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BMC Oral Health

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Open Access 01-12-2023 | Anxiety | Research

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

Authors: Muhammad Taqi, Syed Jaffar Abbas Zaidi, Javaria Javaid, Zainab Alam, Aimen Saleem, Sadia Asghar Khan

Published in: BMC Oral Health | Issue 1/2023

Abstract

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.

Smith TA, Heaton LJ. Fear of dental care: are we making any progress? J Am Dent Assoc. 2003;134(8):1101–8. https://doi.org/10.14219/jada.archive.2003.0326.CrossRefPubMed

Hakim H, Razak IA. Dental fear among medical and dental undergraduates. ScientificWorldJournal. 2014;2014:747508. doi: 10.1155/2014/747508. Epub 2014. PMID: 25386615; PMCID: PMC4216710.

Beaton L, Freeman R, Humphris G. Why are people afraid of the dentist? Observations and explanations. Med Princ Pract. 2014;23:295–301. https://doi.org/10.1159/000357223. Epub 2013 Dec 20. PMID: 24356305; PMCID: PMC5586885.CrossRefPubMed

Yildirim TT. Evaluating the relationship of Dental Fear with Dental Health Status and Awareness. J Clin Diagn Res. 2016;10:ZC105–9. https://doi.org/10.7860/JCDR/2016/19303.8214. Epub 2016 Jul 1. PMID: 27630944; PMCID: PMC5020232.CrossRefPubMedPubMedCentral

Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007;7:1. https://doi.org/10.1186/1472-6831-7-1. Published 2007 Jan 14.CrossRefPubMedPubMedCentral

Armfield JM. What goes around comes around: revisiting the hypothesized vicious cycle of dental fear and avoidance. Community Dent Oral Epidemiol. 2013;41(3):279–87. https://doi.org/10.1111/cdoe.12005.CrossRefPubMed

Eli I. Dental anxiety: a cause for possible misdiagnosis of tooth vitality. Int Endod J. 1993;26:251-3. https://doi.org/10.1111/j.1365-2591.1993.tb00567.x. PMID: 8225645.

Bedi R, McGrath C. Factors associated with dental anxiety among older people in Britain. Gerodontology. 2000;17:97–103. https://doi.org/10.1111/j.1741-2358.2000.00097.x. PMID: 11813685.CrossRefPubMed

Locker D. Measuring oral health: a conceptual framework. Community Dent Health. 1988;5:3–18. PMID: 3285972.PubMed

10.

Akram SJ, Yasmin R, Atif S, Rathore A, Anjum O, Arshad MB, Khaliq IH. Barriers to the access of oral health care facilities among adults: an exploratory study from Lahore. J Fatima Jinnah Med Univ. 2020;14:105–9.CrossRef

11.

Khan AA. Oral health in Pakistan. Ministry of Health, Govt. of Pakistan and World Health Organization. 2003.

12.

Khalil B. Dental Phobia Aquired in Childhood. J Pak Dent Assoc. 2017;26:6–9.CrossRef

13.

Noori S, Aasim S, Rehman A, Siddiqui A. Assessment of dental anxiety in pre and post dental treatment. Pakistan J Med Dentistry. 2019;8:82–6.

14.

Armish siraj H, Hussain U, Rehman S, Khan SB, Tariq A. Impact of education on dental anxiety among the patients visiting public dental hospitals in Pakistan. Saudi J Oral Dent Res. 2020;5:321–3.CrossRef

15.

Rehman K, Karim AA, Mohiuddin S, Zaidi AB. Psychometric assessment of dental phobia and treatment deferral among undergraduate students of health sciences: a cross sectional study. Khyber Med Univ J. 2020;30:12:216–0.

16.

Bay EJ, Algase DL. Fear and anxiety: a simultaneous concept analysis. Nurs Diagn. 1999;10:103–11. https://doi.org/10.1111/j.1744-618x.1999.tb00036.x. PMID: 10595125.CrossRefPubMed

17.

Kleinknecht RA, Klepac RK, Alexander LD. Origins and characteristics of fear of dentistry. J Am Dent Assoc. 1973;86:842–8. https://doi.org/10.14219/jada.archive.1973.0165. PMID: 4511174.CrossRefPubMed

18.

Armfield JM. How do we measure dental fear and what are we measuring anyway? Oral Health Prev Dent. 2010;8:107–15.PubMed

19.

Oliveira MA, Vale MP, Bendo CB, Paiva SM, Serra-Negra JM. Dental fear survey: a cross-sectional study evaluating the psychometric properties of the Brazilian Portuguese version. The Scientific World Journal. 2014;2014.

20.

Milgrom P, Newton JT, Boyle C, Heaton LJ, Donaldson N. The effects of dental anxiety and irregular attendance on referral for dental treatment under sedation within the National Health Service in London. Commun Dent Oral Epidemiol. 2010;38:453–9.CrossRef

21.

López-Jornet P, Camacho-Alonso F, Sanchez-Siles M. Assessment of general pre and postoperative anxiety in patients undergoing tooth extraction: a prospective study. Br J Oral Maxillofac Surg. 2014;52:18–23. doi: 10.1016/j.bjoms.2013.01.004. Epub 2013 Jan 26. PMID: 23357053.

22.

Kleinknecht RA, Thorndike RM, McGlynn FD, Harkavy J. Factor analysis of the dental fear survey with cross-validation. J Am Dent Assoc. 1984;108:59–61. https://doi.org/10.14219/jada.archive.1984.0193. PMID: 6582116.

23.

Milgrom P, Kleinknecht RA, Elliott J, Liu HH, Teo CS. A cross-cultural cross validation of the Dental Fear Survey in South East Asia. Behav Res Ther. 1990;28:227 – 33. https://doi.org/10.1016/0005-7967(90)90005-4. PMID: 2369405.

24.

Firat D, Tunc EP, Sar V. Dental anxiety among adults in Turkey. J Contemp Dent Pract. 2006;7(3):75–82.CrossRefPubMed

25.

Milgrom P, Kleinknecht RA, Elliott J, Liu HH, Teo CS. A cross-cultural cross validation of the Dental Fear Survey in South East Asia. Behav Res Ther. 1990;28(3):227–33.CrossRefPubMed

26.

Liang H, Peng Z, Pan J, Tang Q, Wang P. Development and evaluation of Chinese Version of Dental Fear Survey (DFS). J Sun Yat-Sen Univ (Med Sci). 2006;2. http://en.cnki.com.cn/Article_en/CJFDTOTAL-ZSYK200602031.htm. Accessed 10 Dec 2021.

27.

Heft MW, Meng X, Bradley MM, Lang PJ. Gender differences in reported dental fear and fear of dental pain. Community Dent Oral Epidemiol. 2007;35(6):421–8. https://doi.org/10.1111/j.1600-0528.2006.00344.x.CrossRefPubMed

28.

Lago-Méndez L, Diniz-Freitas M, Senra-Rivera C, Seoane-Pesqueira G, Gándara-Rey JM, Garcia-Garcia A. Dental anxiety before removal of a third molar and association with general trait anxiety. J Oral Maxillofac Surg. 2006;64(9):1404–8. https://doi.org/10.1016/j.joms.2006.05.030.CrossRefPubMed

29.

Malvania EA, Ajithkrishnan CG. Prevalence and socio-demographic correlates of dental anxiety among a group of adult patients attending a dental institution in Vadodara city, Gujarat, India. Indian J Dent Res. 2011;22(1):179–80.CrossRefPubMed

30.

Xu JL, Xia R. Influence factors of dental anxiety in patients with impacted third molar extractions and its correlation with postoperative pain: a prospective study. Med Oral Patol Oral Cir Bucal. 2020;25(6):e714–9. https://doi.org/10.4317/medoral.23293.CrossRefPubMedPubMedCentral

31.

Liddell A, Locker D. Gender and age differences in attitudes to dental pain and dental control. Community Dent Oral Epidemiol. 1997;25:314–8.CrossRefPubMed

32.

Eli I, Baht R, Kozlovsky A, Simon H. Effect of gender on acute pain prediction and memory in periodontal Surgery. Eur J Oral Sci. 2000;108:99–103.CrossRefPubMed

33.

Locker D, Shapiro D, Liddell A. Negative dental experiences and their relationship to dental anxiety. Community Dent Health. 1996;13:86–92.PubMed

34.

Manoela TS, Dadalti, Antônio JL, Cunha, Thaís GD, Souza BA, Silva, Ronir R, Luiz. Patrícia A Risso. Anxiety about dental treatment – a gender issue. Acta Odontol Latinoam. 2021;34(2):195–200.CrossRef

35.

Rowe MM, Moore TA. Self-report measures of dental fear: gender differences. Am J Health Behav. 1998 Jul.

36.

Kay EJ, Lowe JC. A survey of stress levels, self-perceived health and health related behaviours of U.K. dental practitioners in 2005. Br Dent J. 2008; 204:E19. discussion 622–623.

37.

Kim JY, Kam S, Kang YS, Cho YK, Lee SW, Jin DG, Ahn SG, Chun BY, Yeh MH. Professional job perception, job stress and job satisfaction of westerm doctors and oriental doctors practicing at local clinic. J Prev Med Public Health = Yebang Uihakhoe Chi. 2004;37(1):44–50.PubMed

38.

Inglehart MR, Lee AH, Koltuniak KG, Morton TA, Wheaton JM. Do Waiting Times in Dental offices affect patient satisfaction and evaluations of patient-provider relationships? A quasi-experimental study. J Dent Hyg. 2016;90:203–11. PMID: 27340187.PubMed

39.

Domoto P, Weinstein P, Kamo Y, Wohlers K, Fiset L, Tanaka A. “Dental fear of Japanese residents in the United States " Anesthesia Progress. 1991;38(3):90–5.PubMedPubMedCentral

40.

Savithri N. Dental Fear and Caries Experience Amongest ante-natal mothers. MCD, University Malaya; 2006.

41.

Siddiqui TM, Wali A, Azimi M, Salehi T, Siddiqui SM. Socioeconomic status and dental caries: exploring the relation in patients visiting dental teaching hospital, Karachi. J Pak Dent Assoc. 2019;28:27–32. https://doi.org/10.25301/JPDA.281.27.CrossRef

42.

Hmud R. Dental anxiety: causes, Complications and management approaches. J Minimum Intervention Dentistry. 2009;2:67–78.

43.

Vika M, Skaret E, Raadal M, Öst LG, Kvale G. Fear of blood, injury, and injections, and its relationship to dental anxiety and probability of avoiding dental treatment among 18-year‐olds in Norway. Int J Pediatr Dent. 2008;18:163–9.CrossRef

44.

Mohamed N. Dental anxiety and fear among trainee school teachers in Malacca [MCD thesis], University Malaya, Kuala Lumpur, Malaysia, 2001.

45.

Ong A. Dental fear and Caries status among 16-year-old school-children [MCD thesis], University of Malaya, 2002.

46.

Fernandez-Aguilar J, Guillén I, Sanz MT, Jovani-Sancho M. Patient’s pre-operative Dental anxiety is related to diastolic blood pressure and the need for post-surgical Analgesia. Sci Rep. 2020;10:9170.CrossRefPubMedPubMedCentral

47.

Siegel K, Schrimshaw EW, Kunzel C, Wolfson NH, Moon-Howard J, Moats HL, Mitchell DA. Types of dental fear as barriers to dental care among African American adults with oral health symptoms in Harlem. J Health Care Poor Underserved. 2012;23:1294–309. https://doi.org/10.1353/hpu.2012.0088. PMID: 24212175; PMCID: PMC3859136.CrossRefPubMed

48.

Gil-Abando G, Medina P, Signorini C, Casañas E, Navarrete N, Muñoz-Corcuera M. Assessment of Clinical parameters of Dental anxiety during noninvasive treatments in Dentistry. Int J Environ Res Public Health. 2022;19:11141.CrossRefPubMedPubMedCentral

49.

Murad MH, Ingle NA, Assery MK. Evaluating factors associated with fear and anxiety to dental treatment-A systematic review. J Family Med Prim Care. 2020;9(9):4530–5. https://doi.org/10.4103/jfmpc.jfmpc_607_20.CrossRefPubMedPubMedCentral

50.

Liddell A, Locker D. Changes in levels of dental anxiety as a function of dental experience. Behav Modif. 2000;24(1):57–68. https://doi.org/10.1177/0145445500241003.CrossRefPubMed

51.

Aartman IH, de Jongh A, Makkes PC, Hoogstraten J. Treatment modalities in a dental fear clinic and the relation with general psychopathology and oral health variables. Br Dent J. 1999;186(9):467–71. https://doi.org/10.1038/sj.bdj.4800142.CrossRefPubMed

52.

Alkatheri AM, Albekairy AM. Does the patients’ edu-cational level and previous counseling affect their medication knowledge? Annals of Thoracic Medicine. 2013;8(2):105–8.CrossRefPubMedPubMedCentral

Title: Patient perceptions and experiences of dental fear of different dental specialties: a mixed-method study
Authors: Muhammad Taqi
Syed Jaffar Abbas Zaidi
Javaria Javaid
Zainab Alam
Aimen Saleem
Sadia Asghar Khan
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Anxiety
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03626-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Objective

Methodology

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methodology

Results

Conclusion

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