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.

Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental or Injection Phobia: Randomized Controlled Trial.

BACKGROUND: Dental phobia (DP) and injection phobia (IP) are common in children and adolescents and are considered some of the biggest obstacles to successful treatment in pediatric dentistry. Cognitive behavioral therapy (CBT) is an evidence-based treatment for anxiety and phobias. As the availability of CBT in dentistry is low, internet-based CBT (ICBT) was developed. Open trials have shown that ICBT is a promising intervention, but randomized trials are lacking. OBJECTIVE: This randomized controlled trial tests whether therapist-guided ICBT supported by a parent could reduce fear, allowing children and adolescents with DP or IP to receive dental treatment. METHODS: We enrolled 33 participants (mean age 11.2, SD 1.9 y) whom a clinical psychologist had diagnosed with DP, IP, or both. After inclusion, participants were randomized to either ICBT (17/33, 52%) or a control group of children on a waitlist (16/33, 48%). ICBT was based on exposure therapy and comprised a 12-week at-home program combined with visits to their regular dental clinic. Participants corresponded weekly with their therapist after completing each module, and 1 parent was designated as a coach to support the child in the assignments during treatment. All participants completed measurements of the outcome variables before treatment start and after 12 weeks (at treatment completion). The measurements included a structured diagnostic interview with a clinical psychologist. Our primary outcome measure was the Picture-Guided Behavioral Avoidance Test (PG-BAT), which assesses the ability to approach 17 dental clinical procedures, and a positive clinical diagnosis. Secondary outcome measures included self-report questionnaires that measured self-efficacy and levels of dental and injection anxiety. The children and their parents completed the questionnaires. RESULTS: All participants underwent the 12-week follow-up. After treatment, 41% (7/17) of the participants in the ICBT group no longer met the diagnostic criteria for DP or IP, whereas all participants in the control group did (P=.004). Repeated-measure ANOVAs showed that ICBT led to greater improvements on the PG-BAT compared with the control group; between-group effect sizes for the Cohen d were 1.6 (P<.001) for the child-rated PG-BAT and 1.0 (P=.009) for the parent-rated PG-BAT. Reductions in our secondary outcomes-dental fear and anxiety (P<.001), negative cognitions (P=.001), and injection fear (P=.011)-as well as improvements in self-efficacy (P<.001), were all significantly greater among children in the ICBT group than in the controls. No participants reported adverse events. CONCLUSIONS: ICBT seems to be an effective treatment for DP and IP in children and adolescents. It reduced fear and anxiety and enabled participants to willingly receive dental treatment. ICBT should be seriously considered in clinical practice to increase accessibility; this therapy may reduce the need for sedation and restraint and lead to better dental health in children and adolescents. TRIAL REGISTRATION: ClinicalTrials.gov NCT02588079; https://clinicaltrials.gov/study/NCT02588079.

Patient-related predictors of post-operative pain following root canal treatment: A structural model analysis.

AIM: The pathways to post-operative pain are complex and encompass factors that extend beyond the treatment protocol employed. This study aimed to identify patient-related predictors of post-operative pain following root canal treatment. METHODOLOGY: A total of 154 patients received a single-visit root canal treatment for asymptomatic necrotic mandibular molars. Before treatment, dental anxiety, dental fear and sense of coherence (SOC) were measured as predictors for each patient using validated questionnaires. Other measured predictors included gender, age, previous negative experiences at the dental offices and prior root canal treatment. Post-operative pain was assessed using the Numeric Rating Scale at multiple time-points over 30 days. Structural equation analysis was employed to evaluate the direct and indirect effects of patient-related predictors on a theoretical model of post-operative pain. The irrigant solution was also included in the model, as it was the only aspect that varied in the treatment protocol (sodium hypochlorite 2.5% and 8.25%). RESULTS: Dental anxiety (coefficient 0.028; p < .01), dental fear (coefficient 0.007; p = .02) and irrigant solution (coefficient 0.004; p = .03) exerted a direct effect on post-operative pain. SOC exerted an indirect effect on post-operative (coefficient 0.006; p = .01) through dental anxiety and dental fear. Moreover, previous negative experiences (coefficient 0.048; p = .04) exerted an indirect effect on post-operative pain through dental anxiety. CONCLUSIONS: Dental anxiety, dental fear, previous negative experiences and SOC are patient-related predictors of post-operative pain following root canal treatment. These factors should be taken into consideration in clinical practice, as patients with these characteristics may be at an increased risk of experiencing post-operative pain.

Children's experiences during their first dental visit: A qualitative study.

BACKGROUND: While the child's first dental visit can shape his/her attitude towards further treatments, little consideration has been given to exploring this experience from the child's perspective. Therefore, the aim of the study was to delineate the experiences of the first dental visit of children based on self-written stories in their own words. METHODS: Qualitative study conducted as part of the oral health promoting school program in Isfahan city, Iran. Data collection was based on the responses to a question included in the programme's printed educational content. Schoolchildren were asked to explain about their experiences of their first dental visit in a story. Two researchers read the stories separately and identified concepts and themes. In a discussion panel gained consensus about the main themes. Then the researchers integrated and grouped together similar themes to new categories. Categories originating in the data provided insights into and explanations of factors that might influence the schoolchildren's experience in the dental office. Sampling continued until saturation, when no new codes appeared in the data. The childrens' stories were imported in the MAXQD software and analyzed to retrieve the main categories and themes. RESULTS: Factors that influenced experiences appeared to be idiosyncratic, but could be classified into three categories: the person accompanying the child, child and dentist-related factors. Two sub-categories of the person accompanying the child were the role of person in their treatment and the types of persons accompanying them. Dentist-related factors included three more sub-themes of applied behavioral management techniques, their role in oral health education, and organization of the office environment. The three sub-themes of children's related factors were experiencing fear, remembering the details of their experience, and type of care received. CONCLUSION: Although the method was limited to the qualitative written stories of children and there was no opportunity to explore more and consider the detailed opinions by face-to-face interviews, some noticeable elements were mentioned by children. The person accompanying the child, child and dentist-related factors were three main categories obtained from the data.

Associations between the perception of dental pain and pain anxiety, mental pain, and dental anxiety in Iranian sample.

OBJECTIVE: This study examined the perception of dental pain and its relationship to pain anxiety, dental anxiety, and mental pain. METHODS: This cross-sectional study was conducted on 328 patients referred to dental clinics in Kermanshah (Iran) from 2020 to 2021. The instruments used in this study included scales assessing pain anxiety, dental anxiety, mental pain, and pain perception. RESULTS: There was a significant relationship (p = .001) between pain perception with dental anxiety (r = .38), pain anxiety (r = .45), and mental pain (r = .25). CONCLUSION: Psychological factors are associated with the perception of dental pain. Given the importance of dental care to overall health, psychological interventions may help to reduce the perception of dental pain and fear of seeing dentists in Iran.

Cerebral activation caused by dental sounds: a functional magnetic resonance imaging study.

Dental drilling sounds can induce anxiety in some patients. This study aimed to use functional magnetic resonance imaging (fMRI) to assess the relationship between dental fear and auditory stimuli. Thirty-four right-handed individuals (21 women and 13 men; average age, 31.2 years) were selected. The level of dental fear was assessed using the dental fear survey (DFS). Based on a threshold DFS score > 52, participants were categorized into two groups: dental fear (DF) group (n = 12) and control group (n = 22). Two types of stimuli were presented in a single session: dental and neutral sounds. Cerebral activation during the presentation of these sounds was evaluated using contrast-enhanced blood oxygenation level-dependent fMRI. In the DF group, dental sounds induced significantly stronger activation in the left inferior frontal gyrus and left caudate nucleus (one-sample t test, P < 0.001). In contrast, in the control group, significantly stronger activation was observed in the bilateral Heschl's gyri and left middle frontal gyrus (one-sample t test, P < 0.001). Additionally, a two-sample t test revealed that dental sounds induced a significantly stronger activation in the left caudate nucleus in the DF group than in the control group (P < 0.005). These findings suggest that the cerebral activation pattern in individuals with DF differs from that in controls. Increased activation of subcortical regions may be associated with sound memory during dental treatment.

Investigation of the effect of virtual reality distraction in patients undergoing mandibular periodontal surgery: A randomized controlled study.

OBJECTIVE: This clinical study aimed to evaluate the effect of virtual reality (VR) technology on anxiety and pain levels in patients undergoing gingivectomy and gingivoplasty procedures. MATERIALS AND METHODS: The patients were randomized into test (surgery with VR glasses) and control (surgery without VR glasses) groups. Before the surgery, the anxiety level was measured using the modified dental anxiety scale (MDAS), and anticipated pain (AP) was measured by a visual analog scale (VAS). Immediately after the surgery, the pain and discomfort associated with the surgery (VASP), procedure time (T), and time perception (TP) were evaluated. The patients in the test group were requested to assess the immersion (VASI), satisfaction (VASS), perception of reduced anxiety (VASA), and perceived control (VASC). One week after surgery, MDAS was applied to all patients. RESULTS: This trial was conducted with 41 female and 17 male subjects with a mean age of 29.69 ± 12.32. There were no significant differences between the groups in terms of age, sex, preoperative MDAS, or AP. After surgery, MDAS, VASP, T, and TP failed to differ significantly between the groups. The subject age was positively correlated with VASI, VASS, VASA, and VASC (r = 0.60, p = 0.00; r = 0.44, p = 0.02; r = 0.46, p = 0.02; r = 0.50, p = 0.01, respectively) and negatively correlated with VASP (r = 0.47, p = 0.04). CONCLUSIONS: VR application did not affect anxiety and pain levels in patients undergoing periodontal surgery. More studies are needed to evaluate VR distraction in periodontal surgeries with diverse age samples and video options. CLINICAL SIGNIFICANCE: VR does not affect anxiety and pain levels during gingivectomy and gingivoplasty surgeries in the young adult population. It should be evaluated in older age groups. Trial registration ClinicalTrials.gov Identifier: NCT06092177.

Impact of high-speed handpiece noise-induced dental anxiety on heart rate: analyzing experienced and non-experienced patients - a comparative study.

BACKGROUND: Dental anxiety is very much common among the patients and could be due to different factors like the behavior of the dentist, past experiences, Needle phobia, or word of mouth from other patients. According to recent studies, a strong association between sound and anxiety has been found, so this observational study has been conducted to find out the link between the activation of anxiety with the sound of a handpiece between experienced patients, who have already gone through the dental treatments and non-experienced patients. METHODS: Total of 297 participants were part of this study. These participants were divided into 2 groups according to the experienced and non-experienced dental patients. The researcher first filled out the CORAH Dental Anxiety Scale (DAS) form to mark the anxiety level of the patients, and then noted the readings of the heart rate in 3 intervals which were before during, and after the treatment with the pulse oximeter. Later the data was analysed using the SPSS independent t-test. RESULTS: Results show that patients in group 1 who have gone through the dental treatment before were less anxious and had a lesser effect on their heart rate than the patient who were having the treatment for the first time who were in group 2. Another interesting factor was noticed that in both the groups female were found to be more anxious than male participants. Participants with younger age were found to be more anxious than older age patient in both groups CONCLUSIONS: The sound of the handpiece can provoke anxiety in the patient, affecting the heart and increasing the heart rate. Participants who were experienced were found to be less anxious than the participants who were inexperienced.

Effects of dental anxiety and anesthesia on vital signs during tooth extraction.

BACKGROUND: Anxiety is common preceding tooth extraction; hence, it is crucial to identify patients with dental anxiety (DA) and to manage DA. This study assessed the level of DA and influencing factors in tooth extraction patients in a dental hospital in China and changes in their blood pressure (BP) and heart rate (HR) during the tooth-extraction procedure. METHODS: The study was a cohort study. The Dental Anxiety Scale (DAS) was used to assess the level of DA of 120 patients before tooth extraction. A Demographics and Oral Health Self-Assessment Form was used to assess factors influencing DA. The correlations of DAS scores with HR and BP were measured. The effects of local anesthesia and general anesthesia on HR and BP were also compared using a Datex-Ohmeda anesthesia monitor to detect HR and BP continuously before and after anesthesia. Independent sample t-tests, OLS multiple regression model and one-way analysis of variance were applied to analysis the results. RESULTS: Based on the DAS score, 12.5% of the participants were identified as suffering from DA. DA was related to age, gender, and the self-assessment of oral health. The DAS score was correlated with increased BP (P < 0.05). BP showed an overall upward trend after local anesthesia, while it was generally stable after general anesthesia. The systolic BP at 4 and 5 min and the HR at 2 and 4 min increased remarkably (P < 0.05) after local anesthesia compared with those before anesthesia. The HR and BP of patients under local anesthesia were generally higher than those of patients under general anesthesia were during the operation. CONCLUSIONS: The prevalence of DA in adults was 12.5% in this study population. DA was related to gender, age, and the self-assessment of oral health. The score of DAS was correlated with BP. Compare to local anesthesia, general anesthesia can make the vital signs of tooth extraction patients more stable.

Evaluation of the relationship between dental anxiety and oral health status of mothers and their children.

BACKGROUND: Mothers usually have the primary role in raising children and developing health-related behaviors. This study aims to evaluate the relationship between dental anxiety and oral hygiene status of mothers and children's dental anxiety and gingival health. METHODS: The study included 305 children, aged 4-12 years, who came to the dentist for the first time and their mothers. All the demographic and oral hygiene information were collected through a questionnaire. The dental anxiety of the mothers and children was assessed using the Modified Dental Anxiety Scale (MDAS) and Venham Picture Test (VPT), respectively. The oral examination of the mother and children was performed, and their PI, GI, and DMFT scores were recorded. RESULTS: While the correlation between MDAS and VPT was positive and strong in children aged 8-12, it was positive but weak in the 4-7 age group. A significant relationship was detected between the mother's PI, GI, DMFT, and the child's VPT score. According to the mothers' dental anxiety, there were no statistically significant differences in PI, GI, and dmft values in children aged between 4 to 7. A moderately positive and statistically significant relationship between maternal dental anxiety and children's DMFT was identified in children aged 8-12. CONCLUSIONS: Children's dental anxiety was significantly influenced by maternal dental anxiety, post-treatment complications experienced by the mother, and the oral health status of the mother. TRIAL REGISTRATION: Clinical Trials-ID: NCT05563532; Registration Date: 17.09.2022.

The relationship between dental anxiety and oral health literacy with oral health-related quality of life.

BACKGROUND AND AIM: Dental anxiety is a prevalent issue in society, characterized by an uneasy sensation and anticipation of negative experiences in dental settings. In essence, dental anxiety, oral health literacy, and quality of life may have a relationship with each other, however, there is a shortage of evidence examining the interplay between these factors. Therefore, this study aimed to assess the relationship between dental anxiety and oral health literacy (OHL) with oral health-related quality of life (OHRQOL). METHODS: This is an analytical cross-sectional study conducted on 155 patients referred to the Department of Oromaxillofacial Diseases. Three questionnaires consisting of dental anxiety scale, oral health impact profile- 14, and oral health literacy adult questionnaire were used to measure anxiety, health literacy, and the quality of life-related to oral health. Scores were recorded and analyzed by IBM SPSS 24 software using independent samples T-test and ANOVA. Besides, the confirmatory modeling through the goodness of fit index of the model was applied. RESULTS: This study involved 155 participants, with a mean age of 38.44 ± 14 years. The majority were females, comprising 99 individuals (63.9%). In this study, 89 patients (57.4%) had dental anxiety. The mean OHL score in the examined participants was 9.88 ± 3.97. Both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on the OHRQOL. There was no significant difference in the mean OHRQOL among the three categories of OHL (p = 0.085). The confirmatory modeling showed that only the fourth (p = 0.065) and fifth (p = 0.146) questions of the OHL questionnaire had no significant effect on the total score of OHL. Besides, both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on OHRQOL. With an increase of one unit in anxiety, the OHRQOL score increases by 0.31 and for a one-unit increase in the OHL score, the OHRQOL score decreases by 0.66 units. CONCLUSION: In conclusion, it seems that considering various dimensions of oral and dental health can help patients to have reduced psychological anxiety. Notably, further multicenter studies assessing diverse variables related to dental anxiety, OHL, and OHRQOL, and considering more comprehensive study designs with longitudinal follow-up could help provide insights into how changes in dental anxiety and OHL over time affect OHRQOL.

Immediate implant placement influenced by musical flow: a prospective randomized controlled clinical trial.

BACKGROUND: The purpose of this study was to test how musical flow using baroque (BM) and classical era music (CM) as a non-pharmacological therapy can control anxiety and pain levels among patients undergoing IPI (Immediate post-extraction implants). METHODS: 78 patients who required an IPI were enrolled in this randomized clinical trial. Each patient was assigned to one of the three experimental groups with a simple randomization: Group I (n = 26) listened to BM; Group II (n = 27) listened to CM; and Group III (n = 25) did not listen to music and was the control group (C). The physiological dependent variables analyzed were systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO2). The psychological dependent variable analyzed was modified dental anxiety scale (MDAS) and visual analogue scale (VAS), measured before and after surgery. In all cases, the level of statistical significance was set at p < 0.01. RESULTS: Statistically significant differences were found in the SBP decrease in the CM group (p = 0.001, CI = 1.9716-6.5840) and the BM group (p = 0.003, CI = 1.4450-6.4396). Anxiety levels during the intervention decreased in both groups that listened to music: BM group (p = 0.002, CI = 0.645-2.662) and CM group (p = 0.000, CI = 1.523-3.884). CONCLUSIONS: Patients undergoing IPI placement surgery can register lower levels of SBP when listening to BM and CM than patients who were not exposed to the musical flow, improving their anxiety levels.

The impact of parental dental anxiety and oral health literacy on child oral health and dental-visit patterns: a cross-sectional study.

BACKGROUND: Identifying the risk indicators of parental dental anxiety (PDA) and oral health literacy (OHL) can help oral healthcare professionals recognise challenges in this field. Armed with the appropriate information, they can effectively engage with parents to build trust and promote early and regular child dental visits. OBJECTIVES: This study aimed to investigate the association between PDA and OHL with the sociobehavioural characteristics of families, self-reported child oral health (presence of ≥ 1 untreated decayed teeth) and the dental visit patterns amongst children living in Al Jouf Province, Kingdom of Saudi Arabia. SUBJECTS AND METHODS: A total of 430 parents with children aged ≥ 14 years were invited using a systematic random sampling method. PDA was assessed using the Dental Anxiety Scale-Revised (DAS-R) scale, and parents' OHL was measured using the Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30). The relationships amongst participant characteristics, PDA and OHL were evaluated through the Chi-square and ANOVA. Additionally, binary regression analysis was conducted to identify predictor variables associated with PDA and OHL. A P value of < 0.05 was considered statistically significant. RESULTS: Children with ≥ 1 untreated decayed tooth were 2.5 times more likely to have PDA (95% confidence interval [CI] = 1.37, 4.37). Children who visited the dentist in < 6 months had 93% lower likelihood to have PDA (adjusted odds ratio (AOR) = 0.07; 95% CI = 0.03, 0.18). Parents aged 20-25 years were 81% less likely to have OHL than those above 30 years (AOR = 0.19; P = 0.038). Similarly, parents with medium family income were 52% less likely to have OHL than the high-income group (AOR = 0.48; P = 0.013). Finally, parents of children who visited the dentist within < 6 months were 34 times more likely to have OHL than those whose children visited the dentist > 12 months ago (AOR = 34.94; P < 0.001). CONCLUSION: PDA and OHL were significantly affected by parental age, family income, the presence of ≥ 1 untreated decaying tooth and the child dental visit patterns. During a child's first dental visit, paediatric dentists should always assess the PDA, OHL and sociobehavioural characteristics of a family by using appropriate scales and semistructured interviews.

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 Family Factors in the Development of Dental Anxiety in Children.

Background and Objectives: In the literature, the influence of parents who suffer from dental anxiety and a previous unpleasant experience at the dentist are cited as the two most common causes of dental anxiety in children. The aim of this study is to investigate the relationship between socioeconomic factors and the development of dental anxiety in children aged 9 to 12 years. Materials and Methods: A total of 131 children and their accompanying parents/guardians participated in the cross-sectional study. The children were divided into an experimental group, which visited a specialised office for paediatric and preventive dentistry for the examination, and a control group, which visited a primary care dental office. During the visit, the children completed questionnaires on dental anxiety (CFSS-DS). Parents completed a socioeconomic questionnaire and a dental anxiety questionnaire for adults (CDAS). Results: The results showed a statistically significant positive predictor: parental dental anxiety as measured by the CDAS. In addition, the t-test showed that children who visited a specialised dental office did not show a statistically significant increase in dental anxiety compared to children who visited a primary care dental office. Conclusions: With this study, we confirm the influence of parental dental anxiety on the development of dental anxiety in children. The socioeconomic status of the family and the type of dental office do not play a statistically significant role in the development of dental anxiety in children.

Do Subjects from Different Occupational Groups Experience Dental Fear and Anxiety Equally?

Background and Objectives: Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. Materials and Methods: A cross-sectional study with 422 respondents from four occupational groups (physicians, teachers, industry workers, and artists) was carried out. A questionnaire on previous dental experience using the Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and Self-Esteem Scale was self-administered electronically. The data analysis involved descriptive statistics and structural equation modeling (SEM). Results: The DFA levels differed significantly across the occupational groups, with the lowest mean scores among physicians (DAS = 9.29 (SE 0.39); DFS-1 = 14.67 (0.63); DFS-2 = 33.94 (1.69)) and the highest mean scores among artists (DAS = 10.74 (0.38); DFS-1 = 17.19 (0.71); DFS-2 = 41.34 (1.92)). A significant impact of self-esteem on DFA was observed among physicians, teachers, and artists, but not among industry workers. Multi-group analysis with SEM revealed differences in the variable association (Chi-squared = 53.75; df = 21; p < 0.001), thus rejecting the hypothesis of the same mechanism underlying DFA across occupational groups. Conclusions: Individuals from various occupations experience DFA at different levels, and there are different mechanisms underlying their DFA. These findings can provide valuable insights for dental practitioners in developing tailored approaches to reduce the feeling of DFA of their patients.

Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors.

AIM: This study was undertaken with an aim to explore the influence of factors associated with anxiety and fear of dentistry on oral health behavior. MATERIALS AND METHODS: A total of 84 patients aged 20-40 years visiting the dental institute for the management of gum diseases (gingivitis and periodontitis) and tooth decay (dental caries) were enrolled. Fear of dentistry and oral health behaviors were recorded employing a dental fear survey (DFS) and oral health behaviors checklist. Each of the 20-item scale of DFS was rated on a 5-point Likert scale. The oral health behavior checklist was based on oral hygiene habits, patterns of utilization of dental services, food habits, and use of tobacco products. Each of the 13-item checklist comprised a closed-ended statement with a high score corresponding to more positive oral health behavior. RESULTS: Domains of dental fear (avoidance of dentistry, physiological arousal, and fear of specific stimuli) and total dental fear did not predict oral hygiene habits and nutritional preferences (p > 0.05). Physiological arousal was a positive predictor of utilization of dental services (p = 0.009) and oral health behavior (p = 0.042). Oral health behaviors were found to be positively correlated with three factors of DFS. CONCLUSION: Anxiety and fear of dentistry are not found to influence personal preventive oral care with reference to oral hygiene habits. Avoidance of dentistry factor of DFS is positively correlated with oral health behavior. Dental fear and anxiety do not impact oral health behaviors adversely. CLINICAL SIGNIFICANCE: In this era of youth and beauty, the utilization of professional dental care services is not affected by fear of invasive nature of dental procedures. Establishing the groundwork for knowledge regarding the scope of fear appeals in anxiety for dentistry may help to augment positive oral health behaviors for effective primary prevention of oral diseases. Interactions among personality characteristics, attitudes, emotions, and health behavior need further exploration. How to cite this article: Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024;25(3):280-288.

A study on related factors affecting dental fear in preschool children.

This study aims to examine the manifestations of dental anxiety (DA) and its influencing factors during dental visits among preschool children. The data of 166 preschool children who visited the Department of Dentistry of our hospital from April 2021 to April 2023 with oral problems were retrieved. Their DA performance was investigated using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). In addition, based on their general data and potential risk factor information, we performed logistic regression analysis to identify the factors influencing DA. Of the 166 questionnaires distributed, a total of 160 valid questionnaires were retrieved. The average CFSS-DS score was 35.57 ± 3.51 points. Sixty-six children had DA, resulting in an incidence rate of 41.25%. The top 5 items with the highest CFSS-DS scores were fear of needles, dentists, tooth extraction, drilling and oral anesthesia. When the 66 children with DA were classified into a DA group and a non-DA group, we observed significant differences in age distribution, dental experience, only child status, general anxiety symptoms, dental condition, family income and specific dental treatment procedures, particularly tooth extraction, between them (p < 0.05). Multivariate logistic regression analysis revealed that preschool children aged ≤4 years, those with prior dental experiences, single-child status, general anxiety symptoms, suboptimal dental health, family incomes below 100,000 yuan/year, and those undergoing specific dental procedures, such as tooth extractions, were independently associated with a higher risk of DA (p < 0.05). The incidence of DA in preschool children is high, and they exhibit substantial fear of needles, dentists, tooth extraction, drilling and oral anesthesia. Preschool children aged ≤4 years, with prior dental experiences, single-child status, the presence of general anxiety symptoms, suboptimal dental health, family incomes below 100,000 yuan/year, and those undergoing dental procedures, particularly tooth extraction, could be more predisposed to DA.

The effect of virtual reality glasses on dental anxiety during scaling and root planing in patients with periodontitis: A randomized controlled clinical trial.

OBJECTIVES: This study aimed to evaluate the effect of virtual reality distraction (VRD) on dental anxiety during scaling and root planing (SRP) in periodontitis patients. MATERIALS AND METHODS: This randomized controlled split-mouth study included 60 patients who scored 9 or above on the dental anxiety scale (DAS) and required SRP in at least two quadrants with at least five teeth and two sites with a probing depth of ≥4 mm. Randomly chosen quadrants were treated using virtual reality glasses, and other quadrants were treated without glasses at the same visit. During VRD, a video of nature scenes was projected onto the screen in front of the patient's eyes. DAS and a visual analogue scale about patient feelings were applied at the end of the procedure. RESULTS: With VRD, the scale value of pain and discomfort level (VASP) was significantly reduced (p = 0.01, d = 0.57). Starting treatment without glasses significantly decreased VASP in both control and test sides (p = 0.00, d = 0.85; p = 0.00, d = 0.80, respectively) and increased the sensation of immersion and realism (p = 0.03, d = 0.45; p = 0.02, d = 0.46, respectively). Intraoperative and postoperative DAS values were significantly lower in patients who started treatment without VRD (p = 0.04, d = 0.34; p = 0.02, d = 0.44, respectively). Of the patients, 63.3% preferred VRD in the subsequent treatment. While patient preference did not correlate with sex, it correlated with age (r = -0.48, p = 0.01). CONCLUSIONS: The VRD and initiating SRP procedure with VRD affected the pain and discomfort level in anxious periodontitis patients. In addition, the anxiety level was also affected by starting the procedure with glasses.

Piezosurgery versus conventional osteotomy: a randomized clinical trial on pain and anxiety in children with unerupted mandibular third molars.

OBJECTIVE: Dental anxiety for unerupted mandibular third molars extraction in children under local anesthesia is a tricky problem. The purpose of this study was to compare psychological and physiologic findings of extractions of unerupted mandibular third molars in children by piezosurgery and conventional osteotomy. MATERIALS AND METHODS: This prospective, single-center, double-blind study included children who required extraction of mandibular third molars under local anesthesia. All subjects were randomly divided into two groups: piezosurgery and conventional osteotomy (control). The primary outcome variables were dental anxiety assessed by the Modified Child Fear Survey Schedule Dental Subscale (CFSS-DS) and postoperative pain qualified by the visual analog scale (VAS). Secondary outcome variables included blood pressure, heart rate, saturation, and operation duration. The data were analyzed by t-test and chi-square test (P ≤ 0.05). RESULTS: All 40 study patients (37.5% males and 62.5% females with an average age of 14.43 ± 1.32 years) completed the entire trial. There were no statistically significant differences observed between the two groups in terms of gender allocation, age, side of extraction, and Winter's Classification (P > 0.05). The operation duration of the piezosurgery group was significantly longer than the conventional osteotomy group (P < 0.01). The VAS scores showed that pain levels of children in the piezosurgery group were significantly less than the conventional osteotomy group on the first and third days postoperatively (P < 0.05 and P < 0.01, respectively). The CFSS-DS score in the piezosurgery group significantly decreased compared to the conventional osteotomy group (P < 0.05). Compared with the conventional osteotomy group, a significant decrease in heart rate, and lower systolic and diastolic blood pressures were observed after extraction in the piezosurgery group (P < 0.05 and P < 0.01, respectively). CONCLUSION: Compared with conventional osteotomy, piezosurgery can effectively reduce postoperative pain and have some effect in relieving dental anxiety for the extraction of unerupted mandibular third molars in children. CLINICAL RELEVANCE: Piezosurgery may be a viable technique for the extraction of unerupted mandibular third molars in children under local anesthesia.