牙科畏惧症的现状调查及相关心理因素分析

目的　了解社会人群中牙科畏惧症的水平和分布状况 ,并探讨与牙科畏惧症形成和发展相关的因素。方法　主要采用Corah’s问卷 (CDAS)、感觉寻求量表 (SSS)、特质焦虑量表 (T AI)、艾森克人格问卷简式量表中国版(EPQ RSC)对武汉市社会人群进行测查。结果　①社会人群中牙科畏惧总体水平为 11.0 0± 3.5 4 ,其中男性为10 .15± 3.4 9,女性为 12 .0 7± 3.33;②采用多元线性逐步回归法筛选出与牙科畏惧水平显著相关 (P <0 .0 1)的 4个因素 ,分别是性别因素 (β =0 .2 5 2 )、感觉寻求 (β=- 0 .15 6 )、特质焦虑 (β =0 .174 )和对牙医的评估 (β =- 0 .173) ;③有无直接牙科经历对牙科畏惧水平无显著影响 (P >0 .0 5 )。结论　①牙科畏惧症在成人中呈中度流行趋势 ,且女性的畏惧水平高于男性 ;②高感觉寻求特质与牙科畏惧水平呈负相关 ,焦虑特质与牙科畏惧水平呈正相关 ;③对牙科治疗和牙医的主观评价在很大程度上影响了牙科畏惧的水平。     

牙科畏惧症患者的异常心理分析

目的：探讨不同年龄段牙科畏惧症患者的抑郁、焦虑状态、对人性的信心以及自信。方法：选取329名牙痛患者，填写抑郁自评量表（SDS），焦虑自评量表（SAS），信赖他人量表（FPA），状态-特质焦虑问卷（STAI），得到各评分值，用牙科畏惧（DF）量表筛选出畏惧症患者，将无畏惧症者作为正常对照组与畏惧症患者进行比较，并根据年龄段分组，进行统计学分析。结果：牙科畏惧症患者与正常对照组的抑郁自评量表评分经统计学处理有显著性差异。男女患者在牙科畏惧症评分上有显著性差异，女性的畏惧程度较男性要严重。青年组和中年组畏惧症患者的抑郁自评量表与正常对照组比较有统计学差异。青年组的状态焦虑评分有统计学意义。结论：牙科畏惧症患者具有异常的心理状态。     

中外儿童口腔治疗焦虑行为的对比

目的：比较美国佛罗里达大学口腔医学院（university of florida college of dentistry,UFCD）儿童牙科和中国解放军总医院（301医院）（301 general hospital of PLA China）儿童牙病科就诊儿童的恐惧心理,以改进管理儿童患者就诊行为的方法。方法：选取2006—09—2007—08在UFCD就诊儿童150例,2007—11—2008—03在解放军301医院儿童牙科就诊儿童270例,采用儿童畏惧调查表一牙科分量表（children＇s fear survey schedule—dental subscale,CFSS-DS）调查儿童牙科畏惧情况,所得数据进行统计学分析。结果：CFSS平均得分≥2．5者,UFCD为19．7％,301医院为27．2％;两地区6岁前儿童DF值均明显高于6岁后儿童（P〈0．05）;301医院女性DF值明显低于男性（P〈0．05）,UFCD则无显著差异;与治疗无关的恐惧,UFCD为32％,301医院为39％;两地区家长对治疗恐惧经历均明显影响患儿牙科畏惧症（DF）的发生（P〈0．05）。结论：父母不良的牙科经历是患儿DF发生的主要因素。年龄,性别也一定程度上影响儿童DF发生。     

成人根管治疗牙科畏惧原因及行为干预的研究

目的调查成人根管治疗患者牙科畏惧症产生的原因，探讨行为干预对牙科畏惧程度的影响。方法219例患者根据初诊时牙科焦虑症量表得分分为无畏惧型组、畏惧型组、高度畏惧型组和病态畏惧型组，每组患者随机进行常规治疗和干预治疗，在开髓、根备、根充治疗后3个阶段进行根管治疗牙科畏惧症量表的问卷调查，并在根备、根充治疗前后测量血压和脉搏。结果成人根管治疗患者的牙科畏惧受传媒因素（P〈0．01）和经济（费用）因素（P〈0．05）的影响较大。畏惧干预治疗组患者的畏惧程度在根备后和根充后两阶段均较开髓后明显下降（P〈0．05），但无畏惧干预组患者的收缩压在根备后、根充后均较治疗前明显上升（P〈0．05）。结论进行根管治疗的成人患者普遍存在牙科畏惧心理，恰当的干预可有效减轻畏惧症患者的畏惧，但在治疗环境存在较多干扰的情况下，干预措施可能反而会加重患者的畏惧。     

深圳市成人牙科畏惧症患者的口腔健康相关生活质量研究

目的：研究牙科畏惧症（DF）患者的口腔健康相关生活质量。方法：选择在深圳市第五人民医院口腔科门诊就诊的358名18～75岁初诊患者,应用口腔焦虑量表（CDAS）和口腔健康影响程度量表（OHIP-14中文版）、人口统计学一般项目表进行调查。结果：DF患者的OHIP-14的分值中位数为21.25,明显高于一般就诊患者（中位数11.20）。且在生理性疼痛、心理不适和心理障碍等领域影响最大。CDAS与OHIP-14分值间的相关系数为0.255。结论：在牙科畏惧症患者中,牙科畏惧程度与口腔健康影响程度之间存在相关性,焦虑程度越高的患者口腔健康相关生活质量越差。对牙科畏惧症患者进行有效的心理干预可以提高其相关生活质量。     

综合心理干预在儿童牙科畏惧症中的应用

目的：为减少儿童牙科畏惧症的产生,提高儿童牙病的诊疗效果。方法：对本院儿童口腔保健科就诊的具有牙科畏惧症的470名患儿按年龄分4组,初诊行为分4型,在治疗前、中、后进行综合心理干预,最后记录患儿合作行为,并对合作程度及不同性别的干预效果进行分析。结果：各年龄组患儿合作程度干预效果比较：A组（1～3岁）无显著差异,其他各年龄组均有显著差异（P〈0.05）;各年龄组不同性别比较结果：B组（4～6岁）中男、女均有显著性差异,男孩（P〈0.01）,女孩（P〈0.05）,其他各组无显著性差异。结论：综合心理干预能有效地减少或消除儿童牙科畏惧症,随着患儿年龄的增长,显著性差异有下降的趋势。     

基于环境听觉管理的舒适化治疗策略在儿童牙科畏惧症中的应用效果研究

摘要：目的    探讨基于环境听觉管理的舒适化治疗策略在儿童牙科畏惧症中的应用效果。方法    选择2021年7—8月于武汉大学口腔医院儿童口腔科就诊需行口腔治疗的3 ~ 10岁牙科畏惧症患儿60例，随机分为试验组和对照组，每组各30例。对照组仅进行行为管理，试验组在行为管理基础上采用环境听觉管理（佩戴无线智能耳机聆听音乐或音乐故事）。采用儿童畏惧调查-牙科分量表（CFSS-DS）和Venham临床焦虑与合作行为级别评定量表（以下简称“Venham量表”）评估两组患儿治疗前后的焦虑畏惧水平和临床合作情况。结果    在治疗后，两组患儿CFSS-DS评分较治疗前均显著下降，且试验组患儿CFSS-DS评分和Venham量表评级均显著低于对照组，差异均有统计学意义（均P < 0.05）。此外，试验组患儿的临床合作率显著高于对照组，差异有统计学意义（P < 0.05）。结论    基于环境听觉管理的舒适化治疗策略能够有效缓解儿童的牙科畏惧症状和焦虑水平，提高就诊的依从性和配合度，有望为开展儿童口腔舒适化治疗提供新的思路和参考。     

心理指导对牙科畏惧症患儿的影响

目的观察心理指导对牙科畏惧症患儿的影响，为探寻治疗牙科畏惧症患儿的策略提供依据。方法牙科畏惧症患儿317例，随机分为试验组177例和对照组140例，试验组在口腔治疗前、中、后进行心理指导，对照组不进行心理指导，口腔治疗结束后应用Frank临床行为分级评定量表判断其畏惧程度。结果试验组在心理指导前后Frankl行为分级变化情况有统计学意义（P〈0．01）。结论心理指导对改善牙科畏惧症患儿在口腔治疗中的畏惧程度有良好的效果。     

240例儿童牙科畏惧症的临床初步分析

目的：调查儿童患者牙科畏惧症的发生情况及影响因素。方法：采用改良的儿童畏惧调查量表-牙科分量表（CFSS-DS）和行为分级法对240例儿童牙病患者进行调查及统计分析,比较不同分组因素下儿童患者畏惧水平。结果：CFSS-DS平均评分值为15.78±3.90。240例患儿的术前评分值在年龄、性别、看牙经历、母亲文化程度、口腔卫生和精神状态方面有影响,其中年龄、看牙经历、母亲文化程度、口腔卫生这几方面有显著性差异（P〈0.05）,性别和精神状态无显著性差异。患儿的畏惧率为75.83%,术中行为分级受患儿年龄、性别、看牙经历、母亲文化程度、口腔卫生和精神状态方面有影响,其中年龄、看牙经历、母亲文化程度、口腔卫生和精神状态这五方面有显著性差异（P〈0.05）。结论：了解不同因素下患儿术前和术中的畏惧情况,以期将儿童DF降到最低程度,提高诊疗质量,更好地维护儿童的口腔状况。     

成人患者牙科畏惧症的临床调查及相关因素分析

目的探讨引发患者焦虑情绪的相关因素,为临床焦虑控制和制定干预措施提供较好的参考依据。方法深圳市第五人民医院口腔科门诊就诊的358名18～75岁的初诊患者,应用口腔焦虑量表和自编牙科畏惧细评表、人口统计学一般项目表进行调查。结果 84.1%的被试者呈现无畏惧或轻度畏惧状态,6.1%呈现中度畏惧,9.8%呈现重度畏惧。引发患者焦虑的前3位因素分别是疼痛（57.5%）、洗牙时的吱吱声（45.0%）、牙钻的声音和震动（37.5%）。结论针对疼痛、洗牙和钻牙的声音等相关因素的临床干预能够有效缓解畏惧情绪。     

老年患者的根管治疗疼痛程度与应对方式的研究

目的：探讨老年人的应对方式与根管治疗疼痛程度的相关性。方法：采用应对方式问卷和视觉模拟量表测定115位老年患者的应对方式及根管治疗疼痛指数,并进行相关分析。受试对象为60-75岁老年人,男性55人,女性60人。结果：解决问题、求助因子与疼痛指数负相关,自责、退避、幻想因子与疼痛指数正相关。成熟型、不成熟型应对方式分别与疼痛指数呈负相关、正相关。自责、幻想、解决问题因子进入回归模型。结论：对老年患者进行心理护理,指导他们以积极的态度应对治疗,可以一定程度上减轻对疼痛的畏惧,提高早期就诊率、诊治质量和工作效率,为根管治疗的顺利进行提供保障措施,得到令人满意的治疗效果。     

Usefulness of a psychometric questionnaire in exploring parental attitudes in children's dental care

In this methodological study we investigated the usefulness and reliability of a questionnaire designed to capture 4 aspects of parental dental attitudes: dental knowledge, child oral health behavior, perceived importance of dental related aims, and parental responsibility. The study was undertaken in a group of 140 parents of schoolchildren aged 8-12 years from four comprehensive schools in Sweden. Test-retest reliability, quantified by the intraclass correlation coefficient (ICC) or by Cohen's kappa, varied from acceptable to excellent for different aspects of the questionnaire. The knowledge and responsibility-taking sections were also answered by a group of dental experts who showed a high level of internal agreement. Expert profiles, to which the parental assessments could be compared, were created. Exploration of the 4 aspects showed that this group of parents commonly had a multifocal view on the etiology and prevention of caries. Correlations between their knowledge assessments and the assessments made by the expert group varied from moderately negative to strongly positive. The parents revealed a high degree of dental-related motivation and responsibility, particularly according to oral health behaviors. In conclusion, the results indicate that this 4-part psychometric questionnaire might be a suitable instrument in investigations of priority and responsibility-taking as new aspects of parental dental attitudes, along with dental knowledge and child oral health behaviors.     

Usefulness of a psychometric questionnaire in exploring parental attitudes in children's dental care

In this methodological study we investigated the usefulness and reliability of a questionnaire designed to capture 4 aspects of parental dental attitudes: dental knowledge, child oral health behavior, perceived importance of dental related aims, and parental responsibility. The study was undertaken in a group of 140 parents of schoolchildren aged 8-12 years from four comprehensive schools in Sweden. Test-retest reliability, quantified by the intraclass correlation coefficient (ICC) or by Cohen's kappa, varied from acceptable to excellent for different aspects of the questionnaire. The knowledge and responsibility-taking sections were also answered by a group of dental experts who showed a high level of internal agreement. Expert profiles, to which the parental assessments could be compared, were created. Exploration of the 4 aspects showed that this group of parents commonly had a multifocal view on the etiology and prevention of caries. Correlations between their knowledge assessments and the assessments made by the expert group varied from moderately negative to strongly positive. The parents revealed a high degree of dental-related motivation and responsibility, particularly according to oral health behaviors. In conclusion, the results indicate that this 4-part psychometric questionnaire might be a suitable instrument in investigations of priority and responsibility-taking as new aspects of parental dental attitudes, along with dental knowledge and child oral health behaviors.     

口腔正畸医生诊疗行为与患者治疗满意度的相关性研究

目的:探讨口腔正畸医生诊疗行为与患者治疗满意度两者之间的相互关系。方法:选取门诊410名口腔正畸患者,采用“口腔医生行为评价量表”,口腔治疗满意度量表进行问卷调查,并分别按照性别、年龄和疗程进行分组比较。对获得的数据使用SPSS18.0软件进行相关分析、逐步回归和秩和检验等统计分析。结果:口腔正畸医生诊疗行为与患者治疗满意度之间的相关系数R=0.750,有明显的统计学差异(P<0.05)。在24种口腔正畸医生诊疗行为中,有6种与患者治疗满意度产生明显的正相关(P<0.05)。女性较男性对治疗的满意程度更高(P<0.05)。青少年与成人之间以及在不同疗程间的满意度无显著性差异。结论:口腔正畸医生要规范自己的诊疗行为,加强与患者的沟通交流,提高患者治疗满意度。     

拔牙患者牙科畏惧症的临床调查

目的：研究拔牙患者围拔牙手术期的焦虑状况及其相关因素,为临床防治牙科畏惧症提供指导。方法：采用改良牙科焦虑量表（DAS）对200例拔牙患者进行横断面调查和统计分析。结果：200例拔牙患者中有10.50%的患者DAS评分值≥13,属于严重的牙科焦虑情况,尤其在局部麻醉前焦虑水平最高。牙科畏惧相关因素分析中DAS评分较高因素有：女性、性格偏内向、自我或周围人有不良牙科经历者、疼痛耐受程度低、精神状态差和心情紧张等。结论：拔牙术前的牙科畏惧症有较高发生率,达到10.50%,并且其相关因素较多。患者最为恐惧的因素是拔牙前局麻注射时的疼痛。     

Effect of fear on dental utilization behaviors and oral health outcome

OBJECTIVES: This paper assesses the effect of fear on a number of dental utilization behaviors and oral heath outcome in a sample of adult Floridians. METHODS: A telephone survey was conducted in 2004 among 504 adult Floridians. Data collected included sociodemographic factors, specific fear of dental pain (FDP), global FDP, global dental fear, three measures of dental utilization behaviors, and one measure of oral health outcome. Chi-squared tests and logistic regression analyses were conducted to quantify the individual and multivariate associations between fear factors and four behavior and outcome measures. RESULTS: Global FDP was significantly associated with putting off making a dental appointment and approach to dental treatment. Global dental fear showed an independent negative impact on all four behavior and outcome measures; reports regarding specific fear of painful dental events were not significantly associated with four behavior and outcome measures. CONCLUSIONS: Our findings suggest that: (i) dental fear and FDP have independent negative effects on dental utilization behaviors and oral health outcome after controlling for other sociodemographic and general health factors; and (ii) global dental fear encompasses broader components than FDP.     

恐惧心理对口腔门诊病人就诊行为和服务需求的影响

目的:调查影响口腔门诊病人产生恐惧心理的相关因素,分析恐惧心理对就诊行为以及就诊服务需求的影响。方法:采用系统抽样的方式按照纳入标准选取831名口腔门诊病人作为问卷调查对象,问卷内容包括人口统计学资料、就诊心理状态、就诊行为、对服务舒适度需求等。结果:831人中有恐惧心理503人(60.5%),其中男性173人,女性330人,男女之间有显著性差异(P<0.05);有无恐惧心理在不同年龄、不同职业、不同受教育程度人群中也有显著性差异(P<0.05);有、无恐惧心理两组人群在定期口腔检查、按时复诊两个就诊行为中有显著性差异(P<0.05);在就诊前是否了解医生情况方面无显著差异;两组人群对就诊过程中与服务舒适度相关的因素感到不安的程度由高到低依次均为①牙钻声、②出血、③气味、④灯光、⑤体位,各因素不安程度有显著性差异(P<0.05)。结论:恐惧心理在口腔门诊大多数病人中存在,其形成与性别、年龄、职业、受教育程度相关;与无恐惧心理人群相比,有恐惧心理人群更难定期口腔检查,但更容易按时复诊,对就诊服务舒适度的潜在需求明显增高。     

Prevalence of dental fear and its relationship with primary dental caries in 7-year-old-children

BackgroundChild's dental fear has been reported as one of the reasons that increase, aggravate dental diseases and facilitate other oral diseases. This study is aimed to describe the type and prevalence of dental fear and to assess the relationship between cavities of primary teeth and dental fear in 7-year-old children at Phulam Primary School, Hanoi.MethodsThe sample comprised of 132 children aged 7 years. The questionnaire examined the profile of participants and assessed their dental fear using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Children have “dental fear” when the total CFSS-DS score is greater than or equal to 38. By contrast, those without dental fear gain the total point which is less than 38. After completing the questionnaire, a dental examination was undertaken according to the International Caries Detection and Assessment System (ICDAS).ResultsThe prevalence of dental fear was 34.85%. Fear scores were highest for “Dentist drilling” (2.92 ± 1.47) and “Injections” (2.87 ± 1.53). In the univariate analysis, the odds of girls having dental fear were approximately equal to boys (OR = 0.98, 95% CI = ?0.75-0.70). The odds of only children having dental fear were 1.6 times higher than others, but there were not significant. Dental fear was found to be no associated to sex, birth order and primary dental caries (p > 0.05).ConclusionOur findings demonstrated the status of 7-year-old children's dental fear at Phulam primary school, and found that primary dental caries had no correlation with child dental fear score.     

Dental anxiety in children and its relationship to dental caries and gingival condition

The aim of this study was to determine the levels of dental anxiety, dental caries and gingivitis among 12–15‐year‐old schoolchildren, in Irbid Governorate/northern Jordan, and to evaluate the correlation between these variables. Two schools were selected by a simple random method from each of the five geographic areas in Irbid Governorate. All children (1021), from the 10 selected schools, who participated in this study completed a questionnaire modified from Kleinknecht's Dental Fear Survey (DFS questionnaire). Children underwent oral examination for dental caries and gingival condition, using Decayed, Missing and Filled Teeth (DMFT) Index and Löe and Silness Gingival Index (GI), respectively. Results of this survey showed that the prevalence of low to moderate ‘general dental fear’ among the study population was 43% while that of ‘high dental fear’ was 10%. The self‐reported ‘general fear of dental treatment’ was higher among girls than boys. Fear of specific stimuli (pain) was the most common source of dental fear. The sight and sensation of the anaesthetic needle and the sight, sound and sensation of the drill were rated the most fear‐eliciting stimuli. The mean DMFT (2.89) and GI (1.80) of boys was not significantly different from the DMFT (3.37) and GI (1.53) of girls (P > 0.05). Spearman's correlation test demonstrated no association between ‘general dental fear’ and dental caries (r = 0.06) or gingivitis (r = 0.007).