Validating a measure of the prevalence of dental anxiety as applied to Kuwaiti adolescents.

OBJECTIVES: To assess self-reported dental anxiety (DA) among Kuwaiti adolescents and to test whether different dental anxiety scales are valid for measuring DA in Kuwait. BASIC RESEARCH DESIGN: Cross-sectional, structured, anonymous questionnaire survey in Arabic completed at government schools. PARTICIPANTS: 757 pupils aged 13-15 years from three schools filled the questionnaire. Useable response rate was 93.0%. MAIN MEASURES: DA was assessed by: 1, a single-item dental fear question (DF); 2, the Modified Dental Anxiety Scale (MDAS); and 3, the Modified Child Dental Anxiety Scale: faces (MCDAS(f)). RESULTS: A third of the girls and 6% of boys reported being very much afraid of visiting a dentist. Use of the drill and injection in the gum were the most anxiety arousing MDAS items; tooth extraction and injection of the MCDAS(f) items. Total mean for MDAS was 11.4 (sd 4.6) and for MCDAS(f) 16.6 (sd 6.5). A tenth of the children were highly dentally anxious when measured by MDAS (score ≥ 19). Girls reported statistically significantly higher DA scores with all the measures. There was a high correlation between the total score of the MDAS and the total score of the MCDAS(f) (p = 0.855). Statistically significant relationship (p < 0.001) was found between the single-item DF and the total score of the MDAS and a single item and the total score of the MCDAS(f). CONCLUSIONs: A tenth of children were highly dentally anxious; girls reporting higher scores. A single-item dental fear question, MDAS and MCDAS(f) were valid tools for measuring DA among Kuwaiti adolescents.

The physiologic and behavioral effects of oral and intranasal midazolam in pediatric dental patients.

PURPOSE: The purpose of this study was to compare the safety and effectiveness of oral and intranasal midazolam in healthy children by evaluating their physiological and behavioral responses. METHODS: Regimen A patients received 0.5 mg/kg oral midazolam with an intranasal saline spray placebo at their first appointment and 03 mg/kg intranasal midazolam with an oral midazolam placebo at their second appointment. Regimen B patients received the medications in the reverse order at each appointment. Physiological parameters and behavior ratings were recorded. RESULTS: There were no significant differences in physiologic parameters in the 2 treatment groups, except for significantly lower oxygen saturation in the oral group at t=20 minutes (P=.03) The oral group showed significantly lower crying scores at t=5 minutes (P=.02), and lower overall behavior scores at t=papoose and t=5 minutes (P=.04 and .03, respectively). Oral sedations were given ratings by providers of "effective" and "very effective" significantly more than intranasal sedations (P<.05). CONCLUSIONS: Both regimens have similar behavioral outcomes, with the oral group having improved crying and overall behavior early in the appointment, Oral sedations were considered to be more effective by providers than intranasal sedations. Clinically significant desaturations occur in both regimens, indicating the need for operators to recognize and respond to the need for airway correction according to American Academy of Pediatric Dentistry guidelines.

The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial.

OBJECTIVES: To review the effect of lavender scent on anticipatory anxiety in dental participants. METHODS: In a cluster randomized-controlled trial, patients' (N = 340) anxiety was assessed while waiting for a scheduled dental appointment, either under the odor of lavender or with no odor. Current anxiety, assessed by the brief State Trait Anxiety Indicator (STAI-6), and generalized dental anxiety, assessed by the Modified Dental Anxiety Scale (MDAS) were examined. RESULTS: Analyses of variance (anovas) showed that although both groups showed similar, moderate levels of generalized dental anxiety (MDAS F((1,338)) = 2.17, P > 0.05) the lavender group reported significantly lower current anxiety (STAI: F((1,338)) = 74.69, P < 0.001) than the control group. CONCLUSIONS: Although anxiety about future dental visits seems to be unaffected, lavender scent reduces state anxiety in dental patients.

Cerebral activations resulting from virtual dental treatment.

Pain, and anxiety of pain, for some people are serious problems in dental treatment. It is a common practical experience that even entering a dental surgery office, or the sound of a dental drill, may evoke vegetative correlates of toothache without any underlying disease. This everyday phenomenon suggests the hypothesis of a corresponding activation of pain-related brain areas by virtual dental treatment. Twenty healthy subjects viewed two different video clips presenting a dental treatment from the first-person perspective (simulation movie) and a moving hand holding an electrical toothbrush (control movie). Using functional magnetic resonance imaging, the cerebral hemodynamic responses that occurred during simulation and control movies were compared. Virtual dental treatment was associated with increased activity in pain-related brain areas such as the cingulate cortex, the insula, and primary and secondary somatosensory cortexes (SI, SII). The brain activation pattern indicates not only affective-motivational but also sensory-discriminative pain components during virtual dental treatment in all volunteers. Volunteers with a higher level of dental anxiety showed stronger activation of SI and SII. This may be a result of their higher anticipation of pain.