary for the treatment to be successful. Therefore, our study aimed to validate the Screen for Child Anxiety Related Emotional Disorders questionnaire, the child version of 41 items (SCARED-C) in the Romanian population for later use in pediatric dentistry. The instrument showed moderate to good internal consistency (α Cronbach from 0.63 to 0.91 for the total scale) and good test-retest reliability (0.70) on a subset of a sample comprising 85 children. A confirmatory factorial analysis (CFA) was conducted to test the factor structure of the Romanian version of the SCARED-C; the results showed that SCARED-C has good psychometric properties that can be used for screening anxiety in Romanian children and adolescents. The implications of using the SCARED-C in dental practice are discussed. Future studies need to be conducted to explore the convergent and discriminative validity of the instrument and its sensitivity to current DSM-V criteria. Application on a pediatric dental sample is also required.
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Affiliation(s)
- Sorana-Maria Bucur
- Faculty of Medicine, Dimitrie Cantemir University, 540545 Târgu-Mureș, Romania;
| | - Adela Moraru
- Faculty of Psychology, Dimitrie Cantemir University, 540545 Târgu-Mureș, Romania; (A.M.); (B.A.)
| | - Beata Adamovits
- Faculty of Psychology, Dimitrie Cantemir University, 540545 Târgu-Mureș, Romania; (A.M.); (B.A.)
| | - Eugen Silviu Bud
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science and Technology George Emil Palade, 540139 Târgu-Mureș, Romania
| | - Cristian Doru Olteanu
- Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania;
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29
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Wu L, Buchanan H, van Wijk AJ. Translation and Validation of the Short Form of the Fear of Dental Pain Questionnaire in China. Front Psychol 2021; 12:721670. [PMID: 34887796 PMCID: PMC8649632 DOI: 10.3389/fpsyg.2021.721670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
The short form of the Fear of Dental Pain Questionnaire (s-FDPQ) is a validated measure developed to screen patients for their fear of pain associated with dental procedures. As there is a high prevalence of dental fear/anxiety in Chinese adults, the primary aim of our study was to translate the s-FDPQ into standard Mandarin and explore its reliability and validity with Chinese adults. The second aim of our study was to explore fear of dental pain (FDP) scores in relation to dental attendance, anxiety and gender. We translated the s-FDPQ using the forward-backward method. It was completed by 480 Chinese adults alongside the Modified Dental Anxiety Scale (MDAS; Chinese version) to test convergent validity. 109 participants completed the s-FDPQ again 14 days later to evaluate test-retest reliability. The Chinese s-FDPQ (s-CFDPQ) was internally consistent (alpha = 0.87) and demonstrated convergent validity (r = 0.73 when correlated with the MDAS). Test-retest reliability was good (ICC = 0.86). Individuals who had never attended the dentist (22%) had higher FDP scores than those that had, even if they were not dentally anxious. Also, females reported higher FDP scores (p < 0.001). These findings suggest that the s-CFDPQ is a reliable and valid measure for assessing fear of dental pain in Chinese adults. The s-CFDPQ could allow quick identification of individuals who are fearful of dental pain who may require specialist attention.
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Affiliation(s)
- Lei Wu
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Tianjin Normal University, Academy of Psychology and Behavior, Tianjin, China
| | - Heather Buchanan
- Medical School, University of Nottingham, Nottingham, United Kingdom
| | - Arjen J. van Wijk
- Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, Netherlands
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30
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Seligman LD, Talavera-Garza L, Geers AL, Murray AB, Ibarra M, Hovey JD. Development of a Measure of Fearful Implicit Associations with Dental Stimuli in Youth. Child Psychiatry Hum Dev 2021; 54:665-671. [PMID: 34724135 DOI: 10.1007/s10578-021-01269-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/29/2021] [Indexed: 11/26/2022]
Abstract
Youth with dental anxiety are at an increased risk of poor oral health but current tools used to identify dental anxiety in children in clinical settings are hampered by several limitations. This study assessed the psychometric properties of a measure of implicit associations with dental stimuli, the Affective Misattribution Procedure for dental stimuli (AMP-D) in 68 youth between the ages of 9 and 17 years. Measures of self-reported dental anxiety and parental perceptions of child dental anxiety were also administered. The internal consistency of the AMP-D was high (KR-20 = 0.96) and 1-week test-retest reliability was in the acceptable range (r = 0.75). The AMP-D was correlated with self-reported dental anxiety, providing evidence of construct validity. The psychometric properties of the AMP-D suggest it could be a useful tool in identifying youth with dental anxiety, particularly when concerns regarding self-representation may compromise the validity of self-reported anxiety.
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Affiliation(s)
- Laura D Seligman
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, TX, 78539, USA.
| | - Liza Talavera-Garza
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, TX, 78539, USA
| | - Andrew L Geers
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | | | - Marina Ibarra
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, TX, 78539, USA
| | - Joseph D Hovey
- Department of Psychological Science, The University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, TX, 78539, USA
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31
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Stevens ES, Behar E, Siev J. The roles of disgust sensitivity and anxiety sensitivity in attentional bias in dental anxiety. J Anxiety Disord 2021; 83:102450. [PMID: 34340171 DOI: 10.1016/j.janxdis.2021.102450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 05/04/2021] [Accepted: 07/06/2021] [Indexed: 12/15/2022]
Abstract
Individuals with dental anxiety show biased attentional processing of threat- and dental-related information. Disgust sensitivity and anxiety sensitivity are both associated with dental fears and attentional biases. Whereas disgust sensitivity is generally associated with attentional avoidance (Armstrong et al., 2014), anxiety sensitivity may be associated with attentional engagement (Keogh et al., 2001a). Elucidating the role of these constructs in dental anxiety-relevant attentional biases could inform theoretical models and/or intervention recommendations. Participants (N = 51) with high dental anxiety completed a Posner paradigm to assess attentional biases to dental versus neutral stimuli. We examined whether disgust sensitivity and anxiety sensitivity moderated degree of attentional bias. Results indicated that both disgust sensitivity (mutilation subscale) and anxiety sensitivity (physical concerns subscale) statistically moderated degree of attentional bias at trend level, and in opposite directions. Simple effects analyses further indicated that disgust sensitivity regarding mutilation was associated with less attentional bias toward dental relative to neutral stimuli, potentially indicating attentional avoidance, and remained so when adjusting for anxiety sensitivity. In contrast, simple effects analysis indicated that anxiety sensitivity regarding physical concerns was not associated with magnitude of attentional bias. If replicated, findings highlight the potential role of disgust in dental anxiety.
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Affiliation(s)
- Elizabeth S Stevens
- University of Illinois at Chicago, Department of Psychology, United States; VA Puget Sound Health Care System, Seattle Division, United States.
| | - Evelyn Behar
- Hunter College - City University of New York, Department of Psychology, United States
| | - Jedidiah Siev
- Swarthmore College, Department of Psychology, United States
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32
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Townsend JA, Randall CL. Adolescent Dental Fear and Anxiety: Background, Assessment, and Nonpharmacologic Behavior Guidance. Dent Clin North Am 2021; 65:731-751. [PMID: 34503664 DOI: 10.1016/j.cden.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adolescence, the period from 11 to 21 years of age, bridges the chasm between childhood and adulthood. Adolescence can be challenging as bodies, cognition, and personality go through major transformations, but it is also a time of great joy as confident adults with a clear identity develop. Dentists need to be knowledgeable about the developmental characteristics of this group because some of the cognitive and emotional changes make adolescents vulnerable to new fears. Dentists must tailor behavior guidance to this developing psyche in a way that respects independence and promotes confidence to foster lifelong positive views of dentistry.
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Affiliation(s)
- Janice A Townsend
- Department of Dentistry, Nationwide Children's Hospital, 700 Children's Drive, LA Suite 5A, Columbus, OH 43205, USA; Division of Pediatric Dentistry, The Ohio State University, Columbus, OH, USA.
| | - Cameron L Randall
- Department of Oral Health Sciences, University of Washington School of Dentistry, 1959 NE Pacific Street, Box 357475, Seattle, WA 98195, USA
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33
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Patel D, Lahiri B, El-Patal MAE, Alazmah A, Patel P, Abokhlifa YH. To Compare and Analyze the Potency of two Topical Anesthetic Gels in Reducing Inferior Alveolar Injection Pain in Children of 8-12 Years: A Double-Blinded Clinical Trial. J Pharm Bioallied Sci 2021; 13:S646-S650. [PMID: 34447172 PMCID: PMC8375789 DOI: 10.4103/jpbs.jpbs_772_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022] Open
Abstract
Aim: To compare and analyze the clinical adequacy of two topical anesthetic gels, Precaine (8% lidocaine + 0.8% dibucaine) and Precaine B (20% benzocaine) in children before intraoral local anesthetic injections. Materials and Methods: This clinical study included thirty children who needed an inferior alveolar nerve block. They were divided into three groups: Group A: Precaine topical gel group, Group B: Precaine B topical gel Group, Group C: no anesthetic topical gel group (control group). These two effective topical gels were applied before giving intraoral local anesthesia, and afterward, the child's pain response was surveyed utilizing the Wong-Baker Faces Pain Rating Scale. The scores obtained were subjected to statistical analysis. Results: Intergroup comparison showed a significant mean difference between the control group and Precaine group (P > 0.05) as well as Precaine B group (P > 0.05). However, there is no significant difference obtained between Group A and Group B (P < 0.05). Conclusion: It is psychologically and clinically beneficial to apply a topical anesthetic agent before injecting any intraoral anesthesia. In this study, both anesthetic gels showed a nonsignificant difference in reducing inferior alveolar injection pain, but Precaine B shows more promising results than Precaine.
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Affiliation(s)
- Dharati Patel
- Department of Pedodontics and Preventive Dentistry, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Banibrata Lahiri
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Mohamed Abd-Ellatif El-Patal
- Department of Pedodontics and Oral Health, College of Dentistry, Al Azhar University, Cairo, Egypt.,Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
| | - Abdulfatah Alazmah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Alkharj, Kingdom of Saudi Arabia
| | - Parth Patel
- Dental Practitioner, Gujarat University, Ahmedabad, Gujarat, India
| | - Yousef H Abokhlifa
- Department of Pedodontics and Oral Health, College of Dentistry, Al Azhar University, Cairo, Egypt
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34
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Lin CS, Lee CY, Chen LL, Wu LT, Yang SF, Wang TF. Magnification of fear and intention of avoidance in non-experienced versus experienced dental treatment in adults. BMC Oral Health 2021; 21:328. [PMID: 34210309 PMCID: PMC8252235 DOI: 10.1186/s12903-021-01682-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/19/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Dental fear is associated with the experience of prior dental treatment and avoidance of dental visits. It remains unclear if individuals show an intention of avoidance (IA) towards treatments that they have not received (i.e., non-experienced dental treatment). The study aims to investigated (a) if individuals showed an increased fear and IA to non-experienced, compared to experienced dental treatment, and (b) if fear and IA to non-experienced treatment is associated with dental anxiety. METHODS Fear/IA of 12 common conditions of dental treatment of 402 adults were investigated. If subjects have experienced the condition, fear and IA were assessed based on subjects' prior experience (i.e., ExpFear/ExpIA). If they have not experienced the condition, fear and IA were assessed based on their anticipation (i.e., NExpFear/NExpIA). Trait dental anxiety was assessed using the Index of Dental Anxiety and Fear (IDAF-4C+). RESULTS (A) NExpFear and NExpIA were significantly higher than ExpFear and ExpIA, respectively. (B) The IDAF-4C+ scores are positively correlated with NExpFear/NExpIA and negatively correlated with the magnification of fear (i.e., the discrepancy in the fear/IA of non-experienced vs. experienced conditions). (C) The condition 'extraction of a wisdom tooth' and 'root canal treatment' showed the highest ratings on NExpFear. CONCLUSIONS Individuals may develop a high degree of fear and IA of the treatment they have not received. Trait dental anxiety plays a key role in the fear of non-experienced treatment.
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Affiliation(s)
- Chia-Shu Lin
- Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan (ROC). .,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan. .,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
| | - Chen-Yi Lee
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan
| | - Li-Ling Chen
- Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan (ROC)
| | - Long-Ting Wu
- Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan (ROC).,Division of Endodontics and Periodontology, Department of Stomatology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
| | - Shue-Fen Yang
- Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan (ROC).,Division of Endodontics and Periodontology, Department of Stomatology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
| | - Tze-Fang Wang
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
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Using process drama to explore the causes of dental anxiety in primary-school children. Eur Arch Paediatr Dent 2021; 22:869-877. [PMID: 33893625 PMCID: PMC8526446 DOI: 10.1007/s40368-021-00623-4] [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: 11/25/2020] [Accepted: 03/29/2021] [Indexed: 11/05/2022]
Abstract
Background Drama and role play can be unlisted as methods to allow children to view problems from a range of different perspectives that may differ from their own experience. Application of drama technique to assess the cause of dental fear and anxiety in a school setting is novel. Aim The aim of this study was to engage primary school children in the core investigation via participatory arts methodologies, namely, process drama to gain understanding of the causes of dental anxiety. Design Sixty-three children, aged 7–10 years from three primary schools participated in this study. A 90-min drama workshop was carried in each school. The children were encouraged to identify the causes of dental anxiety using key concepts from process drama. The sessions were audio-recorded and transcribed. Results Four key concepts emerged: (1) fear of the unknown; (2) unpleasant sensory experience; (3) society’s perception and portrayal of the dentist; and (4) learnt negative associations with the dentist. Within each four key concepts, two sub-themes were identified. Conclusions Role-playing and use of drama are a novel application and can reveal a considerable amount of information from the child’s perspective on the cause of dental fear and anxiety.
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Hair Cortisol Concentrations Are Associated with Dental Anxiety during Pregnancy. Dent J (Basel) 2021; 9:dj9040042. [PMID: 33920415 PMCID: PMC8069593 DOI: 10.3390/dj9040042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/31/2022] Open
Abstract
Dental anxiety (DA) and hair cortisol concentrations (HCC) are associated with psychological symptoms and vary during pregnancy. We aimed to examine the association between HCC and DA at two points of pregnancy. Participants were pregnant mothers (n = 533) drawn from the FinnBrain Birth Cohort Study donating a hair sample at gestational week (gwk) 24 (n = 442) and/or at delivery (n = 176) and completed questionnaires on DA. Two groups, HCC1 and HCC2, treated as separate in the analyses, were formed according to the hair sample donation time i.e., gwk24 and delivery. 85 subjects were included in both groups. MDAS, EPDS, and SCL-90 were used to measure DA, depressive and anxiety symptoms, respectively, at gwk14 for the HCC1 group and gwk34 for the HCC2 group. The association between DA and HCC was studied with a binary logistic regression model, adjusted for anxiety and depressive symptoms, age, BMI, and smoking status. Individuals with high DA had lower HCC levels at gwk24 (OR = 0.548; 95% CI = 0.35–0.86; p = 0.009), but the association was not statistically significant at the delivery (OR = 0.611; 95% CI = 0.28–1.33; p = 0.216). The independent association between HCC and DA in pregnant women suggests that long-term cortisol levels could play a role in the endogenous etiology of DA. Further studies are however, needed.
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Silveira ER, Cademartori MG, Schuch HS, Armfield JA, Demarco FF. Estimated prevalence of dental fear in adults: A systematic review and meta-analysis. J Dent 2021; 108:103632. [PMID: 33711405 DOI: 10.1016/j.jdent.2021.103632] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To systematically review the literature about: 'What is the global estimated prevalence of dental fear in adults?'. DATA/SOURCES Inclusion criteria were observational population-based studies reporting the prevalence or raw data of dental fear in adults (>18 years). Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library and Web of Science) were searched without language restrictions up to March 2020. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. Risk of bias was performed using the Joanna Briggs Critical Appraisal Checklist for Prevalence and Incidence studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed. STUDY SELECTION The search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. Three studies presented low risk of bias and 28 studies presented high risk of bias. A total of 72,577 individuals 18 years of age or older composed the sample of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 15.3 % (95 %CI 10.2-21.2), 12.4 % (95 %CI 9.5-15.6) and 3.3 % (95 %CI 0.9-7.1), respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instruments used to measure dental fear also affected its prevalence. CONCLUSIONS Dental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women. CLINICAL SIGNIFICANCE Evidence suggests fear negatively impacts dental care pattern, clinical and subjective oral health conditions. A better knowledge of the global prevalence and the factors associated with this problem will allow that prevention or even behavior modulation strategies of the fearful individual's in dental setting being carried out.
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Affiliation(s)
- Ethieli Rodrigues Silveira
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Mariana Gonzalez Cademartori
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Helena Silveira Schuch
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil.
| | - Jason A Armfield
- Australian Centre for Precision Health, University of South Australia, Adelaide, 101 Currie St, Adelaide, SA, 5001, Australia.
| | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, 457, Gonçalves Chaves Street, 96015-560, Brazil; Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, 1160, Marechal Deodoro Street, 96020-220, Brazil.
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38
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O'Grady A, Gray-Burrows K, Tahmassebi J. Inside the waiting room: process drama and dramatic distancing for involving children in research on dental anxiety. Arts Health 2021; 14:149-164. [PMID: 33651666 DOI: 10.1080/17533015.2021.1894465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Dental anxiety in children is a major health concern. Process drama adopts distancing techniques that allow children to examine the possible causes of dental anxiety safely and with authority. Using this method to inform paediatric dentistry is novel and could be adopted in other fields where children experience health-related anxiety.Methods: A 90-minute process drama workshop was conducted in three primary schools in Batley,West Yorkshire. Sixty-three children participated in the study. Sessions were audio-recorded, transcribed and thematic analysis conducted.Results: Four key concepts emerged: 1) Fear of the unknown; 2) Unpleasant sensory experience; 3) Society's perception and portrayal of the dentist and 4) Learnt negative associations with the dentist.Conclusion: Process drama offers a novel approach to develop an understanding of dental anxiety in children. It elicits critical insights from a child's perspective and offers a participatory model for engaging children in health research on sensitive issues.
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Affiliation(s)
- Alice O'Grady
- School of Performance and Cultural Industries, University of Leeds, Leeds, UK
| | - Kara Gray-Burrows
- Department of Paediatric Dentistry, Leeds School of Dentistry, University of Leeds, Leeds, UK
| | - Jinous Tahmassebi
- Department of Paediatric Dentistry, Leeds School of Dentistry, University of Leeds, Leeds, UK
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Delgado A, Ok SM, Ho D, Lynd T, Cheon K. Evaluation of children's pain expression and behavior using audio visual distraction. Clin Exp Dent Res 2021; 7:795-802. [PMID: 33622030 PMCID: PMC8543459 DOI: 10.1002/cre2.407] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/12/2021] [Accepted: 01/28/2021] [Indexed: 11/08/2022] Open
Abstract
Objectives Dental anxiety distresses children and their families with consequent poor oral health and costly pediatric dental services. Children's behaviors could be modified using a distraction technique for improved dental treatment. The study evaluates the effects of an audio‐visual distraction on children's behaviors and pain expressions during dental treatment. Material and Methods One hundred healthy children, between 4 and 6 years of age, were randomly assigned to one of two groups: audio visual distraction (AVD, N = 61) group and control (CTR, N = 39) group. The pre and post pain expression was collected using a faces pain rating scale from the participated children. Children's behavior was evaluated using the Frankl behavior rating scale by the assigned dentist. Data was analyzed using chi‐squared tests and analysis of variance. Results The AVD group demonstrated more “definitely positive” behavior (91.8%) compared to the CTR group (35.9%) based on the Frankl scale evaluation from pre‐ and post‐treatment (p < 0.0001). The pain rating scale did not demonstrate a significant difference in post‐treatment pain scales (p = 0.2073) or changes in pain (p = 0.1532) between the AVD group and CTR group. Conclusions The AVD is an effective distraction tool for young children during dental treatment regardless of child's subjective pain expression.
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Affiliation(s)
- Alicia Delgado
- Department of Pediatric Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Soo-Min Ok
- Department of Pediatric Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Oral Medicine, Dental and Life Science Institute, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea
| | - Donald Ho
- Department of Pediatric Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tyler Lynd
- Department of Pediatric Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kyounga Cheon
- Department of Pediatric Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
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CustÓdio NB, Cademartori MG, Azevedo MS, Mendes MDA, Schardozim LR, Costa LRDRSD, Goettems ML. Efficacy of audiovisual distraction using eyeglasses during dental care: a randomized clinical trial. Braz Oral Res 2021; 35:e26. [PMID: 33605356 DOI: 10.1590/1807-3107bor-2021.vol35.0026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
This randomized parallel-group control trial tested the efficacy of distraction using audiovisual eyeglasses (AVE) during dental procedures [NCT03902158]. Forty-four 6-9 year-old children with low/moderate anxiety and who needed restorative treatment or exodontia of the primary molars were randomly allocated into two groups: the AVE (experimental) and the conventional behavior management techniques (control) groups. Motion sensors were used to measure the participants' body movements. Dental visits were video recorded, and their pain levels and behavior were assessed using the Faces, Legs, Activity, Cry, and Consolability Behavioral Pain Assessment Scale and the Venham Behavioral Scale, respectively. Anxiety was assessed via heart rate measurements. After treatment, the children scored their pain using the Faces Pain Scale. Mann-Whitney U and chi-square tests were used to compare the groups. The mean score on the behavioral scale was 0.59 in the experimental group and 0.72 in the control group under local anesthesia (p = 0.73). During the procedure, the mean score was 0.41 in the experimental group and 1.32 in the control group (p = 0.07). The mean heart rate was similar in both groups (p = 0.47), but a significant increase during treatment was observed in the control group. There was no difference between the groups in terms of pain, behavior, and self-reported pain scores (p = 0.08). Children aged 6-7 who used the AVE had fewer wrist movements (435.6) than that of children in the control group (1170.4) (p = 0.04). The AVE achieved similar results to the basic behavior management techniques, with good acceptance by the children.
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Affiliation(s)
- Natália Baschirotto CustÓdio
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
| | - Mariana Gonzalez Cademartori
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
| | - Marina Sousa Azevedo
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
| | - Márcio de Almeida Mendes
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Epidemiology , Pelotas , RS , Brazil
| | - Lisandrea Rocha Schardozim
- Universidade Federal de Pelotas - UFPel, Departament,of Social and Preventive Dentistry , Pelotas , RS , Brazil
| | | | - Marília Leão Goettems
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
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Eger T, Wörner F, Simon U, Konrad S, Wolowski A. Dental Anxiety and Higher Sensory Processing Sensitivity in a Sample of German Soldiers with Inflammatory Periodontal Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041584. [PMID: 33567560 PMCID: PMC7915768 DOI: 10.3390/ijerph18041584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/17/2022]
Abstract
(1) Background: Dental anxiety with disease value usually leads to avoidance of dental treatment. For the initial diagnosis of the level of anxiety, questionnaires such as the Hierarchical Anxiety Questionnaire (HAQ) are suitable. The construct of sensory processing sensitivity (SPS) describes a general trait in which people with a higher degree of SPS perceive information more strongly and process it more thoroughly. (2) Methods: This cross-sectional study evaluated the relationship between dental anxiety and higher levels of SPS in 116 soldiers referred with different stages of periodontitis for mandatory dental fitness before military deployment. (3) Results: The proportion of patients with periodontitis in stage III + IV was 39% and in stage I + II was 27%. The mean cumulative values of the questionnaires were 20.9 ± 10.6 for HAQ and 27.7 ± 16.0 for SPS. Eleven moderately anxious patients had a SPS value of 37.4 ± 13.5 and 10 highly anxious patients had a value of 36.3 ± 14.1. Patients diagnosed with stage III + IV periodontitis showed significantly higher values on the SPS subscale Low Sensory Threshold (LST), which describes overstimulation by external sensory stimuli, compared to patients with stage I + II periodontitis. Dental anxiety showed moderately significant correlations with the SPS subscale Ease of Excitation (EOE), which measures emotional reactivity to physiological stimuli. (4) Conclusions: Due to the frequency of dental anxiety and higher sensitivity in patients with severe periodontitis, it is useful to record said frequency.
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Affiliation(s)
- Thomas Eger
- Department of XXIII Dentistry-Periodontology, Bundeswehr Central Hospital Koblenz, Ruebenacherstrasse 170, 56072 Koblenz, Germany;
- Correspondence: ; Tel.: +49-261-281-43000
| | - Felix Wörner
- Department of XXIII Dentistry-Periodontology, Bundeswehr Central Hospital Koblenz, Ruebenacherstrasse 170, 56072 Koblenz, Germany;
| | - Ursula Simon
- Department of VI Center for Mental Health and Psychiatry, Bundeswehr Central Hospital Koblenz, Ruebenacherstrasse 170, 56072 Koblenz, Germany;
| | - Sandra Konrad
- Department of Personality Psychology and Psychological Diagnostics, Faculty of Humanities and Social Sciences, Helmut-Schmidt-University/University of the Bundeswehr Hamburg, Gebäude H4, Holstenhofweg 85, 22043 Hamburg, Germany;
| | - Anne Wolowski
- Department of Prosthodontics and Biomaterials, Albert-Schweitzer-Campus 1, University Hospital and Faculty of Medicine Muenster, 48149 Muenster, Germany;
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AlGharebi S, Al-Halabi M, Kowash M, Khamis AH, Hussein I. Children's dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital. Eur Arch Paediatr Dent 2021; 22:29-40. [PMID: 32170653 DOI: 10.1007/s40368-020-00517-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 02/27/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Child dental anxiety (CDA) and uncooperative dental behaviour are common. We aimed to assess the prevalence of CDA (self- and proxy- reported) in the United Arab Emirates (UAE) children related to their dental behaviour. METHODS Data were collected from 312 questionnaires obtained from 156 parent/child (mean age 9.95 ± 2.17 years) pairs attending a postgraduate dental hospital. Demographics, self/proxy- reported CDA scores via a six-question, five-point Likert scale, of the Modified CDA Scale-faces version (MCDAS-f: where ≥ 19 was severe CDA) and Frankl Behaviour Rating Scale (FBRS) scores were compared and analysed. Chi-square test, Pearson's correlation, Kappa- coefficient, one-way ANOVA and independent t test statistical analysis were used (p < 0.05). RESULTS The prevalence of self and proxy severe CDA was 22.4% (n = 35) and 33.3% (n = 52) respectively, with 9% (n = 14) being dentally- uncooperative. In both groups, extractions caused the highest CDA followed by injections and fillings (p < 0.001). The mean scores for self-reported/proxy-reported CDA were 15.02 (± 4.90)/15.70 (± 6.07) respectively. There was a positive linear correlation between self- and proxy- reported CDA scores and a negative linear correlation between self/proxy- reported CDA scores and the FBRS (p < 0.001). Self/proxy concordance of severe anxiety/none-to-moderate- anxiety was fair (68.6%, kappa = 0.23, p = 0.003). Both self/FBRS and proxy/FBRS concordance of severe anxiety/none-to-moderate- anxiety/behaviour was fair (78.8%, kappa = 0.23, p = 0.001) and (71.8%, kappa = 0.22, p < 0.001) respectively. CONCLUSIONS Considering the limitations of the present study in a UAE child population sample, the prevalence of CDA from extractions, injections and fillings was 22.4% (self- reported) and 33% (proxy reported). There was fair agreement between child- self and parent- proxy- reported CDA. Increased CDA led to uncooperative dental behaviour.
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Affiliation(s)
- S AlGharebi
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - M Al-Halabi
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - M Kowash
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - A H Khamis
- Biostatistics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - I Hussein
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.
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Silveira ER, Cademartori MG, Schuch HS, Corrêa MB, Ardenghi TM, Armfield J, Horta BL, Demarco FF. The vicious cycle of dental fear at age 31 in a birth cohort in Southern Brazil. Community Dent Oral Epidemiol 2020; 49:354-361. [PMID: 33283921 DOI: 10.1111/cdoe.12609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/12/2020] [Accepted: 11/18/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES This longitudinal study assessed the prevalence of dental fear in adulthood and the association with socio-economic, behavioural and clinical variables. Also, the existence of a vicious cycle of dental fear was tested. METHODS A random sample of adults (n = 535) from the 1982 Pelotas Birth Cohort, Brazil, was selected. Socio-economic data, behavioural characteristics and clinical variables were collected during different cohort waves. Oral health data were collected at ages 15, 24 and 31 years old, using questionnaires and oral examination. Dental fear (the outcome) was assessed by the question: 'Are you afraid of going to the dentist?', with possible responses: dichotomized into 'No' or 'A little/Yes/A lot'. Exposure variables were as follows: dental visit in the last years (at the ages 15 and 31); caries experience (DMFT ≥ mean) at the ages 15 and 31; the trajectory of caries prevalence from 15 to 31 years old; dental pain in the last six months in the two ages evaluated; and self-rated oral health at age 31. Several multivariable Poisson regression models were used to investigate the association between each of the exposure variables and dental fear. RESULTS Dental fear prevalence was 22.1%, and it was more prevalent among non-white individuals and females. After controlling for potential confounders, dental fear was more likely to be reported by those individuals who had dental pain or a higher prevalence of dental caries at the age 15. Dental fear was also associated with a worse trajectory of dental caries, negative self-rated oral health at age 31 and with not having visited the dentist in the last year (at the age 31). Results supported the proposed vicious cycle of dental fear. CONCLUSIONS Dental fear in adulthood was related to exposures occurring across the lifecourse. Also, it was possible to observe the occurrence of the vicious cycle of dental fear in the 1982 Pelotas Birth Cohort. Therefore, preventive measures during different periods of the life course are required to prevent dental fear and adulthood.
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Affiliation(s)
- Ethieli R Silveira
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Helena S Schuch
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marcos B Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Thiago M Ardenghi
- Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jason Armfield
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Flavio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Xiang B, Wong HM, Perfecto AP, McGrath CPJ. Modelling health belief predictors of oral health and dental anxiety among adolescents based on the Health Belief Model: a cross-sectional study. BMC Public Health 2020; 20:1755. [PMID: 33228621 PMCID: PMC7686751 DOI: 10.1186/s12889-020-09784-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background A vicious cycle exists between dental anxiety, oral health behaviors and oral health status. Based on previous research, psychological factors of the Health Belief Model (HBM) are associated with oral health behaviors and oral health, and are likely involved in this cycle. However, little is known about the relationship between HBM factors and dental anxiety of adolescents. The purpose of this cross-sectional study was to investigate the relationship between health belief factors, oral health and dental anxiety based on the constructs of the HBM. Methods 1207 Grade 2 students from 12 secondary schools in Hong Kong were randomly selected and measured for the decayed, missing and filled permanent teeth (DMFT) index. Data for oral health behaviors, HBM constructs and dental anxiety were collected using questionnaires. The hierarchical entry of explanatory variables into logistic regression models estimating prevalence odds ratios (POR) were analyzed and 95% confidence intervals (95% CI) for DMFT and dental anxiety were generated. Path analysis was used to evaluate the appropriateness of the HBM as predictors for oral health behaviors, DMFT and dental anxiety. Results Based on the full model analysis, individuals with higher perceived susceptibility of oral diseases (POR: 1.33, 95% CI: 1.14–1.56) or girls or whose mother received higher education level were likelier to have a DMFT≥1, while those with higher perceived severity (POR: 1.31, 95%CI: 1.09–1.57), flossing weekly, DMFT≥1 or higher general anxiety level statistically increases the possibility of dental anxiety. The results from path analysis indicated that stronger perceived susceptibility, greater severity of oral diseases, less performing of oral health behaviors and a higher score of DMFT were directly related to increased dental anxiety level. Other HBM variables, such as perceived susceptibility, self-efficacy beliefs, cues to action and perceived barriers, might influence dental anxiety through oral health behaviors and caries status. Conclusions Clarifying the propositional structures of the HBM may help the future design of theory-based interventions in reducing dental anxiety and preventing dental caries. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12889-020-09784-1.
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Affiliation(s)
- Bilu Xiang
- Department of Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 2/F The Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, China
| | - Hai Ming Wong
- Department of Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 2/F The Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, China.
| | - Antonio P Perfecto
- Department of Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 2/F The Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, China
| | - Colman P J McGrath
- Department of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
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Patterson-Norrie T, Ramjan L, Sousa MS, Sank L, George A. Eating disorders and oral health: a scoping review on the role of dietitians. J Eat Disord 2020; 8:49. [PMID: 33062271 PMCID: PMC7552467 DOI: 10.1186/s40337-020-00325-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compromised nutritional intake due to eating disorder related behaviors, such as binge eating and purging, can lead to multi-system medical complications, including an irreversible impact on oral health. However, dental anxiety, fear or embarrassment may hinder individuals with an eating disorder from seeking assistance for their oral health concerns. As key health professionals in eating disorder treatment, dietitians are well positioned to provide basic dental screening, however, their capacity to perform this role in practice has not been established. The aim of this review was to identify current evidence on the role of dietitians in promoting oral health among individuals with eating disorders. METHODS A comprehensive search of eight electronic databases and the grey literature was conducted to address the following three focus areas: 1) guidelines and recommendations on the role of dietitians in oral health 2) knowledge, attitudes and practices of dietitians regarding oral health promotion and; 3) current models of oral health care and resources for dietitians. RESULTS Twelve articles were included. The review indicated that current national and international position statements encourage dietitians to conduct basic oral health screening and promote oral health in high risk populations, such as those with an eating disorder. However, no evidence was found to indicate dietitians performed oral health screening or education in populations with an eating disorder. In other population settings, dietitians were found to play a role in oral health promotion, however, were noted to have mixed knowledge on oral health risk factors, prevention and treatment and generally were not providing referrals. Some oral health promotion resources existed for dietitians working in pediatric, HIV and geriatric clinical areas however no resources were identified for dietitians working in eating disorder settings. CONCLUSION Despite current evidence showing that dietitians can play a role in oral health care, no models of care exist where dietitians promote oral health among individuals with an eating disorder. There are also no training resources and screening tools for dietitians in this area. Further research is required to develop this model of care and assess its feasibility and acceptability.
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Affiliation(s)
- Tiffany Patterson-Norrie
- Centre for Oral Health Outcomes & Research Translation (COHORT), School of Nursing and Midwifery , Western Sydney University/South Western Sydney Local Health District/ Ingham Institute for Applied Medical Research, Liverpool BC, Locked Bag 7103, Sydney, NSW 1871 Australia
| | - Lucie Ramjan
- School of Nursing and Midwifery, Western Sydney University, Centre for Oral Health Outcomes & Research Translation (COHORT), Sydney, Australia
| | - Mariana S. Sousa
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Lindy Sank
- Sydney Dental Hospital, Oral Health Services, SLHD, Sydney, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University/South Western Sydney Local Health District/University of Sydney/ Ingham Institute for Applied Medical Research, Sydney, Australia
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Nydell Helkimo A, Rolander B, Koch G. Attitudes to dental visits in a child population attending public dental health care in Jönköping, Sweden-trends over 40 years. Eur Arch Paediatr Dent 2020; 22:351-360. [PMID: 32860617 DOI: 10.1007/s40368-020-00552-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/31/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To study attitudes to dental visits in a child population attending public dental health care between 1973 and 2013. METHODS Random samples of individuals aged 3, 5, 10, 15 and 20 years took part in cross-sectional studies based on clinical parameters and a questionnaire, all repeated every 10 years using the same study design. One question related to dental attitude; "What do you feel at the prospect of an appointment with a dentist?". The affirmative answers were full of expectation, unaffected, ill at ease, frightened and sick, representing positive, neutral and negative attitudes. During the same 40-year period, a dental health care system based on prevention and regular dental appointments was reinforced. RESULTS In preschool children, the most pronounced change was an increase in the number of children reporting full of expectation during the study period. In 10-, 15- and 20-year-olds, there was an increase in unaffected and a decrease in ill at ease over time. A reduction in frightened was only seen in the 20-year-olds. CONCLUSIONS Despite a simultaneous dramatic decline in caries and a reduced need for operative dental treatment, the dental attitudes were fairly constant during the 40-year period. The moderate shifts to more positive or neutral dental attitudes were merely seen during the first 10 or 20 years. After this, the changes in answers were limited. This leads to the assumption that factors other than dental treatment experiences have an impact on dental attitudes in children.
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Affiliation(s)
- A Nydell Helkimo
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden.
| | - B Rolander
- Futurum, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
- Department of Behavioral Science and Social Work, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - G Koch
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Region Jönköping County, Box 1030, 551 11, Jönköping, Sweden
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Cai H, Xi P, Zhong L, Chen J, Liang X. Efficacy of aromatherapy on dental anxiety: A systematic review of randomised and quasi-randomised controlled trials. Oral Dis 2020; 27:829-847. [PMID: 32267044 DOI: 10.1111/odi.13346] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 02/26/2020] [Accepted: 03/10/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To evaluate the efficacy of aromatherapy on dental anxiety. METHODS A detailed protocol was registered a priori (PROSPERO: CRD42019141093). PubMed, EMBASE, CDSR, CENTRAL, CNKI and grey literature databases were searched from inception to 10 January 2020. Randomised controlled trials (RCTs) and quasi-randomised controlled trials (CCTs) that examined the effects of aromatherapy on dental anxiety, compare to either negative control (i.e. no aromatherapy) or other positive control approaches (e.g. music), were included. The risk of bias of the selected studies was evaluated using the Cochrane Collaboration's tool and ROBINS-I, while the certainty of evidence was assessed using GRADE. A narrative synthesis was performed, rather than meta-analysis, due to the high level of heterogeneity across studies. RESULTS Eleven RCTs and six CCTs were included. The risk of bias was identified as either high or unclear in RCTs, and moderate to serious in CCTs. Performance bias and detection bias were the most prevalent in RCTs, followed by selection bias and reporting bias. As to CCTs, greater risk of bias was found in the selection of participants into the study and in the measurement of outcomes. Based on the selected studies, the most commonly used aromatherapy for dental anxiety management was lavender fragrance, followed by orange. Compared to the negative control condition, aromatherapy might reduce the anxiety-related physiological parameters and psychometric rating, pain, and mood, alertness, and calmness compared to the negative control condition; and there might be no intergroup difference in such outcomes between aromatherapy and music. However, GRADEs of the relevant evidence were judged as low to very low. CONCLUSIONS Compared to the negative control condition, aromatherapy is more effective to reduce dental anxiety and has comparable effects on dental anxiety compared to music intervention; however, the certainty of evidence is relatively limited. Further high-quality randomised trials with robust study design and large sample size are warranted to confirm our findings and to confirm the role of aromatherapy in relieving dental anxiety.
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Affiliation(s)
- He Cai
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Botnar Research Centre, University of Oxford, Oxford, UK
| | - Pengjun Xi
- MRC Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Linna Zhong
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Junyu Chen
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Xing Liang
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Wong HM, Zhang YY, Perfecto A, McGrath CPJ. Dental fear association between mothers and adolescents-a longitudinal study. PeerJ 2020; 8:e9154. [PMID: 32440376 PMCID: PMC7229765 DOI: 10.7717/peerj.9154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/18/2020] [Indexed: 12/17/2022] Open
Abstract
Aim To assess the longitudinal association between adolescents’ and their mothers’ dental fear. Study Design A longitudinal questionnaire survey study. Methods A randomized sample of 12-year-old adolescents were selected from local Hong Kong schools. Adolescents and their mothers self-completed the Modified Dental Anxiety Scale (MDAS). The sociodemographic background of the mothers and the oral health habits of the adolescents were also collected and these measurements were repeated at 15- and 18-years-old. Non-parametric tests (Mann–Whitney U test/Kruskall Wallis test) were used to test associations between MDAS dental fear items and independent variables. Logistic regression (adjusted for family’s sociodemographic background and adolescent’s oral health habits) was performed to evaluate the longitudinal association between adolescents’ and mothers’ dental fear. Results A total of 212 mother-child pairs were recruited at baseline (12-year-old adolescents). In the first and second follow-ups (15- and 18-years-old), 195 and 182 mother-child pairs completed the survey. Significant associations between mother’s and child’s scores in “feeling about having their teeth scraped and polished”, “having teeth drilled”, and ‘having an injection in the gum’ were found when adolescents were 12- years-old (P < 0.01) and 18-years-old (P < 0.05), but not at 15-years-old. Conclusion Adolescents’ and mothers’ dental fear is associated at 12-years-old and 18-years-old, but not at 15-years-old, which is likely specific to the Hong Kong context but may be extrapolated to other industrialized countries with caution.
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Affiliation(s)
- Hai Ming Wong
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yu Yuan Zhang
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Antonio Perfecto
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Colman P J McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Yon MJY, Chen KJ, Gao SS, Duangthip D, Lo ECM, Chu CH. An Introduction to Assessing Dental Fear and Anxiety in Children. Healthcare (Basel) 2020; 8:healthcare8020086. [PMID: 32260395 PMCID: PMC7348974 DOI: 10.3390/healthcare8020086] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 01/30/2023] Open
Abstract
Fear and anxiety constitute an important theme in dentistry, especially with children. Anxiety and the fear of pain during dental treatment can lead to avoidance behaviour, which contributes to perpetuating fear and anxiety of dental care. Understanding and assessing dental fear and anxiety in children is important for delivering successful dental care with high satisfaction in this age group. Among the vast assessment method options available today, self-report assessment, parental proxy assessment, observation-based assessment, and physiological assessment are the four major types for dental fear and anxiety in children. Each method has its own merits and limitations. The selection of a method should be based on the objectives, validity, and setting of the assessment. The aim of this paper is to review and discuss the assessment methods for dental fear and anxiety in children.
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Sirin Y, Yildirimturk S, Ay N. Do state-trait anxiety and previous unpleasant dental experiences predict the need for sedation in women having third molar surgery? Br J Oral Maxillofac Surg 2020; 58:530-534. [PMID: 32127215 DOI: 10.1016/j.bjoms.2020.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/09/2020] [Indexed: 12/11/2022]
Abstract
The aim of this study was to examine the need for sedation in women who had or had not had a previous unpleasant dental experience, and to assess possible contributory factors. The sample size required was estimated at 312 subjects. Healthy women listed for the surgical removal of third molars were asked to complete a questionnaire regarding their health, clinical and personal experience, past dental experience, result of the Indicator of Sedation Need (IOSN) scale, and of the Spielberger's State-Trait Anxiety Inventory. The participants were categorised before analysis by the nature of their previous dental experience. The number of participants who required sedation, their mean IOSN score, and the mean degree of state anxiety were significantly higher in the unpleasant experience group. The younger the patient at the time of the experience, the worse the state-anxiety (r=-0.25). The odds that sedation would be needed were 2.24 times higher in the same group. The final model correctly predicted the need for sedation in 75.3% of the cases. Healthy women having third molar surgery who had had a previous upsetting dental experience were more likely to need sedation and had worse state-anxiety than those who had not.
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Affiliation(s)
- Y Sirin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - S Yildirimturk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - N Ay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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