Dental fear among a young adult Saudian population

AIMS: To assess the prevalence of dental fear and reasons for irregular dental attendance among young adult university students; to describe the gender distribution of the dentally anxious population according to the perceived origins or sources of fear; to identify the time of fear development and preference for anaesthesia or sedation before dental treatment. METHOD: A questionnaire incorporating the Dental Fear Scale (DFS) with items related to sources of dental fear stimuli, together with the preference of anaesthesia or sedation before dental treatment and other characteristics. Approximately 500 questionnaires were distributed among Saudian undergraduate students. RESULTS: 368 questionnaires were completed and presented for statistical analysis. The sight and sensation of anaesthetic needles and the sight, sound and sensation of the drill were rated the most fear-eliciting stimuli. Also, females tended to be more anxious than males. Increased heart rate was the most common reported physiological response to fear resulting from dental treatment. The overall level of fear of dental work among the studied population was found to be about 39%.'Lack of time' and 'no need for treatment' were found to be the main reasons for irregular dental visits. Fear of pain and trauma were the major perceived sources of reported fear reactions and were developed mainly during childhood. About 63% of the subjects preferred to have local anaesthesia before dental treatment to prevent or ameliorate dental fear.     

Perceived sources of stress amongst Indian dental students

Introduction:  Dental students have to face the additional stress of their studies in addition to the stresses related to dentistry as a profession. Furthermore, increasing stress may result in declining student performance. The aim of the present study was to assess perceived sources of stress amongst dental undergraduate students at a private dental institution in India.
Materials and methods:  A modified dental environment stress (DES) questionnaire which consisted of 38 questions was used to assess the levels of stress.
Results:  The first major stressor for all the students was examination and grades with a mean score of 2.86 (SD 1.06) followed by full working day, receiving criticism from supervisors about academic or clinical work, amount of cheating in dental faculty, rules and regulations of the faculty and fear of unemployment after graduation. Amongst the six highest stressors in each year, at least three were dental faculty related. There was a significant difference in stress perception between genders with a predilection for males. Twelve of the 38 questionnaire items had significant differences across the year groups including clinical DES items.
Conclusion:  The primary sources of stress as perceived by nearly 275 students at one private dental school in India were examinations and grades followed by full working day and receiving criticism from supervisors about academic or clinical work. It appears there is a need for the establishment of student advisors and counsellors combined with a faculty advising system in addition to student-oriented programmes.     

Perceived sources of stress within a dental educational environment

The aim of this study was to identify the perceived sources of stress among dental students, dental hygiene students, and dental technology students enrolled at Jordan University of Science and Technology (JUST). The modified dental environment stress questionnaire was administered to 183 students. The perceived stressors varied between major and year. Dental students gave high scores for examinations, reduced holidays, inadequate time for relaxation, fear of failure, completing clinical requirements, and differences in opinion between staff. Dental hygiene students gave the highest scores for uncertainty about the field of study as future career, examinations, inadequate clinical training and supervision, inadequate relaxation, and discrimination between students. Dental technology students also gave high scores for uncertainty about future career, examinations, approachability of the staff, inadequate relaxation, and completing requirements. Females are more stressed than males with regard to personal factors. Dental technology and/or dental hygiene students have significantly higher scores than dental students in 12 items. Students who reported their first choice of study was not their current field of study showed more stress concerning their future careers. The high scores reported for some stressors among students emphasize the need to address student's concerns.     

The student survey of problems in the academic environment in Canadian dental faculties

A survey of problems related to stress encountered by 1,255 Canadian dental students was conducted. Substantial experience with problems was reported infrequently, although most students were affected negatively by at least one problem. Most difficulties concerned students' doubts about harnessing their efforts and abilities to master large amounts of material, which, of necessity, reduced their opportunity to pursue other interests. Few demographic features predicted the level of students' problems, although there was an indication that those who perceived themselves above average academically reported fewer problems.     

A survey of perceived stress among undergraduate dental students in Universiti Kebangsaan Malaysia

The objectives of this study were to determine the sources of stress among undergraduate dental students, and to compare the sources of stress among the 5 years of undergraduate study, between gender, and with other studies done elsewhere. A total of 325 students across the 5 academic years (88.8% response rate) of the Faculty of Dentistry, Universiti Kebangsaan Malaysia, completed the modified Dental Environment Stress questionnaire. All respondents reported that they experienced some form of stress. The preclinical students reported that examinations and fear of failure caused the most stress. The main stressor for clinical students was clinical training, particularly factors relating to meeting clinical requirements. Female students perceived more stress generally than male students. However, male students were more stressed when faced with factors related to clinical training.     

Perceived sources of stress among Greek dental students

The goals of this study were to identify sources of stress in dental education and to explore the role of year of study and gender on perceived stressors. Five hundred and seventy-one undergraduates, officially registered at the University of Athens School of Dentistry, participated in the survey by completing a thirty-item modified version of the Dental Environment Stress Questionnaire. Assigned workload, performance pressure, and self-efficacy beliefs constituted the most stress-provoking factors. Gender differences were found in most of the perceived stressors, whereas stress intensity greatly differed by year of study. Multivariate analysis suggested that, irrespective of gender, fourth-year and graduating students were less concerned about class work overload, clinical training difficulties, and course failing, but were significantly more insecure about their professional future. Entry-level students appeared to be the most concerned about the lack of time for relaxation. However, they were the least stressed about completing graduation requirements compared with the rest of their peers. Possible strategies for reducing stress in Greek dental education are considered in the light of these findings.     

Psychological stress among dental students at the University of Jordan

The purpose of this study was to investigate the level of psychological stress as well as the perceived sources of stress among undergraduate dental students at the University of Jordan. The top perceived stressors were compared with those of a previous study that examined the perceived sources of stress among undergraduate dental students at the University of Jordan in the year 2000. Psychological stress was assessed using the General Health Questionnaire (GHQ-12). Perceived sources of stress were evaluated using the Dental Environment Stress questionnaire. In the study, 520 students completed the questionnaires, for a response rate of 74 percent. These students showed a high level of psychological stress, with 70 percent at the cutoff point of a score of more than 3 for the GHQ-12. Women had a higher level of stress than men: 73 percent scored more than 3 on the GHQ-12 vs. 63 percent for men, which was statistically significant at p=0.05. The top perceived sources of stress from the year 2000 were mostly unaltered in our study, despite a substantial increase in the number of students as well as changes in the curriculum. Further research is needed into methods to minimize stress on dental students.     

Consumer and provider attitudes toward dentist and expanded auxiliary functions.

Consumers, dentists, dental students, dental assistants, dental hygienists, dental assistant trainees, and dental hygiene students in Massachusetts were surveyed for their attitudes toward the concept of expanded-duties auxiliaries. The Osgood sematic differential technique was used, in which study participants were asked to respond to line drawings of a dentist or an auxiliary performing each of three different procedures: cutting tooth structure, placing a restoration, and taking radiographs. The results indicate that most of the groups perceived significant differences between cavity preparation by the dentist and by the auxiliary: they were modierately positive toward the former, near neutral toward the latter. Groups were more positive toward cavity restoration, generally perceiving fewer, but still significant, differences between the dentist and auxiliary as operatiors. All groups were most positive toward taking radiographs and perceived no difference between the two operators. Of all groups, the dentists perceived the greatest difference between operators; dental hygienists and dental hygiene students were the most positive and saw the least differences between operators. Consumers were the least positive to all procedures and perveived only modirate differences between the two operators. In other words, the consumers did not seem overly concerned with who provided the dental care; they just did not like the services themselves. In the study, the consumer was more concerned with the procedure than with the different operators, whereas the dentist was more concerned about the operator.     

The evaluation of perceived sources of stress and stress levels among Turkish dental students

Objective : The purpose of this study was to identify sources of stress and to evaluate stress levels among Turkish dental students and also to investigate the role of year of study and gender on perceived stressors. Methods : This study included 308 dental students. Dental Environment Stress (DES) questionnaire, Beck Depression Inventory (BDI) and Spielberger State Trait Anxiety Inventory (STAI) were used to collect data. Also, some factors considered to be effective on stress levels of dental students were questioned. Data were statistically analysed with Kruskal Wallis and Mann Whitney U tests. Results : The most stress provoking factors were fear of failing the year, completion of clinical requirements and amount of assigned work. Statistically significant differences were found between years of study and gender for many stressors. There was statistically significant difference between years of study and gender for mean DES scores but no statistically significant differences were found between years of study for mean BDI, STAI scores. There was statistically significant difference between genders for STAI‐1. Choice rank of dental school has affected stress levels of dental students. Conclusion : This study showed that perceived sources of stress of clinical students were very similar and stress levels of these students were lower than preclinical students, also gender was effective on stressors and stress levels.     

Stress, burnout and health in the clinical period of dental education

The study examined the extent of stress, burnout and health problems experienced by fourth and fifth year dental students from the three universities of Dresden, Freiburg and Bern. The objectives of the study were to: (i) identify frequent sources of stress and to report the prevalence rates of burnout and health problems in dental students, (ii) determine the rate of students suffering from severe burnout symptoms and (iii) identify stress factors related to the burnout symptoms of emotional exhaustion and depersonalization. A total of 161 dental students from Dresden, Freiburg and Bern participated in the study. They completed the Psychosocial Stress Inventory, the Maslach Burnout Inventory and the Health Survey Questionnaire. Frequent sources of stress were limitation of leisure time, examination anxiety and the transition stress that was related to the adaptation to the demands of the clinical phase of dental education. Few differences existed between the students of the fourth and the fifth study year. Study-related stress was lowest in Bern and considerably higher in Dresden. Differences of mean levels of burnout symptoms were found only for the burnout dimension of emotional exhaustion. Students from Dresden and Freiburg were more emotionally exhausted than students from Bern, students from Dresden also reported more health problems than students from Bern or Freiburg. Ten per cent of the dental students suffered from severe emotional exhaustion, 17% complained about a severe lack of accomplishment and 28% reported severe depersonalization symptoms. Forty-four per cent of the variance of emotional exhaustion was explained by study-related factors such as lack of leisure time, examination anxiety and transition stress. The only predictor of depersonalization was a lack of social integration, accounting for 3% of the variance. A lack of social integration may be an indicator of low social competence which may cause difficulties in dealing with patients adequately and therefore result in depersonalization. The results indicate a need to identify the group of students who may have insufficient social skills for dealing adequately with the patients, and to train them accordingly.     

Dental school faculty teaching the periodontal-systemic connection to medical students: a pilot mini-elective

Given the growing appreciation of systemic health, it is more important than ever that both medical and dental school graduates thoroughly understand the whole-body implications of infection and inflammation. In a 2007 survey of academic deans at North American dental schools, the majority reported being confident about their students' knowledge regarding periodontal-systemic disease connections, but perceived that most nurses and physicians in their university/health science center, geographic location, and in general were not knowledgeable about oral health and its relationship to systemic disease. Though the respondents in this study reported their schools could be doing more to educate their students on this topic, their general confidence in their faculties' knowledge and teaching abilities regarding oral-systemic associations suggests that dental faculty members may be well positioned to educate medical students in this area. In January 2009, faculty members of the University of Pittsburgh School of Dental Medicine and School of Medicine explored this possibility by pilot testing a mini-elective in which several dental school faculty members team-taught medical students about conducting oral exams and the systemic effects of oral diseases. This article gives an overview of this elective and its outcomes.     

Ethical dilemmas reported by fourth-year dental students

Ethics education in dentistry is a requirement for accreditation. Despite universal adoption of ethics courses, there is ongoing discussion about the appropriate content of these courses and about methods to engage students. Faculty who teach ethics must select a limited set of topics from the broad fields of professional ethics, bioethics, and the humanities. The purpose of this article is to describe the ethical issues reported by fourth-year dental students during community-based extramural clinical experiences. Senior dental students (n=123) wrote essays describing an ethical issue they encountered during one of two extramural rotations. Ethical issues were categorized and coded by consensus between two faculty authors. Students most often reported perceived dilemmas related to patients' limited resources (25 percent), conflict between professionals (19 percent), clinic policy or procedures (15 percent), and decision making by patients' surrogates (13 percent). One student (<1 percent) reported encountering no ethical issues. Students' perceptions of ethical issues in clinical practice offer faculty a foundation for designing a dental ethics curriculum that is practical and immediately relevant to the experience of a dental student. Students' reports may also yield a method for systematic assessment of students' abilities to apply classroom ethics instruction to clinical practice.     

Evaluation of stress in final-year Saudi dental students using salivary cortisol as a biomarker

The aims of this study were to identify the perceived sources of stress in final-year dental students studying in a private dental school in Riyadh, Saudi Arabia, using a modified dental environmental stress (DES) scale and to correlate these findings, at various times in the semester, with the level of acute stress measured with salivary cortisol as a biomarker. A total of forty final-year students were administered a modified DES questionnaire consisting of twenty-five questions to determine the perceived causes of stress. Salivary cortisol levels during the first week of the semester, the final week of clinical training, and one hour before the final didactic examination were assessed. Baseline cortisol levels were significantly lower than the cortisol levels in the clinic, and both these values were significantly lower than the salivary cortisol levels before the examination (p<0.001). Comparison of cortisol levels to the perceived sources of stress and demographic data collected showed that certain discrepancies may exist between the perceived and actual stress felt by dental students at different times in the academic semester.     

Oral health status of homeless people in Hong Kong

The authors report on an oral health survey among Hong Kong Chinese homeless people. A total of 140 homeless men underwent clinical examination and were interviewed with a structured questionnaire. More than 90% had evidence of caries experience; most (75%) were related to untreated caries. The mean DMFT score was 9.0 (DT=3.2, MT=5.2. FT=0.6). Periodontal disease was highly prevalent, with 96% having periodontal pockets. The dental problems most frequently reported by the homeless were: bleeding gums or drifting teeth (62%), dental pain (52%) and tooth trauma (38%). More than 70% of the study's participants perceived a need for dental care. The population surveyed had poorer oral health compared to the general population. High levels of dental needs, both normative and perceived, were found. There is a need to provide more accessible and affordable oral health services to this group of people.     

P42 Subjective symptoms and knowledge of oral malodor on dental students in Thailand

The purpose of this study was to investigate subjective symptoms about oral malodor and the knowledge and attitude for bad breath on dental students. The subjects were 213 students from 1st to 6th year undergraduate course of one dental school in Thailand (male: 70, female: 143). Their mean (s.d.) age was 21.0 (1.9). Questionnaire survey was conducted in November 2003. Questionnaire items were subjective symptoms about oral malodor and dry mouth, the knowledge and attitude for bad breath, oral hygiene practice, smoking/drinking habits, and life stress. Five students (2.3%) answered that they concerned their oral malodor often and 87.8% reported sometimes. Of them, 72.9% wanted to receive treatment for their malodor and 70.8% said they suffer from bad breath in daily life. Two‐thirds of students perceived strong oral malodor when waking up. There were no significant differences of the self‐perceived malodor rates between gender or among year of study. More than half of the students did not know that oral diseases and poor oral hygiene are the major causes of bad breath. The students’ attitudes for bad breath were different if the target was family members or friends. The majority of the students (88.7%) answered they perceived dry mouth. Perception of dry mouth was significantly related with self‐reported oral malodor prevalence (P < 0.05). However other oral or behavioral factors did not relate to the self‐reported malodor rates. In this study, dental students perceived bad breath in high prevalence. However the knowledge for bad breath was not enough even the students who already provided dental treatment to the patients. It would be necessary to give them adequate knowledge and methods in education program for managing not only patients’ but also their own oral malodor problem.     

Factors affecting stress among Indian dental students

The aim of this study was to investigate the perceived sources of stress and the role of parents in its etiology among dental students in a private dental school in India. A modified Dental Environment Stress (DES) Questionnaire was administered to 256 dental students. The main sources of stress were found to be fear of facing parents after failure, full loaded day, and fear of failing course or year. Students whose first choice of admission was dentistry experienced less stress than students whose first choice was another field. Also the students who joined dentistry due to parental pressure showed greater stress than those who joined of their own accord. Male students experienced greater stress than females. The results of this study indicate that a congenial environment needs to be created for dental education and parents also need to be counseled against forcing their children to join an educational program that is not of their choice.     

Developing dental education in primary care: the student perspective

A pilot outreach course in restorative dentistry based in community clinics began in 2001. As part of the evaluation, 48 fourth year students completed a questionnaire about their opinions of the new course, and about restorative dentistry clinics in the dental hospital. Time management was the most frequently mentioned gain from outreach. In relation to the dental school, students most often saw the specialised teaching staff as a gain. Outreach was equally or more important for students' confidence in clinical diagnosis of dental caries, treatment planning, direct restorations, communicating with patients, and managing patients, time, and resources. The dental hospital was equally or more important for their confidence in the diagnosis of periodontal disease, root planing, crowns, bridges, dentures, and communicating effectively with laboratory staff. Patients in outreach were seen as different from those at the dental hospital because they were unselected, and had different treatment needs. Meeting course requirements was the most frequent concern about outreach. In relation to the dental hospital, students were most often concerned about the quality of teaching and support available. Outreach and the dental hospital provided complementary experiences and the new course met its educational objectives.     

Smoking cessation counseling in dentistry: attitudes of Nigerian dentists and dental students

The study was aimed at assessing the awareness, attitude, practices, willingness, and perceived barriers of dental students and dentists in Lagos University Teaching Hospital, Lagos, Nigeria, in relation to smoking cessation in the dental care setting. An anonymous self-administered questionnaire that contained questions relating to attitudes, views, and perceived barriers to smoking cessation activities in the dental clinic was hand-delivered to all dentists and clinical dental students in 2007. One hundred and thirty-six respondents took part in the study (response rate=81.9 percent). Although 95 percent of the respondents believed that smoking affects the dental management of the patient, only 65 percent always ask their patients about their smoking habits, and only 30 percent have heard about smoking cessation programs. A significantly higher proportion of students always ask patients about their smoking habits compared with dentists (p=0.0017). Also, a significantly higher proportion of dentists (97 percent) advised their patients against tobacco use compared with 77 percent of students (p=0.0000). Only 2 percent and 3 percent agreed that it is their professional responsibility to educate or encourage patients to quit smoking, respectively. Also, 98 percent strongly disagreed that it is within the scope of dental practice to ask about tobacco use, and 86 percent disagreed that tobacco counseling can be effective in helping patients quit tobacco use. Perceived barriers reported were lack of time (88 percent), lack of necessary materials (81 percent), and lack of knowledge of smoking cessation (74 percent). However, 81 percent of the respondents said they are willing to undergo training in tobacco use cessation. Since most of the dentists and dental students had poor attitudes and negative perceptions of smoking cessation activities, possibly due to lack of training and resources to carry it out in the clinics, there is need to include smoking cessation training in the dental curriculum in Nigeria.