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Journal of Dental Research Nov 2022Dental care-related fear and anxiety (DFA) is prevalent, affects oral health care utilization, and is related to poor oral health and decreased quality of life. In... (Meta-Analysis)
Meta-Analysis
Dental care-related fear and anxiety (DFA) is prevalent, affects oral health care utilization, and is related to poor oral health and decreased quality of life. In addition to learned and cultural factors, genetics is hypothesized to contribute to DFA. Therefore, we performed a genome-wide association study to identify genetic variants contributing to DFA. Adult and adolescent participants were from 4 cohorts (3 from the US-based Center for Oral Health Research in Appalachia, = 1,144, 1,164, and 535, and the UK-based Avon Longitudinal Study of Parents and Children [ALSPAC], = 2,078). Two self-report instruments were used to assess DFA: the Dental Fear Survey (US cohorts) and Corah's Dental Anxiety Scale (ALSPAC). Genome-wide scans were performed for the DFA total scores and subscale scores (avoidance, physiological arousal, fear of dental treatment-specific stimuli), adjusting for age, sex, educational attainment, recruitment site, and genetic ancestry. Results across cohorts were combined using meta-analysis. Heritability estimates for DFA total and subscale scores were similar across cohorts and ranged from 23% to 59%. The meta-analysis revealed 3 significant ( < 5E-8) associations between genetic loci and 2 DFA subscales: physiological arousal and avoidance. Nearby genes included ( = 3.05E-8), ( = 4.40E-8), and ( = 7.72E-9). Of these, , which was associated with the avoidance subscale, mediates neurotensin function, and its deficiency may lead to altered fear memory in mice. Gene enrichment analyses indicated that loci associated with the DFA total score and physiological arousal subscale score were enriched for genes associated with severe and persistent mental health (e.g., schizophrenia) and neurocognitive (e.g., autism) disorders. Heritability analysis indicated that DFA is partly explained by genetic factors, and our association results suggested shared genetic underpinnings with other psychological conditions.
Topics: Dental Anxiety; Genome-Wide Association Study; Longitudinal Studies; Neurotensin; Quality of Life; Humans; Adolescent; Adult
PubMed: 35771046
DOI: 10.1177/00220345221105226 -
International Journal of Environmental... Jun 2022This study aimed to investigate the association between dental anxiety (DA) and oral-health-related quality of life (OHRQoL) among rural community-dwelling older...
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. 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 -value of ≤0.001. : 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 ( ˂ 0.001). 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.
Topics: Aged; Cross-Sectional Studies; Dental Anxiety; Humans; Independent Living; Oral Health; Quality of Life; Surveys and Questionnaires
PubMed: 35805302
DOI: 10.3390/ijerph19137643 -
Dentistry Journal Oct 2023Although there is an established connection between diet and mental health, the relationship between diet and dental anxiety has not been examined yet. The purpose of...
Although there is an established connection between diet and mental health, the relationship between diet and dental anxiety has not been examined yet. The purpose of this study was to fill this gap by assessing the association between diet quality, mental distress, and dental anxiety. The data was collected through an anonymous Google Forms survey. The survey consisted of a modified version of the validated Food-Mood Questionnaire and the Modified Dental Anxiety Scale with questions about demographics, dental health, and dental health anxieties. Data collection was performed over seven months, from April to October 2021. Data were analyzed using Pearson's correlation coefficient in SPSS version 25.0 and STATA 17 for sample size calculation, data processing and regression analyses. A total of 506 responses were collected. Our data verified that diet quality modulates dental anxiety. Women exhibited a stronger link with dental anxiety than men ( < 0.01). Consumption of sugary foods was associated with different attributes of dental anxiety ( < 0.01). Low-quality energy-dense foods and dairy were associated with dental anxiety, whereas caffeine, meat, nuts, and green leafy vegetables produced a negative correlation. This cross-sectional study provides proof of concept that dietary patterns are potentially associated with dental anxiety.
PubMed: 37886925
DOI: 10.3390/dj11100240 -
Patient Preference and Adherence 2022The purpose of the study was to investigate dental anxiety (DA) screening and management practices among dental professionals in Saudi Arabia. The study also evaluated...
PURPOSE
The purpose of the study was to investigate dental anxiety (DA) screening and management practices among dental professionals in Saudi Arabia. The study also evaluated correlation between patients' self-reported DA and dentists' ratings of patients' DA.
PARTICIPANTS AND METHODS
This cross-sectional observational study included dentist/patient pairs (N = 279) from the Eastern Province of Saudi Arabia. The dentists responded to a questionnaire about their DA screening and management practices and they evaluated patients' DA using the visual analogue scale (VAS). In addition, patients responded to the Modified Dental Anxiety Scale (MDAS) to measure their DA.
RESULTS
About 15.1% of dentists reported using a published scale for screening DA in dental practice and Corah's Dental Anxiety Scale and Dental Fear Survey were their main scales. However, 69.2% reported directly asking their patients about DA. The use of DA management technique was reported by 89.6% of the dentists. Approximately half of the participants (53%) reported receiving DA training in their undergraduate dentistry programs and 65.2% expressed their interest in continuing education courses related to DA. In multiple logistic regression analysis, statistically significant factors associated with DA screening practice included gender (AOR = 0.46, P = 0.037), place of work (AOR = 3.68, P = 0.039), and interest in continuing education courses (AOR = 3.21, P = 0.015). Monthly income (AOR = 0.20, P = 0.029) and directly asking patient about DA (AOR = 6.15, P = 0.025) were significant factors associated with management of patients with DA. The study also showed a significant but weak correlation between DA evaluated by the dentists and DA reported by the patients (rho = 0.185, P = 0.002).
CONCLUSION
The present study showed a low prevalence of DA screening practices among dentists. Dentists' rating of patients' DA weakly correlated with patients' self-reported DA.
PubMed: 36601029
DOI: 10.2147/PPA.S393399 -
The Journal of Clinical Pediatric... Jul 2023The aim of this study was to evaluate the relationship between personal traits, dental anxiety level and dental appearance of the individuals.
OBJECTIVE
The aim of this study was to evaluate the relationship between personal traits, dental anxiety level and dental appearance of the individuals.
STUDY DESIGN
The study included 431 individuals who completed State Trait Anxiety Inventory-Trait Form (STAI-T) and Corah's Dental Anxiety Scale (CDAS) questionnaires during their first appointment at the orthodontic clinic. The Index of Complexity, Outcome and Need (ICON) index scoring was performed using intraoral frontal photographs by an orthodontist. According to the STAI-T scores, three anxiety groups were formed: mild, moderate, and severe. The Kruskal-Wallis H test was used for intergroup comparisons. Spearman's correlation analysis was performed to evaluate the relationship between STAI-T, CDAS, and ICON scores.
RESULTS
It was found that 38.28% of the participants had mild, 34.1% had severe, and 27.62% had moderate anxiety levels. CDAS score was significantly lower in the mild anxiety group ( ≤ 0.0001) compared to the groups showing moderate and severe anxiety. There was no significant difference between the moderate and severe anxiety groups. ICON score was significantly higher in the severe anxiety group ( ≤ 0.0001) than the other groups. It was also significantly higher in the moderate anxiety group ( ≤ 0.0001) than in the mild anxiety group. There was a significant positive correlation between STAI-T and both CDAS and ICON scores. There was no significant correlation between CDAS and ICON scores.
CONCLUSION
Dental appearance had a significant effect on the general anxiety of individuals. Improving the dental appearance with orthodontic treatments can have positive effects on reducing anxiety. The low level of dental anxiety in individuals with a high need for treatment will facilitate the work of the orthodontist in the procedures to be applied.
Topics: Humans; Anxiety; Dental Care; Surveys and Questionnaires; Dental Anxiety
PubMed: 37408345
DOI: 10.22514/jocpd.2023.018 -
Acta Odontologica Scandinavica Jul 2023There is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process.
INTRODUCTION AND OBJECTIVE
There is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process.
MATERIALS AND METHODS
Eleven semi-structured interviews were conducted with dental clinicians from the public dental service of Östergötland, Sweden. Purposive and theoretical sampling was used. Theoretical saturation was reached after eight interviews. The interviews were audio-recorded and transcribed verbatim. Classical grounded theory was used to inductively analyse data by constant comparative analysis.
RESULTS
The core category was identified as; 'the clinical eye', clinicians noticing behaviours possibly due to dental anxiety based on their knowledge, experiences, or intuition. The core category comprises the five categories: , , , and . Initially there is usually uncertainty about whether a behaviour is due to dental anxiety or part of a patient's normal behaviour. To gain additional certainty, clinicians need to recognise a stressor as something in the dental setting by observing a change in behaviour, for better or for worse, in the anticipation, presence or removal of the stressor.
CONCLUSIONS
Clinicians identify patients as dentally anxious if their behaviour changes with exposure to a stressor.
Topics: Humans; Dental Anxiety; Grounded Theory; Anxiety Disorders; Sweden
PubMed: 36519282
DOI: 10.1080/00016357.2022.2154263 -
Patient Preference and Adherence 2023The purpose of study was to investigate dental anxiety (DA) and its relationship with oral health problems, dental visits, and socio-demographic factors among physicians.
PURPOSE
The purpose of study was to investigate dental anxiety (DA) and its relationship with oral health problems, dental visits, and socio-demographic factors among physicians.
PATIENTS AND METHODS
This cross-sectional study was conducted on physicians working in Dhahran, Khobar, Dammam, and Qatif cities of the kingdom of Saudi Arabia. The study included physicians (general practitioners, residents, specialists, and consultants) working in the public and private sectors. Modified Dental Anxiety Scale and World Health Organization's Oral Health Questionnaire for Adults were used to evaluate DA, oral health problems, and dental attendance.
RESULTS
The study included data from 355 participants with a mean age of 40.13 ± 10.45 years. There were 57.2% of non-Saudi and 42.8% of Saudi participants in the study. Bad dental experience in the previous dental visit was reported by 40% of participants, which was significantly related to DA (P = 0.002). Only 9.60% of participants had no DA, whereas 41.10% demonstrated low DA, 23.4% moderate DA, 18.9% high DA, and 7% extreme DA. Common oral problems included tooth sensitivity (65.40%), tooth cavities (45.90%), bleeding gums (43.10%), and bad breath (36.90%). More than half of participants (58.3%) visited the dentist during the last year and dental pain was the most common reason for dental visits (31.3%). Saudi participants demonstrated significantly increased DA than non-Saudis (P = 0.019). DA was significantly related to tooth sensitivity (P = 0.001), tooth cavities (P = 0.002), dry mouth (P = 0.044), and bad breath (P = 0.005). The participants with difficulty in biting foods (P > 0.001) and feeling embarrassed due to the appearance of teeth (P < 0.001) demonstrated significantly higher DA.
CONCLUSION
This sample of physicians showed a high prevalence of DA, oral problems, and dental visits due to pain. DA was significantly related to physicians' negative dental experience, tooth sensitivity, dental decay, dry mouth, and bad breath.
PubMed: 37113214
DOI: 10.2147/PPA.S406105 -
International Journal of Environmental... Dec 2022The aim of this study was to review the health information of dental fear-, dental anxiety-, and dental phobia-related videos on YouTube. The 100 most widely viewed... (Review)
Review
The aim of this study was to review the health information of dental fear-, dental anxiety-, and dental phobia-related videos on YouTube. The 100 most widely viewed videos for the keywords "dental fear", "dental anxiety", and "dental phobia" were chosen for evaluation. Out of the 300 videos, 145 videos met the inclusion criteria and were analyzed. It was found that most of them were produced by the professions, with a dentist delivering the key messages or with patients giving testimonials. Many etiological factors and symptoms were described. Many pharmacological and non-pharmacological interventions were recommended to the audience, such as sedation and distraction, respectively. However, there was a lack of information on the definition or diagnostic criteria of dental fear, dental anxiety, and dental phobia. Videos with high views had a higher ratio of misleading information. Videos with a dentist being the informant had a similar ratio of misleading information compared to other videos. Without adequate information on how to diagnose, it would be very difficult for the audience to determine if the video content was relevant or useful. The dental profession can work together with psychologists or psychiatrists to produce authoritative videos with accurate content.
Topics: Humans; Anxiety; Information Dissemination; Patients; Phobic Disorders; Social Media; Video Recording
PubMed: 36613071
DOI: 10.3390/ijerph20010750 -
Journal of Dental Sciences Jan 2023Dental anxiety and fear in children are major public health concerns. This study aimed to determine the effectiveness of music therapy combined with aromatherapy, in...
BACKGROUND/PURPOSE
Dental anxiety and fear in children are major public health concerns. This study aimed to determine the effectiveness of music therapy combined with aromatherapy, in reducing the children's dental anxiety and fear.
MATERIALS AND METHODS
A total of 128 school-age children aged 10-12 years were randomly allocated into 4 groups: a control group with 32 volunteers, an experimental group that received music therapy, with 33 volunteers, an aromatherapy experimental group with 31 volunteers, and 32 volunteers in an experimental group with music therapy combined with aromatherapy.
RESULTS
The results found that within-group comparisons before and after the experiment revealed the outcomes with a statistically significant change at the 0.05 level of each group as follows. The control group had increased heart rate. The music therapy group showed decreased dental anxiety and fear and systolic blood pressure. The aromatherapy experimental group exhibited increased oxygen saturation. The experimental group receiving music therapy combined with aromatherapy showed decreased dental anxiety and fear, heart rate, and systolic and diastolic blood pressure as well as increased oxygen saturation values. In addition, it was found that music therapy combined with aromatherapy had a co-influence on dental anxiety and fear (F = 22.22, < 0.001) and oxygen saturation (F = 17.40, < 0.001), and the two main treatments also significantly influenced these outcomes at the 0.05 level.
CONCLUSION
The results showed that music therapy in combination with aromatherapy reduced children's anxiety and fear of dental services better than a single treatment.
PubMed: 36643242
DOI: 10.1016/j.jds.2022.06.008 -
BMC Oral Health Sep 2023Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music, audiovisuals, and virtual reality (VR) technologies has been employed to reduce dental anxiety. This network meta-analysis (NMA) aimed to assess the comparative effectiveness of relaxing music, audiovisuals, and VR in reducing dental anxiety associated with tooth extraction.
METHODS
Four electronic databases were searched up to March 8, 2023, to identify randomized controlled trials (RCTs) evaluating different multimedia interventions, including the application of using relaxing music, audiovisuals, and VR technologies for dental anxiety. Studies utilizing various anxiety scales for tooth extraction were considered eligible. The pooled standard mean difference (SMD) and 95% confidence interval (CI) of anxiety scale scores were analyzed using Bayesian NMA.
RESULTS
A total of 11 RCTs were included in this NMA. The Bayesian NMA results demonstrated that relaxing music (SMD = -0.64, 95% CI: -1.04, -0.25) and VR (SMD = -0.54, 95% CI: -1.08, -0.02) were associated with a reduction in dental anxiety, while audiovisuals (SMD = -0.34, 95% CI: -0.97, 0.33) required further consideration. Ranking probabilities indicated that relaxing music might be the most acceptable method for individuals with dental anxiety. The frequentist NMA yielded consistent rankings in a sensitivity analysis.
CONCLUSIONS
Relaxing music shows the greatest potential for reducing dental anxiety related to tooth extraction when compared to other multimedia interventions.
Topics: Humans; Dental Anxiety; Music; Music Therapy; Network Meta-Analysis; Tooth Extraction
PubMed: 37735362
DOI: 10.1186/s12903-023-03407-y