Background: Survey quality, in particular sampling, coverage, and issues of representativity, are important for valid and reliable conclusions from epidemiological data. Dental anxiety (DA) still challenges dental cli...Background: Survey quality, in particular sampling, coverage, and issues of representativity, are important for valid and reliable conclusions from epidemiological data. Dental anxiety (DA) still challenges dental clinicians since it is synonymous with care avoidance. Accurate estimates of DA are important for public health. Aims were to 1) assess demographic representativity (age/ gender) of a 2013-14 web survey and a 1992-93 telephone survey about DA in Danish adults aged 16 - 80 yr using government statistics;2) assess DA frequency and characteristics from web survey data (N = 701);and 3) compare web results with 1993 results. Method: Dental Anxiety Scale (DAS) measured DA, while other items revealed gender, age, education, dentist avoidance, and three types of negative dentist behaviors. Analyses used frequencies, Chi- square, odds ratios (OR) and ANOVAs. Results: Samples from 1992-3 and 2013-14 were not significantly different by demographics or government statistics, with the exception of low numbers in ages 16 - 19 yr for both surveys. Ages 20 - 29 yr and 30 - 39 yr were slightly overrepresented in telephone data, while ages 50 - 59 yo were in web data. Mean DAS scores were 7.5 for both 1992-3 and 2013-14. Extreme DA (DAS 20-15) increased from 4.2% to 5.3%, while high DA (DAS ≥ 13) increased from 6% to 9.5%. Main 2013-14 associations with DAS ≥ 15 were women (OR = 4.7), avoiding dentists (OR = 11.4) and negative dentist behaviors (OR = 4.2 - 6.7) similar to 1992-3 data. Conclusion: Web survey results from this convenience sample were demographically representative for adults 20 - 80 yo and showed small changes in DA after 20 years. Future strategies regarding survey of teenagers require special attention.展开更多
BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support(BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, I...BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support(BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India.METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory(STAI) Questionnaire. Chi-square test was performed on SPSS 21.0(IBM Statistics, 2012) to determine statistically signifi cant differences(P<0.05) between assessed knowledge and anxiety.RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123(67.21%) reported unavailability of professional training. The majority(180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above highstress level. Comparison of assessed knowledge and stress was found to be insignifi cant(P=0.983).CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.展开更多
Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108)...Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears;2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.;25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.展开更多
Objective—Anxiety and expected dental pain are the main reasons for avoiding any dental treatment by general population. In this study, we aimed to evaluate the various factors which can in-crease the anxiety and its...Objective—Anxiety and expected dental pain are the main reasons for avoiding any dental treatment by general population. In this study, we aimed to evaluate the various factors which can in-crease the anxiety and its association with pain perception of patients following dental extraction. Material and Methods—We had included 100 patients in our study who were undergoing orthodontic treatment and required extraction of either 34 or 44. Pain and anxiety levels after extraction were assessed with a visual analog scale (VAS) and an anxiety questionnaire consisting of eleven questions. Results—The mean VAS score for the entire study group was 16.23 ± 1.28 with statistically significant differences between genders, and was high in females and no statistically significant differences between different age groups. The mean anxiety score was 10.64 ± 3.12. This was significantly higher in women (P = 0.005), but there was no statistically significant differences between different age groups. There was a statistically significant correlation between VAS and total anxiety score (P < 0.001) as well as each question, except for question number 4, 8 and 9 in men. Conclusion—Although most patients had experienced limited pain, there was a significant gender difference in pain and anxiety level. They were anxious because they expected pain, women being more anxious than men. The most provoking factor for anxiety and pain while going for extraction in females was “being seated in dental chair”, while in men the most provoking factor was “uncertainty about proper numbness before extraction”.展开更多
Background: The autonomy of dental anxiety may be compared with other psychopathologies, however, it is classified as indicative of a specific phobia. It is interesting to know how dental anxiety operates within a wid...Background: The autonomy of dental anxiety may be compared with other psychopathologies, however, it is classified as indicative of a specific phobia. It is interesting to know how dental anxiety operates within a wider context. Material and Method: The group was made by 514 subjects, recruited from several dental surgeries. The entire process, consisted in self-compilation of the Dental Anxiety Scale (DAS), and the Patient Health Questionnaire (PHQ). The software used for statistical calculations was the Statistical Package for Social Sciences (SPSS) version 16.0. The chi-square test was used for the distribution of the nominal variables. Results: The analysis of data revealed a significantly different distribution between high and low levels of dental anxiety and comorbidity in relation to only one diagnostic category, namely mood disorders. Dental fears and comorbidity were mostly in line with our expectations, except about fear of needles with eating disorders. Dental anxiety is to be considered as a dimension on a par with other psychopathologies. Conclusions: The study of comorbidity between mood disorders and dental anxiety, suggests that dental anxiety rather than belonging to the family of anxiety disorders would be better classified along with mood disorders. The findings regarding emotional inducers (fears) in relation to the distribution of psychopathology are worth noting. The above observations reaffirm the need to form links between dentistry and psychiatry.展开更多
Background: Negative stress symptoms are reported in the literature among clinical dental and medical students and can include signs of anxiety or depression. However, very little has been researched about existing ps...Background: Negative stress symptoms are reported in the literature among clinical dental and medical students and can include signs of anxiety or depression. However, very little has been researched about existing psychological preconditions of these students that could make them more vulnerable to negative stress symptoms. Objective: The aims were to explore first year clinical dental and medical students’ experiences of stress intensity, stress sensitivity and signs of anxiety or depression. Gender was also explored as a possible predictor of these psychosocial phenomena. Methods: First year clinical students at Aarhus University dental (n = 49) and medical schools (n = 59) were recruited to fill out a 45-item questionnaire that comprised demographics and three scales: Cohens Perceived Personal Stress (PPS-10), Stress Sensitivity Inventory (SSI) and Depression Anxiety & Stress Scale (DASS-21). Groups and genders were compared by frequency and using association statistics, bivariate odds ratios, nominal logistic regression and ANOVA. Results: Stress intensity perceptions were moderate to high for many. Dental students scored higher than medical students on all mean test scores. In general, women showed higher levels of stress than men. Dental students scored significantly higher than medical students on Depression, Anxiety and Chronic Stress with ANOVA tests. However, when gender, age and medical or dental student status were added into a logistic regression analysis in which high stress sensitivity was the main dependent variable, only high scores in perceived stress intensity and signs of depression and anxiety showed significant main effects. Conclusion: Present study confirmed the literature that reports high degrees of stress among dental and medical students. But more importantly, Stress Sensitivity Inventory appeared to be a reliable and excellent predictor of high perceived stress and signs of depression and anxiety. It can be useful to detect and prevent student psychosocial dysfunction in clinical learning environments. An important challenge for medical and dental educational institutions is to provide specific student emotional support as early as needed as well as to consider appropriate stress prevention curriculum reforms.展开更多
Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twent...Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0.5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment. All patients received painless local anesthetic injection and were restrained with children’s board and bands. Blood pressure (BP), heart rate (HR), oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Buttner scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child.Results HR in intervention group (82.5±5.1 bpm) was much lower than that in control group (95.2±8.9 bpm; F=31.20, P<0.001). Intervention group had a significantly lower systolic BP level (94.8±5.6mmHg) than control group (98.5±5.5mmHg; F=4.34, P=0.04), but the diastolic BP (63.0±3.5mmHg) was not significantly lower than control group (65.5±4.8mmHg; F=3.31, P=0.07). Children in intervention group showed more compliance. The patients’ scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group (1.37±0.96, 1.37±0.83, 1.32±0.67, and 2.32±1.49, respectively) were significantly lower than those in control group (3.71±1.23, 2.71±0.96, 2.71±0.90, and 4.71±1.19; F=44.66, 22.36, 30.39, and 31.88, respectively, all P<0.001). Conclusions Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.展开更多
目的探讨自助型认知行为疗法对改善低龄龋病患儿牙科焦虑和合作行为的效果。方法采用便利抽样法,选取2021年1月-7月于深圳市儿童医院口腔科就诊的龋病患儿63例,采用随机数字表法将其分为对照组(n=32)及干预组(n=31)。对照组在牙科诊疗...目的探讨自助型认知行为疗法对改善低龄龋病患儿牙科焦虑和合作行为的效果。方法采用便利抽样法,选取2021年1月-7月于深圳市儿童医院口腔科就诊的龋病患儿63例,采用随机数字表法将其分为对照组(n=32)及干预组(n=31)。对照组在牙科诊疗过程中实施常规行为管理,干预组在对照组的基础上增加自助型认知行为疗法。采用中文版儿童畏惧调查表-牙科分量表(children′s fear survey schedule-dental subscale,CFSS-DS)、Venham临床焦虑及合作行为级别,比较2组在口腔诊疗过程中的焦虑程度及合作行为。结果2组CFSS-DS得分在组间效应方面比较,差异有统计学意义(F组间=25.893,P<0.001)。干预组口腔诊疗合作行为优于对照组(Z=3.594,P<0.001)。结论自助型认知行为疗法能有效缓解低龄龋病患儿对口腔诊疗的焦虑,提高其口腔诊疗合作行为,值得临床推广应用。展开更多
文摘Background: Survey quality, in particular sampling, coverage, and issues of representativity, are important for valid and reliable conclusions from epidemiological data. Dental anxiety (DA) still challenges dental clinicians since it is synonymous with care avoidance. Accurate estimates of DA are important for public health. Aims were to 1) assess demographic representativity (age/ gender) of a 2013-14 web survey and a 1992-93 telephone survey about DA in Danish adults aged 16 - 80 yr using government statistics;2) assess DA frequency and characteristics from web survey data (N = 701);and 3) compare web results with 1993 results. Method: Dental Anxiety Scale (DAS) measured DA, while other items revealed gender, age, education, dentist avoidance, and three types of negative dentist behaviors. Analyses used frequencies, Chi- square, odds ratios (OR) and ANOVAs. Results: Samples from 1992-3 and 2013-14 were not significantly different by demographics or government statistics, with the exception of low numbers in ages 16 - 19 yr for both surveys. Ages 20 - 29 yr and 30 - 39 yr were slightly overrepresented in telephone data, while ages 50 - 59 yo were in web data. Mean DAS scores were 7.5 for both 1992-3 and 2013-14. Extreme DA (DAS 20-15) increased from 4.2% to 5.3%, while high DA (DAS ≥ 13) increased from 6% to 9.5%. Main 2013-14 associations with DAS ≥ 15 were women (OR = 4.7), avoiding dentists (OR = 11.4) and negative dentist behaviors (OR = 4.2 - 6.7) similar to 1992-3 data. Conclusion: Web survey results from this convenience sample were demographically representative for adults 20 - 80 yo and showed small changes in DA after 20 years. Future strategies regarding survey of teenagers require special attention.
文摘BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support(BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India.METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory(STAI) Questionnaire. Chi-square test was performed on SPSS 21.0(IBM Statistics, 2012) to determine statistically signifi cant differences(P<0.05) between assessed knowledge and anxiety.RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123(67.21%) reported unavailability of professional training. The majority(180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above highstress level. Comparison of assessed knowledge and stress was found to be insignifi cant(P=0.983).CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.
文摘Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears;2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.;25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.
文摘Objective—Anxiety and expected dental pain are the main reasons for avoiding any dental treatment by general population. In this study, we aimed to evaluate the various factors which can in-crease the anxiety and its association with pain perception of patients following dental extraction. Material and Methods—We had included 100 patients in our study who were undergoing orthodontic treatment and required extraction of either 34 or 44. Pain and anxiety levels after extraction were assessed with a visual analog scale (VAS) and an anxiety questionnaire consisting of eleven questions. Results—The mean VAS score for the entire study group was 16.23 ± 1.28 with statistically significant differences between genders, and was high in females and no statistically significant differences between different age groups. The mean anxiety score was 10.64 ± 3.12. This was significantly higher in women (P = 0.005), but there was no statistically significant differences between different age groups. There was a statistically significant correlation between VAS and total anxiety score (P < 0.001) as well as each question, except for question number 4, 8 and 9 in men. Conclusion—Although most patients had experienced limited pain, there was a significant gender difference in pain and anxiety level. They were anxious because they expected pain, women being more anxious than men. The most provoking factor for anxiety and pain while going for extraction in females was “being seated in dental chair”, while in men the most provoking factor was “uncertainty about proper numbness before extraction”.
文摘Background: The autonomy of dental anxiety may be compared with other psychopathologies, however, it is classified as indicative of a specific phobia. It is interesting to know how dental anxiety operates within a wider context. Material and Method: The group was made by 514 subjects, recruited from several dental surgeries. The entire process, consisted in self-compilation of the Dental Anxiety Scale (DAS), and the Patient Health Questionnaire (PHQ). The software used for statistical calculations was the Statistical Package for Social Sciences (SPSS) version 16.0. The chi-square test was used for the distribution of the nominal variables. Results: The analysis of data revealed a significantly different distribution between high and low levels of dental anxiety and comorbidity in relation to only one diagnostic category, namely mood disorders. Dental fears and comorbidity were mostly in line with our expectations, except about fear of needles with eating disorders. Dental anxiety is to be considered as a dimension on a par with other psychopathologies. Conclusions: The study of comorbidity between mood disorders and dental anxiety, suggests that dental anxiety rather than belonging to the family of anxiety disorders would be better classified along with mood disorders. The findings regarding emotional inducers (fears) in relation to the distribution of psychopathology are worth noting. The above observations reaffirm the need to form links between dentistry and psychiatry.
文摘Background: Negative stress symptoms are reported in the literature among clinical dental and medical students and can include signs of anxiety or depression. However, very little has been researched about existing psychological preconditions of these students that could make them more vulnerable to negative stress symptoms. Objective: The aims were to explore first year clinical dental and medical students’ experiences of stress intensity, stress sensitivity and signs of anxiety or depression. Gender was also explored as a possible predictor of these psychosocial phenomena. Methods: First year clinical students at Aarhus University dental (n = 49) and medical schools (n = 59) were recruited to fill out a 45-item questionnaire that comprised demographics and three scales: Cohens Perceived Personal Stress (PPS-10), Stress Sensitivity Inventory (SSI) and Depression Anxiety & Stress Scale (DASS-21). Groups and genders were compared by frequency and using association statistics, bivariate odds ratios, nominal logistic regression and ANOVA. Results: Stress intensity perceptions were moderate to high for many. Dental students scored higher than medical students on all mean test scores. In general, women showed higher levels of stress than men. Dental students scored significantly higher than medical students on Depression, Anxiety and Chronic Stress with ANOVA tests. However, when gender, age and medical or dental student status were added into a logistic regression analysis in which high stress sensitivity was the main dependent variable, only high scores in perceived stress intensity and signs of depression and anxiety showed significant main effects. Conclusion: Present study confirmed the literature that reports high degrees of stress among dental and medical students. But more importantly, Stress Sensitivity Inventory appeared to be a reliable and excellent predictor of high perceived stress and signs of depression and anxiety. It can be useful to detect and prevent student psychosocial dysfunction in clinical learning environments. An important challenge for medical and dental educational institutions is to provide specific student emotional support as early as needed as well as to consider appropriate stress prevention curriculum reforms.
文摘Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0.5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment. All patients received painless local anesthetic injection and were restrained with children’s board and bands. Blood pressure (BP), heart rate (HR), oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Buttner scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child.Results HR in intervention group (82.5±5.1 bpm) was much lower than that in control group (95.2±8.9 bpm; F=31.20, P<0.001). Intervention group had a significantly lower systolic BP level (94.8±5.6mmHg) than control group (98.5±5.5mmHg; F=4.34, P=0.04), but the diastolic BP (63.0±3.5mmHg) was not significantly lower than control group (65.5±4.8mmHg; F=3.31, P=0.07). Children in intervention group showed more compliance. The patients’ scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group (1.37±0.96, 1.37±0.83, 1.32±0.67, and 2.32±1.49, respectively) were significantly lower than those in control group (3.71±1.23, 2.71±0.96, 2.71±0.90, and 4.71±1.19; F=44.66, 22.36, 30.39, and 31.88, respectively, all P<0.001). Conclusions Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.
文摘目的探讨自助型认知行为疗法对改善低龄龋病患儿牙科焦虑和合作行为的效果。方法采用便利抽样法,选取2021年1月-7月于深圳市儿童医院口腔科就诊的龋病患儿63例,采用随机数字表法将其分为对照组(n=32)及干预组(n=31)。对照组在牙科诊疗过程中实施常规行为管理,干预组在对照组的基础上增加自助型认知行为疗法。采用中文版儿童畏惧调查表-牙科分量表(children′s fear survey schedule-dental subscale,CFSS-DS)、Venham临床焦虑及合作行为级别,比较2组在口腔诊疗过程中的焦虑程度及合作行为。结果2组CFSS-DS得分在组间效应方面比较,差异有统计学意义(F组间=25.893,P<0.001)。干预组口腔诊疗合作行为优于对照组(Z=3.594,P<0.001)。结论自助型认知行为疗法能有效缓解低龄龋病患儿对口腔诊疗的焦虑,提高其口腔诊疗合作行为,值得临床推广应用。
