Dentophobia and dental treatment: An umbrella review of the published literature

AIMS

Dentophobia is a well-know kind of phobia and psychological problem in dentistry. Although patients might suffer from severe oral pain and have serious health complications, dentophobia is still posing a threat to oral healthcare and remains an unresolved worldwide phenomenon. According to estimates, up to 80% of the general population are affected by this condition. Dentophobia is an unpleasant problem with serious consequences not only for patients but also for dentists and the public health system in general. This umbrella review provides a comprehensive overview of the various aspects of dentophoia as addressed in the published literature, and the current level of knowledge concerning their treatment.

METHODS AND RESULTS

Based on 35 reviews of the published literature, addressing various aspects of dentophobia and published between 2008 and 2021, this umbrella review was written. The search was based on the PubMed and PsycINFO databases. The extraction was structured by open coding and each aspect of the subject analyzed according to Ritchie and Lewis.

CONCLUSION

We conclude that the evidence concerning the efficacy of the various interventions is still rather weak and there is an obvious need for further research, because of the yet and unresolved challenges and the lack of standardised guidelines to deal with patients with dentophobia.

Self-reported dental anxiety and injection phobia among individuals with tattoos and piercings

Injection phobia and dental anxiety can, in severe cases, lead to avoidance of necessary treatment. The aim of this pilot study was to investigate self-reported injection phobia and dental anxiety among individuals with tattoos and/or piercings. The Injection Phobia Scale-Anxiety (IPSA) short form and the Modified Dental Anxiety Scale (MDAS) questionnaires were applied. Both the total IPSA and MDAS scores were significantly higher for individuals with tattoos in comparison with a control group (P < 0.001), suggesting a need for anxiety-reducing measures and facilitated treatment for this group of patients.

Dental Fear and Dental Health and Attendance among Finnish Male Prisoners

Objectives

The aim of the present study was to evaluate the prevalence of dental fear and the associations between dental fear and dental health and dental attendance among Finnish prisoners.

Material and Methods

Eighty-nine voluntary male prisoners from the Pelso Prison participated in this cross-sectional clinical study between September 2014 and February 2015. Forty-six (51.7%) of them were also interviewed for their background factors, dental fear and dental attendance. To evaluate the prisoners’ level of dental fear, the Modified Dental Anxiety Scale and Dental Visual Analogue Scale were used. The numbers of decayed, missing, filled and remaining teeth reported dental health. For analyses Pearson’s Chi-square test, Fisher’s exact test, logistic regression analyses and the independent samples Kruskall-Wallis test were conducted.

Results

Among male prisoners four out of 46 (8.7%) reported severe and fourteen out of 46 (30.4%) moderate dental fear, 60.9% had mild or no dental fear. Those with no dental fear visited a dentist regularly more often than those with dental fear. The use of snuff and number of medications were positively associated with severe dental fear.

Conclusions

Dental fear is common among Finnish male prisoners. High number of prescribed medications, use of snuff and irregular dental attendance may indicate severe dental fear among Finnish male prisoners.

Management of pedodontic patients in moderate sedation in clinical dentistry: evaluation of behaviour before and after treatment

The aim of this study is to evaluate the success of functional rehabilitation of one dental session in patients with severe disabilities such as severe autism, baby bottle syndrome and severe odontophobia, and to assess how patient compliance pre- and post-intervention changes in moderate sedation. Between the beginning of 2016 and the end of 2018, 20 pedodontic patients with severe odontophobia, severe autism and baby bottle syndrome who needed dental treatment came to our attention. Patients were aged between 3 and 12 years, including 9 males and 11 females, including 10 odontophobics, 6 with severe autism and 4 with baby bottle syndrome. During the first visit, these patients were evaluated with a rating scale to evaluate the need to carry out dental intervention in a moderate sedation regime. We were able to treat 18 of the 20 patients, and carried out a total of 45 extractions, 4 oral hygiene sessions, 60 dental caries, 29 root canal treatments and 13 sealing pits and fissures. Before and after treatment, each patient's mood was assessed by using a test. Control visits were performed after 30 days, 3 months and the last one after 6 months. After the last follow-up visit, the patient was asked to complete the assessment test of his mood so that it could be compared with the one completed before the intervention. Complete functional and aesthetic rehabilitation of the patient's oral cavity was carried out in a single session. Emotional state and patient compliance improved one year after surgery in about 67% of patients, especially in children with odontophobia. Children with severe autism showed less collaboration in post-intervention assessment. The approach with moderate sedation was effective for the elimination of pain and for the treatment of preventive care, also improving the compliance and the mood of young patients.

Psychometric validation of Corah's Dental Anxiety Scale in the Polish population

BACKGROUND

Corah's Dental Anxiety Scale (DAS) is one of the most popular psychological scales used for diagnosing odontophobia worldwide. Despite being used by Polish researchers, it has never been validated in the Polish population. Also, there are no similar tools that could be used by dentists for screening.

OBJECTIVES

The aim of this study was to validate and present the psychometric properties of the Dental Anxiety Scale adapted to Polish. The scale is a self-assessment tool designed to measure odontophobia and dental anxiety.

MATERIAL AND METHODS

The sample consisted of 162 adults. The adaptation to Polish of the DAS scale included a back-translation and a think-aloud study. The validation procedure incorporated 3 basic methods to be applied in the reliability analysis - the test-retest method, the statistical properties analysis of test items as well as a factor analysis. The general result of the responders was also compared to the anxiety-trait STAI scale and the neuroticism scale form IPIP-BMF-20.

RESULTS

The Cronbach's α was 0.9. The solution obtained in the exploratory factor analysis was a one-factor model, explaining 76.24% of the variance of responses. The test-retest gave a strong correlation (rho = 0.69, p < 0.001). The correlations between the DAS score, the anxiety-trait STAI score and the neuroticism scale form IPIP-BMF-20 were moderate, as expected. The percent of responders with odontophobia and intense dental anxiety was almost similar to the results of other studies.

CONCLUSIONS

The psychometric characteristics of the Polish adaptation of the DAS scale are similar to those reported in the original version. The results allow us to recommend the method for scientific research and patient screening. However, further analyses are necessary to assess if the scores indicating odontophobia and dental anxiety are similar in Poland and in the USA.