Short-term antidepressant treatment of comorbid dental anxiety in patients with panic disorder

OBJECTIVES: The aims of this study were to determine the frequency of dental anxiety (DA) and dental phobia (DP) in panic disorder, and to follow the changes in DA levels during antidepressant treatment of panic disorder. METHODS: Fifty-three controls and 102 panic disorder patients were assessed using the Structured Clinical Interview (SCID), the Panic-Agoraphobia Scale (PAS), and the Corah Dental Anxiety Scale (DAS). Oral health status was defined by the number of decayed, missing, and filled teeth (DMFT) index. The patients were classified into three groups: (1) those without dental anxiety (WDA), (2) those with dental anxiety (DA), and (3) those with dental phobia (DP). All patients were treated with antidepressants for 3 months and the response rates were assessed. RESULTS: At baseline, DAS was significantly higher in both the DA and the DP groups than in the control group. Ten (9.8%) of the panic disorder patients fulfilled the diagnostic criteria for DP; 31 (30.4%) had severe DA. In the control group, none of the patients was diagnosed as DP, whereas 7 (13.5%) had severe DA. Panic disorder and DA both responded to the antidepressant treatment, but DAS scores remained significantly higher in the DP group than in the DA group and the control group at the end of the third month. CONCLUSIONS: Our data suggest that both DA and DP are more frequent in panic disorder than in healthy controls. Antidepressant treatment may have been helpful in decreasing DA levels in the DA group but not in the DP group.     

Psychological disorders and dental anxiety in a young adult population

OBJECTIVES: It has been suggested that some individuals who are fearful or anxious about dental treatment have a constitutional vulnerability to anxiety disorders as evidenced by the presence of multiple fears, generalized anxiety or panic disorders. This paper compares the prevalence of psychological disorders among dentally anxious and non-anxious groups drawn from the general population. METHODS: Data were obtained as part of a birth cohort study when study members were aged 18 years. They were assessed using the Dental Anxiety Scale (DAS) and the Diagnostic Interview Schedule (DIS). The disorders diagnosed by the DIS were major depressive episode, dysthymia, generalized anxiety disorder, panic disorder, agoraphobia, social phobia, simple phobia, obsessive compulsive disorder, conduct disorder, cannabis and alcohol dependence. RESULTS: Overall, 12.5% of study members had DAS scores of 13 or more and were considered to be dentally anxious. Those who were dentally anxious were more likely than the non-anxious to be diagnosed with one or more psychological disorders (55.0% vs. 42.3%). However, those with DAS scores of 13 or 14 (moderately dentally anxious) were broadly similar to the non-anxious in terms of their psychological profile. This excess prevalence of psychological disorder was largely accounted for by high rates of disorder among those with DAS scores of 15 or more (highly dentally anxious). The highly anxious were more likely than the non-anxious to have a diagnosis of conduct disorder, agoraphobia, social phobia, simple phobia or alcohol dependence. Odds ratios ranged from 2.8 to 5.0 after controlling for the effects of gender. The data also suggested that dentally anxious individuals with psychological disorders were more likely to maintain their anxiety over time. CONCLUSIONS: In this population of young adults, high rates of psychological disorder were characteristic of those with high levels of dental anxiety. Psychological disorder was related to the maintenance of dental anxiety over time.     

Prevalence of dental anxiety and associations with oral health,psychological distress,avoidance and anticipated pain in adolescence: a cross-sectional study based on the Tromsø study,Fit Futures

Objective: To describe the prevalence of dental anxiety (DA) among adolescents in Tromsø and Balsfjord region in northern Norway and present a multivariate logistic regression model to predict high dental anxiety scores (DASs) among these adolescents.

Materials and methods: We used self-report questionnaires and clinical dental examination data from adolescents registered in upper secondary school (15–18 years of age) in this region (n?=?986). Logistic regression was used to estimate odds ratios and their 95% confidence intervals (CI) when using Corah’s DAS as a dichotomous dependent variable.

Results: Twelve percent of the respondents reported a DAS score ≥13, indicating high DA. The strongest predictors for reporting high DA were anticipated pain at the dentist, ‘external control belief’, avoidance, low social motivation on oral health behaviour and sex. In this population, dental caries (DMFS), symptoms of psychological distress (HSCL-10) and self-motivation concerning oral health behaviour did not differ significantly between those reporting high DA (DAS ≥13) and those that reported low DA (DAS ≤12).

Conclusions: Severe DA in adolescence is a dental public health challenge and this study shows that DA is a hindrance to seeking dental treatment irrespective of dental status. Dental anxiety should have a higher focus on preventive oral health strategies and have a higher priority in public dentistry to avoid this problem to escalate into adulthood.     

Differential diagnosis of odontophobic patients using the DSM-IV

Categories of extreme anxiety for dental treatment were derived using, DSM-IV psychiatric criteria. A sample of 40 men and 40 women patients with extreme dental anxiety were initially evaluated with Dental Anxiety Scale (DAS), Trait Anxiety Inventory (STAI-T) and Geer Fear Scale (GFS). Patients all had DAS scores ≥15 indicating extreme dental anxiety and were further evaluated with clinical interviews, Denial Fear Survey (DPS), Dental Beliefs Survey (DBS) and Mood Adjective Checklist (MACL). Results showed that 46% of 80 patients complained mainly of powerlessness and embarrassment about dental treatment while also having greater DBS scores than other categories, i.e. social phobia. Another 19% reported conditioned specific phobias (pain, drilling, injection, etc.) most often and lower DBS and GFS scores than other groups; while 35% had broader general anxiety complications, such as multiple phobias and agoraphobia with or without general anxiety symptoms (higher GFS and STAI-T compared to others). Symptoms of general anxiety disorder (GAD) were present in 30 of 80 patients, who had greater STAI-T and GFS and lower MACL scores than non-GAD patients. These results have implications for appropriate treatment strategies.     

Dental pain and oral health-related quality of life in individuals with severe dental anxiety

Objectives: To analyze the prevalence and level of dental pain among adult individuals with severe dental anxiety (DA), and the association between dental pain and oral health-related quality of life (OHRQoL).

Methods: The study was based on 170 adult individuals with DA referred to a specialized DA clinic. All patients answered a questionnaire including questions on DA (DAS, DFS), OHRQoL (OIDP) and dental pain. An adapted clinical examination and a panoramic radiograph revealed the present oral status.

Results: The prevalence of dental pain was high (77.6%) and among those reporting pain the intensity was high (49.0–61.0 on a VAS). One or more problems during the last 6 months with the mouth or teeth affecting the individual’s daily activities were reported in 85.3% of the participants. Individuals who reported dental pain had lower OHRQoL compared with those who did not report dental pain (p?p?p?=?.008).

Conclusion: This study revealed a high prevalence and a high level of dental pain among adult individuals with severe DA. Having dental pain was associated with poor OHRQoL.     

Dental anxiety in Iceland: an epidemiological postal survey

In this study, we examined the prevalence of specific (dental) phobia among a sample of the Icelandic population. In addition to dental anxiety we explored factors that could be related to dental anxiety. In the period 1972–73, a stratified sample of 1641 schoolchildren in Reykjavík was selected for a study on malocclusion, dental maturation and other factors. Twenty‐two years later (1995), a postal survey conducted in this group looked at many variables relating to oral health, including orofacial pain, functional oral disorders, self‐perception of dental and general appearance and need for orthodontic treatment. Out of 1529 individuals contacted, 1192 completed questionnaires were returned (response rate 78%). Questions based on DSM‐IV criteria of specific (dental) phobia (DP) were included. Ninety‐six participants reported that they had avoided dental treatment during the previous 6 months. Twenty‐one respondents fulfilled DSM‐IV criteria for specific (dental) phobia (DP) and 75 admitted to many symptoms of dental anxiety (DA). Specific (dental) phobia (DP) was more prevalent among women than among men. The divorced or widowed were most at risk, as were non‐salaried respondents. Most respondents attributed the onset of their phobias to a specific painful or fearful experience. There was a significant difference between the total dentally anxious (TDA = DA+DP) and the not dentally anxious (NDA) with regard to sex (women‐higher TDA) and marital status (divorced or widowed‐higher TDA). The TDA had statistically fewer teeth than the NDA and received dental treatment less frequently.     

Orofacial esthetics and dental anxiety: Associations with oral and psychological health

Objective. Severe dental anxiety (DA) is associated with both oral health and psychosocial consequences in what has been described as a vicious circle of DA. The aim of this study was to investigate self-rated orofacial esthetics in patients with DA and its relationship to psychological and oral health. Materials and methods. A consecutive sample of 152 adult patients who were referred or self-referred to a specialized dental anxiety clinic filled out the Orofacial Esthetic Scale (OES) as well as measurements on DA, self-rated oral health and general anxiety and depression. Clinical measures of dental status were also obtained. Results. Compared with the general population, patients with DA had lower ratings of satisfaction on all aspects of their orofacial esthetics, which included the teeth, gingiva, mouth and face, as well as a global orofacial assessment. Furthermore, the perception of the orofacial appearance was related both to dental status and self-rated oral health, as well as to general anxiety and depression. The level of dissatisfaction with the orofacial appearance was similar for both genders, but women reported more regular dental care and better dental status. Conclusions. The results of this study clearly show less satisfaction with dental and facial appearance in patients with DA, and that the self-rating of orofacial esthetics is related to both oral and psychological health. The OES can be used to assess orofacial esthetics in patients with DA.     

The Course of the Premaxillary and Maxillary Vessels and Nerves in Cleft Jaw

Abstract

Objective. To evaluate quality-of-life (QoL), before and after cognitive behavioral therapy (CBT) in patients diagnosed with intra-oral injection phobia according to DSM-IV and to compare with the general population. This study also aimed to evaluate if QoL was associated with self-reported injection anxiety, dental anxiety, time since last dental treatment and oral health. Materials and methods. Subjects were 55 patients (mean age 35.5 ± 12.2, 78.2% women) who participated in a treatment study in which 89% managed an intra-oral injection at 1 year follow-up. The patients completed a set of questionnaires including Quality of Life Inventory (QOLI), Injection Phobia Scale-Anxiety, Dental Anxiety Scale and a single-item question assessing self-perceived oral health. Objective measures of oral health and treatment needs were based on clinical examination. QOLI-scores from a non-clinical sample were used for comparison. Results. Before treatment the general and health specific QoL were lower among intra-oral injection phobics than in the non-clinical sample. At 1 year follow-up the QoL in general had improved significantly and was similar to that of the non-clinical sample. Poor self-reported oral health and long-term avoidance of dental treatment were associated with lower general and health-specific QoL. Self-reported injection anxiety and dental anxiety were not associated with QoL. Conclusions. Patients with intra-oral injection phobia report lower QoL compared with a general population. Phobia treatment seems to increase QoL to normative levels. Self-perceived poor oral health is associated with reduced QoL in these patients.     

Dental anxiety, optimism–pessimism, and dental experience from childhood to adolescence

Abstract 94 adolescents, 58% of the original study group, participated in a 5-yr follow-up questionnaire study to assess the predictive power of self-reported dental anxiety, optimism–pessimism dimension, and previous dental experience on dental anxiety level over the 5-yr period. The mean values on Corah's Dental Anxiety Scale (DAS) and Dental Anxiety Question (DAQ) had increased for the girls and remained stable for the boys. The predictive power of DAS and DAQ on anxiety levels as measured by these same scales 5 yr later was weak to moderate, although statistically significant. The optimism–pessimism dimension and dental treatment experiences did not have any effect on dental anxiety changes from childhood to adolescence. DAS had an independent, weak, but statistically significant negative effect on optimistic disposition over the period. The internal reliability of DAS was high and highly similar results using DAS and DAQ were found. Except for significantly more dental experience in the drop-out group (n= 69) than in the current study group in the first study, there were no satistically significant differences in mean scores between the groups with respect to self-reported and clinical dental anxiety, and optimism. Methodological complications are discussed.     

Efficacy of a trauma‐focused treatment approach for dental phobia: a randomized clinical trial

It has been hypothesized that treatment specifically focused on resolving memories of negative dental events might be efficacious for the alleviation of anxiety in patients with dental phobia. Thirty‐one medication‐free patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV‐TR) criteria of dental phobia were randomly assigned to either Eye Movement Desensitization and Reprocessing (EMDR) or a waitlist control condition. Dental anxiety was assessed using the Dental Anxiety Questionnaire (DAS), the Dental Fear Survey (DFS), a behavior test, and dental attendance at 1‐yr of follow up. Eye Movement Desensitization and Reprocessing was associated with significant reductions of dental anxiety and avoidance behavior as well as in symptoms of post‐traumatic stress disorder (PTSD). The effect sizes for the primary outcome measures were d = 2.52 (DAS) and d = 1.87 (DFS). These effects were still significant 3 months (d = 3.28 and d = 2.28, respectively) and 12 months (d = 3.75 and d = 1.79, respectively) after treatment. After 1 yr, 83.3% of the patients were in regular dental treatment (d = 3.20). The findings suggest that therapy aimed at processing memories of past dental events can be helpful for patients with dental phobia.     

重度骨量不足种植牙患者牙科焦虑症分析及心理护理

目的：调查重度骨量不足种植牙患者牙科焦虑症（DA）的流行情况和焦虑程度,从而提出相应的心理护理。方法：100例重度骨量不足种植牙患者,随机分为实验组和对照组。采用改良的牙科焦虑量表（DAS）对两组患者就诊时的牙科焦虑状况进行调查;实验组采用心理护理,对照组采用常规护理;手术完成时采用视觉模拟标尺评估术中焦虑及疼痛程度。结果：100例重度骨量不足种植牙患者DAS的平均分值为13．5±2．6,属较高畏惧;两组患者DAS平均分值无差异（P〉0．05）;手术完成时试验组患者的焦虑状态指数及疼痛指数小于对照组,差异有统计学意义（P〈0．05）。结论：重度骨量不足患者在接受口腔种植手术所产生的牙科焦虑是显著的,心理护理能有效缓解焦虑状态,提高其诊疗依从性。     

Dental anxiety in Iceland: an epidemiological postal survey

In this study, we examined the prevalence of specific (dental) phobia among a sample of the Icelandic population. In addition to dental anxiety we explored factors that could be related to dental anxiety. In the period 1972-73, a stratified sample of 1641 schoolchildren in Reykjavík was selected for a study on malocclusion, dental maturation and other factors. Twenty-two years later (1995), a postal survey conducted in this group looked at many variables relating to oral health, including orofacial pain, functional oral disorders, self-perception of dental and general appearance and need for orthodontic treatment. Out of 1529 individuals contacted, 1192 completed questionnaires were returned (response rate 78%). Questions based on DSM-IV criteria of specific (dental) phobia (DP) were included. Ninety-six participants reported that they had avoided dental treatment during the previous 6 months. Twenty-one respondents fulfilled DSM-IV criteria for specific (dental) phobia (DP) and 75 admitted to many symptoms of dental anxiety (DA). Specific (dental) phobia (DP) was more prevalent among women than among men. The divorced or widowed were most at risk, as were non-salaried respondents. Most respondents attributed the onset of their phobias to a specific painful or fearful experience. There was a significant difference between the total dentally anxious (TDA = DA + DP) and the not dentally anxious (NDA) with regard to sex (women--higher TDA) and marital status (divorced or widowed--higher TDA). The TDA had statistically fewer teeth than the NDA and received dental treatment less frequently.     

Treatment of dental anxiety disorders. Outcome related to DSM-IV diagnoses

In this study we evaluated treatment effects in 70 consecutively admitted patients in a specialized university clinic for treatment of dental fear. Thirty-three (47%) of the patients fulfilled the diagnostic criteria for Specific Phobia alone (Dental Phobia, DP), 24 (33%) had severe dental anxiety without fulfilling the criteria for phobia (ND), and 13 (19%) fulfilled the criteria for multiple DSM-IV diagnoses (MD). Dental anxiety was measured prior to, immediately after and at follow-up (mean = 19 months) using Corah's Dental Anxiety Scale and Dental Fear Survey. Dental attitudes were measured by Getz' Dental Beliefs Survey. Dental attendance and everyday functioning were measured by self-report. DP patients received significantly more treatment-sessions as compared to the ND group. Despite significant overall reductions in scores on all psychometric instruments from pretreatment to follow up, patients in the MD group reported significantly more severe anxiety at pre- and post-treatment and at follow-up as compared to patients in the ND group. There was no interaction between diagnostic group and assessment occasion (pre treatment, post treatment and follow up) on the self-reported anxiety. Patients reported significant improvements in self-esteem, social relations and everyday functioning, regardless of diagnostic group. Sixty-three percentage of the respondents had been to the dentist within 1 year after completed treatment. Patients treated by dentists who had received supervised training in exposure treatment had significantly more often seen the dentist at follow-up.     

Effects of audiovisual distraction on children’s behaviour during dental treatment: a randomized controlled clinical trial

Aim: Dental anxiety leads to undesirable distresses such as avoidance of dental treatment and increase stress among caregivers that consequently affect the treatment quality. The aim of this study was therefore to evaluate the effectiveness of viewing videotaped cartoons using an eyeglass system (i-theatre?) as an audiovisual (AV) distraction technique on behaviour and anxiety in children receiving dental restorative treatment.

Methods: Fifty-six consecutive children patients who presented for treatment and met inclusion criteria were included and randomly divided into two groups; a control group without distraction (CTR-group) and a distraction-group (AV-group). Three dental treatment visits were provided for each patient. Anxiety and cooperative behaviour were assessed with the Facial Image Scale (FIS) and the Modified Venham’s clinical ratings of anxiety and cooperative behaviour scale (MVARS). The vital signs, blood pressure and pulse were also taken.

Results: The AV-group showed significantly lower MVARS scores than the CTR-group (p?=?0.029), and the scores decreased significantly during treatment in the AV-group (p?=?0.04). Further, the pulse rate was significantly increased in the CTR-group during injection with local anaesthesia (p?=?0.02), but not in the AV-group.

Conclusion: AV distraction seems to be an effective method in reducing fear and anxiety in children during dental treatment. Further, children who used eyeglass goggle display as a distraction tool during dental treatment reported not only less anxiety than control groups but also showed more positive responses after injection with local anaesthesia. Hence, AV-distraction seems to be a useful tool to decrease the distress and dental anxiety during dental treatment.     

Translation and psychometric properties of the Swedish version of the Index of Dental Anxiety and Fear (IDAF‐4C+)

Dental anxiety (DA) is a common condition, with significant medical, psychological, and social consequences. High‐quality psychometric tools for the assessment of dental anxiety are necessary for clinical and research purposes. The aim of this study was to adapt the Index of Dental Anxiety and Fear (IDAF‐4C⁺) to the Swedish language and to explore the psychometric properties of the translated version. The study included a clinical sample (n = 414; 17–91 yr of age) and a non‐clinical sample (n = 51; 19–47 yr of age). The scales used were the IDAF‐4C⁺, the Single‐Question Assessment of Dental Anxiety (SQDA), the Dental Fear Survey (DFS), and the Internal Health Locus of Control (IHLOC). The Swedish IDAF anxiety module showed a clear, one‐dimensional structure, good internal consistency (Cronbach's alpha = 0.95), and adequate validity, as evidenced by strong correlations with the other DA measures (SQDA and DFS) and weak correlations with the IHLOC. In addition, the IDAF phobia module and the IDAF stimulus module were strongly correlated with the other DA measures. To conclude, the study shows promising findings for the reliability and validity of the Swedish translation of the IDAF‐4C⁺, as a useful measure of dental anxiety in research and clinical practice.     

The relationship between children’s media habits and their anxiety and behaviour during dental treatment

Objective: The existing evidence suggests that media habits may have moderating role on children’s psychological adjustment in the dental setting. The aim of this study was to investigate the relationship between children’s media habits and their anxiety and behaviour management problems (BMP) during dental treatment.

Materials and methods: A total of 289 children aged 3–6 years old were included. Dental anxiety (DA) and BMP were assessed using Clinical Anxiety Rating Scale and Frankl’s Rating Scale during the dental treatment. The parents reported their own DA, educational level and economic status; and the children’s and also their own daily hours of using media. The data were analysed with the Mann–Whitney U, Kruskal–Wallis, Chi-square or Fisher exact tests, Spearman’s correlation coefficient and logistic regression.

Results: The children with DA had significantly higher amount of watching TV, playing e-games and surfing the Internet, and total amount of using electronic media than those without DA. The amount of watching TV and the total amount of using electronic media were significantly higher in the children with BMP than those without BMP. DA and BMP were significantly correlated with the children’s hours of watching TV and total media time.

Conclusions: There was a significant relationship between the amount of electronic media usage and DA and BMP in 3- to 6-year-old children.     

The burden of disease of dental anxiety: generic and disease‐specific quality of life in patients with and without extreme levels of dental anxiety

The aim of this study was to compare disease‐specific (oral health‐related) quality of life (OHRQoL), assessed using the Oral Health Impact Profile‐14 (OHIP‐14), and generic (health‐related) quality of life (HRQoL), assessed using the EuroQol5D (EQ‐5D‐5L), in patients with severe dental anxiety (who were visiting a centre for special care dentistry) with a control group from the general population. Seventy‐six patients with severe dental anxiety [Dental Anxiety Scale (DAS) score ≥ 13] were matched, according to age, gender, and socio‐economic status, to a control group of 76 participants in a larger epidemiological study on oral health in the Netherlands (n = 1,125). The Wilcoxon signed‐rank test was used to compare levels of HRQoL and OHRQoL in both groups. The total OHIP score (indicating lower OHRQoL) was higher for the patient group (10th percentile = 30.5; 90th percentile = 46.0) than for the control group (10th percentile = 1.0; 90th percentile = 14.5). The patient group showed higher scores on all seven OHIP domains. Lower utility scores were found in patients with severe dental anxiety (HRQOL: 10th percentile = 0.7; 90th percentile = 0.9) relative to the control group (HRQOL: 10th percentile = 0.9; 90th percentile = 1.0). A disease burden of 74,000 disability‐adjusted life years (DALYs) was calculated for the Netherlands. The findings of this study show differences between patients visiting a dental fear clinic and matched controls from the general population for both OHRQoL and HRQoL, indicating that having severe dental anxiety generates a significant burden of disease.     

Evaluating the validity of the Index of Dental Anxiety and Fear (IDAF-4C+) in adults with severe dental anxiety

Dental anxiety is a common condition with severe consequences for oral health and health-related quality of life. The aim of this study was to evaluate the recently developed self-report scale Index of Dental Anxiety and Fear (IDAF-4C⁺) in adults with severe dental anxiety. A sample of 147 adults (age 20–71 yr) with severe dental anxiety completed a questionnaire including the IDAF-4C⁺ and three other dental anxiety scales. In a clinically assessed subgroup (n = 93), 95% had an International classification of diseases and related health problems 10th version (ICD-10) diagnosis of specific phobia for dentistry. Agreement between the scales was analysed using Spearman’s correlation, the Kappa measure of agreement and the intraclass correlation coefficient. The agreement of dental phobia according to the IDAF-4C⁺ phobia module and the ICD-10 was very low (ĸ = 0.02). The anxiety and fear module of the IDAF-4C⁺ showed acceptable agreement with the other scales (r_s 0.69–0.75; ICC 0.90, 95% CI 0.87–0.93). We conclude that the IDAF-4C⁺ offers more information to clinicians and researchers than the older dental anxiety scales, but the phobia module needs further development.     

Development of a questionnaire measuring treatment concerns in regular dental patients

Abstract – Objectives: The aim of this study was to develop an instrument measuring core concerns about dental treatment guided by Reiss’ expectancy theory of fear. This would include the content domains of injury, somatic reaction and interpersonal concerns, to study the underlying factorial structure, and to determine the test quality of the resulting subscales. Methods: A total of 555 regular dental patients answered the item pool. Subsamples filled in the Dental Anxiety Scale (DAS) (n = 346) and the Anxiety‐Present Scale of the state‐form of the State‐Trait Anxiety Inventory (STAI‐S) (n = 187). A second sample (n = 89) was used to determine test‐retest reliability and bias for social desirability [Self Disclosure Scale of the Freiburg Personality Inventory (FPI)]. Results: Exploratory and confirmatory factor analyses identified a stable three‐dimensional structure underlying the items convergent to the content domains of interpersonal, injury and somatic reaction concerns. Internal consistencies of the resulting subscales were between α = 0.84 and α = 0.87, test‐retest reliabilities were from r_tt = 0.72–0.78. No evidence for a social desirability response bias was found. All subscales discriminated between patients with low and high dental trait anxiety at a level of P < 0.00001. Dental treatment concerns predicted 36% of variations in actual anxiety during treatment. Conclusions: The results suggest that the proposed instrument, namely the Dental Treatment Concerns Inventory, shows good test qualities according to construct, discriminant and predictive validity, and may be a promising tool for research and clinical applications.     

Oral health,sense of coherence and dental anxiety among middle-aged women

Abstract

Aims. The specific aims of this investigation were to analyze the relationship between sense of coherence (SOC), dental anxiety (DA) and oral health status among middle-aged women, measured both subjectively and objectively and adjusted for socioeconomic status (SES). Materials and methods. Randomly selected women, 38 (n = 206) and 50 (n = 287) years of age, were included in a cross-sectional health examination. The participants underwent a series of examination stages, including a clinical and dental radiographic examination. The women responded to questionnaires concerning SES, oral health, DA and SOC. Results. The number of teeth was significantly related to SOC, where more missing teeth revealed a lower SOC level among 50-year-olds. The variables of caries, apical periodontitis and filled surfaces were not statistically significantly associated with SOC. However, the self-reported measure of oral health was associated with SOC in both age groups. High DA was significantly related to self-perceived poor oral health regardless of age. Individuals with high DA also had fewer teeth, more filled surfaces and more approximal caries. The multivariate models showed that higher SOC levels were associated with better oral health, as estimated by objective or subjective measures, while the inverse results were seen for DA. Thus, individuals reporting high DA were more likely to have fewer teeth and poor perceived oral health, taking SES into account. Conclusions. Sense of coherence and dental anxiety are psychological aspects with respect to health- and risk-factors of oral health.