[Access to oral health care for patients attending a medical-psychological center]. / Accès aux soins bucco-dentaires des patients suivis en centre médico-psychologique.

People with mental health problems have a worse oral health condition than the general population. As part of a qualitative study using semi-directive interviews aimed at analyzing the perceptions of professionals working in medical-psychological centers regarding the difficulties encountered by their patients in accessing dental care, three obstacles were identified: factors intrinsic to the patient, background in prevention and the organization of the healthcare system.

A cross sectional study on levels of dental anxiety, its influencing factors, and the preferred management techniques among patients in Riyadh, Saudi Arabia.

BACKGROUND: Dental anxiety is marked by intense and irrational fear of dental procedures affecting millions of individuals worldwide. The purpose of this study was to investigate the relationship between dental anxiety, its influencing factors, and the preferred management techniques among adults seeking dental care in Riyadh. METHODS: A cross-sectional questionnaire study was carried out among 1734 patients who visited dental clinics in Riyadh. A self-administered questionnaire was developed and validated, comprising 28 closed-ended questions; it demonstrated good reliability and internal consistency (Cohen's kappa coefficient = 0.90, Cronbach's alpha coefficient = 0.86), it contained pre-validated Modified Dental Anxiety Scale to quantitatively assess the level of dental anxiety. Data analysis involved descriptive analysis, Chi-square test, Pearson correlation coefficient and multiple linear regression. RESULTS: Majority (59.2%) of participants reported moderate anxiety, while 10.9% experienced high anxiety which was significantly linked to factors such as fear of pain (37.8%) and anaesthetic needles (25.8%). Topical anaesthetic gel (64.5%), pre-treatment explanations (78.9%), and conducive clinic environment (79.4%) were perceived as effective anxiety alleviators. A negative correlation existed between dental anxiety and preferred management techniques. Dental anxiety had significant association between gender (ß = 0.910) and age (ß = 0.263). CONCLUSION: This study revealed that majority of participants had moderate dental anxiety, linked significantly to influencing factors like frequency and purpose of dental visits and past dental experiences. The study also found the preferred anxiety management methods among participants which included topical anaesthetic gel, pre-treatment explanations, and a comfortable clinic environment.

Dental anxiety and dental care - a comparison between Albania and Germany.

BACKGROUND: The present study is the first in Albania on dental fear and dental anxiety and also in the field of psychosocial medicine. The purpose of this study was to find out whether there are differences in dental anxiety using the Dental Anxiety Scale, their level of psychological distress using the Brief Symptom Inventory-18 and the evaluation of oral health among Albanian and German patients. METHODS: This study was conducted in the period from December 2019 to July 2020, a sample of N = 263 patients (133 Germans, 130 Albanians) using the Dental Anxiety Scale questionnaires to determine anxiety before dental treatment and the Brief Symptom Inventory-18 to evaluate psychological distress. Moreover, the patients answered questions regarding their oral health and dental care. In Germany, there were four refusals to entrance in the study due to various reasons, in contrast to Albania, where there were no refusals at all For the purposes of this study, data on both populations aged 14 years and older were used. RESULTS: The questionnaires results were calculated for all participants. The current subjective health status of Albanian patients was assessed to be significantly worse than that of German patients (p < 0,000). Germans were more susceptible to signs of Anxiety (p < 0,000), Depression and Somatization and scored higher on the Dental Anxiety Scale and the Global Severity Index (p < 0,000) than Albanian patients. Additionally Albanian patients scored significantly lower on the preventive care index (p < 0,000). Despite an elevated DAS anxiety level, German patients reported going to the dentist more frequently than Albanian patients. CONCLUSION: The results showed that between both populations differences in dental anxiety, psychological distress and oral health exists. Patients from Germany report more psychological distress and described more dental anxiety compared to Albanian patients. Albanian patients reported not utilization on oral health care.The implementation of educational programs and preventive measures, would contribute to raising awareness about the importance of oral health and increased use of dental services.

Psychological Factors Determining Prognosis of Dental Treatments.

Many psychological factors may have a significant bearing on an individual's oral health and success of dental treatments. Overall, these factors may result in the avoidance of dental visits, emergency-based dental appointments, noncompliant dental behavior, the utilization of multiple oral health care providers, and poor oral health. These factors may affect the quality of life of individuals and may lead to patient dissatisfaction, poor prognosis, and failure of dental treatment. Multiple psychological factors may affect the dentist and the patient. Those factors may alter the prognosis for successful dental treatment. Physician empathy is fundamental in developing long-term physician-patient trust.

Oral Health Literacy Status, Knowledge Levels, Beliefs, and Behaviors of Pregnant Women.

CONTEXT: Pregnancy may exacerbate the frequency and severity of some dental problems. However, most pregnant women avoid going to the dentist. AIMS: To examine the oral hygiene and dental care behaviors of women during pregnancy, to measure their knowledge levels, to reveal their oral and dental health literacy status, and their beliefs about treatment. SETTINGS AND DESIGN: The study was conducted for a period of 1 month with pregnant women over the age of 18 who presented to the obstetrics outpatient clinic and agreed to participate in the study and who had no known anomalies or complications. METHODS AND MATERIAL: A survey was completed by face-to-face interviews with 317 pregnant women of different ages and gestational weeks. Participants were asked questions regarding their sociodemographic characteristics, pregnancy characteristics, oral hygiene-related beliefs, behaviors, and knowledge levels. STATISTICAL ANALYSIS USED: The data obtained in the study were analyzed with SPSS 21.0 program. Since the kurtosis and skewness values were between +3 and -3, parametric tests were used. RESULTS: In total, 317 pregnant women between the ages of 18 and 43 participated in the study. The most common beliefs are listed as; babies receive the necessary calcium from the teeth, antibiotics given during dental treatment harm the baby, and panoramic radiography taken during treatment harms the baby. 91.5% of the participants did not visit the dentist after planning a pregnancy, and 89% of them did not visit the dentist during pregnancy. The most common reason not to visit the dentist is not having a dental problem. The rate of knowing that dental infections during pregnancy will affect the baby is 50.5%. CONCLUSIONS: In the present study, it is seen that pregnant women do not have adequate oral hygiene. The reasons were listed as various false beliefs and lack of sufficient knowledge. Health professionals should provide information about oral hygiene to pregnant women and direct them to the dentist.

Associations between Dental Anxiety Levels, Self-Reported Oral Health, Previous Unpleasant Dental Experiences, and Behavioural Reactions in Dental Settings: An Adult E-Survey.

Background and Objectives: The aim of this study was to investigate the prevalence of dental anxiety, its association with self-reported oral health, and sociodemographic factors in adults that are critical for improving oral health and well-being. Materials and Methods: An online survey was conducted via social media, with 1551 adults (76.5% women, 23.5% men) participating nationwide. Data collected included demographic data, Modified Dental Anxiety Scale (MDAS) scores, and associations between dental anxiety, negative experiences, and self-reported oral health. The analysis included psychophysiological, behavioural, and emotional responses and avoidance of dental visits, using descriptive and generalised linear regression models. Results: This study found that the mean score of the MDAS was 9.70 ± 5.11 out of 25, 19.1% of the participants reported no dental anxiety, and 7.8% suffered from dental phobia. Gender, age, and socioeconomic status had no significant effect on the prevalence of anxiety. Although more than half of the participants reported negative dental experiences, particularly in childhood, anxiety levels were unaffected. However, those who rated their oral health as excellent or very good had lower anxiety scores (p = 0.008, p = 0.024). Among the dental procedures, oral surgery (58.7%) and prosthetic (restorative) dental treatments (15.2%) caused the most anxiety. Avoidance behaviour correlated with increased anxiety (p ≤ 0.001), as did postponing dental visits until severe pain occurred (p = 0.011). Conclusions: These results emphasise the significant prevalence of dental anxiety in adults, particularly for surgical procedures and drilling, posing challenges in patient management. Tailored strategies are essential to reduce anxiety, improve patient well-being, and optimise dental service delivery and treatment efficacy.

Trauma-Informed Care in Oral Health Care: The role of dental hygienists.

Traumatic experiences can impact individuals' oral health and how they experience dental treatment in ways patients and their dental providers may or may not initially anticipate. As approximately half of children and two-thirds of adults in the United States have experienced some type of traumatic event, it is critically important for providers to be aware of patients' trauma histories and to appropriately provide trauma-informed care to their patients when needed. Individuals with a trauma history may experience significant anxiety and distress in the dental setting, even for treatment many providers and patients consider to be "simple," such as a brief intraoral examination, radiographs, or prophylaxis. Such aspects of the dental setting may trigger memories and emotions related to the original trauma and may re-traumatize patients. This short report introduces links between traumatic history, poor oral health, and dental care-related fear and anxiety. Additionally, this paper briefly describes how dental hygienists can provide compassionate trauma-informed care to their patients with the goal of providing whole-person care that considers patients' comfort, health goals, and prior experiences. Specific recommendations for providing trauma-informed care to children and adults within the scope of dental hygiene practice are provided, as is suggested wording for acknowledging a patient's prior trauma and tailoring dental care to accommodate patient experiences and concerns. As dental hygienists are often the oral health providers spending the most time with patients, they are uniquely positioned to provide compassionate effective trauma-informed care to patients with past traumatic experiences.

Dentally Anxious Patients' Perceptions of Oral Health Care.

Purpose Many adults in the United States struggle with mild, moderate, or severe dental anxiety (DA). Understanding the perspectives of patients with DA may help oral health professionals gain greater insight into their needs and learn how to provide an improved experience for these patients. The purpose of this study was to identify patients' perspectives on factors that impact anxiety in a dental practice setting.Methods A qualitative, descriptive case study design was used to identify patients' perspectives on factors impacting anxiety in a dental practice setting. Potential participants were screened using the Modified Dental Anxiety Scale (MDAS) and needed a moderate DA score to qualify for the study. An interview guide focused on obtaining information about the etiology, contributing factors, management strategies, and participant experiences of DA was used for the semi-structured virtual interviews. Responses were coded using a qualitative research analytic platform (Dedoose; Los Angeles, CA, USA). The co-investigators systematically reviewed the codes using the classic qualitative analysis strategies and journal notes to identify themes and subthemes.Results Twenty-two individuals qualified for participation in this study. Most participants reported having DA beginning in early childhood and throughout their adult life. Seven themes, including Avoidance, Supportive Behaviors, Confidence in Provider, Diversion, Enduring, Adaptations, and Benevolence emerged. Participants reported their primary method for managing DA was to avoid attending their dental appointments.Conclusion Participants in this study expressed various coping mechanisms and management strategies to alleviate the symptoms of DA. Multiple opportunities exist for increasing patient-provider trust and patient comfort to reduce DA, and ultimately improve the oral health status of individuals with DA.

Torture victims' perspective on dental treatment: "Every sign you make, every move you take" - A qualitative study.

Torture victims struggling with post-traumatic stress often experience elements in the dental treatment situation that may trigger trauma-related reactions. The aim of the study was to explore intervention strategies that will enable dental health workers to adapt dental treatment to the needs of torture survivors. Exploratory interviews were conducted with 10 torture-exposed resettled refugees with dental treatment experience in Norway. The data was analyzed using qualitative content analysis, which suggested that to minimize trauma-reactions, dental personnel should focus on creating a safe therapeutic space and strengthening the patient's sense of control. Four main categories of clinical advice were proposed: (i) Acquire knowledge about psychology, consequences of torture, cultural differences, trauma-informed care, and the patients' individual needs; (ii) Recognize the trigger-potential of busyness or delays; (iii) Avoid surprises, such as sudden moves or actions and explore triggers individually, but make sure not to evoke images of interrogation, and; (iv) Provide overview both with respect to visibility in the clinical room, and to predictability regarding the dental treatment. Although undergoing dental treatment may be challenging for torture-exposed individuals, it is possible to reduce the predicaments considerably by making feasible adaptions to the treatment and adopting a trauma-informed approach.

The effects of a therapy dog intervention on dental fear and anxiety in adult patients undergoing dental procedures: a pilot study.

Dental anxiety poses challenges for providing effective oral healthcare. While therapy dogs have shown promise in various medical and mental health contexts, their use for alleviating dental anxiety in adults remains underexplored. This study aimed to investigate the emotional and physiologic effects of therapy dogs on self-reported dental anxiety. Adults with dental anxiety were randomly assigned to an intervention group (DOG; n = 19) or a standard care group (SC; n = 14). Standard self-report measures were used to assess dental anxiety (Index of Dental Anxiety and Fear [IDAF-4C+]), depression (Patient Health Questionnaire 9), and generalized anxiety (Generalized Anxiety Disorder 7) prior to the intervention. Participants in the DOG group received a 10-minute therapy dog intervention before dental procedures in sessions 1 and 2, while participants in the SC group rested quietly for 10 minutes before their procedure. The SC participants received the 10-minute therapy dog intervention before dental procedures in the third and final session, while patients in the DOG group received no intervention prior to their third procedure. After the dental procedures, patients completed a questionnaire about their satisfaction with the dog therapy (Therapy Satisfaction Scale) and recorded their anxiety and comfort levels on visual analog scales. Continuous electrocardiographic recording measured heart rate variability during the intervention and dental procedure. Prior to the intervention, most participants (90.9%) met the IDAF-4C+ criteria for dental anxiety, with 7 (21.2%) meeting the criteria for dental phobia. The DOG group participants expressed high satisfaction with the therapy dog intervention. No significant differences in heart rate variability were observed between the groups during dental procedures. Therapy dogs can effectively manage dental anxiety in adults with mild to moderate dental anxiety, offering potential benefits for oral healthcare.

The role of psychological distress in the relationship of financial strain with oral health and dental attendance in Dutch adults: A mediation analysis based on cross-sectional data.

OBJECTIVES: The study aimed to assess whether psychological distress mediates the association between financial strain and oral health and dental attendance in the Dutch adult population. METHODS: The study followed a cross-sectional design based on 2812 participants from the 2014 wave of the Dutch population-based GLOBE study. Financial strain was considered the exposure, while psychological distress measured with the Mental Health Inventory-5 (MHI-5) was the mediator. The outcomes included self-reported number of teeth, self-rated oral health, and self-reported dental attendance. Generalized regression analyses were used for the mediation analysis adjusted for several covariables. RESULTS: Greater financial strain was significantly associated with poorer self-rated oral health (total effect: 0.09, 95%CI: 0.05; 0.14) and restorative or no dental attendance (i.e. participants never visiting a dentist or only visiting a dentist for regular treatments or when they have complaints with their mouth, teeth, or prosthesis) (total effect: 0.05, 95%CI: 0.02; 0.09). Greater financial strain was not significantly associated with self-reported number of teeth (total effect: -0.14, 95%CI: -0.91; 0.64). Psychological distress significantly mediated the association of financial strain with self-rated oral health (average causal mediation effect [ACME]: 0.02, 95%CI: 0.01; 0.03) and self-reported dental attendance (ACME: 0.01, 95%CI: 0.00; 0.02), respectively. However, it did not significantly mediate the association of financial strain with self-reported number of teeth (ACME: -0.11, 95%CI: -0.25; 0.02). The estimated proportion of the total effect of financial strain on self-rated oral health and self-reported dental attendance that could be explained by psychological distress was respectively 24% (95%CI: 14%; 48%) and 19% (95%CI: 6%; 62%). CONCLUSIONS: Psychological distress partly explains the association of financial strain with self-rated oral health and dental attendance, but not with self-reported number of teeth. Future studies using longitudinal data are necessary to confirm the results.

Oral health-related quality of life in the LGBTIQ+ population: a cross-sectional study.

The aim of this cross-sectional study was to investigate the associations between oral health-related quality of life (OHRQoL) and socioeconomic and demographic variables, suicidal ideation, self-perception of oral health, and experiences of dental care in the Brazilian adult LGBTIQ+ population. A sample of 464 participants completed self-administered online questionnaires and provided information for OHRQoL assessment, using the OHIP-14 instrument at three hierarchical levels of explanatory variables: LGBTIQ+ identities; socioeconomic and demographic data and existential suffering; and self-perception of oral health and experience of dental care. The collected data were fitted to hierarchical multiple logistic regression models, in which the associations between each independent variable with the OHIP-14 prevalence outcome were analyzed. The OHIP-14-prevalence index showed that 33.2% of the participants answered 'frequently' or 'always', and the highest frequencies were obtained for the psychological discomfort (27.8%), psychological disability (18.3%), and physical pain (17.5%) domains. According to the adjusted final model, LGBTIQ+ individuals who were more likely to have their OHRQoL affected were those who were indifferent (OR=3.21; 95% CI: 1.26-8.20), dissatisfied (OR=10.45; 95% CI: 3.86-28.26), or very dissatisfied (OR=53.93; 95% CI: 12.12-239.93) with their oral health status, and also those who had or have difficulty accessing dental treatment (OR=2.06; 95% CI: 1.24-3.41) (p<0.05). It may be concluded that the OHRQoL of the investigated Brazilian LGBTIQ+ population showed associations with individual aspects and with access to dental services.

Experiences of dental behaviour support techniques: A qualitative systematic review.

BACKGROUND: Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can provide unique insight into these experiences. AIM: To explore and synthesize qualitative literature related to patient experience of dental behaviour support. METHODS: A PROSPERO-registered systematic review of qualitative articles was undertaken. Studies were identified through MEDLINE, Embase and PsycINFO. Abstracts were screened by two reviewers and data were extracted to summarize the qualitative findings included within them. A thematic summary approach was used to synthesize the qualitative data identified. RESULTS: Twenty-three studies were included. Studies primarily explored experiences of dental care of children by speaking to their parents (n = 16), particularly regarding paediatric dental general anaesthesia (DGA) (n = 8). Studies of adults' experiences of DBS (n = 7) covered a range of techniques. Nine studies explored broader dental care experiences and did not study specific DBS approaches. A thematic synthesis identified five themes applicable across the studies identified: Trust and the therapeutic alliance supporting effective care delivery; considered information sharing often alleviated anticipatory anxiety; control and autonomy-reduced anxieties; variations in the perceived treatment successes and failures of DBS techniques; and DBS techniques produced longer positive and negative impacts on patients beyond direct care provision. CONCLUSION: Qualitative research has been under-utilized in research on DBS techniques. Care experiences of most DBS techniques outside of paediatric DGA are poorly understood. Building trust with patients and enabling autonomy appear to support positive patient-reported experiences of care.

Determinants of Dentist-Patient Relationships: A Scoping Review.

OBJECTIVES: The dentist-patient relationship (DPR) is considered to be a key element in dental clinical settings. This scoping review aimed to examine the extent of previous research on DPR, focussing on its determinants for the reification of the construct. METHODS: This research was directed by the guidance for systematic scoping reviews from the Joanna Briggs Institute. The inclusion/exclusion criteria were based on participants of general adults and dentists, the concept of determinants of DPR, and the context of dental health care encounters. A literature search was performed in 6 major electronic databases in July 2023. Key information from included articles was extracted to chart the results, mainly to identify the determinants of DPR. Each determinant of DPR was classified according to the conceptual model of DPR. RESULTS: A total of 1727 records were initially identified, and 16 articles were included in the review. Nine studies used a quantitative method and 7 were nonempirical articles. All but 2 articles were from the perspective of patients. Factors were grouped into 6 main domains: dentist, patient, society/environment, clinical structure, clinical process, and outcome. Amongst the 6 domains of DPR, most determining factors were related to the clinical process. "Communication" was most frequently counted, at 8 times, followed by "trust" (frequency, 6). At the patient level, "dental fear/anxiety" was frequently used to measure DPR. CONCLUSIONS: Previous literature about DPR indicated a few common and dentistry-specific determinants from the patient perspective. Further studies are encouraged to develop a more comprehensive framework and evaluation scale of DPR.

Excessive Gag Reflex, Dental Anxiety, and Phobia of Vomiting in Dental Care.

BACKGROUND: The most known and commonly studied behavioral obstacle to dental care is dental anxiety. An obstacle that is less studied though no less problematic is excessive gag reflex, which can severely impede dental treatment. Another understudied and possibly related syndrome is emetophobia (a specific phobia of vomiting). OBJECTIVE: The aim of this study was to examine possible comorbidity amongst self-reported emetophobia, dental anxiety, and excessive gagging in the dental office. METHODS: A cross-sectional online survey was conducted using the following self-report questionnaires: Dental Anxiety Scale, Gagging Problem Assessment, Gagging Assessment Scale (GAS), and Specific Phobia of Vomiting Inventory (SPOVI). RESULTS: In all, 164 participants fully completed the questionnaires (87.8% female; mean age, 34 ± 11.07 years). Positive correlations were found amongst all variables (P < .001). High gagging (GAS > 6) was associated with a 7.29 times (P < .000) greater risk of positive emetophobia (SPOVI ≥ 10). Linear regression analyses revealed that the intensity of the reflex and the experience of gagging upon encountering odours in the dental office as well as dental anxiety and vomiting phobia significantly predicted participants' gagging scores as evaluated by GAS (R2 = 0.59; F = 21.16; P < .001). CONCLUSIONS: The study shows that excessive gagging reflex in the dental office is closely related both to dental anxiety and to emetophobia.

Actitudes de los psicólogos costarricenses hacia la aplicación de la psicología en la consulta odontológica / Attitudes of Costa Rican Psychologists Towards the Application of Psychology During the Dentistry Consultation

Resumen Estudio exploratorio-descriptivo sobre un grupo de profesionales costarricenses en psicología acerca de sus actitudes hacia la aplicación de los principios psicológicos en la práctica odontológica. La muestra fue de 377 psicólogos (activos en el Colegio de Profesionales en Psicología de Costa Rica). A partir del cuestionario original diseñado por Gómez y Gómez (2007), el cual fue construido para estimar la necesidad de conformar programas universitarios que integren la psicología y la odontología, se aplicó una adaptación consistente en una encuesta de 10 preguntas autoadministradas de selección simple, la cual se efectuó en línea a través del sistema QuestionPro®. Se pudo evidenciar que existe una actitud positiva ante el enfoque interdisciplinario entre la Odontología y la Psicología; se demostró que un 74% de la muestra sostiene que los aspectos psicosociales son "Bastante importantes" en el marco de la atención odontológica. A pesar de ello, la mayoría (57%) de las personas consultadas indicó que no ha tenido ocasión de aplicar sus conocimientos y experiencia en psicología al contexto odontológico. Asimismo, un 72% de los participantes considera "Bastante importante" que los profesionales en Odontología reciban capacitación básica en el área psicológica para la prevención o contención de ciertos síntomas que puedan incidir en la salud mental. Por otra parte, el 80% de quienes respondieron la encuesta indicaron que las iniciativas interdisciplinarias de colaboración científica (investigación) y aplicada (ejercicio profesional) son "Bastante importantes" para producir beneficios tangibles en la prestación de servicios integrales a los pacientes y el bienestar del personal sanitario.

Abstract Exploratory-descriptive study on a group of Costa Rican professionals in psychology about their attitudes towards the application of psychological principles in dental practice. The sample consisted of 377 psychologists (active in the Association of Psychology Professionals of Costa Rica). From the original questionnaire designed by Gómez and Gómez (2007), which was built to estimate the need to create university programs that integrate psychology and dentistry, an adaptation consisting of a survey of 10 self-administered questions of simple selection was applied, which was carried out online through the QuestionPro® system. It was possible to show that there is a positive attitude towards the interdisciplinary approach between Dentistry and Psychology; it was shown that 74% of the sample maintains that psychosocial aspects are "Quite important" in the context of dental care. Despite this, the majority (57%) of the people consulted indicated that they had not had the opportunity to apply their knowledge and experience as psychologists to the dental context. Likewise, 72% of the participants consider it "Quite important" that dental professionals receive basic training in the psychological area for the prevention or containment of certain symptoms that may affect mental health. On the other hand, 80% of the survey respondents indicated that interdisciplinary initiatives of professional scientific (research) and applied (practice) collaboration are "Quite important" to produce tangible benefits in the provision of comprehensive services to patients and wellbeing of health personnel.

Patients' perspectives on the use of artificial intelligence in dentistry: a regional survey.

The use of artificial intelligence (AI) in dentistry is rapidly evolving and could play a major role in a variety of dental fields. This study assessed patients' perceptions and expectations regarding AI use in dentistry. An 18-item questionnaire survey focused on demographics, expectancy, accountability, trust, interaction, advantages and disadvantages was responded to by 330 patients; 265 completed questionnaires were included in this study. Frequencies and differences between age groups were analysed using a two-sided chi-squared or Fisher's exact tests with Monte Carlo approximation. Patients' perceived top three disadvantages of AI use in dentistry were (1) the impact on workforce needs (37.7%), (2) new challenges on doctor-patient relationships (36.2%) and (3) increased dental care costs (31.7%). Major expected advantages were improved diagnostic confidence (60.8%), time reduction (48.3%) and more personalised and evidencebased disease management (43.0%). Most patients expected AI to be part of the dental workflow in 1-5 (42.3%) or 5-10 (46.8%) years. Older patients (> 35 years) expected higher AI performance standards than younger patients (18-35 years) (p < 0.05). Overall, patients showed a positive attitude towards AI in dentistry. Understanding patients' perceptions may allow professionals to shape AI-driven dentistry in the future.

Knowledge, Dental Anxiety, and Patient Expectations During the COVID-19 Pandemic

Abstract Objective: To assess the knowledge, dental anxiety, and expectations regarding dental services during the COVID-19 pandemic. Material and Methods: The respondents were Indonesian citizens above 18 years old. An online Google survey was administered using a structured questionnaire with a snowball sampling technique. Survey items comprised knowledge related to COVID-19, dental anxiety assessed using the modified DAS (Dental Anxiety Scale) and expectations regarding dental services using four dimensions of dental service quality. All questionnaires were tested for reliability and indicated acceptable and good agreement. The data were analyzed descriptively. Results: A total of 553 responses were analysed. Most respondents were female (72.9%), 76.7% knew of recommendations to postpone dentist visits and 86.8% knew methods of preventing COVID-19 transmission. More than 70% of respondents knew the precaution procedures in the dental office during COVID-19, and only 27.9% had moderate-severe anxiety. Most respondents' expectations regarding dental services during the pandemic era were related to the quality domain of reliability and responsiveness. Conclusion: Respondents knew about COVID-19 transmission and prevention, emergency conditions warranting a visit to the dentist and the procedures used at the dental office. Most respondents stated that they were not anxious about visiting a dentist during the pandemic. The respondents expect the dentist to provide sufficient information to improve oral health and treatment plan.

Held still or pressured to receive dental treatment: self-reported histories of children and adolescents treated by non-specialist dentists in Hordaland, Norway.

AIM: This study aimed to estimate the prevalence of a self-reported history of restraint in children and adolescents when receiving dental care by non-specialist dentists and to assess differences in dental fear and anxiety (DFA), intra-oral injection fear, and trust in dentists between patients with and without a self-reported history of restraint. METHODS: An electronic cross-sectional survey was distributed to all 9 years old (n = 6686) and 17 years old (n = 6327) in the Public Dental Service in Hordaland County, Norway, in 2019. For statistical evaluation, we generated descriptive statistics and Mann-Whitney U tests. RESULTS: The response rate ranged between 43.5 and 59.9% for the different questions. The prevalence of a self-reported history of being held still against one's will during dental treatment and pressured to undergo dental treatment against one's will was 3.6% and 5.1%, respectively. In general, these patients reported higher DFA, and higher intra-oral injection fear compared with those without such histories of restraint. Patients who had reported being held still against their will during dental treatment had significantly higher distrust in dentists than those who did not report restraint (p < 0.001). CONCLUSION: To feel pressured to receive dental treatment and to be held still against one's will overlap with the concepts of psychological and physical restraint. Patients with a self-reported history of restraint recorded significant differences in DFA, intra-oral injection fear, and trust in dentists compared to those who did not report restraint. Future studies should explore the role that restraint may play in relation to a patient's DFA, intra-oral injection fear, and trust in dentists.