Patient perceptions and experiences of dental fear of different dental specialties: a mixed-method study.

OBJECTIVE: The primary objective of this study was to validate an Urdu translation of Kleinknecht's Dental Fear Survey (DFS) for use in Pakistan and to explore which items contribute the most to the variance in dental fear scores based on patient perceptions and lived experiences during dental care. METHODOLOGY: This mixed-method study was conducted at Dow Dental Hospital from February 2022 to June 2022. For quantitative analysis, a total of 273 participants were enrolled through convenience sampling. After obtaining signed consent, participants were asked to self-report their dental fear. In-depth interviews with 25 patients displaying moderate to high dental fear were conducted to clarify the elements of dental fear scores through the lens of individual perceptions and experiences. RESULTS: The prevalence of moderate dental fear was significantly higher among female participants than males. The mean dental fear score was higher among females (39.47 ± 14.23) as compared to males (30.83 ± 10.50). Most of the female participants reported an increase in breathing rate and heartbeat during dental treatment. The highest mean fear score was reported by participants who underwent oral surgical treatment (42.98 ± 14.21), followed by participants who received restorative care (36.20 ± 12.60). Approaching the dentist's office was the significant factor that contributed the most to the variance in dental fear scores. Four themes were generated through the content analysis of the interviews: physical reactions to dental procedures, perceptions and fears about surgical and restorative procedures, and gender and environmental factors in dental fear and interaction with dentists. CONCLUSION: The Urdu translation of DFS is a reliable and valid instrument for assessing dental fears in Pakistan based on the findings of this study. Patients perceive surgical and restorative procedures as unpleasant and threatening. It was noted that "the heart beats faster" and "the breathing rate increases." were the top two physiological responses.

Psychometric evaluation of the Lebanese Arabic version of the Dental Fear Survey: a cross-sectional study.

BACKGROUND: Dental fear is a prevalent problem that can lead to poor dental health. The Kleinknecht's Dental Fear Survey (DFS) is one of the used scales to assess dental fear. The present study aims to evaluate the psychometric properties of the Lebanese Arabic version of the DFS (DFS-A) and to determine the optimal cut-off to identify dental fear as well as the correlates of dental fear in a group of Lebanese adults dental patients. METHODS: A cross-sectional study was conducted among a group of 442 dental patients (18-65 years) recruited at 29 dental clinics from March to June 2019. Patients completed a questionnaire including questions about demographic characteristics, previous bad dental experience, trauma's experience period, the sensation of nausea during dental treatment, the DFS-A scale, the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A), and a general question about dental fear. RESULTS: DFS-A revealed evidence of adequate psychometric properties. DFS-A scale demonstrated high internal consistency (cronbach's alpha = 0.93). Test-retest reliability assessment demonstrated strong reproducibility of the DFS-A scale score (ICC = 0.92 with 95% CI (0.83-0.96), p value < 0.0001 (N = 30). Confirmatory factor analysis revealed a three-factor structure of the DFS-A reflecting fear associated with specific dental stimuli and procedures, patterns of dental avoidance and anticipatory anxiety, and physiologic arousal during dental treatment. A significant correlation was found between DFS-A and the MDAS-A indicating a good convergent validity. The optimal cut-off point to identify patients with and without dental fear is 41. Considering this cut-off score, the prevalence of dental fear in our sample was reported at 33.8%. Multivariable analysis showed that having previous scary and painful dental experiences, a sensation of nausea during treatment, and having dental anxiety were identified as predictors of dental fear. CONCLUSION: The adapted Arabic version of the DFS (DFS-A) is a valid tool to evaluate dental fear among Lebanese adult patients.

Validity and Reliability of the Vietnamese Version of the Dental Fear Survey.

OBJECTIVES: The use of questionnaires to assess patients' dental fear is critical to dental research and practice. As one of the most well-established tools in this field, the Dental Fear Survey (DFS) was translated into Vietnamese (V-DFS) and employed in previous studies. However, its validity and reliability have not been reported. This study aimed to determine the validity and reliability of V-DFS in adults. METHODS: The DFS was translated to Vietnamese in accordance with the "Guideline for the Process of Cross-cultural Adaptation of Self-reported Measures" to create the V-DFS. Next, 414 students at Pham Ngoc Thach University of Medicine completed the V-DFS to examine its validity and reliability. The factorial validity of V-DFS was assessed using exploratory factor analysis (EFA) and structural equation modeling (SEM). The internal consistency and test-retest reliability of the V-DFS were assessed using Cronbach's alpha (α), intraclass correlation coefficient (ICC), and Spearman's rank-order correlation coefficient (rs). RESULTS: The rotated component matrix of the EFA revealed 3 factors: specific stimuli, anticipatory fear and avoidance, and physiologic arousal. The statistical indices of the best-fitting V-DFS model in SEM analysis satisfied the cutoff values. Cronbach's α ranged from .82 to .94 for the 3 factors. The ICC and rs of the whole questionnaire were .86 and .86, respectively. CONCLUSIONS: DFS was successfully translated into Vietnamese with good validity and reliability. Further research should be conducted to examine its validity in various populations and to improve its characteristics.

Evaluating the Relationship of Dental Fear with Dental Health Status and Awareness.

INTRODUCTION: Dental fear is one of the most common problems in dentistry, for both the patient and for the dentist. This issue can have an important effect on an individual's dental health. AIM: The aim of this paper was to report on the prevalence of dental anxiety and to explore if high levels of anxiety are associated with sociodemographic factors, oral health status, and level of oral health awareness. MATERIALS AND METHODS: The sample for this cross-sectional study included 294 patients (154 males and 140 females). All participants filled out a Dental Fear Survey (DFS) to evaluate their level of dental fear. Gender, age, education level, socioeconomic status and oral health awareness were also noted. Oral health behaviors and oral health awareness levels were investigated using seven questions. Also, the periodontal status of all participants was evaluated using the Community Periodontal Index of Treatment Needs (CPITN). Differences between different subgroups were tested using the chi-square test. RESULTS: There was a statistically significant difference between the DFS groups with regard to sociodemographic data. Women had significantly higher scores than men, and young patients had significantly higher scores than others. Patients with low education levels and low socioeconomic status had high DFS scores. Periodontal status was better in groups that had scores in the low and moderate ranges compared to groups that had high scores on the DFS. There was a statistically significant difference between the groups of DFS and CPITN (p<0.05). Patients with low and moderate levels of DFS answered the oral health knowledge questions correctly. There was a statistically significant difference between the DFS groups based on correct answers to the oral health knowledge questions (p<0.05). CONCLUSION: The elimination of dental fear is very important and should be treated according to a patient-centered assessment. These individuals were informed about the dental treatment procedure so their prejudices were eliminated. Patients with a high level of dental fear may be given psychiatric support for comfortable treatment procedure.

Dental anxiety and fear among a young population with hearing impairment.

BACKGROUND AND AIM: Dental fear and anxiety is a major barrier for dental care provision. Identifying anxious patients can help dental professionals manage them appropriately. The study aimed at assessing dental fear and anxiety among a deaf population in Cluj-Napoca, Romania and their associated and contributing factors. METHOD: In this cross sectional study 165 deaf participants were invited to complete a questionnaire comprising three sections. The first section contained questions about social and economical status, the second comprised a Romanian version of the Modified Dental Anxiety Scale (MDAS) while part three was the Dental Fear Survey (DFS). Data was introduced and analyzed with the Statistical Package for Social Sciences (SPSS) program, version 20.0 (SPSS Inc., Chicago, Illinois, USA). RESULTS: Thirty four point nine percent (34.9%) of respondents were found to be insignificantly anxious, 59.7% were moderately or extremely anxious with 5.3% being identified with dental phobia based on the MDAS scores. Mean total score for dental anxiety on the MDAS scale was 13.7. Patients suffering from a prior negative experience were found to be more anxious (p<0.05). CONCLUSIONS: Dental fear and anxiety is widespread in the deaf communities. Higher percentages were observed among women and people with a previous traumatic dental experience.

Reliability and validity of the Korean version of the Dental Fear Survey.

BACKGROUND: Many people experience varying levels of discomfort when confronted with the prospect of dental treatment. Dental treatment can be a traumatic experience, especially for children and adolescents with dental anxiety. In this age group, dental fear causes a significant problem in dental management and has been related to severe dental caries and dental pain. The Dental Fear Survey ( DFS ) is the most widely used measure of dental fear. This study was undertaken to develop the Korean version of the DFS ( K-DFS ) and test its reliability and validity. METHODS: The K-DFS, which uses projective techniques to measure children's and adolescents' dental fear, was developed. The DFS was translated into Korean and participants were selected via convenience sampling. Reliability and validity were tested using data from a sample of 813 middle school students in Gyeonggi Province, selected from the Self questionnaire survey. The K-DFS was administered twice to 102 adolescents aged 12-15 years. RESULTS: The K-DFS had high internal consistency reliability (99.1%) but low test-retest reliability. CONCLUSIONS: The results indicate that the Korean versions of the DFS have good internal consistency reliabilities and test-retest validities. However, we need to further examine the test-retest reliability of the K-DFS and replicate the current study in different samples covering various age groups.