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Exploring Dental Anxiety among Male and Female across Adolescents, Young Adults, and Middle Adults

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Abstract

Introduction: Dental anxiety is a state of uneasiness and worry, making the patient feels that something terrible will happen to him regarding dental treatment and procedure. Research suggests that dental anxiety is a prominent factor in leading to avoidance of dental treatment by the patients. The intensity of dental anxiety varies individually and across gender. Research suggests that adopting healthy dental care habits encourages good oral health, contributing to the quality of life, whereas poor dental habits can lead to dental problems. Therefore, the present study attempts to explore the level of dental anxiety and dental care habits across age groups and gender. Methods: The sample consists of 150 patients from Delhi/National Capital Region. They were divided into three age groups – adolescence (n = 50), young adulthood (n = 50), and middle adulthood (n = 50). Modified Dental Anxiety Scale was used to assess dental anxiety and a semi‑structured interview was taken to assess the level of dental hygiene among the patients. Results: there are statistically significant differences in dental anxiety scores between males and females. Our results also point that these gender differences persist across age groups – adolescence, young adulthood, and middle adulthood on dental anxiety. Conclusion: The findings reveal higher dental anxiety levels among adolescents, which gradually increase with age. Furthermore, females are more susceptible to have dental anxiety than males. Thus, dental professionals should provide age and gender‑targeted counseling to avoid dental anxiety among their patients. Keywords: Adolescence, dental anxiety, dental hygiene, middle adulthood, young adulthood https://www.jdrr.org/text.asp?2021/8/2/107/321526
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Volume 8 / Issue 2 / April-June 2021
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Introduction
Dental problems are always acted as a
burden on the people. They are often
accompanied by pain, decreased social
functioning, disturbance in daily routine,
etc.[1] There is an increase in the prevalence
of dental diseases and one of the reasons
is dental anxiety. Dental anxiety is a
condition involving worry about dental
treatment leading to the feeling of losing
control.[2] It is excessive or unreasonable
anxiety toward dental procedures and
treatment leading to a negative impact on
one’s daily life as well as avoidance of
dental treatment.[3] Researchers identied
few behavioral symptoms in dental anxiety
patients such as dgeting, sitting on the
edge of the chair, startled reaction to noise,
and generalized muscle tensions.[4]
Dental anxiety is the major concern for
dental care professionals and is ranked
fourth among common fears.[5,6] Research
Address for correspondence:
Dr. Kriti Vyas,
Department of Psychology,
Faculty of Humanities and
Social Sciences, Vishwakarma
University, Pune, Maharashtra,
India.
E-mail: kritivyas8288@gmail.
com
Access this article online
Website: www.jdrr.org
DOI: 10.4103/jdrr.jdrr_142_20
Quick Response Code:
Abstract
Introduction: Dental anxiety is a state of uneasiness and worry, making the patient feels that
something terrible will happen to him regarding dental treatment and procedure. Research suggests
that dental anxiety is a prominent factor in leading to avoidance of dental treatment by the patients.
The intensity of dental anxiety varies individually and across gender. Research suggests that adopting
healthy dental care habits encourages good oral health, contributing to the quality of life, whereas
poor dental habits can lead to dental problems. Therefore, the present study attempts to explore the
level of dental anxiety and dental care habits across age groups and gender. Methods: The sample
consists of 150 patients from Delhi/National Capital Region. They were divided into three age
groups – adolescence (n = 50), young adulthood (n = 50), and middle adulthood (n = 50). Modied
Dental Anxiety Scale was used to assess dental anxiety and a semi‑structured interview was taken
to assess the level of dental hygiene among the patients. Results: there are statistically signicant
differences in dental anxiety scores between males and females. Our results also point that these
gender differences persist across age groups – adolescence, young adulthood, and middle adulthood
on dental anxiety. Conclusion: The ndings reveal higher dental anxiety levels among adolescents,
which gradually increase with age. Furthermore, females are more susceptible to have dental anxiety
than males. Thus, dental professionals should provide age and gender‑targeted counseling to avoid
dental anxiety among their patients.
Keywords: Adolescence, dental anxiety, dental hygiene, middle adulthood, young adulthood
Exploring Dental Anxiety among Male and Female across Adolescents,
Young Adults, and Middle Adults
Original Article
Samina Bano,
Syed Ansar
Ahmad1,
Kriti Vyas2
Department of Psychology,
Jamia Millia Islamia,
1Department of Oral and
Maxillofacial Surgery,
Faculty of Dentistry, Jamia
Millia Islamia, New Delhi,
2Department of Psychology,
Faculty of Humanities and
Social Sciences, Vishwakarma
University, Pune, Maharashtra,
India
How to cite this article: Bano S, Ahmad SA, Vyas K.
Exploring dental anxiety among male and female
across adolescents, young adults, and middle adults.
J Dent Res Rev 2021;8:107-12.
This is an open access journal, and arcles are
distributed under the terms of the Creave Commons
Aribuon‑NonCommercial‑ShareAlike 4.0 License, which allows
others to remix, tweak, and build upon the work non‑commercially,
as long as appropriate credit is given and the new creaons are
licensed under the idencal terms.
For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com
suggests that only a few dental patients
do not experience anxiety.[7] Dental
anxiety was also found high among dental
patients in India.[8] Studies suggest that
dental anxiety can vary according to the
age group. Dental anxiety increases from
11% to 13% in adolescence to 26% during
young adulthood.[9]
Studies show different reasons for this
dental anxiety. One of the reasons is the
clinical setup; for example, patients feel
powerless while sitting on the patient
chair in the reclined position and dentist
checking the patients’ mouth cavity and
using drillers.[10,11] Another reason for
dental anxiety is the dental treatment
and procedures such as use of injections,
scrapping, and the sight of blood.[12]
Patients with dental anxiety problems
tend to avoid dental treatment and further
aggravate the dental problem leading to
poor oral health.[3,13] Research suggests
that it leads to a vicious cycle of dental
fear or anxiety because avoidance leads to
delay in treatment, this further deteriorates
Submitted: 10‑Oct‑2020
Accepted: 22‑Feb‑2021
Published: 16‑Jul‑2021
Bano, et al.: Gender dierences in dental anxiety across age groups
108 Journal of Dental Research and Review | Volume 8 | Issue 2 | April-June 2021
dental problem; as a result, the patients need to undergo
specialized and complex treatment procedures. These
treatments cause them pain thereby reinforcing their dental
anxiety or fear.[14] Therefore, dental professionals must deal
with and ease the dental anxiety of the patients.
Another concern for dental health professionals is
maintaining good dental hygiene by the patients. It has
been established that following regular and proper dental
care habits such as brushing at least twice a day, regular use
of dental oss and mouthwash, and using uoride‑based
toothpaste help in reducing the occurrence of dental caries
and other dental problems.[15,16]
Apart from the aforementioned reasons, dental anxiety is
also affected by a number of factors like age and gender
of the patients. Regarding age, some studies suggest that
dental anxiety starts in childhood and is at the peak in
early adulthood and slowly tapers down with increasing
age.[17] In contrast, some studies have indicated that it
originates in adolescents and young adulthood or maybe
later life.[18] A study conducted by a group of researchers
provides evidence that dental anxiety was high among the
age groups of 25–35 and 35–45 years and low for the age
group of 55–65 years.[8] On the contrary, another study
found that the age group between 20 and 39 years was
high on dental anxiety as compared to the younger and
older population.[19] Due to such mixed results, the present
study explores the level of dental anxiety across three age
groups – adolescents, young adults, and middle adults.
In addition to age, previous literatures have also suggested
that dental anxiety varies according to gender, particularly
females are prone to high dental anxiety as compared to
males.[8,20,21] However, again few recent studies found no
signicant gender difference on dental anxiety.[22,23]
To summarize, previous studies investigating dental anxiety
across different age groups have shown an inconsistent
nding. Studies have looked at dental anxiety either across
gender or age, and their conclusion is focused either on
age difference or gender difference. None of the studies
so far have explored the age‑related changes in dental
anxiety with respect to gender. However, how dental
anxiety changes among males and females as the age
progresses is still an open question. Therefore, the present
study investigates whether dental anxiety varies across the
different age groups with respect to gender.
Methods
Participants
Dental patients were selected from Dental Hospital at Jamia
Millia Islamia University, Delhi. One hundred and sixty‑ve
patients were approached, those who gave the consent were
included in the nal sample. Few of the participants were
dropped from the sample due to incomplete information.
Hence, the nal sample comprised 150 dental patients. The
sample was divided into three age groups – adolescence
(12–19 years), young adulthood (20–40 years), and
middle adulthood (41–60 years). Each group consists of
50 patients.
Materials
Demographic prole
The patients were asked to ll up a brief sociodemographic
prole about their age, gender, religion, education
qualication, profession, family type, family annual
income, housing type, and housing space [Table 1].
Dental history and hygiene
The patients were asked to ll up details, such as frequency
of brushing and tongue cleaning, methods of maintaining
oral health, complaints of tooth sensitivity and gums’
bleeding, reasons for a dental visit, and treatment sought
by them.
Dental anxiety
Modied Dental Anxiety Scale (MDAS) developed by
Humphris, Morrison, and Lindsay (1995)[24] was used to
measure dental anxiety. The scale was originally based on
the Corah’s Dental Anxiety Scale. The scale consists of
5 items and patients need to rate their responses from not
anxious (1) to extremely anxious (5). The total score ranges
from 5 to 25. A cutoff score of 19 and above denotes high
Table 1: Sociodemographic prole of the participants
Demographics Percentage
Gender
Male 43.3
Female 56.7
Religion
Hindu 34
Muslims 63.3
Sikhs 0.7
Christian 2
Family annual income
Low 49.3
Middle low 29.3
Middle high 19.3
High 2
Family type
Joint 47.3
Nuclear 52.7
Housing ownership
Self‑owned 57.3
Paid (Government) 6.7
Rented 36
Housing space
LIG 20.7
MIG 54
HIG 25.3
LIG: Low income group, MIG: Middle income group, HIG: High
income group
Bano, et al.: Gender dierences in dental anxiety across age groups
109Journal of Dental Research and Review | Volume 8 | Issue 2 | April-June 2021
dental anxiety or dental phobic. The Cronbach’s alpha
value of the Dental Anxiety Scale for the present study
was 86.
Ethical approval
The protocol involved in the present study was approved
by the Institutional Ethics Committee for the Faculty of
Social Sciences, Jamia Millia Islamia, New Delhi.
Procedure
The Dental Hospital at Jamia Millia Islamia was contacted
and permission was obtained from the authorities. The
patients sitting in the waiting area of the out‑patient
department were approached. The patients were briefed
about the study. They were assured about the condentiality
and anonymity of the information. After obtaining
verbal consent from them, they were asked to ll up the
demographic prole and gave details about the dental
history and dental care habits. After that, they were asked
to ll the MDAS to assess dental anxiety among patients.
The patients were thanked for contributing to the research.
Statistical analysis
After the data collection, a statistical analysis was
performed using JASP‑0.12.2 software. To examine the
differences in terms of age and gender on dental anxiety,
we employed a two‑way analysis of variance (ANOVA)
along with the simple main effect analysis.
Results
Participants’ responses were recorded and summarized in
terms of mean and standard deviation across the age group
and gender [Table 2].
To investigate whether the dental anxiety scores differ
across age and gender, we employed 2 (gender: male and
female) ×3 (age: adolescents, young, and middle adults)
ANOVA. The ANOVA results suggest that the dental anxiety
scores were signicantly different across three different age
groups (F (2, 144) =10.31, P = 0.001 partial η2 = 0.11).
Similarly, the results also indicate that the dental anxiety
scores for males and females were also signicantly
different (F (1, 144) =27.07, P = 0.001, partial η2 = 0.14).
However, age × gender interaction term was not
statistically signicant (F (2, 144) =1.26, P = 0.28, partial
η2 = 0.01) [Table 3].
Since the main effect of age and gender was found
signicant, we motivated to do the simple main effect
to test whether the dental anxiety scores differ for
males and females across three age groups. Therefore,
we conducted the simple main effect analysis, and
the results suggest that the dental anxiety scores
were signicantly different for male and female in
adolescents (F (1, 144) = 8.623, P = 0.004) and young
adults (F (1, 144) =17.343, P = 0.001). However, the male
and female dental anxiety scores in the middle adult group
were partially signicant (F (1, 144) =3.730, P = 0.055).
The overall analysis revealed that dental anxiety differs
across different age groups. The adolescents experience
the highest dental anxiety (13.52 ± 4.73), and middle
adults (8.94 ± 4.69) experience the lowest dental anxiety.
Similarly, the results also indicate that females (13.32 ± 5.21)
exhibited more dental anxiety than males (9.12 ± 3.6).
Discussion
In the present study, we investigated the effect of age and
gender on the dental anxiety. The results of the present
study are in line with the previous literature suggesting that
dental anxiety decreases with the age.[16,25‑28] Our ndings
are also in line with the previous study suggesting a similar
pattern for general anxiety. For example, it has been noted
that general anxiety decreases with increasing age, exposure
to diseases, and medications.[29] A few older patients of the
present study also reported that they are already suffering
from several other diseases such as thyroid, knee pain, skin
diseases, and taking medical treatments. The exposure to
continuous medical treatment makes them more habituated
and enhanced their ability to cope up with medical
treatments.[29,30]
Table 3: Analysis of variance result table showing the
main effects of age, gender, and age×gender interaction
Variable Sum of
squares
df Mean
square
F P η² P
Age 384.935 2 192.468 10.311 <0.001 0.125
Gender 505.444 1 505.444 27.079 <0.001 0.158
Age×gender 47.170 2 23.585 1.264 0.286 0.017
Residuals 2687.832 144 18.666
Table 2: The mean and standard deviation for males and females across the three different age groups
Age Gender Mean SD N
Adolescents Female 14.639 4.734 36
Male 10.643 3.455 14
Middle Adults Female 10.120 4.944 25
Male 7.760 4.196 25
Young Adults Female 14.708 4.894 24
Male 9.615 2.743 26
SD: Standard deviation
Bano, et al.: Gender dierences in dental anxiety across age groups
110 Journal of Dental Research and Review | Volume 8 | Issue 2 | April-June 2021
Further, the item‑wise inspection suggests that among all
the items, adolescents were more extremely anxious from
the use of local anesthetic injection and tooth drilling
during the dental procedures. This is also consistent with
previous studies.[31,32] The potential explanation for such
behavior could be that adolescents or younger population
have relatively less exposure to these dental equipment as
compared to older adults.[29] This leads to the development
of “fear of unknown.” It has been argued that because of
the feeling of such unknown fear, adolescents are more
prone to anxiety toward the various dental procedures.[2]
In regard to gender, current ndings are in line with the
previous studies, wherein females showed a higher level of
dental anxiety as compared to males across the three age
groups.[21,33‑36] This can be due to gender roles which makes
female more acceptable of their anxiety and low tolerance
toward pain. For males, it might be difcult to accept
their anxiety about the conventional gender roles.[37,38]
Researchers have suggested the differential pain tolerance
ability among males and females. For example, females
were more likely to exhibit low pain tolerance compared
to males.[29,39,40] At the same time, it was also observed
that women tend to remember their painful experience
more vividly even after the treatment is over.[41] These
fundamental differences in tolerance level could also be
another reason for the gender difference.
Further, it has also been suggested that maintaining dental
hygiene is very important for optimal oral health and
prevention of dental problems. Our data related to dental
hygiene indicate that majority of patients were only using
toothpaste and brush (87.3%) and only 1.3% of people
used dental oss as the methods to maintain the dental
hygiene. Ten percent of patients used mouthwash as well as
toothpaste. This shows that there is a need of improvement
in the methods used for implementing dental hygiene habits.
It has been found that patients need to use dental oss and
mouthwash rather than just toothpaste and brush. Research
suggests that toothbrushing alone cannot take out the plaque
formation from teeth; therefore, the use of mouthwash
and oss is important.[42] If plaque is not removed, then it
could affect the gums leading to gum bleedings[43] and this
problem is present in 42% of patients in the present study.
It was also found that 40% of the patients are brushing once
in a day and 20% of patients never clean their tongue. The
research found that if the tongue is not properly cleaned,
then bacteria can be produced in the mouth leading to
various problems like bad smell and oral diseases.[44] It could
also be seen that very few dental patients visited the dentist
for a regular checkup (14.7%) and they visited mainly
when there was tooth pain (80.7%). This is again pointing
toward negligence by patients toward maintaining dental
hygiene. They only get attentive to their oral health when
there is unbearable pain. It is recommended by the dental
professionals that regular dental health checkup is important
for avoiding the dental caries and other diseases.[45]
Limitations and future scope
The present study has a few limitations and implications
for future research. First, the data collection was based on
the opportunity sampling technique; hence, the possibility
of sample selection bias could be there. Only one dental
hospital in Delhi (Jamia Millia Islamia) was approached
for the same, so ndings could not be generalized. To
avoid such bias, further research needs to be conducted in
different parts of the country on the larger sample. Second,
the current study only used quantitative data to explore
the differences in the level of anxiety among different
age groups and gender. However, the study did not use
qualitative data to explore in‑depth causes for dental anxiety
and factors contributing to it. Hence, future researches can
focus on using qualitative (i.e., interview) methods to gain
more in‑depth understanding of dental anxiety. Third, due to
methodological limitations, the present study fails to explore
any relationship between dental care habits and dental
anxiety. Researchers can further explore more about dental
care habits and then nding the relation between the uses of
healthy or unhealthy dental habits with dental anxiety.
Conclusion
Oral health is an essential part of our life. However, it
seemed to be neglected by many people. Therefore, it is
essential for dental professionals to spread awareness about
dental treatment and procedures as well as dental hygiene
habits such as regular brushing, use of mouthwash and
ossing, and regular dental checkups. Dental professionals
can also set up free dental service camps so that people
can get access to dental services and be aware. Increased
awareness about dental procedures will help in relieving
the patients’ anxiety. It is imperative to identify patients’
dental anxiety before starting the treatment. This will be
helpful in generating awareness of dental hygiene with
regular appointments, which further can reduce the level
of anxiety among those patients. It is imperative for dental
professionals to be sensitive and empathetic to patients’
anxiety. As the results suggested that dental anxiety is
more among adolescents, this means school and college
authorities can play an important role in promoting
awareness and the importance of dental hygiene. Further,
in regard to gender, female patients can be counseled
before any dental treatment and made aware of whole
dental procedures. As per the ndings, male dental patients
might not be expressing their anxieties due to gender roles.
Hence, dental care providers can provide the space to
these patients so that they can freely share their feelings
and thoughts. These steps will be helpful to improve
patient–doctor relationship and patients’ well‑being.
Ethical clearance
The study was approved by the Institutional Ethical
Committee for Social Sciences, Jamia Millia Islamia, New
Delhi. An ethical clearance letter was issued on 07/01/2020.
Bano, et al.: Gender dierences in dental anxiety across age groups
111Journal of Dental Research and Review | Volume 8 | Issue 2 | April-June 2021
Acknowledgment
The authors acknowledge Faculty of Dentistry, Jamia
Millia Islamia, New Delhi, for the dental hospital and
dental patients who have volunteered themselves for this
study.
Financial support and sponsorship
Self.
Conicts of interest
There are no conicts of interest.
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... Introduction healthcare procedures. [1,19,[23][24][25][26] Past studies note females to be more susceptible to dental anxiety and more often report fear and anxiety related to healthcare procedures, [1,19,23,24,26] including the fear of needles. [19] Conflicting with other studies, Ihara et al. [25] found males to have more severe dental fear and avoidance. ...
... Introduction healthcare procedures. [1,19,[23][24][25][26] Past studies note females to be more susceptible to dental anxiety and more often report fear and anxiety related to healthcare procedures, [1,19,23,24,26] including the fear of needles. [19] Conflicting with other studies, Ihara et al. [25] found males to have more severe dental fear and avoidance. ...
... The study's second research question aimed to investigate potential relationships between demographics and reported fear/anxiety related to dental and healthcare procedures. Considering people of different backgrounds and identities' experience dental and healthcare visits differently, [3,23,25,26,38] it is important to continue to investigate patterns in their experiences to develop further understanding.Most study participants were female, but, consistent with past research findings, [1,2,19,23,24,26,35,38,39] a significantly larger percentage of female participants than males still reported fear/anxiety related to healthcare and dental procedures. The discrepancy between the sample's demographic populations makes it difficult to draw significant conclusions, but multiple observable patterns of interest did emerge. ...
Article
A BSTRACT Background and Purpose Fear and anxiety related to dental and healthcare procedures are common among young adults and can negatively impact dental and healthcare consumership, resulting in poor health outcomes. Purpose This cross-sectional study aimed to examine young adults’ experiences of fear related to dental and healthcare procedures and the potential relationships between the two forms of fear experiences and demographic factors. Methods Young adults (252) were recruited from a large public university and completed a survey about their dental and healthcare fear/anxiety as well as their confidence in healthcare professionals. Descriptive and correlational analyses were completed to describe the experiences of young adults and the relationships between variables. Results Ten types of fear/anxiety were identified related to healthcare procedures, with the most common being needles and pain. Nine fears/anxieties were identified for dental visits, of which pain and sensory experiences other than pain were most common. Female participants were significantly more likely to report fear/anxiety related to dental procedures, and there was a statistically significant relationship between fear/anxiety related to healthcare procedures and that related to dental procedures. There was also a significant negative relationship found between confidence in healthcare providers and fear/anxiety related to healthcare procedures. Conclusions Young adults experience fear/anxiety related to healthcare and dentist visits, and this fear/anxiety can impact their confidence in healthcare providers, such as primary physicians. The findings of the current study suggest primary care providers should be aware of potential fears/anxieties and offer patients appropriate supports.
... 19,20 Also, it was determined that even after the therapy, females continue to memorize their negative episodes profoundly. 21 Hence, the dissimilarity among the tolerance levels can be another factor for the disparity. When opposed to older adults, teenagers and kids tend to have minor engagement with dental apparatus. ...
... Hence, through this kind of unidentified dread, teenagers tend to be susceptible to be apprehensive when it comes to dental operations. 21 Infrequent visits to the dentist, long waits in the dental office, past painful dental encounters, discomfort during dental care, the type of treatment received, and how intrusive the treatment is may all lead to high levels of dental apprehension in females. 22 Patients' apprehension can be compounded by a lack of dental health education, resulting in impaired patient treatment outcomes and behaviors. ...
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Introduction As of now, there are not many investigations about the improvement of dental apprehension and dental participation in various populations over time. This investigation includes an examination of emotional appraisals of levels of dental apprehension in patients selected at the AB Shetty Memorial Institute of Dental Sciences. The investigation also aimed to discover the causes of dental apprehension as well as the effect of sexuality on the distinguished dental apprehension. Materials and Methods The level of dental apprehension was assessed using questionnaires that included 15 questions before and after the scaling and polishing procedures for 78 patients. The typical features were drawn such as gender, age, and oral hygiene habits. The data analysis was analyzed using paired t-test or Wilcoxon signed rank test to assess pre- and postanxiety levels. Results A total of 78 responses were collected, resulting in a participation rate of 100%. Despite the fact that women had significantly higher overall dental apprehension levels compared with men, the discrepancy among the two genders was substantial and could be clarified. Conclusion Dental fear was common in females, especially among those with dental problems, and a larger degree of dental fear can contribute to periodontal disease.
... In a gender-wise comparison among elderly patients with periodontitis, OHRQoL was found to be better among males, and no differences were found with different parameters of periodontitis [36]. Previous studies have reported that women experience more anxiety than men during dental treatment [37]. This has been explained by social roles, since women are more open to express their feelings, and it is more acceptable for women to express anxiety openly, whereas men are expected not to fear and show pain. ...
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Objectives: This study aimed to (1) investigate whether dental anxiety (DA) and oral health-related quality of life (OHRQoL) differed between patients diagnosed with periodontitis and individuals with periodontal health, (2) examine associations and correlations between these patient-reported measures, and (3) analyze demographic and clinical parameters. Methods: Ninety-six patients diagnosed with periodontitis and age- and sex-matched periodontally healthy controls were included. Participants’ demographic characteristics, smoking status, current dental pain, dental pain during the last month, the Modified Corah’s Scale (MDAS), and the Oral Health Impact Profile (OHIP-14) were determined. Results: The mean age of participants was 48.51 years ± 11.41. Patients with periodontitis experienced higher pain in the last month compared to controls (p = 0.003). Patients with periodontitis exhibited significantly higher MDAS total and sub-scores (p < 0.001). Compared to controls, the periodontitis group indicated extreme DA (1.04% vs. 7.79%, p = 0.034). Patients with periodontitis feared having a foreign object in the mouth compared to controls (p = 0.004). The periodontitis group exhibited worse OHIP-14 global and sub-scores (all Ps < 0.001). Positive associations and correlations of MDAS total and sub-scores with OHIP-14 global and domain scores were found for the periodontitis group, but not for controls. Patients with periodontitis who reported “moderate and extreme anxiety” had poorer OHRQoL compared to controls (p = 0.001). The minimal importance difference for this finding indicates a large effect size and a moderate standardized response mean between groups. Conclusions: Patients with periodontitis had higher levels of DA and worse OHRQoL compared to controls. Our study highlights the importance of providing a comprehensive approach, including psychosocial well-being, when diagnosing and treating periodontal disease.
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Background- Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system. Dental anxiety is common and occurs before, during, or after dental treatment. As a result, extensive anxiety leads to dental avoidance and many missed appointments, impacting both oral and overall health. In particular, those people who delay visiting the dentist for a long time, even when experiencing signicant pain, may have extensive problems that require more complex and complicated treatment. Aim- To evaluate the level of dental anxiety in patients undergoing dental treatment based on the variables of age and gender. Materials and Methods- In the conducted study, a total of 100 dental patients took part, comprising 56 males and 43 females. The research employed a pre-treatment design to evaluate the impact of the dental procedure on the anxiety levels experienced by the patients. To gauge the anxiety levels of the patients before the treatment, the Modied Dental Anxiety Scale (MDAS) was utilized. Results- Out of 100 patients,29 had MDAS scores above 19 i.e. were highly anxious. The results were evaluated based on age and gender. Females were twice as highly anxious as men, with 69% of females and 31% of males being highly anxious. Middle-aged group showed the maximum level of dental anxiety among all age groups. Conclusions- Dental anxiety and fear need to be alleviated and controlled with adequate measures. Highly anxious patients must be identied and adequate measures and assurance must be provided.
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Dental anxiety has been reported to be impacted by an individual’s sociodemographic characteristics like age, gender, marital status and level of education. This anxiety can be attributed to the pain experienced during dental treatment. Objective: To evaluate the impact of sociodemographic and dental clinic related factors causing dental anxiety in patients. Methods: A descriptive cross sectional study was conducted on 196 patients in Sharif Medical and Dental College, Lahore. Those with any psychological, systemic disorders and on medications were excluded. Participants who underwent dental extraction irrespective of their age, marital status, gender and education were included. Modified Norman Corah Dental Anxiety scale was used as data collection tool. Chi square was used to find the association between sociodemographic factors and dental anxiety level. Results: The study was done on 196 participants with 49% females and 51% males. Most of the patients (64.3%) were below 35 years of age while 35.7% were above it. Majority of the patients suffered severe dental anxiety (38%) followed by high (22%), moderate (20.9%) and mild (18.4%). Significant associations between gender and anxiety while taking dentist`s appointment (p=0.048), being next in turn at the clinic (p=0.029), being on the way to clinic (p=0.023) were seen. Significant impact of marital status on anxiety caused in patients going to the clinic was seen (p=0.039). Age also significantly affected dental anxiety in patients undergoing dental extraction (p=0.017). Conclusions: Severe dental anxiety was higher in the older age group. The impact of sociodemographic factors on dental anxiety due to dental clinic related factors (getting an appointment, waiting for their turn in clinic and on their way to the dentist) showed males and those who were married generally had a relaxed state of mind.
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Background: Dental anxiety continues to be a widespread problem afecting adult populations. The primary aim of our study was to evaluate the psychometric properties of the Lebanese Arabic version of the Modifed Dental Anxiety Scale (MDAS-A) and to identify the optimal cut-of for assessing dental anxiety and dental phobia among adults in Lebanon. In addition, we sought to assess dental anxiety and phobia as well as their correlates among Lebanese adult patients. Methods: A cross-sectional study was carried out on a sample of 451 dental adult patients aged between 18 and 65 years old. Information about demographic characteristics, previous bad dental experience, trauma’s experience period, perception of a periodontal problem, sensation of nausea during dental treatment, the MDAS-A scale, and the Visual Analogue Scale for anxiety (VAS-A) were collected. Results: MDAS-A exhibited evidence of adequate psychometric properties. The optimal cut-of was 12 for dental anxiety and 14 for dental phobia. Out of the total sample, 31.5% sufered from dental anxiety while 22.4% had a dental phobia. Multivariable analysis showed that the odds of dental anxiety and phobia were higher among females compared to males. Also, patients sufering from periodontal problem perceptions, bad dental experiences during childhood and adolescence, and the sensation of nausea during dental treatment were at a higher risk of developing dental anxiety and phobia compared to their counterparts. However, a higher level of education was found to be a protective factor against dental phobia among Lebanese adult patients. Conclusion: The MDAS-A scale is a suitable tool for the routine assessment of dental anxiety and phobia among Lebanese adult patients. Identifying patients with dental anxiety at the earliest opportunity is of utmost importance for delivering successful dental care.
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Introduction A careful assessment of dental anxiety is necessary for its management. The Modified Dental Anxiety Scale (MDAS) is one of the most commonly used questionnaires to measure dental anxiety in the world. The reliability and validity of the Japanese version of MDAS has been demonstrated using undergraduates and a few patients with dental anxiety. The aim of the present study was to examine the reliability and validity of the Japanese version of the MDAS using a wide range of age samples in dental clinics. Methods A total of 275 outpatients (145 men and 130 women; 21−87 years) from two dental clinics participated in the present study. Dental anxiety was assessed using the Japanese version of the MDAS and the Dental Fear Survey (DFS). The psychometric evaluation included exploratory factor analysis, and Cronbach’s α was used to evaluate for internal consistency. Criterion validity was assessed by correlating the MDAS and DFS scores using Spearman’s correlation coefficient. Construct validity was evaluated by examining related factors’ differences in the MDAS score (e.g. sex, negative dental experiences). Results Six patients (2.2%) reported high levels of dental anxiety (MDAS score ≥ 19). The internal consistency of the MDAS score was high (Cronbach’s α = 0.88). Dental anxiety was significantly higher among women (P = 0.007), in patients with previous negative dental experiences (P < 0.001), and among those with lower frequencies of dental visits (P < 0.001). The MDAS score was significant and related to age (r = 0.48) and the DFS score (r = 0.88). Factor analysis revealed all items measured only one construct. Conclusions The Japanese version of the MDAS score was found to be a reliable and valid measure of dental anxiety among dental outpatients. It could be useful for Japanese dental practitioner to measure dental anxiety in a clinical setting.
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Background: This study investigated the expectations and experiences of a sample of new patients visiting an Australian regional university Student Dental Clinic with regard to anxiety provoking and alleviating stimuli in the clinical environment. Differences in anxiety levels were examined by age, gender and the type of procedure undergone. Methods: The number of dental patients who participated in the study was 102 (56 males, 43 females). The study used a pre-treatment/post-treatment design to assess the effect of the dental procedure on anxiety levels of patients. The Modified Dental Anxiety Scale (MDAS) was used to measure anxiety levels in patients at pre-treatment. Questions were also asked about factors which may increase (length of the appointment, invasiveness of procedure) or decrease (perceived student interpersonal skills and clinical ability) dental fear. Results: Females reported higher total MDAS scores (M = 11.93) compared to males (M = 9.94). Younger patients (M = 12.15) had higher dental anxiety than older patients (M = 9.34). There was a reduction in dental anxiety from pre-treatment (M = 1.92) to post-treatment (M = 1.23) on the single item anxiety measure though most of the treatment being undergone by patients was for less complex procedures. Conclusions: Patients' anticipatory experience of anxiety was higher than the anxiety experience after having undergone treatment at the student dental clinic. Student interpersonal skills and clinical ability as perceived by the patient can lessen dental anxiety in patients. Clinical Supervisor-student ratios need to be more equivalent in order to reduce the time length of appointments which currently are associated with increased patient anxiety levels in student dental clinics.
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Introduction An increasing body of literature on sex and gender differences in pain sensitivity has been accumulated in recent years. There is also evidence from epidemiological research that painful conditions are more prevalent in older people. The aim of this narrative review is to critically appraise the relevant literature investigating the presence of age and sex differences in clinical and experimental pain conditions. Methods A scoping search of the literature identifying relevant peer reviewed articles was conducted on May 2016. Information and evidence from the key articles were narratively described and data was quantitatively synthesised to identify gaps of knowledge in the research literature concerning age and sex differences in pain responses. Results This critical appraisal of the literature suggests that the results of the experimental and clinical studies regarding age and sex differences in pain contain some contradictions as far as age differences in pain are concerned. While data from the clinical studies are more consistent and seem to point towards the fact that chronic pain prevalence increases in the elderly findings from the experimental studies on the other hand were inconsistent, with pain threshold increasing with age in some studies and decreasing with age in others. Conclusion There is a need for further research using the latest advanced quantitative sensory testing protocols to measure the function of small nerve fibres that are involved in nociception and pain sensitivity across the human life span. Implications Findings from these studies should feed into and inform evidence emerging from other types of studies ( e.g. brain imaging technique and psychometrics) suggesting that pain in the older humans may have unique characteristics that affect how old patients respond to intervention.
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Objective Anxiety towards dental procedures are common difficulties that may be experienced by dental patients all over the world. This study focused on evaluating the dental anxiety frequency and its relationship with age, gender, educational level, and past dental visits among patients attending the outpatient clinics of College of Dentistry, Al Jouf University, Saudi Arabia. Material and Methods A total of 221 patients, aged 21–50 years were selected for the study. A questionnaire comprising the Modified Dental Anxiety Scale (MDAS) was used to measure the level of dental anxiety. Data was analyzed using SPSS version 20. Results The mean anxiety score of the 221 patients was 11.39 (SD ± 2.7). Independent t-test showed a significant variation between the age groups with regards to their mean overall anxiety score (P < 0.05), which reduced with increasing age. A significant difference was found by independent t-test in the mean total score between male and female groups and regarding previous dental visit (P < 0.05). Regarding education level, there was no significant difference between the groups (P > 0.05). Conclusion Younger patients, female, and patients with previous unpleasant dental experience were associated with increased MDAS score. Clinical Significance The present study was done for better patient management and proper treatment plan development for dentally anxious patients.
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Introduction. For proper management of anxious dental patients it is imperative to assess their levels of dental anxiety before treatment. Modified Dental Anxiety Scale (MDAS) is the most commonly used questionnaire to assess dental anxiety. But a Nepali version of MDAS is still lacking. Hence, the objective of this study was to develop a reliable and valid Nepali version of MDAS. Materials and Methods. The English version of the MDAS was translated into Nepali following a forward and backward translation process. Following pretesting and cognitive interviewing a final version of Nepali questionnaire was obtained. One hundred and fifty patients attending Department of Orthodontics completed the Nepali version of MDAS questionnaire at their convenience. Also, patients were asked to rate their overall anxiety on a 100 mm visual analog scale (VAS). A test-retest of the questionnaire was performed with 30 patients after 2 weeks. Results. Cronbach’s alpha value of the Nepali version of MDAS was 0.775. The Intraclass Correlation Coefficient between test and retest was 0.872. Spearman’s correlation coefficient between the total MDAS score and VAS score was 0.838. Conclusion. The translated Nepali version of MDAS is a reliable and valid instrument to measure the dental anxiety of Nepali patients.
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Full text: http://rdcu.be/j9mw Objective Does dental anxiety have an effect on dental and periodontal health? Methods Survey data was collected from n = 200 adults (53 % females, average age 49 years) in a cross-sectional study. Dental anxiety was measured with the modified dental anxiety scale (MDAS, score 1–5, the greater the score, the greater the anxiety). Clinical parameters including probing depth (PD), clinical attachment level (CAL), plaque index (SLI), and bleeding on probing (BoP) as well as the DMFT index were recorded and statistically analyzed. ResultsRating of dental anxiety was higher in women than in men (65 vs 35 %). Subjects with higher MDAS values visited the dentist less frequently (p = 0.001) and had more decay (DT 6.7 ± 4.2 vs 1.7 ± 2.4; p < 0.001) but fewer filled teeth than subjects with lower ratings of dental anxiety (FT 7.1 ± 4.5 vs 9.8 ± 5.7; p = 0.042). There were no differences in PD or CAL between subjects with or without dental anxiety, while patients with higher MDAS value showed significantly more BoP (50 ± 19 vs 34 ± 20 %; p = 0.002) than patients with low MDAS scores (no or low dental anxiety). Conclusions Patients with higher ratings of dental anxiety had significantly more caries experience and gingivitis. Therefore, dental anxiety is associated with negative effect on dental and periodontal health. Clinical relevanceIdentifying patients with high dental anxiety and helping to manage this anxiety has important implications to improve oral health in adults. The MDAS appears to be an easy and efficient tool that can be used to identify patients with dental anxiety in dental practices.
Article
Gender differences in dental fear have been of increasing interest among clinicians and researchers and dental fear is a common obstacle to obtain dental care. People with high dental fear have poorer oral health and often suffer significant social and psychological impacts associated with their oral state. People with dental phobia may also suffer from a variety of anxiety disorder, mood disorder, personality and behavioral disorder s as well as from multiple other specific fears. One measure of dental fear captures the aspect of state anxiety more while another measure emphasizes the aspect of trait anxiety. This study examines the gender differences of dental fear among the Chennai population across a broad range of relevant factors, including biological influences, temperamental factors, stress and trauma, cognitive factors, and environmental factors. Gender differences are observed with increasing consistency as the scope of analysis broadens to molar levels of functioning. Socialization processes cultivate and promote processes related to anxiety, and moderate gender differences across levels of analysis.
Article
Objective: To analyse the prevalence of Dental Anxiety (DA) in the general adult population of Sweden, to study concomitant factors of DA and also to compare the prevalence of DA in 1962 with that in 2013. Method: The national study for 2013 included 3,500 individuals, randomly selected from the Swedish population. The data sampling was performed as a telephone survey including 38 questions and this report is a selection of those questions with the focus on DA. The national study from 1962 was a face-to-face survey of 1,331 individuals randomly selected from the Swedish population. Both surveys were conducted by the same company. Results: In 2013, severe DA was reported in 4.7%, moderate DA in 4.5%, low DA in 9.8% and no DA in 80.9% of the subjects. Most (72.9%) of the subjects who reported severe DA attended dental care regularly. Important predictive factors of DA were age, gender, education, and self-rated poor oral and general health. The analysis showed a decrease in the prevalence of DA between 1962 and 2013, specifically a change towards more individuals reporting no dental anxiety (38.5% vs. 80.9%) but also smaller proportions of individuals having low and high DA (46.4% vs 9.8% and 15.1% vs 9.2%, respectively). Conclusions: In this national representative sample of Swedish adults the prevalence of severe DA was 4.7%. The main finding revealed a significant decrease of the prevalence of DA over 50 years.