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Dental anxiety and symptoms of general anxiety and depression in 15-year-olds
Jönköping University, School of Health Science, HHJ. Oral health.
Department of Behavioral and Community Dentistry Institute of Odontology, The Sahlgrenska Academy University of Gothenburg, Sweden.
Department of Behavioral and Community Dentistry Institute of Odontology, The Sahlgrenska Academy University of Gothenburg, Sweden.
2013 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 11, no 2, 99-104 p.Article in journal (Refereed) Published
Abstract [en]

Objectives:  The objective of the study was to analyse the relationship between dental anxiety and symptoms of general anxiety and depression among 15-year-old individuals. Methods:  The sample analysed included 221 randomly selected 15-year-old individuals living in the city of Jönköping, Sweden. One questionnaire captured sociodemography and dental history, while dental anxiety was assessed by the Dental Fear Survey (DFS) and symptoms of general anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). Results:  About 6% of the adolescents were classified as dentally anxious. Symptoms of general anxiety and depression were significantly correlated with dental anxiety in both the bivariate and multivariate analyses. The latter analyses were adjusted for gender and previous painful experiences of dental care. Individuals with high dental anxiety showed general anxiety scores on a clinical level (mean = 9.8, SD = 4.3). Conclusions:  Symptoms of general anxiety and depression were shown to be significantly correlated with dental anxiety among 15-year-old individuals.

Place, publisher, year, edition, pages
2013. Vol. 11, no 2, 99-104 p.
Keyword [en]
adolescents; cross-sectional; dental anxiety; depression and anxiety; epidemiology
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-19752DOI: 10.1111/j.1601-5037.2012.00551.xOAI: oai:DiVA.org:hj-19752DiVA: diva2:564477
Available from: 2012-11-01 Created: 2012-11-01 Last updated: 2015-05-11Bibliographically approved
In thesis
1. Dental anxiety among 15-year-olds: Psychosocial factors and oral health
Open this publication in new window or tab >>Dental anxiety among 15-year-olds: Psychosocial factors and oral health
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

AIM: The overall aim of this thesis was to examine the associations between dental anxiety, experiences of dental care, psychosocial factors and oral health among 15-year-olds, and to analyse changes in the prevalence of dental anxiety over time.

MATERIALS AND METHODS: The thesis was based on two cross-sectional epidemiological studies in Jönköping, Sweden. Papers I, II, and III were based on a random sample of 15-year-old individuals. The total sample consisted of 221 individuals. Six questionnaires were used, one included items of background data, while the others were psychometric instruments measuring dental anxiety, temperament, general anxiety and depression, general fearfulness and attitudes to dental care. Paper IV was based on the Jönköping studies, a series of epidemiological studies from 1973, 1983, 1993, and 2003 in which random samples of 15-year-old individuals were included. The total sample consisted of 405 individuals. Questionnaires including background data and dental anxiety were used and clinical data were collected.

RESULTS: Of the 15-year-old individuals 6.5% were classified as dentally anxious with girls proportionally more fearful than boys (Papers I-III). Dental anxiety correlated significantly with three of the temperament dimensions; emotionality, activity and impulsivity. Reported pain or unpleasant experiences during dental care treatment were clear predictors concerning dental anxiety (Paper I). Both symptoms of general anxiety and depression were significantly correlated with dental anxiety after controlling for other potential risk factors (Paper II). Dental anxiety was associated with both general fearfulness and with attitudes to dental care, where the strongest predictor of dental anxiety was general fearfulness (Paper III). A trend analysis over the 30-year period showed a gradient of statistically significantly decreasing dental anxiety prevalence, from 38.1% in 1973 to 12.8% in 2003. Over the period the 15-year-old individuals with dental anxiety had significantly higher number of filled tooth-surfaces than those with no dental anxiety, and also more caries in 1973. There were no such differences concerning plaque and gingivitis (Paper IV).

CONCLUSIONS: Dental anxiety in 15-year-olds correlated with experiences of dental care, psychosocial factors as well as to oral health. Specifically, pain experiences related to dental care, attitudes to dental care and general fearfulness seem to have the strongest impact on dental anxiety. Dental anxiety showed a clear declining change over time. More girls than boys reported dental anxiety. The thesis shows that dental care providers need paying attention on providing a supportive dental care situation, in which the patients should not experience pain. One part may be adequate local anaesthesia during operative dentistry or similar dental treatments. Another part may be a good oral health to prevent negative experiences of dental care. There is a need for the understanding of psychological factors associated with dental care procedures.

Abstract [sv]

SYFTE: Det övergripande syftet med denna avhandling var att bland 15-åringar undersöka sambanden mellan tandvårdsrädsla, erfarenheter av tandvård, psykosociala faktorer och oral hälsa, samt att analysera förändringar i förekomsten av tandvårdsrädsla över tid.

MATERIAL OCH METOD: Avhandlingen baseraspå två epidemiologiska tvärsnittsstudier i Jönköping. I arbete I, II och III redovisas studier av 221 slumpmässigt utvalda 15-åriga individer. Deltagarna besvarade frågor avseende bakgrundsdata, tandvårdsrädsla, temperament, ångest och depression, generell rädsla samt attityder till tandvård. Arbete IV bygger på Jönköpingsstudierna, från 1973, 1983, 1993, och 2003, där sammanlagt 405 slumpmässigt utvalda 15-åriga individer ingick. Datainsamling gjordes med hjälp av frågeformulär, bestående av bakgrundsdata och tandvårdsrädsla, samt kliniska data.

RESULTAT: Resultatet i arbete I, II och III visade att 6,5% av ungdomarna rapporterade hög tandvårdsrädsla, där en övervägande andel var flickor. I arbete I visade tandvårdsrädsla samband med tre av temperamenten; emotionalitet, aktivitet och impulsivitet. Rapporterad smärta eller obehagliga upplevelser under tandbehandling var tydliga prediktorer avseende tandvårdsrädsla. I arbete II visade både symtom på ångest och depression samband med tandvårdsrädsla, sedan effekterna av andra potentiella riskfaktorer hade kontrollerats för statistiskt. I arbete III visade tandvårdsrädsla starkt samband med både generell rädsla och med attityder till tandvård, där den starkaste prediktorn för tandvårdsrädsla var generell rädsla. I arbete IV visade en trendanalys en statistiskt säkerställd minskning gällande förekomsten av tandvårdsrädsla, från 38,1% år 1973 till 12,8% år 2003. Ungdomarna med tandvårdsrädsla hade signifikant fler fyllda tandytor än ungdomarna utan tandvårdsrädsla under 30-årsperioden, och år 1973 även mer karies. Det fanns inga sådana skillnader avseende plack och gingivit.

SLUTSATSER: Resultatet visar att tandvårdsrädsla är relaterat till smärtsamma erfarenheter av tandvård, generell rädsla, och oral hälsa. Resultatet visar också att tandvårdsrädsla hos 15-åringar har minskat över tid och är vanligare hos flickor. Resultaten pekar på att tandvårdspersonalen har en viktig uppgift i att unga tandvårdspatienter inte utsätts för smärtsam behandling. Framtida forskning av intresse kan vara hur olika sätt att administrera lokalbedövning kan förändra uppfattningen av smärta och nivåer av tandvårdsrädsla.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, Jönköping University, 2015. 77 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 59
Keyword
Adolescents, cross-sectional, dental anxiety, experiences of dental care, oral health, prevalence, psychosocial factors, Erfarenheter av tandvård, oral hälsa, prevalens, psykosociala faktorer, tandvårdsrädsla, tvärsnittsstudie, ungdomar
National Category
Dentistry
Identifiers
urn:nbn:se:hj:diva-26500 (URN)978-91-85835-58-4 (ISBN)
Public defence
2015-06-12, Forum Humanum, Jönköping, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2015-05-11 Created: 2015-05-11 Last updated: 2015-05-11Bibliographically approved

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