Key Points
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Highlights that dentate people with dental phobia have higher levels of active caries, higher PUFA scores and report poorer oral health-related quality of life in comparison to non-phobic adults.
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Reports that there were no differences in the number of sound and missing teeth and sugar intake.
Abstract
Introduction The aim of this study was to conduct an exploration of differences in oral health behaviour and outcome between dentally phobic and non-phobic participants in the UK Adult Dental Health Survey (ADHS, 2009). The null hypotheses for this study were that there are no differences in oral health status of non-phobic and dental phobic individuals.
Methods The ADHS survey covered the adult population in England, Wales and Northern Ireland and was commissioned by the NHS Information Centre for Health and Social Care (NHS IC). Dental anxiety was defined using the Modified Dental Anxiety (MDAS) with the cut-off point set at 19 and above as indicating dental phobia. Descriptive statistics were calculated and the chi-square test was used to compare both groups in terms of their demographics, oral health, oral health-related behaviour and attitudes, and treatment.
Results More women (16.8% [1,023]) than men (7% [344]) reported dental phobia. Generally, people with dental phobia were in routine occupations (648 [47.7%]), single (402 [29.4%]) and with lower educational attainment (858 [80.9%]). They were irregular attendees (798 [58.5%]), had a less restored dentition, increased numbers of one or more teeth with caries (292 [39.9%]), and were more likely to have PUFA (puss, ulceration, fistulae, abscess) scores of one or more (89 [12.2%]) in comparison to the non-phobic group (314 [5.6%]). However, people with and without dental phobia had similar numbers of sound and missing teeth (34.5% of the phobic group had 20 or more sound teeth in comparison to 31.7% of the non-phobic group). There were significant differences (p <0.001) between the phobic group's and non-phobic group's Oral Health Impact Profile-14 (OHIP) and Oral Impacts on Daily Performance (OIDP) scores with phobic participants having generally higher scores. Additionally, the phobic group responded negatively more commonly about their most recent dental treatment in terms of dentists' ability to listen to their concerns, explaining the reasons for their dental care while paying full attention to their needs by treating them with respect and dignity. The difference between the two groups was statistically significant (p <0.001).
Conclusions Participants reporting dental phobia are mostly females, irregular attendees and have a greater treatment need with increased caries levels.
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References
Hakeberg M, Berggren U, Carlsson S G . Prevalence of dental anxiety in an adult population in a major urban area in Sweden. Community Dent Oral Epidemiol 1992; 20: 97–101.
Poulton R, Waldie K E, Thomson W M, Locker D, Poulton R, Waldie K E . Determinants of early- vs late-onset dental fear in a longitudinal-epidemiological study. Behav Res Ther 2001; 39: 777–785.
Moore R, Birn H . Kirkegaard E, Brodsgaard I, Scheutz F . Prevalence and characteristics of dental anxiety in Danish adults. Community Dent Oral Epidemiol 1993; 21: 292–296.
Office for National Statistics. Social Survey Division and Information Centre for Health and Social Care. Adult Dental Health Survey, 2009 [computer file]. 2nd edition. Colchester, Essex: UK Data Archive [distributor], August 2012. SN: 6884.
Humphris G M, Dyer T A, Robinson P G . The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age. BMC Oral Health 2009; 9–20.
Humphris G M, King K . The prevalence of dental anxiety across previous distressing experiences. J Anxiety Disord 2011; 25: 232–236.
Humphris G M, Morrison T, Lindsay S J E . The modified dental anxiety scale; UK norms and evidence for validity. Community Dental Health 1985; 12: 143–150.
Humphris G M, Crawford J R, Hill K, Gilbert A, Freeman R . UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results. BMC Oral Health 2013; 13: 29.
Locker D, Allen F . What do measures of 'oral health-related quality of life' measure? Community Dent Oral Epidemiol 2007; 35: 401–411.
Cohen S, Fiske J, Newton T . The impact of dental anxiety on daily living. Br Dent J 2000; 189: 385–390.
Mehrstedt M, Tönnies S, Eisentraut I . Dental fears, health status, and quality of life. Anesth Prog 2002; 51: 90–94.
Milgrom P, Newton J T, Boyle C, Heaton L J, Donaldson N . The effects of dental anxiety and irregular attendance on referral for dental treatment under sedation within the National Health Service in London. Community Dent Oral Epidemiol 2010; 38: 453–459.
Craft M H, Croucher R E . Factors that influence dental visiting among young adults 16–24 years old. Community Dent Oral Epidemiol 1980; 8: 347–350.
McGrath C, Bedi R . Can dental attendance improve quality of life? Br Dent J 2001; 190: 262–265.
O'Sullivan I, Lader D, Beavan-Seymour C, Chenery V, Fuller E, Sadler K . Foundation report: Adult Dental Health Survey 2009 (Technical report). 24 March 2011. The Information Centre for Health and Social Care, 2011.
Hallstrom T, Halling. A . Prevalence of dentistry phobia and its relation to missing teeth, alveolar bone loss and dental care habits in an urban community sample. Acta Psychiatr Scand 1984; 70: 438–446.
Armfield J M, Stewart J F, Spencer A J . The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health 2007; 7: 1.
Sohn W, Ismail A I . Regular dental visits and dental anxiety in an adult dentate population. J Am Dent Assoc 2005; 136: 58–66.
Donaldson A N, Everitt B, Newton T, Steele J, Sherriff M, Bower E . The effects of social class and dental attendance on oral health. J Dent Res 2008; 87: 60–64.
Liddell A, Locker D . Gender and age differences in attitudes to dental pain and dental control. Community Dent Oral Epidemiol 1997; 25: 314–318.
Kleinknecht R A, Bernstein D A . The assessment of dental fear. Behaviour Therapy 1978; 9: 626–634.
Oosterink F M, de Jongh A, Hoogstraten J . Prevalence of dental fear and phobia relative to other fear and phobia subtypes. Eur J Oral Sci 2009; 117: 135–143.
Sheiham A, James WPT . A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake. BMC Public Health 2014; 14: 863.
Schuller A A, Willumsen T, Holst D . Are there differences in oral health and oral health behviour between individuals with high and low dental fear? Community Dent Oral Epidemiol 2003; 31: 116–121.
Pohjola V, Mattila A K, Joukamaa M, Lahti S . Anxiety and depressive disorders and dental fear among adults in Finland. Eur J Oral Sci 2011; 119: 55–60.
Woolgrove J, Cumberbatch G . Dental anxiety and regularity of dental attendance. J Dent 1986; 14: 209–213.
Thomson W M, Locker D, Poulton R . Incidence of dental anxiety in young adults in relation to dental treatment experience. Community Dent Oral Epidemiol 2000; 28: 289–294.
Sabbah W, Tsakos G, Sheiham A, Watt R G . The role of health-related behaviours in the socioeconomic disparities in oral health. Soc Sci Med 2009; 68: 298–303.
Dolan T A, Gilbert G H, Duncan R P, Foerster U . Risk indicators of edentulism partial tooth loss and prosthetic status among black and white middle-aged and older adults. Community Dent Oral Epidemiol 2001; 29: 329–340.
Porritt J, Baker S R, Marsham Z . A service evaluation of patient pathway and care experiences of dentally anxious adult patients. Community Dental Health 2012; 29: 198–202.
Beaton L, Freeman R, Humphris G . Why are people afraid of the dentist? Med Princ Pract 2014; 23: 295–301.
De Jongh A, Schutjes M, Aartman I H . A test of Berggren's model of dental fear and anxiety. Eur J Oral Sci 2011; 119: c361–365.
Astrrom A N, Skaret E, Haugejorden O . Dental anxiety and dental attendance among 25 year olds in Norway: time trends from 1997 to 2007. BMC Oral Health 2011; 11: 10.
Locker D, Liddell A, Shapiro D . Diagnostic categories of dental anxiety: a population –based study. Behav Res Ther 1999; 37: 25–37.
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Heidari, E., Banerjee, A. & Newton, J. Oral health status of non-phobic and dentally phobic individuals; a secondary analysis of the 2009 Adult Dental Health Survey. Br Dent J 219, E9 (2015). https://doi.org/10.1038/sj.bdj.2015.853
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DOI: https://doi.org/10.1038/sj.bdj.2015.853
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