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 Table of Contents  
Year : 2020  |  Volume : 12  |  Issue : 2  |  Page : 92-94

The prevalence of anxiety and fear in dental patients: A short study

1 Department of Oral and Maxillofacial Pathology and Microbiology, Daswani Dental College and Research Centre, Kota, Rajasthan, India
2 Department of Orthodontics and Dentofacial Orthopaedics, Daswani Dental College and Research Centre, Kota, Rajasthan, India
3 Department of Oral Medicine and Radiology, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India

Date of Submission25-Sep-2019
Date of Acceptance10-Mar-2020
Date of Web Publication21-May-2020

Correspondence Address:
Karandeep Singh Arora
House No. 1078, Sector 19-B, Chandigarh (UT) - 160 019
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJDS.IJDS_112_19

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Background: Dental anxiety and fear are the major complications for both patient and dental care providers. The purpose of this study was to assess the prevalence of dental anxiety and fear in patients visiting the dental institute with respect to their gender. Materials and Methods: In the present study, 100 patients were provided with certain questionnaire which included two sections. The first section concerning age, gender, educational level, frequency of dental visits, reasons for irregular attendance, and existence of past traumatic experience. The second section comprises modified dental anxiety scale. Data was collected and analyzed with respect to gender using the statistical analysis. Results and Conclusion: Anxiety-associated dental treatment is widespread in the study population. Dental anxiety was higher in women and in the patients with traumatic dental experiences.

Keywords: Anxiety, dental patients, fear, modified dental anxiety scale

How to cite this article:
Chaudhary D, Saxena S, Mahanta D, Yadav P, Patel SH, Agarwal S, Arora KS. The prevalence of anxiety and fear in dental patients: A short study. Indian J Dent Sci 2020;12:92-4

How to cite this URL:
Chaudhary D, Saxena S, Mahanta D, Yadav P, Patel SH, Agarwal S, Arora KS. The prevalence of anxiety and fear in dental patients: A short study. Indian J Dent Sci [serial online] 2020 [cited 2020 Aug 11];12:92-4. Available from: http://www.ijds.in/text.asp?2020/12/2/92/284665

  Introduction Top

Dental anxiety is a very common problem that can be quite unpleasant for the patient[1] and interferes with the dental treatment.[2] Individuals with high dental anxiety most of the time avoid treatment, delay it,[3] or demand requests for assistance that can range from a short discussion with dental staff to general anesthesia.[4] Additional risk factors for the development of dental fear include personality factors such as children expressing shyness or tendencies of negative emotionality.[5],[6] The amount and nature of dental anxiety varies from one individual to another. It has been recommended that with the help of psychometric measures, patient's dental anxiety can be assessed.[7] There are numerous dental anxiety measurement scales for assessments. Most well-known adult questionnaire made to assess dental anxiety is the Corah's Dental Anxiety Scale (DAS).[8] The DAS consists of four questions about different dental situations. Each question is scored from 1 (not anxious) to 5 (extremely anxious), and hence, the range of possible scores is 4–20. Significant anxiety is indicated for the score of 15 or more. Another popular anxiety scale is the modified DAS (MDAS),[9],[10] which consists of five questionnaires having score distributed as one (nonanxious) and five extremely anxious. The score for each respective questionnaire is added. Cutoff is 19 or above indicates a highly dentally anxious patient, possibly dentally phobic.[9] Dentists are not very use to analyzing individual responses to dental anxiety measures and thus do not prefer to adopt such a process. However, with practice and training, the inclusion of routine anxiety assessment may lessen the overall contact time between patient and dentist.[11] Therefore, this study aims at assessing the level of anxiety in the study population according to gender.

  Materials and Methods Top

A total of 100 patients comprising 43 males and 57 female patients visiting the dental hospital were randomly selected for the study and were provided with the first section of MDAS questionnaire. The first section was concerned with age, gender, educational level, frequency of dental visits, reasons for irregular attendance, and existence of past traumatic experience. The second section comprises the MDAS and this section was not provided to the study group. Patients were asked to select a suitable option for each question and the form was submitted. For each questionnaire, patient scoring was added to give a total score for all five respective questions. Data were collected and analyzed with respect to gender using MDAS.

  Results Top

In the present study, male and female patients showed significant P value with anxiety scale [Table 1]; however, female patients showed a higher level of anxiety as compared to males in the study group having a mean anxiety score of 11.80 [Table 2].
Table 1: Frequency breakdown and N size for participant sample including modified dental anxiety scale mean standard deviation and percent ≥19

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Table 2: Graphical representation showing mean modified dental anxiety scale score in male and female

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  Discussion Top

The present study results were consistent with the study done by Neverlien in 1990, who assessed that women had significantly higher mean values on the data acquisition (DAQ) than men in all age groups, and for both genders, the mean DAQ values decreased with increasing age.[12]

Settineri et al., in 2005, studied the presence of dental anxiety in a group of 189 females and 176 males using the following scales: the DAS (divided into DAS 1 containing six items, which explores a patient's dental anxiety and DAS 2 containing 13 items, which looks at dental anxiety concerning dentist-patient relations), the self-rating depression scale (SDS), and the quality of life index (QL-Index). The results obtained showed significant differences only in relation to dental anxiety regarding the use of instruments (such as needles and handpieces) and the tilted-back position of the chair (DAS 1). There were no significant gender differences emerged between the two groups in relation to dental anxiety regarding dentist-patient relations (DAS 2), depression (SDS), and the quality of life (QL-Index).[13]

Similarly, study by Berggren in 1992 reported women have high anxiety scores than men. The frequencies of extreme fears (6 and 7 on a 7-point scale) were high, and 92.7% of the patients reported at least one extreme fear.[14] There are some studies which indicate that younger adults may show lower dental anxiety than their more middle-aged counterparts.[9],[15] Lehrner et al. reported that ambient odor of orange in a dental office reduces anxiety and improves mood in female patients.[16]

  Summary and Conclusion Top

Anxiety may be described as an emotional state that is commonly present on a visit to the dentist and is more frequently associated with females than in males. The present study was carried out to assess the anxiety levels in patients with respect to gender. It showed that study patients showed significant levels of anxiety with respect to dental treatment, with females having a higher P value than males. The higher level of dental anxiety in females can be because of various conditions such as infrequent visits to the dentist, the long wait in the dental office, and previous traumatic procedure. This dental anxiety explains why women commonly avoid dental treatment. Certain measures such as reducing long waiting time and proper explanation of surgical procedure should be carried out by the dental office staff to reduce dental anxiety for female patients to motivate them for dental treatment and lessen dental anxiety.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Kleinknecht RA, Klepac RK, Alexander LD. Origins and characteristics of fear of dentistry. J Am Dent Assoc 1973;86:842-8.  Back to cited text no. 1
Coldwell SE, Wilhelm FH, Milgrom P, Prall CW, Getz T, Spadafora A, et al. Combining alprazolam with systematic desensitization therapy for dental injection phobia. J Anxiety Disord 2007;21:871-87.  Back to cited text no. 2
Haugejorden O, Klock KS. Avoidance of dental visits: The predictive validity of three dental anxiety scales. Acta Odontol Scand 2000;58:255-9.  Back to cited text no. 3
Goumans C, Veerkamp JS, Aartman IH. Dental anxiety and behavioural problems: What is their influence on the treatment plan? Eur J Paediatr Dent 2004;5:15-8.  Back to cited text no. 4
Venham LL, Gaulin-Kremer E. A self-report measure of situational anxiety for young children. Pediatr Dent 1979;1:91-6.  Back to cited text no. 5
Klaassen M, Veerkamp J, Hoogstraten J. Predicting dental anxiety. The clinical value of anxiety questionnaires: An explorative study. Eur J Paediatr Dent 2003;4:171-6.  Back to cited text no. 6
Dailey YM, Humphris GM, Lennon MA. The use of dental anxiety questionnaires: A survey of a group of UK dental practitioners. Br Dent J 2001;190:450-3.  Back to cited text no. 7
Corah NL, Gale EN, Illig SJ. Assessment of a dental anxiety scale. J Am Dent Assoc 1978;97:816-9.  Back to cited text no. 8
Humphris GM, Morrison T, Lindsay SJ. The modified dental anxiety scale: Validation and United Kingdom norms. Community Dent Health 1995;12:143-50.  Back to cited text no. 9
Tunc EP, Firat D, Onur OD, Sar V. Reliability and validity of the modified dental anxiety scale (MDAS) in a Turkish population. Community Dent Oral Epidemiol 2005;33:357-62.  Back to cited text no. 10
King K, Humphris G. Evidence to confirm the cut-off for screening dental phobia using the modified dental anxiety scale. Soc Sci Dent 2010;1:21-8.  Back to cited text no. 11
Neverlien PO. Assessment of a single-item dental anxiety question. Acta Odontol Scand 1990;48:365-9.  Back to cited text no. 12
Settineri S, Tati F, Fanara G. Gender differences in dental anxiety: Is the chair position important? J Contemp Dent Pract 2005;6:115-22.  Back to cited text no. 13
Berggren U. General and specific fears in referred and self-referred adult patients with extreme dental anxiety. Behav Res Ther 1992;30:395-401.  Back to cited text no. 14
Humphris GM, Dyer TA, Robinson PG. The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age. BMC Oral Health 2009;9:20.  Back to cited text no. 15
Lehrner J, Eckersberger C, Walla P, Pötsch G, Deecke L. Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiol Behav 2000;71:83-6.  Back to cited text no. 16


  [Table 1], [Table 2]


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