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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1713-1716  

Assessment of anxiety associated with the dental treatments on the quality of life: An original research


1 Department of Orthodontics and Dentofacial Orthopeadics, Advance Dental Care, Bokaro Thermal, Jharkhand, India
2 Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India
3 Department of Pedodontist and Preventive Dentist, Mumbai, Maharashtra, India
4 Department of Periodontist and Oral Implantologist, Jalandhar, Punjab, India
5 Department of Periodontics, Faculty of Dentistry, AIMST University, Bedong, Kedah, Malaysia
6 Department of Oral and Maxillofacial Surgery, Hazaribagh College of Dental Sciences and Hospital, Hazaribagh, Jharkhand, India

Date of Submission26-Feb-2021
Date of Decision11-Mar-2021
Date of Acceptance26-Mar-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Sneha Thakur
Department of Orthodontics and Dentofacial Orthopeadics, Advance Dental Care, Bokaro Thermal, Jharkhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_108_21

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   Abstract 


Background: Patients around the world when attending the dental clinic are prone to undergo the feelings of fear and anxiety. This may impact the dental follow-up and prognosis. Aim: The aim of the study is to evaluate the dental anxiety in the patients attending for the dental treatment in a college, in India. Materials and Methods: A sample of 500 adults with ages 15–60 years was considered for the study. Modified dental anxiety questionnaire was used in the present study to assess the anxiety faced by the patients attending for the dental treatment. ANOVA and Chi-square test were used to test for the significance between the variables, and the correlation between these variables was assessed using the Spearman's correlation. Likert scale was used to know the cutoff for the severity of the dental anxiety. Results: Only in the 4% of the participants in the present study had dental anxiety. Gender, age, financial status, education impacted the dental anxiety and the regularity toward the appointments. Conclusion: It can be concluded from our study that there was a low anxiety in the dental patients toward the dental treatment and also anxiety decreased with the age. However, regular dental visits are advised to prevent the overall impact of the oral health on the general health.

Keywords: Dental anxiety and fear, modified dental anxiety scale, socioeconomic status


How to cite this article:
Thakur S, Kadam H, Jha S, Lall A, Kondreddy K, Singh A. Assessment of anxiety associated with the dental treatments on the quality of life: An original research. J Pharm Bioall Sci 2021;13, Suppl S2:1713-6

How to cite this URL:
Thakur S, Kadam H, Jha S, Lall A, Kondreddy K, Singh A. Assessment of anxiety associated with the dental treatments on the quality of life: An original research. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Aug 12];13, Suppl S2:1713-6. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1713/329937




   IntroductionW Top


Patients around the world when attending the dental clinic are prone to undergo the feelings of fear and anxiety. Ever changing technology and the innovations in the dental practices have added a little to the evasion of the common fear of the patient when attending the clinic.[1] There are various classifications and subclassifications of the anxiety and fear.[2] The dentists are quite commonly faced with the patients being anxious and apprehensive of the dental treatments that are seen irrespective of age and socioeconomic class. However, the factors such as previous traumatic experiences and domestic climates are seen to impact the patient attending the dental treatment. It has been shown in few studies that this may lead to the irregular follow-ups in the dental patients.[3],[4],[5],[6],[7] To have a good prognosis and the treatment success, the factors associated with the dental anxiety are to be explored and assessed. Dental anxious patients can be easily recognized as they often defer the regular visits and have typical signs like they sit at the edge of dental chair, are visibly apprehensive, look unrelaxed, and are easily startled. Similar behavior can be seen in the children that may hamper the dental and overall heath.[8],[9],[10],[11],[12] In this study, we evaluated the anxiety in the patients attending the dental treatment.


   Materials and Methods Top


Modified dental anxiety questionnaire was used in the present study to assess the anxiety faced by the patients attending for the dental treatment. After taking the ethical clearance, a total of 500 participants were selected between the ages 15 and 60 for the study that was conducted for 10 months from November 2019 to July 2020 in a dental college in India. Edentulous, uncooperative patients, and the individuals who did not give assent were exempted from the study. Information was gathered through the modified dental anxiety scale (MDAS) adjusted from Corah NL.[13] Sociodemographic variables such as age and sex, economic and education status, and previous dental experiences were collected. The survey was pretried and preapproved through a pilot study and its Cronbach's alpha worth was discovered to be 0.830. A moral leeway was appropriately gotten from the moral council of Dental Institution. Statistical analysis was done using IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp. ANOVA and Chi-square test were used to test for the significance between the variables, and the correlation between these variables was assessed using the Spearman's correlation.


   Results Top


Among the 500 participants, almost equal distribution of the male and female participants (50.3, 49.7) was seen. There was a significant difference noted in the age distribution with the majority in the group of 15–29 years (68.31). When the education levels, financial status, and visits to dentist were considered, no significant difference was noted. Significant difference in attitude was seen in those who had a previous dental visit and it can be noted to be a good experience [Table 1].
Table 1: Distribution of the sociodemographic variables in the present study

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Majority (86.65%) of the participants in the present study were observed to be postponing their dental visits due to the anxiety and the fear and it was statistically significant (P = 0.001) [Table 2].
Table 2: Percentage of the patients having dental anxiety and hence postponing the treatments

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Few observations were made in our study when the various factors related to the patients, and the dental anxiety was correlated. It was noted that there was a significant impact of the gender on the dental anxiety. However, there was an inverse relation between the financial status and the age was seen. Deferment of the dental treatment directly affects dental anxiety [Table 3]. Based on the severity of the anxiousness five questions, each of five points on the Likert scale was given. For the total points of 25, 19 points were considered as the cutoff point that specified an extremely dentally anxious patient, possibly dentally phobic.[13],[14] In only 20 (4%) participants, dental anxiety was observed [Table 4].
Table 3: The correlation between anxiety scores and the variables in the study

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Table 4: Distribution of the participants among the various scores

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   Discussion Top


In the present study, we used the MADS, for the assessment of the dental anxiety as it had the Cronbach's alpha values 0.83 that was similar to Indian version 0.781.[15] We observed that very few participants showed dental anxiety (4%). Furthermore, it was observed that majority of the patients who had dental anxiety were in the habit of postponing the dental treatments. This could have been associated with a previous dental negative experience. Our observations in the study where we found that dental anxiety was seen more in less educated people and who had a negative previous experience with the dental treatment, were similar to the study of Acharya[15] and Yuan et al.[16] However, the present observations were in contradiction to the studies of Pavi et al.[17] and Stole et al.[18] In the study of Moore and Brødsgaard,[4] they studied the dental anxiety in Danish patients and concluded that the dental anxiety was related with the financial, educational, and professional backgrounds of the patients which is similar to the outcome observed in our study. In the study of Kumar et al.,[19] they attempted to find the role of the dental anxiety on the oral health-related quality of life. They observed that women were more anxious and that negatively influenced the overall health in women than men. Men were seen to be less anxious than women, but the differences were not seen to be significant. Similar findings were also reported in the study of Morse.[20] We observed that as the age progressed, the anxiety also decreased. Similar observations were seen in the study of Udoye et al.[21] among the Nigerian patients undergoing various dental treatments where they also noted a decrease in anxiety with the age. This observation was supported in the studies of Locker and Lindell[22] and Neverlien.[23] In the present study, the reason for the postponement of the dental visits was observed to be the dental anxiety. Similar observations were made by Hägglin et al.[24] However, in our study, we have taken care to avoid the bias such as selection and recall bias. Longitudinal studies are warranted to know over long-term impact of the dental anxiety.


   Conclusion Top


The dental treatments include procedures which might look and sound fearful to some and may increase anxiety in the patients. It can be concluded from our study that there was a low anxiety in the dental patients toward the dental treatment and also anxiety decreased with the age. However, regular dental visits are advised to prevent the overall impact of the oral health on the general health. Efforts are to be made to cater to the various factors that create the anxiety in patients and improve the dental visits.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Kvale G, Berg E, Raadal M. The ability of Corah's Dental Anxiety Scale and Spielberger's State Anxiety Inventory to distinguish between fearful and regular Norwegian dental patients. Acta Odontol Scand 1998;56:105-9.  Back to cited text no. 1
    
2.
Bhalla A, Singh SB, Sujata H, Singh A, Choudhary A. Self-assessment of dental anxiety in patients visiting comprehensive rural health service project. J Depress Anxiety 2013;2:137-41.  Back to cited text no. 2
    
3.
Locker D, Shapiro D, Liddell A. Negative dental experiences and their relationship to dental anxiety. Community Dent Health 1996;13:86-92.  Back to cited text no. 3
    
4.
Moore R, Brødsgaard I. Dentists' perceived stress and its relation to perceptions about anxious patients. Community Dent Oral Epidemiol 2001;29:73-80.  Back to cited text no. 4
    
5.
Dailey YM, Humphris GM, Lennon MA. Reducing patients' state anxiety in general dental practice: A randomized controlled trial. J Dent Res 2002;81:319-22.  Back to cited text no. 5
    
6.
McGrath C, Bedi R. The association between dental anxiety and oral health-related quality of life in Britain. Community Dent Oral Epidemiol 2004;32:67-72.  Back to cited text no. 6
    
7.
Milgrom P, Weinstein P, Rubin J. Assessing patients' fears. Dentistry 1986;86:14-7.  Back to cited text no. 7
    
8.
Gift HC, Atchison KA. Oral health, health, and health-related quality of life. Med Care 1995;33:NS57-77.  Back to cited text no. 8
    
9.
Enkling N, Marwinski G, Jöhren P. Dental anxiety in a representative sample of residents of a large German city. Clin Oral Investig 2006;10:84-91.  Back to cited text no. 9
    
10.
Stouthard ME, Hoogstraten J. Prevalence of dental anxiety in The Netherlands. Community Dent Oral Epidemiol 1990;18:139-42.  Back to cited text no. 10
    
11.
Locker D, Shapiro D, Liddell A. Overlap between dental anxiety and blood-injury fears: Psychological characteristics and response to dental treatment. Behav Res Ther 1997;35:583-90.  Back to cited text no. 11
    
12.
Seeman K, Molin C. Psychopathology, feelings of confinement and helplessness in the dental chair, and relationship to the dentist in patients with disproportionate dental anxiety (DDA). Community Dent Oral Epidemiol 1999;27:19-24.  Back to cited text no. 12
    
13.
Corah NL. Development of a dental anxiety scale. J Dent Res 1969;48:596.  Back to cited text no. 13
    
14.
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. 14
    
15.
Acharya S. Factors affecting dental anxiety and beliefs in an Indian population. J Oral Rehabil 2008;35:259-67.  Back to cited text no. 15
    
16.
Yuan S, Freeman R, Lahti S, Lloyd-Williams F, Humphris G. Some psychometric properties of the Chinese version of the Modified Dental Anxiety Scale with cross validation. Health Qual Life Outcomes 2008;6:22.  Back to cited text no. 16
    
17.
Pavi E, Kay EJ, Stephen KW. The effect of social and personal factors on the utilisation of dental services in Glasgow, Scotland. Community Dent Health 1995;12:208-15.  Back to cited text no. 17
    
18.
Stole AC, Holst D, Schuller AA. Decreasing numbers of young adults seeking dental care on yearly basis. A reason for concern? Nor Tannlaegeforen Tid 1999;109:392-5.  Back to cited text no. 18
    
19.
Kumar S, Bhargav P, Patel A, Bhati M, Balasubramanyam G, Duraiswamy P, et al. Does dental anxiety influence oral health-related quality of life? Observations from a cross-sectional study among adults in Udaipur district, India. J Oral Sci 2009;51:245-54.  Back to cited text no. 19
    
20.
Morse Z. Dental anxiety is very high in the Republic of Kiribanti. South Pac Stud 2007;28:23-30.  Back to cited text no. 20
    
21.
Udoye CI, Oginni AO, Oginni FO. Dental anxiety among patients undergoing various dental treatments in a Nigerian teaching hospital. J Contemp Dent Pract 2005;6:91-8.  Back to cited text no. 21
    
22.
Locker D, Liddell AM. Correlates of dental anxiety among older adults. J Dent Res 1991;70:198-203.  Back to cited text no. 22
    
23.
Neverlien PO. Assessment of a single-item dental anxiety question. Acta Odontol Scand 1990;48:365-9.  Back to cited text no. 23
    
24.
Hägglin C, Hakeberg M, Ahlqwist M, Sullivan M, Berggren U. Factors associated with dental anxiety and attendance in middle-aged and elderly women. Community Dent Oral Epidemiol 2000;28:451-60.  Back to cited text no. 24
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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