Dental Fear: One Single Clinical Question for Measurement

A new dental fear measurement instrument, the Short Dental Fear Question (SDFQ), was developed and tested for clinical practice purposes. The correlations of the SDFQ with the Dental Anxiety Scale (DAS) and the Dental Fear Survey (DFS) were tested in 15-16-year-old adolescents. The Spearman correlations (rs) between the dental fear measurement instruments were: SDFQ – DFS: rs = 0.79, n = 26; DFS – DAS: rs = 0.72, n = 26; SDFQ– DAS: rs = 0.69, n = 27. DAS and DFS mean scores were clearly higher in the SDFQ fear group than SDFQ in the relaxed group. The SDFQ is a short and compact instrument which might be convenient for the measurement of dental fear in clinical practice

Aspects and determinants of children’s dental fear

Abstract The aims of this study were to explore different aspects of dental fear and their determinants among children at different ages. The study samples comprised 378 children from the Veneto region of Italy aged 3–13 years and 1474 children from Jyväskylä and Kuopio, Finland, aged 3, 6, 9, 12 and 15 years. In the Italian study, the child’s age, first dental visit, number of subsequent visits and dental fear, and the parent’s dental fear were asked in a questionnaire. In the Finnish study, a questionnaire was used that contained 11 dental fear-related questions and family member’s dental fear and questions on oral health habits and family characteristics. Dental status was determined clinically and information on treatment procedures from three preceding years was collected from patient records. A total of 21 to 36% of Finnish children were quite or very afraid of something in dental treatment. The prevalence of dental fear among Finnish children was not lower among older children but rather fluctuated among different ages. The characteristics of dental fear differed among children at different ages. Among Finnish children, four aspects of dental fear were revealed from the questionnaire, i.e. ‘Treatment of dental decay’, ‘Attending dentist’, ‘Peak value for dental fear’ and ‘Fear of dental treatment in general’. Correlations between the four abovementioned aspects, the differences between age groups separately for the above mentioned aspects, and the determinants of dental fear were studied. At younger ages, the dental fear was abstract, commonly related to attending dentist. At older ages, dental fear was often related to invasive treatment, such as fear of local anaesthesia and drilling. Fear of pain which was common among all age groups. Among Italian children, the first dental experiences were strong determinants of dental fear. Among Finnish children, dental fear among other members of the family was more often found among children with dental fear than among non-fearful children. 15-year-old girls were more likely to be afraid than boys of the same age but gender differences were not found at younger ages. The results indicated that dental fear is not solely based on direct conditioning but rather consists of child, family and environment related determinants.Tiivistelmä Tutkimuksen tarkoituksena oli selvittää lasten hammashoitopelon piirteitä ja niihin liittyviä seikkoja eri-ikäisillä lapsilla. Tutkimuksessa käytettiin havaintoaineistoa, joka koostui 378:sta 3–13-vuotiaasta italialaisesta lapsesta Veneton maakunnan alueelta sekä 1474:stä 3-, 6-, 9-, 12- ja 15-vuotiaasta lapsesta Jyväskylästä ja Kuopiosta. Tutkimuksessa italialaisilla lapsilla vanhempi täytti kyselylomakkeen, joka sisälsi kysymyksiä lapsen iästä, hammashoitopelosta, ensimmäisestä hammashoitokäynnistä ja seuraavien hoitokäyntien lukumäärästä sekä vanhemman omasta hammashoitopelosta. Suomalaisilla lapsilla tutkimustiedot kerättiin kyselylomakkeella, joka sisälsi 11 kysymystä lapsen hammashoitopelosta ja kysymyksiä lapsen suun terveystottumuksista sekä perheeseen liittyvistä seikoista, kuten perheenjäsenten hammashoitopelosta. Hampaiden senhetkinen kliininen tila sekä kolmen tarkastusta edeltävän vuoden hoitokäynnit ja tuolloin tehdyt toimenpiteet otettiin mukaan tutkimukseen. Suomalaisista lapsista 21–36 % pelkäsi jonkin verran tai paljon jotain asiaa hammashoidossa. Suomalaisten lasten hammashoitopelko ei ollut alempi nuoremmilla lapsilla vaan vaihteli ikäryhmien välillä. Myös hammashoitopelon luonne vaihteli ikäluokittain. Suomalaisesta kyselystä löydettiin neljä pelon osa-aluetta: paikkaushoitoon liittyvä pelko, hammaslääkärissä käymiseen liittyvä pelko, yleinen hammashoitopelko sekä voimakkaimmaksi koettu hammashoitoon liittyvä yksittäinen pelko. Tutkimuksessa tutkittiin pelon osa-alueiden välisiä korrelaatioita ikäryhmittäin, erikseen yksittäisen pelon osa-alueen vaihtelua ikäryhmien välillä sekä hammashoitopelon liittyviä seikkoja ikäryhmittäin. Nuoremmilla lapsilla hammashoitopelko oli useammin abstraktia, yleensä hammashoidossa käymiseen liittyvää pelkoa. Vanhemmilla lapsilla hammashoitopelko oli usein hammashoitotoimenpiteisiin liittyvää pelkoa, esimerkiksi puudutuksen ja porauksen pelkoa. Kivun pelko oli yleistä kaikissa ikäryhmissä. Ensimmäiset hammashoitokokemukset olivat voimakkaita hammashoitopelon selittäjiä italialaisilla lapsilla. Suomalaisten lasten hammashoitopelko oli vahvasti yhteydessä muiden perheenjäsenten hammashoitopelkoon. 15-vuotiaat tytöt pelkäsivät hammashoitoa enemmän kuin pojat, mutta sukupuolten välisiä eroja ei havaittu nuoremmissa ikäryhmissä. Tutkimus osoittaa, että lasten hammashoitopelko ei ole ainoastaan seurausta suorasta ehdollistumisesta hammashoitokokemusten kautta vaan siihen vaikuttavat enemmänkin lapseen, perheeseen ja ympäristöön liittyvät seikat

Pressure pain sensitivity is associated with dental fear in adults in middle age:findings from the Northern Finland 1966 birth cohort study

Abstract Introduction: Dental fear is a prevalent problem leading to severe deterioration of oral health and health‐related quality of life. Despite the knowledge that dental fear is closely linked to painful experience, the association between pain sensitivity and dental fear remains unclear. This study was designed to evaluate this association with validated measures of dental fear and pressure pain sensitivity in a cohort population. Methods: The study population consisted of a subpopulation of the Northern Finland Birth Cohort 1966. At the age of 46 years, 1736 participants completed the valid and reliable Modified Dental Anxiety Scale (MDAS) and participated in a clinical examination, where their nonorofacial pressure pain sensitivity was evaluated by validated pressure pain threshold (PPT) and tolerance (PPTo) measurements. Gender‐specific Tobit regressions were performed to analyse this association adjusted for smoking and depressive and anxiety symptoms. Results: Women with moderate dental fear had 5% (31.3 kPa; P < 0.05), and women with high dental fear had 7% (42.9 kPa; n.s.) lower pressure pain threshold than women with low dental fear. Women with moderate dental fear had 4% (35.4 kPa; P < 0.05) and women with high dental fear had 9% (82.7 kPa; P < 0.01) lower pressure pain tolerance than women with low dental fear. Men with moderate and high dental fear had 3% lower pressure pain tolerance (35.4 kPa; P < 0.05 and 29.6 kPa; n.s., respectively) than men with low dental fear, whereas the associations with pain threshold were not statistically significant. Among women, both anticipatory and treatment‐related dental fears were associated with pain threshold and pain tolerance. Among men, pain threshold was associated with treatment‐related dental fear only and the associations with pain tolerance were not statistically significant. Conclusions: Nonorofacial pressure pain threshold and tolerance appeared to be lower in participants with dental fear, which emphasizes the role of pain sensitivity in dental fear

The relationship of dental caries and dental fear in Malaysian adolescents: a latent variable approach

This paper is funded by University Malaya.Background To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. Methods A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. Results The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (chi2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. Conclusion In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.Publisher PDFPeer reviewe