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

The contribution of embarrassment to phobic dental anxiety: a qualitative research study

BACKGROUND: Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. METHODS: Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20–65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. RESULTS: Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of avoidance and degree of mouth-hiding behaviors. CONCLUSIONS: Embarrassment is a complex dental anxiety manifestation with qualitative differences by complaint characteristics and perceived intensity. Some cases exhibited manifestations similar to psychiatric criteria for social anxiety disorder as chief complaint, while most manifested embarrassment as a side effect

Ansiedade ao tratamento odontológico em atendimento de urgência Dental anxiety in an emergency dental service

OBJETIVO: Avaliar a freqüência de pacientes com ansiedade ou medo do tratamento odontológico em um setor de urgência. MÉTODOS: Participaram do estudo 252 pacientes, com 18 anos ou mais, que compareceram ao setor de urgência de uma faculdade de odontologia, de São Paulo, SP, entre agosto e novembro de 2001. Para avaliar a ansiedade, foram utilizadas a Modified Dental Anxiety Scale (MDAS), e a Escala de Medo de Gatchel. O grupo estudado respondeu a questões sobre: tempo decorrido desde a última visita ao dentista e desde o início dos sintomas, escolaridade, renda familiar e história prévia de trauma. Os resultados foram analisados pelos testes estatísticos (chi2 e Teste Exato de Fisher). RESULTADOS: Foram identificados 28,2% de indivíduos com algum grau de ansiedade, segundo a MDAS, na qual as mulheres foram consideradas mais ansiosas que os homens (chi2=0,01); e 14,3% de pacientes com alto grau de medo segundo a Escala de Medo de Gatchel. Em 44,4% da amostra a demora para procura de alívio dos sintomas foi > sete dias. Mulheres ansiosas procuraram atendimento mais rapidamente e em maior número. Experiência traumática anterior ocorreu em 46,5% dos pacientes ansiosos. Não foi possível relacionar escolaridade e renda familiar com ansiedade e/ou medo. CONCLUSÕES: Pacientes ansiosos, com destaque para as mulheres, são freqüentes no atendimento odontológico de urgência. Experiência prévia traumática mostrou-se importante para o desenvolvimento da ansiedade em relação ao atendimento odontológico.<br>OBJECTIVE: The purpose of the study was to assess the frequency of dental anxiety and/or fear among patients in an emergency dental service. METHODS: Research was based on interviews with 252 patients, aged 18 years old and over, attended at an emergency dentistry service of São Paulo, Brazil, from August to November, 2001. Two methods were used to measure dental anxiety: the Modified Dental Anxiety Scale (MDAS) and the Gatchel Fear Scale. The study group answered questions concerning major complaint, how much time had elapsed since their last visit to the dentist and since the initial symptoms leading to the current visit to the emergency service, level of education, family income and previous traumas. Statistical analysis (chi2 and Fisher exact test) was performed to evaluate these characteristics. RESULTS: It was found that 28.17% of this sample was dentally anxious, according to the MDAS, and 14.29%, felt fear related to dental treatment according to the Gatchel Fear Scale. Women were more anxious than men at a statistically significant rate (MDAS). The time elapsed since the onset of initial symptoms was more than 7 days for 44.44% of the participants. A large proportion of anxious women returned to treatment during the last year. A previous traumatic experience with dental was identified in 46.48% of the dentally anxious patients. No significant relation between level of education or income and dental anxiety was found. CONCLUSIONS: Dentally anxious patients frequent attend emergency care. Females are more likely to report high dental anxiety than males. Previous experience seems to be an important factor contributing to avoidance of dental care

Ibuprofen arginine for pain control during scaling and root planing: a randomized, triple-blind trial.

OBJECTIVES: The aim of this controlled clinical trial was to investigate the analgesic efficacy and tolerability of ibuprofen arginine in patients with mild-to-moderate periodontitis during and after non-surgical periodontal treatment. METHODS: This randomized, triple-blind, placebo-controlled, parallel-group trial assessed the analgesic efficacy of ibuprofen arginine (Spedifen) in patients undergoing routine periodontal scaling and root planing. 64 patients with chronic periodontitis received either 800 mg ibuprofen arginine or placebo 30 min. before treatment. Numeric pain and electronic visual analogue scales ranging from 0 to 100 were used. RESULTS: The average pain levels during treatment were lower following ibuprofen arginine (quartiles: 0.5, 4.5, 11) compared with placebo (4, 16, 26), corresponding to a percentage reduction in median pain of 72% (p=0.023). The median maximum pain was 28 (inter-quartile range 10-50) following placebo and 10 (4-31) following ibuprofen arginine (p=0.065). CONCLUSIONS: In patients with mild-to-moderate chronic periodontitis, ibuprofen arginine was safe and superior to placebo for alleviating pain during non-surgical periodontal treatment. Its painless administration and rapid onset of action make it well suitable for pain management in a general dental office