Dental anxiety, the parental family and regularity of dental attendance

A survey was carried out among 25-yr-old inhabitants of Amsterdam in order to study the relationship between regularity of dental attendance on the one hand and dental anxiety, dental upbringing of the respondents, dental behavior of the parents, education, sex, and the interactions between these independents, on the other. The data were analyzed hierarchically with regression analysis, the logistic approach. Dental anxiety, sex, dental upbringing and the interaction between education and anxiety, in that order, were found to be of importance for the prediction of regularity of dental attendance. Two other terms, though lacking substantial standardized regression coefficients, namely education and the interaction between education and dental upbringing, are also present in the model found. The prediction of one being a regular attender is satisfactory, but the classification of the irregular attenders is disappointing. The effect is discussed of the rather large non-response and attention is given to the effect of dental upbringing in regard to coping resources in the dental situation. It has to be concluded that other factors must be included to achieve an improvement of the classification of the irregular attenders. Dental anxiety, although of importance, cannot account for an adequate differentiation between regular and irregular attenders.     

Initial development of a scale to measure dental indifference

Abstract Lack of concern about dental health contributes significantly to the reluctance of people to attend for dental check-ups and to implement preventive dental measures. The aim of this study was to develop and assess a questionnaire method of detecting this attitude which was described as dental indifference. The questionnaire was tested on 910 dentate adults in Scotland. A 62% response rate was obtained. Five hundred of the respondents were then sent a second copy of the questionnaire to assess its reliability, a 67% response rate was obtained. The Pearson correlation coefficient between the first and second completion of the dental indifference questionnaire was 0.79. The internal consistency measured by Chronbach's alpha was 0.71. High scores on the dental indifference questionnaire were significantly associated with being young, male and a manual worker. High scorers had fewer teeth, on average, than the rest of the sample and more than half of them had no record of attending for denial care within 4 years. Those who did attend a dentist were more likely to have teeth filled or extracted. The dental indifference questionnaire may be useful for targeting groups who require oral health promotion activity and may prove to be a reliable means of identifying individuals who display behaviours which could be expected to be associated with a lack of interest in dental health, such as lack of compliance with oral care instructions and failing to complete courses of treatment.     

Dental anxiety and regularity of dental attendance in younger adults

Dental anxiety constitutes a major problem for patients and dental care providers alike. The aim of this study was to examine the relationship between dental anxiety and regularity of dental attendance among young adults. A random sample of 15 course directors (1:50) was asked to participate in the study. Of these, only 10 course-directors agreed to handout the 500 questionnaires. All undergraduate students who participated in this study were asked to complete a questionnaire modified from Dental Fear Survey (DFS) questionnaire and 368 (73.6%) filled forms were returned for statistical analysis. The results showed that only 20.9% were regular dental attendee while the majority (79.1%) were irregular attendee. The reasons given for irregular attendance were 'lack of time' (36%), 'treatment not needed' (34.1%), 'fear from dentist' (13.3%) and 'cost' (16.6%). The sight and sensation of the injection and sight, sound, and sensation of the drill were the most common fear-eliciting stimuli. Increased heart rate was the commonest reported physiological response. Females had higher mean ratings, therefore tended to be more anxious than males. Dental anxiety represented by the mean responses to the items, was found to be higher in irregular dental attendee than regular attendee. In conclusion, this suggests that dental anxiety may affect the seeking of dental care, therefore to be taken into account when training dental care providers.     

Dental Public Health for the 21st Century: Implications for Specialty Education and Practice

A panel of public health practitioners sponsored by the Health Resources and Services Administration met December 6–8, 1994, to examine current roles and responsibilities for dental public health workers and to recommend changes in education and training to meet challenges posed by an evolving health care system. Overall, at least the same number, if not more, dental public health personnel will be needed in the future. While some new roles were identified, the panel felt that only small numbers of personnel will be needed to fill these new roles. Not all of these roles necessarily require a dental degree. The panel felt that a need exists for more academicians for dental schools, schools of public health, dental public health residencies, and dental hygiene programs; oral epidemiologists and health services researchers; health educators; and specialists in utilization review/outcomes assessment, dental informatics, nutrition, program evaluation, and prevention. To meet these personnel needs: (1) dental public health residency programs should be structured to meet the educational needs of working public health dentists with MPH degrees through on-the-job residency programs; (2) the standards for advanced specialty education programs in dental public health should be made sufficiently flexible to include dentists who have advanced education and the requisite core public health courses; (3) flexible MPH degree programs must be available because of the rising debt of dental students and the decreased numbers of graduating dentists; (4) loan repayment should be available for dentists who have pursued public health training and are working in state or local health departments; and (5) standards for advanced education in dental public health should be developed for dental hygienists.     

The value of extended-setting-time amalgam in pre-clinical practice in undergraduate dental training

This is a single-blind controlled study investigating the advantages of extended-setting time dental amalgam compared to a standard amalgam in the training of undergraduate dental students. 50 dental students were randomly assigned 1 of the 2 alloys for each restoration placed in the study. Each student placed class I and class II restorations in extracted human teeth mounted in typodont arches. 449 completed restorations were available for assessment, 228 restorations in the experimental group and 221 restorations in the control group. The test restorations were overall marginally inferior to those of the control group. There appears to be no advantage in using extended-setting time dental amalgam in undergraduate training.     

Attitudes of two groups of dentists towards dental hygienists

The purpose of the study was to assess whether cooperation with a dental hygienist was based on pursuit of financial gain or on aspirations to improve patient care. To this end a questionnaire was sent to 972 dentists. 412 dentists replied, of whom 178 had patients treated by a dental hygienist. Questions were asked regarding practice profile, preventive orientation and dentists' opinion about the material and immaterial value of cooperation with a dental hygienist. Discriminant analysis showed that the main distinguishing factor between dentists who did and dentists who did not cooperate with dental hygienists was their opinion about the quality of the dental hygienists' work in relation to the non-financial costs for patients, insurance companies, and dentists. The difference in the dentists' opinions about the direct profitability of dental hygienists was not significant. The conclusion can be drawn that the orientation of Dutch dentists towards care for their patients plays a more important role in a dentist's decision to cooperate with a dental hygienist than is usually presumed.     

Direct ratings of acceptance of dental treatment in Swedish children

The aim of the present study was to bring forward data of acceptance of dental treatment for 3-16-yr-old children in a population with good dental health and annual dental care, and to evaluate the influence on acceptance of age, sex, residential area, and previous experience and present need of dental treatment. The material consisted of 2773 children. Direct ratings of behavior were made at each of 10 different treatment steps passed during dental appointments. The majority of children needed no more than one dental visit and 79% showed positive acceptance at all steps of treatment passed during dental visits. Eight percent of all children sometimes reacted in such a way that treatment could not be carried out without restraint or undue delay. Dental fear was diagnosed in 3% of all children.     

Effectiveness of the school dental screening programme in stimulating dental attendance for children in need of treatment in Northern Ireland

The school dental screening programme has been in existence from the beginning of the 20th century yet its value in encouraging attendance among children with a dental health need is not fully established. OBJECTIVE: To evaluate the effectiveness of school dental screening in promoting dental attendance among children with a treatment need and to examine the relative importance of screening, social class and other factors in dental attendance. METHODS: Sixty-four participating schools were assigned to study and control groups using a stratified, blocked randomisation technique. The study group children received the standard school dental screening and the dental attendance of those with a positive screening result was assessed after 2 months by means of a questionnaire issued to the children's parents. The control group children were not, at this stage, screened, yet their parents received the same questionnaire assessing dental attendance over the 2-month period. However, only questionnaires from control group children who had a positive result at a subsequent screening were retained for analysis. RESULTS: A total of 2,321 children were screened, with 980 having a positive result. The mean dmft of those screening positive was 4.85. In all, 664 completed questionnaires were returned, giving a response rate of 67.8%. Dental attendance was reported among 45.5% of the study group (n=352) in the 2 months following screening. In the same period, 27.6% of the control group (n=312) claimed attendance. The effect was found to be significant among the high employed group (P<0.01) and the unemployed group (P<0.05). CONCLUSION: School dental screening was capable of stimulating dental attendance. The strong effect among the lowest socio-economic group shows that school dental screening may be used to decrease dental health inequalities.     

Dimensionality of dental anxiety measurements

A survey among 620, 30-40-yr-olds, was carried out in order to measure dental anxiety with Corah's DAS, Weiner's AALC, and some other questions on anxiety, among which was the duration of psychophysiologic responses prior to a dental appointment. The data were analyzed with a Non Metric Components analysis. The DAS turned out to be unidimensional. The AALC on the other hand appeared to contain four components. A second stage analysis comprising the DAS component, the four AALC components, and the remaining variables revealed a two-dimensional structure, of which only the first component is dentistry related. This component showed better differentiation of the respondents than with DAS or AALC alone. Part of AALC's questions and a question about anxiety in daily life proved to be superfluous for measuring dental anxiety. It is concluded that dental anxiety and anxiety in general have to be measured with questions covering different aspects.     

Attendance pattern of anxiety-treated dental patients: a pilot study

Ex-patients of a dental fear clinic were found to have significantly reduced, yet still high, dental anxiety scores in comparison with the pre-intervention scores. In spite of the intervention about one quarter of the ex-patients did not visit a dentist regularly. A positive relationship was found between dental anxiety, measured with Corah's DAS, and "dislike of drilling". A short duration of (self-reported) psychophysiologic anxiety reactions appeared to be associated with the intention to ask for treatment, e.g. if a cavity were present. However, regular dental attendance was not correlated with dental anxiety scores.     

Utilisation of dental services in Turkey: a cross-sectional survey

AIM: To assess the factors affecting the utilisation of dental service in Turkey. METHOD: A cross-sectional study using a sample of 866 adults randomly selected from nine provinces, collecting data on socio-demographic characteristics, frequency of dental visits and attitudes toward dental services in face-to-face interviews. RESULTS: 40.4% of adults had visited a dentist within the previous year. Logistic regression analysis showed that gender and educational level were significant factors affecting the utilisation of dental services, with women using dental services significantly more than men and those having higher education compared to those having low education. Satisfaction from the services of the private dental offices and private hospitals was higher than from state hospitals. Age, reasons for dental visit and the place of the last visit were found to be the most significant predictors of satisfaction. CONCLUSION: Utilisation of dental services is low amongst Turkish adults. Women and individuals with higher levels of education use dental services more than others. The majority of the people prefer private dental offices, where the patient satisfaction is high.     

Dental hygienists''influence on the patients''knowledge, motivation, self-care, and perception of change

The purpose of this study was to assess the success of the dental hygienist in the dental health education of dental patients in general dental practice. Special emphasis was laid on health education in the field of periodontics. The answers on a questionnaire of 159 dental patients who visited a dental hygienist were compared with the answers of 302 dental patients who had never visited a dental hygienist. The comparison was done by means of t-test and regression analysis on specially developed scales with regard to knowledge, motivation, self-care, and perception of change. On all scales the dental patients who visited a dental hygienist scored better. This difference remained when social demographic variables and the dentist's influence were taken into account. This indicates that the dental hygienist is successful in the behavioral aspect of her work.     

Sociodemographic correlates of dental anxiety

In a survey comprising 620 30-40-yr-old inhabitants of a Dutch town, dental anxiety was measured along with some sociodemographic variables. The data were analyzed in an attempt to reveal associations between sociodemographically determined groups of respondents and their scores on the different measurements of dental anxiety. Women reported higher dental anxiety levels than men, with the exception of body damage anticipation anxiety. The rank order of birth seemed to have no influence. Divorced men and women reported a higher anxiety level on two of the anxiety measurements, but the association appeared to be weak. A lower level of education, irregular dental attendance, and edentulousness appeared to be associated with a higher level of dental anxiety.     

Replacement of missing teeth in a southern region of Vietnam — a descriptive dental laboratory study

Aim : To explore whether tooth replacement in a southern region of Vietnam is in line with the primary health care approach, aiming at health services for all people at affordable costs. Methods : Tooth replacement was investigated by means of prostheses as delivered by four dental laboratories of which the output was considered representative. Information was based on dental casts related to the prostheses. Results : Prostheses replaced almost all missing teeth, irrespective of the types (interrupted or shortened dental arches) and numbers of missing teeth in the dental arch they were made for. Acrylic removable partial dentures were the most common prostheses delivered (65% of removable partial dentures). Conclusion : It cannot be stated that dental arch conditions in this study were representative for the southern Vietnamese population. However, it is concluded that dental practitioners tend to provide complete dental arches by tooth replacements. This morphologically based approach might introduce over treatment. In line with primary oral health care, a functionally oriented treatment management, including the shortened dental arch concept, should be implemented.     

Tooth loss, prosthetics and dental treatment habits in a group of Swedish men

Dental history, dental status, the need for prosthetic treatment and dental treatment habits were studied in 389 men aged 21--54 years. The men were selected from a group undergoing military refresher training in the south of Sweden. One percent of the men were toothless. About 3% had full dentures in one or both jaws and an equal percentage had partial dentures. About 3% of the men had bridges in the maxilla and 2% in the mandible. Tooth loss was greatest in the mandibular molar segment, followed by the maxillary molar segment. By means of an index for dental status about 8% of the men were judged to be in great need of prosthetic treatment for aesthetic reasons and/or to improve occlusion. Age, place of birth, educational level and smoking habits were among the factors which seemed to be related to dental status. Seventy percent of the men reported that they went to the dentist once a year, while about 10% seemed rarely or never to seek dental treatment. Dental treatment habits were correlated to place of birth, number of brothers and sisters, edentulousness and the need for prosthetic treatment, among other factors.     

Relationship of children's anxiety to their potential dental health behaviour

In this study of 200 New Zealand schoolchildren aged 7-13 years, a questionnaire interview was used to gain information related to estimating dental anxiety and general illness anxiety. Information related to sociodemographic differences, belief differences, and an estimate of potential health behaviour was also collected. Oral examinations were performed and the number of dental restorations present recorded. Dental anxiety was associated with memory of pain during a dental visit. The number of restorations present, and a history of pain during a dental visit, were important predictors of illness anxiety. Neither dental anxiety nor illness anxiety operating alone provided an estimate of future dental health behaviour. Dental anxiety and illness anxiety operated through a complex interplay of variables. A stepwise multiple regression technique was used to determine the possible pathways to potential dental health behaviour. Perceived vulnerability to dental caries and perceived severity of dental disease were important in the prediction of potential denture wearing; school attended and ethnic background were useful predictors of potential extraction seeking; and school grade and level of perceived internal control were predictors of potential preventive visitation.     

Use of dental floss by Finnish students

In order to elucidate dental care behavior related to interdental cleaning, a group of first-year students were invited to a free dental examination. 186 of the students invited (76%) were examined clinically and roentgenologically. The mean DMFS-index of the students was 22.6 (+/- 12.6). They were also asked about their use of dental floss. 35% of the students reported using dental floss, but only 2% reported daily usage. 45% of the students had been taught how to use dental floss, and 83% of these had been taught by dental personnel. Teaching had no effect on the reported frequency of use. There were no statistically significant differences in the occurrence of dental plaque and gingivitis between those who used dental floss and those who did not. The subjects were unable to use dental floss on 1 out of every 3 filled proximal surfaces of the first molars. No correlation could be found between dental caries experience and the reported use of dental floss.     

Demirjian法测定成都地区8-16岁青少年牙龄

目的评估Demirjian法测定成都地区青少年牙龄的准确度并对其进行修正。方法应用Demirjian法测定445名成都地区8～16岁汉族青少年牙齿成熟指数及牙龄,比较测得牙龄与实际年龄的差异;将牙齿成熟指数与实际年龄进行曲线拟合,建立两者问的数学模型。结果Demirjian法测得牙龄比实际年龄平均高估：其差异为女性0．67岁,男性0．52岁,其差异有统计学意义;牙齿成熟指数与实际年龄呈指数关系;根据修正后方程所得牙龄与实际年龄平均差异为女性0．15岁,男性-0．08岁,其差异无统计学意义。结论Demirjian法不能直接用于测定成都地区青少年牙龄,应用时需对其进行修正。     

A method of planning a dental treatment program for an institutionalized population

ABSTRACT A dental treatment program, for a subnormal group in an institution near London, England, was designed by applying both epidemiologic data and empirically derived data from the Experimental Dental Care Project at The London Hospital Dental School. For the epidemiologic study, a two-examiner system was developed to help overcome the special problems of examining subnormal adults. The data collected in the study had to be flexible enough to allow the analysis of several alternative treatment strategies. Once these alternative treatment strategies were defined, the data from the Experimental Dental Care Project were applied to analyze the effects of using dental teams of varying composition to carry out the treatment. It was found that to meet the dental needs of the group, a team consisting of one dentist, three New Cross auxiliaries and one dental surgery assistant would be 30 % less expensive than a traditional team of one dentist and one assistant. This larger team would also be able to complete the necessary initial treatment in less than half the time that the traditional team would require.