ArticlePDF Available

Abstract and Figures

The effects of oral health conditions on physical and psychosocial dimensions have been a matter of interest for several authors over the last decades. Nevertheless, literature lacks studies that address the relationship between the oral health–related quality of life (OHRQoL) and emotions. The present study aimed to investigate the psychological impact of oral disorders on people’s emotional well-being, with a particular attention to gender and age differences. Two hundred twenty-nine dental patients in care at private dental clinics were individually tested. One hundred thirty of them were females (56.8%) and 99 males (43.2%), aged between 18 and 83 years (M = 38.11; SD = 16.7). For the evaluation, the Profile of Mood States (POMS) and the Oral Health Impact Profile (OHIP-14) were used. Data were analyzed using Pearson’s correlations, the ANOVA, and the Kruskal–Wallis test. OHRQoL showed several correlations with all the emotions explored, overcoming the well-known relationship with anxiety and depression (p < .05). The degree of OHRQoL produced differences on mood states, which could appear normal, moderately altered, or psychopathological (p < .03). Furthermore, in different life stages, patients showed specific OHRQoL and emotions.
Content may be subject to copyright.
https://doi.org/10.1177/2158244017728319
SAGE Open
July-September 2017: 1 –7
© The Author(s) 2017
DOI: 10.1177/2158244017728319
journals.sagepub.com/home/sgo
Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License
(http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of
the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages
(https://us.sagepub.com/en-us/nam/open-access-at-sage).
Article
Introduction
According to the World Health Organization (WHO; 2012),
Oral health is essential to general health and quality of life. It is
a state of being free from mouth and facial pain, oral and throat
cancer, oral infection and sores, periodontal (gum) disease, tooth
decay, tooth loss, and other diseases and disorders that limit an
individual’s capacity in biting, chewing, smiling, speaking, and
psychosocial wellbeing.
As the above-mentioned definition suggests, a number of
psychological factors seem to be implicated. At first, it is
well known that the concept of quality of life (QoL) is “mul-
tidimensional and may be categorized within five dimen-
sions: physical wellbeing, material wellbeing, social
wellbeing, emotional wellbeing, and development and activ-
ity” (Felce & Perry, 1995, p. 51).
As oral health–related quality of life (OHRQoL) is “an
integral part of general health and well-being,” it can be
hypothesized that oral disorders may impair at least three of
the QoL dimensions: the physical, emotional, and social
well-being (Åstrøm, Haugejorden, Skaret, Trovik, & Klock,
2005; Sischo & Broder, 2011).
Studies have demonstrated the impact of oral health con-
ditions on physical and psychosocial dimensions (John et al.,
2004; Locker & Allen, 2007; Settineri, Rizzo, Liotta, &
Mento, 2014), while there is a lack of scientific evidence
about the link between OHRQoL and emotions. The majority
of existing studies have focused exclusively on the relation-
ship with dental anxiety (Kurer, Watts, Weinman, & Gower,
1995; McGrath & Bedi, 2004) and/or depression (Marques-
Vidal & Milagre, 2006).
From a psychological point of view, all emotions play a
fundamental regulatory role in human behavior (Gross,
1998), as they intervene in stressful situations, such as facing
illness. Positive or negative feelings toward health problems
may produce different outcomes (Bowman, 2001), suggest-
ing a strict link between health and emotions. According to
Kressin, Reisine, Spiro, and Jones (2001), the personality
trait of “negative affectivity,” compared with the “positive
affectivity” trait, is associated not only with a worse general
physical health and worse health-related quality of life
(HRQoL) but also with specific aspects of OHRQoL. On the
728319SGOXXX10.1177/2158244017728319SAGE OpenSettineri et al.
research-article20172017
1University of Messina, Italy
Corresponding Author:
Carmela Mento, Department of Cognitive Sciences, Psychology,
Educational and Cultural Studies COSPECS, via Concezione 6/8,
98100 Messina, Italy.
Email: cmento@unime.it
Clinical Psychology of Oral Health: The
Link Between Teeth and Emotions
Salvatore Settineri1, Amelia Rizzo1, Marco Liotta1,
and Carmela Mento1
Abstract
The effects of oral health conditions on physical and psychosocial dimensions have been a matter of interest for several authors
over the last decades. Nevertheless, literature lacks studies that address the relationship between the oral health–related
quality of life (OHRQoL) and emotions. The present study aimed to investigate the psychological impact of oral disorders
on people’s emotional well-being, with a particular attention to gender and age differences. Two hundred twenty-nine dental
patients in care at private dental clinics were individually tested. One hundred thirty of them were females (56.8%) and 99
males (43.2%), aged between 18 and 83 years (M = 38.11; SD = 16.7). For the evaluation, the Profile of Mood States (POMS)
and the Oral Health Impact Profile (OHIP-14) were used. Data were analyzed using Pearson’s correlations, the ANOVA,
and the Kruskal–Wallis test. OHRQoL showed several correlations with all the emotions explored, overcoming the well-
known relationship with anxiety and depression (p < .05). The degree of OHRQoL produced differences on mood states,
which could appear normal, moderately altered, or psychopathological (p < .03). Furthermore, in different life stages, patients
showed specific OHRQoL and emotions.
Keywords
OHRQoL, emotions, psychological well-being
2 SAGE Open
contrary, an active coping and the trait of optimism seem to
be related to dental health behavior, suggesting that the trait
of optimism could be a determinant for both oral and general
health (Ylöstalo, EK, & Knuuttila, 2003).
OHRQoL—as a part of a broad range of QoL domains—
could have relationships with a wider emotional spectrum,
from a functional affect expression to a psychopathological
condition. In fact, emotions in clinical situations may become
pathological, for example, when “there is a lack of balance
between real and perceived danger” (Settineri, Mallamace,
Muscatello, Zoccali, & Mento, 2013, p. 168).
Furthermore, as individuals during life span vary in their
ability to regulate emotions and cope with stress (Wang &
Saudino, 2011), it can be hypothesized that even the relation-
ship between OHRQoL and emotions may differ across age,
even if the existing literature seems to have neglected this
point.
On the basis of these premises, the main aim of this study
was to investigate the relationship between all emotions
(Tension, Depression, Anger, Fatigue, Vigor, and Confusion)
and the patient’s OHRQoL, with a particular attention for
different life stages.
The hypotheses are the following:
Hypothesis 1: Poor OHRQoL is linked not only to anxi-
ety and depression but also to other mood states.
Hypothesis 2: In different life stages, there are different
OHRQoL degrees and different emotions.
Hypothesis 3: Different OHRQoL degrees produce dif-
ferent expression of emotions, until psychopathology.
Method
Instruments
For the evaluation, two questionnaires were used.
The POMS is a self-assessment mood scale consisting
of 58 items (McNair, Lorr, & Droppleman, 1992). The
participant has to indicate on a Likert-type scale from 0
(not at all) to 4 (very much) as the last week has experi-
enced the moods listed. The instrument consists of six
subscales: (a) Tension–Anxiety, (b) Depression–Dejection,
(c) Aggression–Anger, (d) Vigor–Activity, (e) Fatigue–
Indolence, and (f) Confusion–Bewilderment. The partici-
pant obtains a score for each subscale, which can be
transformed into standard scores (T points). Being a stan-
dardized instrument, on both clinical and nonclinical sam-
ples, it allows to discriminate between normal range
(40-60 T points) and psychopathology (over 61 T points).
The Oral Health Impact Profile (OHIP-14)—Italian ver-
sion edited by Franchignoni et al. (2010)—consists of 14
items (Slade, 1997). As described by Meredith, Strong, Ford,
and Branjerdporn (2016), each pair of item captures a specific
dimension of the perception of the state of oral health: (a)
Functional Limitation (e.g., difficulty chewing), (b) Physical
Pain (e.g., sensitivity of teeth), (c) Psychological Discomfort
(e.g., self-consciousness), (d) Physical Disability (e.g.,
changes to diet), (e) Psychological Disability (e.g., reduced
ability to concentrate), (f) Social Disability (e.g., avoiding
social interaction), and (g) Handicap (e.g., being unable to
work productively). Respondents were asked to indicate how
frequently they experienced each problem within a reference
period of 12 months on a 5-point Likert-type scale—never
(score 0), hardly ever (score 1), occasionally (score 2), fairly
often (score 3), and very often (score 4). Highest valor corre-
sponds to greater discomfort related to oral health; a non-
pathological condition is instead closer to zero.
Procedure
The study was in conformity with ethical principles of
research as it was conducted according to the Declaration of
Helsinki. Each participant was informed in advance about
methods and study aims and answered to the issued question-
naires only after signing informed consent. Data were col-
lected in the period from January to May 2013. The
administration was conducted by operators who had a brief
training for the administration of psychological tests. The
completion of the questionnaires required from 15 to 30 min,
being two self-report measures. Data were analyzed using
the Statistical Package for the Social Sciences (SPSS 17.0).
To verify our hypothesis, we performed Pearson’s correla-
tions, the ANOVA, and the Kruskal–Wallis test. The reliabil-
ity of questionnaire used obtained a Cronbach’s alpha value
of .93 for the OHIP-14 and .80 for the POMS.
Results
Sample
The whole sample consisted of 263 dental patients, all
belonging to private dental surgeries of the center of Messina,
Sicily (240,000 habitants). We included all participants with
mild or moderate dental problems (gingivitis, cavities,
plaque, sensitive teeth, halitosis, denture discomfort, etc.)
according to the judgment of the dentist. For the analysis, we
considered only the valid cases: 130 of them were females
(56.8%) and 99 males (43.2%), for a total of 229 participants
(see Table 1).
To verify any difference between life stages, patients aged
between 18 and 83 years (M = 38.11 ± 16.7) were split into
three age groups, based on age classes: (a) young patients,
from 18 to 30 years; (b) adult patients, from 31 to 50 years;
and (c) old age patients, from 51 to 83 years. The chi-square
values according to age and gender were not significant,
indicating that groups were well balanced. The measure of
sampling adequacy met the criteria for statistical analysis
(Kaiser–Meyer–Olkin [KMO] = .92, p < .001). Table 2
shows descriptive statistics of the scores obtained by dental
patients on the OHIP-14 and POMS.
Settineri et al. 3
Each dimension of OHIP-14 was referred to a pair of
items (e.g., Functional Limitation, Items 1 and 2; Physical
Pain, Items 3 and 4, etc.); subsequently, scores range from a
minimum of 0 to a maximum of 8. As regards the POMS
from raw scores, we obtained T points: Scores ranging from
40 to 60 are conventionally considered normal. In our dental
patients sample, each subscale scores exceed the norm (mini-
mum 6, maximum 98), even if the mean is contained in the
conventional range.
Hypothesis 1: Poor OHRQoL is linked not only to anxiety and
depression but also to other mood states. To verify our first
hypothesis, we performed Pearson’s correlation (see Table 3).
All the POMS subscales were positively related to OHIP-14
items. Oral health dimensions were significantly related not
only to the well-known constructs of Anxiety and Depression
but also with Aggression, Fatigue, and Confusion, with the
exception for Vigor subscales. The higher the level of emo-
tional psychopathology, the worse the OHRQoL. Further-
more, both physical and psychological aspects of oral health
were significantly linked to mood states.
Hypothesis 2: In different life stages, there are different OHRQoL
degrees and different emotions. Second, we excluded any pos-
sible significant effect of gender by performing the Student t
test for independent samples. On the contrary, the ANOVA
revealed significant difference in the OHIP between age
classes, as shown in Table 4.
Adult patients aged from 31 to 50 years had the higher
scores and hence the worse oral health profile in almost all
subscales, with the exception of Functional Limitation in
which old age patients were more compromised.
As regards POMS, there were no differences between
males and females and between age classes. In the whole
sample, 66 patients showed a level of Tension upper normal,
58 for Depression, 75 for Aggression, 86 for Fatigue, and 44
for Confusion.
Hypothesis 3: Different OHRQoL degrees produce different
expression of emotions, until psychopathology. According to the
classification of the total score of OHIP-14, one hundred
forty-four patients obtained a score lower than 14, which
indicates the absence of oral health problems; 79 patients
obtained a total score between 15 and 41, on the average; and
only six patients obtained a score higher than 42, showing
oral health problems. To verify our third hypothesis, we per-
form the nonparametric Kruskal–Wallis test (Table 4).
Patients who obtained a total score on the average (from
15 to 41) reported increased feelings of Depression and
Confusion. Instead, patients who obtained OHIP-14 total
scores higher than 42 reported more Aggression and Fatigue.
Discussion and Conclusions
At first, as general result, all mood states subscales resulted
positively related to oral health dimensions, with the excep-
tion for the Vigor, the unique positive mood state. Oral health
dimensions were strictly linked not only to the well-known
constructs of Anxiety and Depression but also with
Aggression, Anger, and Confusion. This result clearly con-
firmed our hypothesis: The perception of the patient’s
OHRQoL was connected to an emotional spectrum, broader
than known, ranging from adequately modulated mood, until
emotional dysregulation. In fact, in 19% to 37% of cases, the
patients tested showed mood alterations in association with
OHRQoL problems. Specifically, we observed that patients
who obtained a total oral health score on the average reported
increased feelings of Depression and Confusion. Instead,
patients who scored lower in the oral health profile, suggest-
ing a poor OHRQoL, reported more Aggression and Fatigue.
Different degrees of perceived severity of the OHRQoL con-
ditions were connected to different emotional shades. A pos-
sible explanation is that mood states may also depend on
cognitive evaluation of oral health impairment (i.e., having
coping abilities, self-efficacy, danger perceived, etc.), but
this pathway has not yet been investigated in detail. One of
the few attempts to draw the association between oral health
and mood states is the Meridian Tooth Chart developed by
Wilson and Williams (2011) (see Figure 1). The authors have
compiled a list of the associations between teeth, organs, and
positive or negative mood states. Although fascinating, this
theory borrowed from oriental medicine had never been the
subject of empirical studies: The psychometric investigation
of the relationship between teeth and emotions may even
serve as a first scientific evidence to support this intuitive
association.
Regarding the issue of age differences, we observed that
the most significantly impaired oral health dimension for
elderly patients is Functional Limitation which was in
Table 1. Descriptive Statistics of OHIP-14 and POMS.
OHIP-14 M SD
Functional Limitation 1.29 1.84
Physical Pain 3.07 2.19
Psychological Discomfort 2.52 2.41
Physical Disability 1.75 1.97
Psychological Disability 2.07 2.15
Social Disability 1.73 2.11
Handicap 1.06 1.79
POMS M SD
Tension–Anxiety 54.85 11.39
Depression–Dejection 53.08 11.94
Aggression–Anger 56.45 13.07
Vigor–Activity 53.59 11.00
Fatigue–Indolence 57.01 12.55
Confusion–Bewilderment 51.15 9.93
Note. OHIP-14 = Oral Health Impact Profile; POMS = Profile of Mood
States.
4 SAGE Open
association with specific mood states: Depression, low Vigor
and Confusion. These results are consistent with the findings
of similar studies conducted by Friedlander, Friedlander,
Gallas, and Velasco (2003). The authors found an association
between oral health and late life depression (LLD): Old age
patients with LLD seem to develop behavioral patterns char-
acterized by “compromised social function and impaired
self-maintenance skills (e.g., bathing, dressing, hygiene).”
The depressed, who lose pleasure and interest for daily life
activities, lose even the interest in personal oral hygiene.
Similarly, Macentee, Hole, and Stolar (1997) found, through
a structured interview, that in older adults, mouth has a par-
ticular significance related to three interacting themes: com-
fort, hygiene, and health. An amount of studies, coherent
Table 3. Differences in Oral Health Impact Profile Between Age Classes (OHIP-14).
18-30 years 31-50 years 51-83 years ANOVA
M SD M SD M SD F Significance
Functional Limitation 0.97 1.64 1.43 1.71 1.69 2.25 2.99 .050
Physical Pain 2.57 2.03 3.58 2.29 3.24 2.17 4.97 .008
Psychological Discomfort 2.20 2.43 3.00 2.46 2.41 2.24 2.46 .087
Physical Disability 1.44 1.85 2.19 2.11 1.67 1.90 3.28 .039
Psychological Disability 1.71 2.15 2.48 2.04 2.13 2.23 2.79 .063
Social Disability 1.34 1.88 2.30 2.26 1.61 2.13 4.68 .010
Handicap 0.57 1.35 1.53 2.07 1.28 1.87 7.04 .001
Note. In bold are statistically significant values. OHIP-14 = Oral Health Impact Profile.
Table 4. Differences in Mood States Based on OH Classification.
OH classification Kruskal–Wallis test
Low 0-14 (n = 144) On the average 15141 (n = 79) High 42-56 (n = 6) Grouping variable: OH classification
Mean rank Mean rank Mean rank Chi-square Asymptotic significance
Level of Tension 109.83 121.99 147.08 4.516 .105
Level of Depression 104.11 134.12*** 124.50 18.430 .000
Level of Aggression 103.5 134.65 138.25*** 16.589 .000
Level of Vigor 114.6 116.82 99.17 0.517 .772
Level of Fatigue 107.8 125.35 149.67* 6.912 .032
Level of Confusion 107.5 129.94** 109.17 9.024 .011
Note. OH = oral health.
*In bold are statistically significant values (p < .05; p < .01).
Table 2. Correlations Between POMS and OHIP-14.
Tension–Anxiety Depression–Dejection Aggression–Anger Vigor–Activity Fatigue–Indolence Confusion–Bewilderment
1. Difficult pronounce words .115 .111 .127* −.043 .099 .145*
2. Worsened taste .097 .143* .133* −.176** .160** .154*
3. Pain .200** .138* .152* −.025 .187** .132*
4. Uncomfortable to eat .128* .077 .089 −.092 .155* .113
5. Self-conscious .202** .214** .209** −.091 .206** .258**
6. Feel tensed .244** .217** .257** −.113 .274** .237**
7. Diet unsatisfactory .175** .259** .186** −.087 .225** .174**
8. Interrupted meals .245** .238** .259** −.050 .257** .230**
9. Difficult to relax .238** .232** .226** −.072 .280** .295**
10. Embarrassed .209** .221** .187** −.036 .229** .255**
11. Irritable .262** .280** .293** −.101 .305** .319**
12. Difficult to do jobs .247** .342** .284** −.085 .273** .300**
13. Life less satisfying .270** .319** .226** −.150* .262** .303**
14. Totally unable to function .274** .322** .272** −.113 .221** .305**
OHIP-A .279** .296** .278** −.116 .302** .309**
Note. POMS = Profile of Mood States; OHIP-14 = Oral Health Impact Profile; OHIP-A = Total Oral Health Impact Profile.
*Correlation is significant at the .05 level (2-tailed). **Correlation is significant at the .01 level (2-tailed).
Settineri et al. 5
with our results, have demonstrated that “many older adults
have chewing problems, pain, difficulties in eating, and
problems in social relationships because of oral disorders”
(Zainab, Ismail, Norbanee, & Ismail, 2008, p. 19). Even
Locker, Clarke, and Payne (2000) found that poor self-per-
ceived oral health and relatively poor QoL in older adults
coexist. On the contrary, adult patients of our sample aged
from 31 to 50 years scored worse oral health profile, in
almost all subscales. These results can be explained by the
epidemiological distribution of oral health–related problems
and its impact on the specified age range. According to
Nuttall, Steele, Pine, White, and Pitts (2001), “over half
(51%) of dentate adults said they had been affected in some
way by their oral health, and in 8% of cases the impact was
sufficient to have reduced their quality of life” (p. 121).
Locker and Miller (1994) comparing different age groups of
dental patients on self-reported oral health status obtained
that the initial hypothesis that younger participants would
report lower problems on oral health indicators has been not
supported. On all measures except ability to chew, younger
participants were as likely to be compromised by oral condi-
tions as older participants. On the contrary, in the present
study, younger patients showed the lower levels of oral
health impairment and adequate emotional regulation.
Nevertheless, we have reason to think that the oral compro-
mission of adolescents and young adults could be tied not so
much for the physical aspects, such as pain or discomfort,
assessed in this study, but above to other oral health aspects
belonging to the general health QoL such as dental aesthetics
perceptions and dysmorphic levels, as suggested by literature
(Settineri, Mento, et al., 2013; Settineri et al., 2014; Settineri,
Rizzo, Ottanà, Liotta, & Mento, 2015).
It is also necessary to discuss issues surrounding the
gender. Both in OHIP-14 and in the POMS, gender differ-
ences were not found. On the contrary, several studies
have shown that males and females have a different per-
ception of oral health status and oral health behavior in
favor of females. Young woman “had better oral health
Figure 1. Meridian Tooth Chart.
Source. Wilson and Williams (2011).
6 SAGE Open
behaviour and more factors associated with their oral
health in comparison with young men” (Tada & Hanada,
2004, p. 104). At the same time, women perceived oral
health as having a greater impact than men on their QoL in
general, having both a greater negative or positive impact
(McGrath & Bedi, 1999). Nevertheless, good general
health habits correlate with higher oral health behaviors in
males as well. For this reason, Fukai, Takaesu, and Maki
(1998) hypothesized that “gender specificities in oral
health depend on individual attitudes to oral health and
dental utilization” (p. 187).
Although the findings have offered a first level of study of
the psychopathology of emotions in dental patients, we must
point out some limitations of the study. First, the sample
showed the limits of generalizability, having been sourced in
the same geographic region, because there are some evidence
that oral health is influenced also by cultural background.
For example, in Australia, those aged between 30 and 49
years showed the worst oral health profile scores; in the
United Kingdom, instead, patients below 30 years showed
the highest scores, reporting the worse oral health quality
(Steele et al., 2004).
It would also be interesting to verify, both from the psy-
chological and the dental point of view, whether the discom-
fort felt by the patient is congruent with the severity attributed
by the dentist or whether there are differences attributable to
the degree of invasiveness of the treatment.
In conclusion, the results of this study showed a signifi-
cant relationship between the perception of the patient’s oral
health and the mood states experienced. This knowledge
may help to better understand the psychological mechanisms
involved in the treatment compliance. The attention about
the role of emotions in oral health life involves both psy-
chologists and dentists, who have to safeguard the psychoso-
cial, physical, and emotional well-being of dental patients.
The teeth moreover have a symbolic value in the emotional
life. The mouth, the main organ of our ability to express, can
be read scientifically as an organ to cure, or symbolically as
part of the body capable of recording and expressing our psy-
choemotional experience.
Acknowledgments
The authors are grateful to the dental students of the University of
Messina for the data collection which was carried out as a clinical
psychology exercise to deeper understand the psychological aspects
that influence dental patients’ behavior.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, author-
ship, and/or publication of this article.
References
Åstrøm, A. N., Haugejorden, O., Skaret, E., Trovik, T. A., & Klock,
K. S. (2005). Oral impacts on daily performance in Norwegian
adults: Validity, reliability and prevalence estimates. European
Journal of Oral Sciences, 113, 289-296.
Bowman, G. S. (2001). Emotions and illness. Journal of Advanced
Nursing, 34, 256-263.
Felce, D., & Perry, J. (1995). Quality of life: Its definition and mea-
surement. Research in Developmental Disabilities, 16(1), 51-
74.
Franchignoni, M., Giordano, A., Brigatti, E., Migliario, M., Levrini,
L., & Ferriero, G. (2009). Psychometric properties of the
Italian version of the reduced form of the Oral Health Impact
Profile (OHIP-14). Giornale Italiano Di Medicina Del Lavoro
Ed Ergonomia, 32(3, Suppl. B), B71-78.
Friedlander, A. H., Friedlander, I. K., Gallas, M., & Velasco, E.
(2003). Late-life depression: Its oral health significance.
International Dental Journal, 53, 41-50.
Fukai, K., Takaesu, Y., & Maki, Y. (1999). Gender differences in
oral health behavior and general health habits in an adult popu-
lation. The Bulletin of Tokyo Dental College, 40, 187-193.
Gross, J. J. (1998). The emerging field of emotion regulation: An
integrative review. Review of General Psychology, 2, 271-279.
John, M. T., Hujoel, P., Miglioretti, D. L., LeResche, L., Koepsell,
T. D., & Micheelis, W. (2004). Dimensions of oral-health-
related quality of life. Journal of dental research, 83, 956-960.
Kressin, N. R., Reisine, S., Spiro, A., & Jones, J. A. (2001). Is nega-
tive affectivity associated with oral quality of life? Community
Dentistry and Oral Epidemiology, 29, 412-423.
Kurer, J. R. B., Watts, T. L. P., Weinman, J., & Gower, D. B.
(1995). Psychological mood of regular dental attenders in rela-
tion to oral hygiene behaviour and gingival health. Journal of
Clinical Periodontology, 22, 52-55.
Locker, D., & Allen, F. (2007). What do measures of “oral health-
related quality of life” measure? Community Dentistry and
Oral Epidemiology, 35, 401-411.
Locker, D., Clarke, M., & Payne, B. (2000). Self-perceived oral
health status, psychological well-being, and life satisfaction
in an older adult population. Journal of Dental Research, 79,
970-975.
Locker, D., & Miller, Y. (1994). Subjectively reported oral health
status in an adult population. Community Dentistry and Oral
Epidemiology, 22, 425-430.
Macentee, M. I., Hole, R., & Stolar, E. (1997). The significance of
the mouth in old age. Social Science & Medicine, 45, 1449-
1458.
Marques-Vidal, P., & Milagre, V. (2006). Are oral health status
and care associated with anxiety and depression? A study of
Portuguese health science students. Journal of Public Health
Dentistry, 66, 64-66.
McGrath, C., & Bedi, R. (1999). Gender variations in the social
impact of oral health. Journal of the Irish Dental Association,
46, 87-91.
McGrath, C., & Bedi, R. (2004). The association between den-
tal anxiety and oral health-related quality of life in Britain.
Community Dentistry and Oral Epidemiology, 32, 67-72.
McNair, D. M., Lorr, M., & Droppleman, L. F. (1992). POMS:
Profile of mood states. North Tonawanda, NY: Multi-Health
Systems.
Settineri et al. 7
Meredith, P., Strong, J., Ford, P., & Branjerdporn, G. (2016).
Associations between adult attachment and oral health-related
quality of life, oral health behaviour, and self-rated oral health.
Quality of Life Research, 25, 423-433.
Nuttall, N. M., Steele, J. G., Pine, C. M., White, D., & Pitts, N. B.
(2001). Adult dental health survey: The impact of oral health on
people in the UK in 1998. British Dental Journal, 190, 121-126.
Settineri, S., Mallamace, D., Muscatello, M. R. A., Zoccali, R., &
Mento, C. (2013). Dental anxiety, psychiatry and dental treat-
ment: How are they linked? Open Journal of Psychiatry, 3,
168-172.
Settineri, S., Mento, C., Rizzo, A., Liotta, M., Militi, A., &
Terranova, A. (2013). Dysmorphic level and impact of den-
tal aesthetics among adolescents. Paripex–Indian Journal of
Research, 2, 210-214.
Settineri, S., Rizzo, A., Liotta, M., & Mento, C. (2014). Italian
validation of the Psychosocial Impact of Dental Aesthetics
Questionnaire (PIDAQ). Health, 6, 2100-2108.
Settineri, S., Rizzo, A., Ottanà, A., Liotta, M., & Mento, C. (2015).
Dental aesthetics perception and eating behavior in adoles-
cence. International Journal of Adolescent Medicine and
Health, 27, 311-317.
Sischo, L., & Broder, H. L. (2011). Oral health-related quality
of life: what, why, how, and future implications. Journal of
Dental Research, 90, 1264-1270.
Slade, G. D. (1997). Derivation and validation of a short-form
oral health impact profile. Community Dentistry and Oral
Epidemiology, 25, 284-290.
Steele, J. G., Sanders, A. E., Slade, G. D., Allen, P. F., Lahti, S.,
Nuttall, N., & Spencer, A. J. (2004). How do age and tooth loss
affect oral health impacts and quality of life? A study com-
paring two national samples. Community Dentistry and Oral
Epidemiology, 32, 107-114.
Tada, A., & Hanada, N. (2004). Sexual differences in oral health
behaviour and factors associated with oral health behaviour in
Japanese young adults. Public Health, 118, 104-109.
Wang, M., & Saudino, K. J. (2011). Emotion regulation and stress.
Journal of Adult Development, 18, 95-103.
Wilson, R., & Williams, L. (2011). Meridian Tooth Chart. Available
from TheLighsomeLife.com
World Health Organization. (2012). Oral health. Fact Sheet, N°318.
Retrieved from http://www.who.int/oral_health/en/
Ylöstalo, P., Ek, E., & Knuuttila, M. (2003). Coping and optimism
in relation to dental health behaviour—A study among Finnish
young adults. European Journal of Oral Sciences, 111, 477-482.
Zainab, S., Ismail, N. M., Norbanee, T. H., & Ismail, A. R. (2008).
The prevalence of denture wearing and the impact on the oral
health related quality of life among elderly in Kota Bharu,
Kelantan. Archives of Orofacial Sciences, 3, 17-22.
Author Biographies
Salvatore Settineri is an associate professor of clinical psychology
at the University of Messina, Italy. He teaches in university courses
in clinical psychological, health psychology, and psychodynamics.
Amelia Rizzo received her PhD in psychological sciences at the
University of Messina, Italy. She deals with clinical psychology
research, psychopathology of emotions, and psychological
well-being.
Marco Liotta received his PhD in psychological sciences at the
University of Messina, Italy. He is interested in research topics on
the psychopathology of emotions in the clinical field.
Carmela Mento is an assistant professor of clinical psychology at
the University of Messina, Italy. She teaches in psychology courses
at the university and deals with psychopathology and clinic.
... The relationship between emotions and the Oral Health-Related Quality of Life (OHRQoL), which differs across age is described in the following hypotheses. [1] 1. Poor OHRQoL is linked not only to anxiety and depression but also to other mood states [1] 2. In different life stages, there are different OHRQoL degrees and different emotions [1] 3. Different OHRQoL degrees produce different expressions of emotions, until psychopathology. [1] Sustained stress can produce high blood pressure, heart disease, and cancer in addition to nausea or a sleepless night and often have their roots in stress as it impacts the hormonal and nervous systems, among others. ...
... The relationship between emotions and the Oral Health-Related Quality of Life (OHRQoL), which differs across age is described in the following hypotheses. [1] 1. Poor OHRQoL is linked not only to anxiety and depression but also to other mood states [1] 2. In different life stages, there are different OHRQoL degrees and different emotions [1] 3. Different OHRQoL degrees produce different expressions of emotions, until psychopathology. [1] Sustained stress can produce high blood pressure, heart disease, and cancer in addition to nausea or a sleepless night and often have their roots in stress as it impacts the hormonal and nervous systems, among others. ...
... The relationship between emotions and the Oral Health-Related Quality of Life (OHRQoL), which differs across age is described in the following hypotheses. [1] 1. Poor OHRQoL is linked not only to anxiety and depression but also to other mood states [1] 2. In different life stages, there are different OHRQoL degrees and different emotions [1] 3. Different OHRQoL degrees produce different expressions of emotions, until psychopathology. [1] Sustained stress can produce high blood pressure, heart disease, and cancer in addition to nausea or a sleepless night and often have their roots in stress as it impacts the hormonal and nervous systems, among others. ...
... In the hierarchical analysis, we found that three groups were formed ( Figure 4). Figure 4 shows that items S8, 10, 11, 14, 17, 19, 20, 24, 26 and 27 were grouped in cluster 1. Items S12, 37 and 41 were grouped in cluster 2 and items S1, 15,16,18,21,22 and 25 were grouped in cluster 3. ...
... Regarding dimension 1, the effects of oral health conditions on physical and psychosocial dimensions have been a topic of interest for several authors over the last decades [20,21]. Like Settineri et al. [22], we found a significant relationship between the patient's perception of oral health and their mood states: "Item 25: I am worried about my oral health", "Item 26. I am embarrassed to speak because of the condition of my mouth", "Item 19: I have bad breath". ...
... Teeth have a symbolic value in emotional life insofar as the mouth, the main organ of our expressive capacity, can be read scientifically as an organ to be treated or symbolically as a part of the body capable of recording and expressing our psycho-emotional experience [21,22]. This is documented in "Item 27: I am embarrassed to speak because of the state of my mouth" and "Item 25: I am worried about my oral health" by PWS. ...
Article
Full-text available
The Schizophrenia Oral Health Profile questionnaire was developed to assess the oral health-related quality of life among individuals with schizophrenia based on their perceptions rather than from caregivers. A 5-point Likert scale was used to self-report on 42 items. In the present study, different analyses were conducted to determine the dimensional structure of the final scale: (1) inter-item correlation analysis and Cronbach’s α coefficient, (2) Rasch model analysis, (3) exploratory factor analysis and (4) confirmatory factor analysis. The final version of the Schizophrenia Oral Health Profile questionnaire consisted of 20 items and an internal structure composed of three dimensions: (1) emotions related to oral health, (2) oral pain and discomfort and (3) self-image, others’ views and the need for care. We showed that the difficulty and discrimination indices of each of the 20 selected items were acceptable according to the Rasch model, as well as their inter-item and inter-score correlations (α = 0.875). The psychometric study of the Schizophrenia Oral Health Profile questionnaire is still in progress to investigate reproducibility, sensitivity to change and external structure.
... In addition, some studies suggest that the specific dental anxiety is not even a component of their classical general anxiety disorders family but rather belongs to the group of mood disorders by using specific scales such as dental anxiety scale and Patient Health Questionnaire. Therefore, the authors accentuate/emphasize the fact that this might represent a very specific manifestation and not just a simple diversification of other phobias, such as those for blood and injections [19]. ...
... Therefore, the literature contains some scarce original research studies [15,19] some case presentations [16,20] as well as some reviewing [13,14] on the current data, which are stating clearly the necessity for further efforts in understanding the correlations between neuropsychiatric and dental manifestations, as well as some attempts in establishing a few preliminary guidelines in this matter [21,22]. ...
... In addition, other studies are suggesting that perhaps some of these disorders, such as, for example, the specific dental anxiety, are not even a component of their classical general anxiety disorders family, but it rather belongs to the group of mood disorders [19]. ...
Article
Full-text available
Although the connections between neuropsychiatric and dental disorders attracted the attention of some research groups for more than 50 years now, there is a general opinion in the literature that it remains a clearly understudied and underrated topic, with many unknowns and a multitude of challenges for the specialists working in both these areas of research. In this way, considering the previous experience of our groups in these individual matters which are combined here, we are summarizing in this minireport the current status of knowledge on the connections between neuropsychiatric and dental manifestations, as well as some general ideas on how oxidative stress, pain, music therapy or even irritable bowel syndrome-related manifestations could be relevant in this current context and summarize some current approaches in this matter.
... The problem of people with halitosis is that this condition can often remain unnoticed because people are generally unaware of the quality of their oral odor. Research conducted on Korean adolescent subjects [4] has made tend to be more alert and anxious about their health, obtaining significantly higher scores in the OLT (organoleptic test, the gold standard to detect bad oral smell) and showing significant symptoms of anxiety and depression, with the anxiety itself increasing oral levels of volatile sulfur compounds (VSCs) [20][21][22][23][24][25][26][27]. A gender difference in the perception of halitosis was highlighted in one study [23]: 21.7% were male and 35.3% were female. ...
... People who have a bad oral odor problem tend not to be aware of their bad breath, while those who do not have a bad breath problem worry excessively about having a bad odor problem. Young and middle-aged people tend to be more alert and anxious about their health, obtaining significantly higher scores in the OLT (organoleptic test, the gold standard to detect bad oral smell) and showing significant symptoms of anxiety and depression, with the anxiety itself increasing oral levels of volatile sulfur compounds (VSCs) [20][21][22][23][24][25][26][27]. A gender difference in the perception of halitosis was highlighted in one study [23]: 21.7% were male and 35.3% were female. ...
Article
Full-text available
(1) Background: Halitosis is a frequent condition that affects a large part of the population. It is considered a “social stigma”, as it can determine a number of psychological and relationship consequences that affect people’s lives. The purpose of this review is to examine the role of psychological factors in the condition of self-perceived halitosis in adolescent subjects and adulthood. (2) Type of studies reviewed: We conducted, by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines, systematic research of the literature on PubMed and Scholar. The key terms used were halitosis, halitosis self-perception, psychological factors, breath odor and two terms related to socio-relational consequences (“Halitosis and Social Relationship” OR “Social Issue of Halitosis”). Initial research identified 3008 articles. As a result of the inclusion and exclusion criteria, the number of publications was reduced to 38. (3) Results: According to the literature examined, halitosis is a condition that is rarely self-perceived. In general, women have a greater ability to recognize it than men. Several factors can affect the perception of the dental condition, such as socioeconomic status, emotional state and body image. (4) Conclusion and practical implication: Self-perceived halitosis could have a significant impact on the patient’s quality of life. Among the most frequent consequences are found anxiety, reduced levels of self-esteem, misinterpretation of other people’s attitudes and embarrassment and relational discomfort that often result in social isolation.
... Psychological stress triggers the neuro-endocrine system, resulting in the continued release of pro-inflammatory mediators and an alteration in normal microbiota, thereby leading to periodontal inflammation [7][8][9]. The effect of different aspects of psychological stress, including emotional stress, work-related stress, and dissatisfaction at home or in society, is associated with compromised oral health as suggested by previous studies [10,11]. In previous literature by Pistorius et al. and Wimmer et al., a correlation has been found between increased level of chronic stress and periodontitis with clinical attachment loss [8,9]. ...
Article
Full-text available
The present study aimed to assess the effect of self-perceived psychological stress on the periodontal health of socially deprived women. The study included three hundred and eighty-five socially deprived women residing in shelter homes. The presence of stress and its severity was assessed by using Sheldon Cohen’s 10-item perceived stress scale (PSS), and periodontal health status was assessed utilizing the community periodontal index. Statistical analyses were performed using an independent sample t-test, a one-way ANOVA, the Pearson chi-Square test, and binary logistic regression. Results: A total of 385 samples were included, the majority of whom (n = 297; 72.5%) belonged to the age group of 15–30 years. There were 34 (8.8%) participants who were educated up to graduate level. A total of 47.8% of the women were found with healthy periodontal status, and 52.5% of the samples were diagnosed with major psychological stress. Half of the samples (201-52.2%) had a periodontal problem. The mean PSS was found statistically significant concerning age group, education, and psychological stress level. In the univariate logistic regression analysis, a significant association of periodontal status was observed with the age group 31–45 years [(OR = 1.76; 95% C.I (1.11–2.78)] and with a major psychological stress level [(OR = 2.60; 95% C.I (1.72–3.93)]. Psychosocial stress among socially deprived women was found to be a risk factor for periodontal disease.
... People in Wuhan may have suffered more from stress and other negative emotions. Previous studies have evaluated the mutual impact of psychological emotions and oral health [16][17][18]. In our study, the significantly higher prevalence of oral problems among participants in Wuhan may also be proof of this mutual correlation. ...
Article
Full-text available
Background COVID-19 has seriously threatened the health and lives of people. This study aimed to investigate the impact of COVID-19 on the oral health of adults in Wuhan and other places of China amid the epidemic and to evaluate attitudes towards dental care in the post-epidemic period. Methods An online cross-sectional survey based on a questionnaire of 22 questions was conducted. Results A total of 3352 valid questionnaires were collected. Participants from Wuhan tended to be relatively psychologically affected and more concerned about future dental treatment. Toothbrushing frequency did not differ significantly between participants from Wuhan and other places and was associated with the prevalence of oral problems people encountered. Gingival bleeding, bad breath and oral ulcers were the three most common oral problems amid the epidemic, and significantly more participants in Wuhan experienced oral problems than other places in China. Conclusion The three most common oral problems amid the epidemic were gingival bleeding, bad breath and oral ulcers. Adults in Wuhan tended to be more seriously affected and suffered more oral problems than people from other places in China. Maintaining good oral health behaviours plays an important role in preventing dental problems. It is crucial to establish and to follow the standard guidelines for the provision of dental care during and after the epidemic.
... Teeth have a symbolic value in the emotional life of a human being. The mouth is the main organ of ability to express psycho-emotional experience (2). Older adults are often vulnerable, and may require help in maintaining their independence and preserving their confi dence in oral health functioning, including daily life activities such as eating, talking and smiling. ...
Article
Objectives: To test reliability of the Oral Health Impact Profile-14 (OHIP-14) questionnaire translated into Lithuanian, and to evaluate impacts of dental health status as well as factors related to it on daily wellbeing among older adults attending Lithuanian University of Health Sciences (LUHS) dental clinic. Material and methods: The permission to conduct the present study was granted by Center of Bioethics at LUHS. OHIP-14 was translated into Lithuanian and applied on adults aged 50 and more years (n=52) who received dental treatment at university clinic in March 2015. Data about dental health status of the subjects was collected from patients' records. Gender, marital status, education and income served as background information. The data were analysed by ANOVA and Chi-square test, taking the cut-off level for statistical significance at 0.05. Reliability analysis was performed by Cronbach's alpha. Results: The standardized Cronbach's alpha value of the Lithuanian version of the OHIP-14 was 0.924, considered as excellent. The mean total score of the OHIP-14 was 18.17 with the most commonly reported subscale of Psychological Discomfort. Just 8% of all respondents did not experience any impact from the dental health status on their daily wellbeing. There were significant differences in OHIP-14 items scores by gender, with women having higher scores for feeling tensed, self-conscious and having the unsatisfactory diet. Conclusion: The present findings indicate that the Lithuanian version of the OHIP-14 is reliable measure to be used in further studies. The majority of the study participants reported experiencing impacts from the dental health status on their daily wellbeing, with the psychological discomfort being the most common. Female gender was associated with reporting significantly higher impacts.
... 48 Moreover, unmanaged oral pain may contribute to agitation and confusion, which may intensify clinical workload. 49 Clinical practice guidelines can assist clinicians in identifying appropriate care for oral pain, thereby potentiating improved care processes and outcomes. 50 Future ICU research may explore the impact of procedural oral pain assessment and management on oral care delivery and patient experiences. ...
Article
Full-text available
Background: Intubated and mechanically ventilated patients in the intensive care unit (ICU) may experience pain during routine oral procedures such as oral suctioning and tooth brushing. Despite the importance of pain prevention and management, little is known about patients’ experiences of procedural oral pain. Aims: The aim of this study was to explore patients’ recollections and recommendations for pain and discomfort during routine oral procedures. Methods: A qualitative descriptive design was used. Adult patients were recruited from a mixed medical-surgical-trauma ICU in an academic hospital in Toronto, Canada. Participants were interviewed using object elicitation methods within seven days of discharge from the ICU. Data were analyzed using directed content analysis methods. Results: We recruited 33 participants who were primarily male (23, 70%), 54 (SD 18) years of age, admitted with a medical (13, 39%), trauma (11, 33%), or surgical (9, 27%) diagnosis and dentate (27, 82%). Most participants described oral procedures as painful, discomforting, and emotionally distressing. Identified sources of pain included dry, inflamed oral tissues and procedural technique. Procedural pain behaviors were perceived to be frequently misinterpreted by clinicians as agitation, with consequences including physical restraint and unrelieved suffering. Participants advocated for greater frequency of oral care to prevent oral health deterioration, anticipatory procedural guidance, and structured pain assessment to mitigate the dehumanizing experience of unmanaged pain. Conclusions: Patients described routine oral care procedures as painful and recalled suboptimal management of such pain. Procedural oral pain is an important target for practice improvement.
Article
Full-text available
Oral health is increasingly seen as a public health challenge due to the remarkable prevalence of oral diseases worldwide, the impact on general health, and health consequences that can arise for individuals. Compared to other health services, oral health services are usually not fully covered by statutory health insurance, which is seen as one reason in decision-making on dental treatments. Nevertheless, patients’ reasons for treatment decisions are not well understood although they can provide valuable insights. The objective of this study was to identify reasons of choice for dental treatments and to explore patients’ view on cost coverage in Germany. We conducted four focus group interviews with a total of 27 participants. The interviews were audiotaped and transcribed verbatim. Data was analyzed performing conventional content analysis. As part of a qualitative analysis, subcategories and categories were formed from identified reasons using an inductive approach. Our study supports and expands research in exploring patients’ decision-making on dental treatments. It highlights a variety of 53 reasons of choice for dental treatments from patients’ perspective, split in two categories “health care service”, and “dentist & dental office”. First category includes reasons regarding dental care performance (subcategories: “preconditions”, “treatment”, “costs”, and “outcomes”). Second category demonstrates reasons regarding dentists, office structures and processes (subcategories: "professional skills", "social skills", "office staff & equipment", and "office processes”). Reasons named “most important” by the participants are out-of-pocket payments, dentists’ training, and a relationship of trust between patient and dentist. Although the participants use incentive measures to lower financial burden, several perceived challenges exist. Identified reasons for choosing dental treatments provide a basis for further studies to quantify the relevance of these reasons from patients’ perspective. Based on this, the various reasons identified can be considered in future policies to improve patients’ utilization behavior, which can range from improved information sources to increased incentive measures.
Article
Aim: To assess oral health-related quality of life among psychiatric patients. Materials and methods: A total of 400 inpatients and outpatients reporting to the Department of Psychiatry was taken as the final sample. Subjects diagnosed with mental illness and on medication for at least 1 year, who were able to respond to the pro forma and oral health impact profile (OHIP) questionnaire, were included. A guided, self-administered structured questionnaire was designed to include sociodemographic characteristics and short form of the OHIP-14 consisting of 14 items covering 7 domains: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and handicap. It was used to assess the impact of oral conditions on well-being and quality of life. The data collected were subjected to statistical analysis using SPSS IBM version 20.0. Results: The highest mean OHIP score for the disorders was seen among the patients diagnosed with schizophrenia for functional limitation (2.73 ± 1.194), 2.91 ± 1.111 for psychological discomfort, 2.67 ± 1.203 was recorded for physical disability, 2.79 ± 1.156 was the mean score for psychological disability followed by a score of 2.87 ± 1.172 for social disability. The highest mean score for the handicap domain was recorded for schizophrenia patients (2.73 ± 1.241) whereas for physical pain, a mean score of 3.01 ± 1.261 was recorded for patients diagnosed with bipolar disorder. Conclusion: Based on the findings of the study, it can be stated that the psychiatrists should pay attention to the dental anxiety concerns of the patients and encourage them to visit oral health professionals. Clinical significance: The study highlights the importance of incorporating dental health education to psychiatric rehabilitation programs.
Article
Full-text available
Background: This correlational study explored the psychosocial aspects related to eating behavior in different age samples of adolescents in treatment from 0 to 60 months at the Clinic of Orthodontics and Dentistry of Messina, Messina, Italy. The aim of the study was to investigate the relationship between psychosocial impact, levels of self-esteem, and the possible connection with eating habits of adolescents under orthodontic treatment. Methods: Sixty-one adolescents, aged between 12 and 22 years (mean=15.6±2.8) participated to the study. Each adolescents was interviewed with the Eating Attitudes Test, the Rosenberg Self Esteem Scale, and the Psychosocial Impact of Dental Aesthetics Questionnaire. Results: Data did not show a direct connection between eating disorder and dental aesthetics, nevertheless, adolescents under orthodontic treatment, especially in the earliest phase of wearing braces, showed peculiar eating habits and underwent a higher psychological impact of dental aesthetics. Eating behaviors are strictly linked to global self-esteem. The processing of the results was made through the Student’s t-test and using Pearson’s correlation analysis. Conclusions: Increased knowledge of the psychological aspects involved in orthodontic treatment compliance may have positive effects in the relationship between adolescent patients and orthodontists. More attention should be paid to aspects that are often underestimated in clinical practice, thus, influencing the outcome of treatment and patient satisfaction, not only in terms of dental health, but also of mental health.
Article
Full-text available
The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is a scale which measures aspects of the oral health-related quality of life. However, no Italian version of PIDAQ has been developed. The aim of this study was to translate the original English version of PIDAQ into Italian and to assess the validity and reliability of the Italian version for application among Italian adults. The questionnaire was translated into Italian, back translated, pre-tested, and cross-culturally adapted. Subsequently, the Italian version of PIDAQ and the Oral health impact Profile-14 (OHIP-14) were administered to 264 orthodontic patients aged from 18 to 83 years old, mean age was (38.39 + 16.9) belonging to Southern Italy. Cronbach’s alpha of the translated PIDAQ was 0.82, corrected item-total correlation ranged from 0.48 to 0.67. The 23 items of PIDAQ were divided into four domains. There was a logical relation among the items in the same domain and a highly significant association among scores of PIDAQ and the other scale. The translated Italian version of PIDAQ demonstrated good reliability and validity. Its sufficient discriminative and evaluative psychometric properties provide the theoretical evidence for further use in study on orthodontic-specific aspects of quality of life among Italian adults.
Article
Full-text available
The aim of this study was to verify the relationship between the dysmorphic level and the psychosocial impact of dental aesthetics among adolescents undergoing orthodontic treatment. 61 subjects, between 12 and 22 years, completed the Psychosocial Impact of Dental Aesthetics (PIDAQ), the Rosenberg’s Self esteem Scale and were interviewed with the Body Dysmorphic Disorder Interview (BDDE). The data showed significant correlations between self esteem, self dental confidence (SDC) and dental aesthetics’ psychological impact (IP). In addition, items that fulfill specific criteria for the Body Dysmorphic Disorder (BDD) showed significant relationships not only with the psychological (PI) and social impact (SI), but also with the patient’s beliefs (PB ) relating to the role of dental aesthetics in their lives. The body image of adolescents undergoing orthodontic treatment is moderately negative. Psychological factors involved concern not only the dental self-confidence, but also the overall assessment of self-esteem.
Article
Full-text available
This study aims to determine the prevalence of denture wearing among elderly and to compare the oral health related quality of life (OHRQoL) between elderly with dentures and those without dentures. This cross sectional study involved 506 randomly selected edentulous elderly in the district of Badang, Kota Bharu, Kelantan. Consented participants were interviewed in the Kelantanese dialect at their homes by a single trained interviewer using the short version Oral Health Impact Profile (S-OHIP(M)) which had been translated into the Malay language, tested and validated for use in Malaysian population. Denture wearing and self rated denture status was noted. The prevalence of denture wearing was 46.2% (95% CI=41.83, 50.70). There was a significant difference in sex, smoking status, self perceived treatment need and self perceived satisfaction between denture wearers and non denture wearers. Denture wearers reported better overall OHRQoL compared to non denture wearers (p
Article
Full-text available
Background: The autonomy of dental anxiety may be compared with other psychopathologies, however, it is classified as indicative of a specific phobia. It is interesting to know how dental anxiety operates within a wider context. Material and Method: The group was made by 514 subjects, recruited from several dental surgeries. The entire process, consisted in self-compilation of the Dental Anxiety Scale (DAS), and the Patient Health Questionnaire (PHQ). The software used for statistical calculations was the Statistical Package for Social Sciences (SPSS) version 16.0. The chi-square test was used for the distribution of the nominal variables. Results: The analysis of data revealed a significantly different distribution between high and low levels of dental anxiety and comorbidity in relation to only one diagnostic category, namely mood disorders. Dental fears and comorbidity were mostly in line with our expectations, except about fear of needles with eating disorders. Dental anxiety is to be considered as a dimension on a par with other psychopathologies. Conclusions: The study of comorbidity between mood disorders and dental anxiety, suggests that dental anxiety rather than belonging to the family of anxiety disorders would be better classified along with mood disorders. The findings regarding emotional inducers (fears) in relation to the distribution of psychopathology are worth noting. The above observations reaffirm the need to form links between dentistry and psychiatry.
Article
Full-text available
Knowledge of the extent of dental disease gives a clinical indication of the experience of dental problems but it does not necessarily reflect the problems that people experience as a result of their dentition. It is becoming increasingly appreciated that the way a disease affects people's lives is just as important as epidemiological measures of its prevalence or incidence. The 1998 Adult Dental Health survey is the first of the decennial series of UK adult dental health surveys to use and report a measure of the self-perceived impact on people of the dental and periodontal diseases and other oral conditions. Over half (51%) of dentate adults said they had been affected in some way by their oral health, and in 8% of cases the impact was sufficient to have reduced their quality of life.
Article
Although adult attachment theory has been revealed as a useful theoretical framework for understanding a range of health parameters, the associations between adult attachment patterns and a range of oral health parameters have not yet been examined. The aim of this study was to examine potential associations between attachment insecurity and: (1) oral health-related quality of life (OHRQoL), (2) oral health behaviours, and (3) self-rated oral health. In association with this aim, sample characteristics were compared with normative data. The sample in this cross-sectional study was comprised of 265 healthy adults, recruited via convenience sampling. Data were collected on attachment patterns (Experiences in Close Relationships Scale-Short Form, ECR-S), OHRQoL (Oral Health Impact Profile-14, OHIP-14), oral health behaviours (modified Dental Neglect Scale, m-DNS), and self-rated oral health (one-item global rating of oral health). Multivariate regression models were performed. Both dimensions of attachment insecurity were associated with lowered use of favourable dental visiting behaviours, as well as decreased OHRQoL for both overall well-being and specific aspects of OHRQoL. Attachment avoidance was linked with diminished self-rated oral health. This study supports the potential value of an adult attachment framework for understanding a range of oral health parameters. The assessment of a client's attachment pattern may assist in the identification of people who are at risk of diminished OHRQoL, less adaptive dental visiting behaviours, or poorer oral health. Further research in this field may inform ways in which attachment approaches can enhance oral health-related interventions.
Article
The emerging field of emotion regulation studies how individuals influence which emotions they have, when they have them, and how they experience and express them. This review takes an evolutionary perspective and characterizes emotion in terms of response tendencies. Emotion regulation is defined and distinguished from coping, mood regulation, defense, and affect regulation. In the increasingly specialized discipline of psychology, the field of emotion regulation cuts across traditional boundaries and provides common ground. According to a process model of emotion regulation, emotion may be regulated at five points in the emotion generative process: (a) selection of the situation, (b) modification of the situation, (c) deployment of attention, (d) change of cognitions, and (e) modulation of responses. The field of emotion regulation promises new insights into age-old questions about how people manage their emotions. (PsycINFO Database Record (c) 2013 APA, all rights reserved)