Thinking about going to the dentist: a Contemplation Ladder to assess dentally-avoidant individuals' readiness to go to a dentist

<p>Abstract</p> <p>Background</p> <p>The Transtheoretical Model suggests that individuals vary according to their readiness to change behavior. Previous work in smoking cessation and other health areas suggests that interventions are more successful when they are tailored to an individual's stage of change with regards to the specific behavior. We report on the performance of a single-item measure ("Ladder") to assess the readiness to change dental-avoidant behavior.</p> <p>Methods</p> <p>An existing Contemplation Ladder for assessing stage of change in smoking cessation was modified to assess readiness to go to a dentist. The resulting Ladder was administered to samples of English-speaking adolescents (USA), Spanish-speaking adults (USA), and Norwegian military recruits (Norway) in order to assess construct validity. The Ladder was also administered to a sample of English-speaking avoidant adolescents and young adults who were enrolled in an intervention study (USA) in order to assess criterion validity. All participants also had dental examinations, and completed other questionnaires. Correlations, chi square, t tests and one-way ANOVAs were used to assess relationships between variables.</p> <p>Results</p> <p>In two samples, participants who do not go to the dentist had significantly more teeth with caries; in a third sample, participants who do not go to the dentist had significantly worse caries. Ladder scores were not significantly related to age, gender, caries, or dental fear. However, Ladder scores were significantly related to statements of intention to visit a dentist in the future and the importance of oral health. In a preliminary finding, Ladder scores at baseline also predicted whether or not the participants decided to go to a dentist in the intervention sample.</p> <p>Conclusions</p> <p>The data provide support for the convergent and divergent construct validity of the Ladder, and preliminary support for its criterion validity. The lack of relationship between dental fear and Ladder scores suggests that avoidant individuals may be helped to decide to go to a dentist using interventions which do not explicitly target their fear.</p

Additional psychometric data for the Spanish Modified Dental Anxiety Scale, and psychometric data for a Spanish version of the Revised Dental Beliefs Survey

<p>Abstract</p> <p>Background</p> <p>Hispanics comprise the largest ethnic minority group in the United States. Previous work with the Spanish Modified Dental Anxiety Scale (MDAS) yielded good validity, but lower test-retest reliability. We report the performance of the Spanish MDAS in a new sample, as well as the performance of the Spanish Revised Dental Beliefs Survey (R-DBS).</p> <p>Methods</p> <p>One hundred sixty two Spanish-speaking adults attending Spanish-language church services or an Hispanic cultural festival completed questionnaires containing the Spanish MDAS, Spanish R-DBS, and dental attendance questions, and underwent a brief oral examination. Church attendees completed the questionnaire a second time, for test-retest purposes.</p> <p>Results</p> <p>The Spanish MDAS and R-DBS were completed by 156 and 136 adults, respectively. The test-retest reliability of the Spanish MDAS was 0.83 (95% CI = 0.60-0.92). The internal reliability of the Spanish R-DBS was 0.96 (95% CI = 0.94-0.97), and the test-retest reliability was 0.86 (95% CI = 0.64-0.94). The two measures were significantly correlated (Spearman's rho = 0.38, p < 0.001). Participants who do not currently go to a dentist had significantly higher MDAS scores (t = 3.40, df = 106, p = 0.003) as well as significantly higher R-DBS scores (t = 2.21, df = 131, p = 0.029). Participants whose most recent dental visit was for pain or a problem, rather than for a check-up, scored significantly higher on both the MDAS (t = 3.00, df = 106, p = 0.003) and the R-DBS (t = 2.85, df = 92, p = 0.005). Those with high dental fear (MDAS score 19 or greater) were significantly more likely to have severe caries (Chi square = 6.644, df = 2, p = 0.036). Higher scores on the R-DBS were significantly related to having more missing teeth (Spearman's rho = 0.23, p = 0.009).</p> <p>Conclusion</p> <p>In this sample, the test-retest reliability of the Spanish MDAS was higher. The significant relationships between dental attendance and questionnaire scores, as well as the difference in caries severity seen in those with high fear, add to the evidence of this scale's construct validity in Hispanic samples. Our results also provide evidence for the internal and test-retest reliabilities, as well as the construct validity, of the Spanish R-DBS.</p

Characteristics and Fate of Orthodontic Articles Submitted for Publication: An exploratory study of the American Journal of Orthodontics and Dentofacial Orthopedics

Thesis (Master's)--University of Washington, 2013Purpose: The orthodontic literature lacks any study that investigates the characteristics and fate of manuscripts submitted to a top journal, such as the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO). Having such information could be valuable to authors and editors alike in understanding critical aspects of the review process. Methods: This exploratory study looked at original articles submitted to the AJO-DO in 2008 and gathered the following information: (1) For rejected articles: main reason for rejection, publication elsewhere, and journal of subsequent publication where applicable; (2) For accepted articles: number/type of revisions and time elapsed to publication; (3) For all articles: study topic, study design, area of origin, and presence of statistically significant findings. Descriptive statistics were used to describe the manuscripts in terms of the above characteristics. Interactions between the above characteristics and rejection/acceptance/publication elsewhere were explored and reported using the Chi-squared test for equality of proportions, with Fisher's exact test used for samples of five and below. Post-hoc pairwise tests were checked against the Bonferroni correction to account for multiple testing. Results: Of the 440 original articles submitted to the AJO-DO in 2008, 113 (25.9%) were accepted for publication while 323 (74.1%) were rejected. All accepted articles underwent either major or minor revision before acceptance and were published in an average of 20.9 months (sd=4.9) after acceptance. Of the rejected articles, 137 were subsequently published in 58 different journals with an average time to publication of 22.2 months (sd=10.9) after rejection from AJO-DO. Among articles not accepted by AJO-DO, the top three reasons for rejection were: (1) Poor study design/small sample size (59% of rejected papers); (2) Outdated/Unoriginal topic (41.5%); and (3) Inappropriate for AJO-DO audience (27.2%). Manuscripts rejected for poor study design had the least success in subsequent publication, while those rejected as inappropriate for the AJO-DO had the highest rate of publication elsewhere. Neither study topic nor study design were significantly associated with acceptance to AJO-DO or publication elsewhere except among rejected observational studies, where it was found that cross-sectional studies were most likely to be published elsewhere, and case series had the least success (p=0.002). Area of origin was found to be significantly associated with acceptance to AJO-DO, with articles from USA and Canada most likely to be accepted (pConclusions: Rejection by AJO-DO does not preclude publication elsewhere. Geographic origin is a predictor of acceptance to AJO-DO as well as subsequent journals. Authors aiming to maximize their chance of article acceptance should submit to an appropriate journal, use a well-designed and described study with adequate sample sizes, and emphasize the novelty and relevance of their work