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BMC Oral Health
Published in: BMC Oral Health 1/2021

Open Access 01-12-2021 | Vulgar Psoriasis | Research article

The impact of psychological attachment on the relationship between periodontal health and dental fear in patients with versus without psoriasis: a questionnaire-based, cross-sectional study

Authors: Christian Graetz, Sirka Woeste, Ullrich Mrowietz, Johannes C. Ehrenthal

Published in: BMC Oral Health | Issue 1/2021

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Abstract

Background

While there is increasing evidence for the relevance of psychosocial variables such as dental fear or psychological attachment in dentistry, much less is known about the mechanisms that determine the strength of those associations. One potential moderator is the occurrence of a comorbid chronic disease such as psoriasis, which is linked to relevant disease parameters such as periodontal inflammation. The aim of the study was to test a moderation model of the relationship between dental fear, psychological attachment and psoriasis on periodontal health.

Methods

A total of 201 patients (100 with psoriasis, 101 without psoriasis) were included in a questionnaire-based, cross-sectional study. Dental status was measured with the Community Periodontal Index (CPI), dental fear was measured with the Hierarchical Anxiety Questionnaire (HAQ), and psychological attachment was measured with the Relationship Questionnaire (RQ). In addition to the examination of main effects, bootstrapping-based analyses were conducted to test the moderating influence of psychological attachment on the association between CPI and dental fear, gain moderated by group (with vs. without psoriasis).

Results

Controlling for several covariates, higher CPI scores were associated with higher levels of dental fear only in individuals without psoriasis under conditions of higher levels of psychological attachment anxiety and lower levels of attachment avoidance.

Conclusion

In individuals without psoriasis, psychological attachment can moderate the association between periodontal health and dental fear. This may provide a useful framework for reducing dental fear through interventions on the level of the dentist-patient relationship.
Footnotes
1
For the current analyses, due to some individual missing data in the questionnaire files, the sample size varied between 201 and 189.
 
2
In detail, the analyses conducted under the umbrella of ‘conditional process analysis’ make use of OLS regression, testing the related effects simultaneously, while applying bootstrapping, i.e., a resampling procedure that allows for a better estimation of the sampling distribution and therefore related confidence intervals.
 
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Metadata
Title
The impact of psychological attachment on the relationship between periodontal health and dental fear in patients with versus without psoriasis: a questionnaire-based, cross-sectional study
Authors
Christian Graetz
Sirka Woeste
Ullrich Mrowietz
Johannes C. Ehrenthal
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2021
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-021-01457-8

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