Review on dental fear and anxiety factors by DFS

Jin-Sil Hong; Young-Sam Kim; Hae-Jin Lee; Ju-Yeon Kim; Kee-Wan Chang

doi:10.11149/jkaoh.2015.39.4.229

Journal List > J Korean Acad Oral Health > v.39(4) > 1057654

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Hong, Kim, Lee, Kim, and Chang: Review on dental fear and anxiety factors by DFS

Original Article

J Korean Acad Oral Health 2015;39(4):229-236.

Published online: 12 December 2015

DOI: https://doi.org/10.11149/jkaoh.2015.39.4.229

Review on dental fear and anxiety factors by DFS

Jin-Sil Hong, Young-Sam Kim, Hae-Jin Lee, Ju-Yeon Kim, Kee-Wan Chang

Department of Preventive and Community Dentistry, Institute of Oral-bio Science, School of Dentistry, Chonbuk National University, Jeonju, Korea

Corresponding Author: Kee-Wan Chang Department of Preventive and Community Dentistry, Institute of Oral-bio Science, School of Dentistry, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Korea Tel: +82-63-270-4034 Fax: +82-63-270-4035 E-mail: prevdent@jbnu.ac.kr

Received 13 August 2015 Revised 26 October 2015 Accepted 17 November 2015

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The study on dental fear has increased recently. Studies found that people with high dental fear and or anxiety were less likely to visit dentists. The aim of this study is to review the trend of study on dental fear and to analyse the major factors related to dental fear.

Methods

Seventy four papers listed in Korea Citation Index and SCI(E) were assessed. Quality Assessment and Validity Tool for Correlation Studies (QAVTCS) and Dental Fear Study (DFS) were used in this study. SPSS 12.0 was employed to analyse the descriptive statistics, t-test and Multiple Linear Regression (MLR) with stepwise.

Results

The total mean score of QAVTCS for international studies was significantly higher than domestic studies (P=.001). The mean scores of item, ‘Seeing the anesthetic needle’ and ‘Feeling the anesthetic needle’, were severe level (Means= 3.05, 3.14, severe>3.00). According to the MLR, the powerful predisposing factors (independent variable) on ‘Overall fear of dentistry (dependent variable)’ were ‘Hearing the drill’ (P<.01) and ‘Having teeth cleaned’ (P<.05).

Conclusions

It was concluded that people had high dental fear in direct dental treatment environment such as contact with seeing anesthetic needle and hearing dental drill. Therefore, this study suggests the need to map out specific and multidirectional plan for decreasing dental fear.

Keywords: Dental fear, Dental phobia, DFS, Multiple regression, Review

References

1. Cohen LA, Snyder TL, LaBelle AD. Correlates of dental anxiety in a university population. J Pub Health Dent. 1982; 42:228–235.

2. Kleinknecht RA, Klepac RK, Alexander LD. Origins and characteristics of fear of dentistry. J Am Dent Assoc. 1973; 86:842–848.

3. Jun BH. Descriptive literature review on dental fear in Korea (2004-2012). J Korean Soc Dent Hyg. 2014; 14:251–259.

4. Hong SH, Oh JS. A relevant factor analysis on dental treatment fear in some high school students. J Korean Soc Dent Hyg. 2012; 12:741–749.

5. Choi JS, Kim KK. Relationships between dental fear and dental services utilization with respect to oral health promotion. J Korean Soc Health Educ Prom. 2006; 23:47–65.

6. Choi JS, Han SJ, Lee MJ, Han GS. Factors associated with the dental fear level and sub-factors of the dental fear survey scale. J Korean Acad Oral Health. 2009; 33:51–61.

7. Choi SS, Kim JY, Song KB, Lee SK. Analysis of the related factors of dental fear among teenagers in private dental clinics. J Korean Acad Oral Health. 2004; 28:495–503.

8. Dobros K, Hajto-Bryk J, Wnek A, Zarzecka J, Rzepka D. The level of dental anxiety and dental status in adult patients. J Int Oral Health. 2014; 6:11–14.

9. Schuller AA. Are there differences in oral health and oral health behavior between individuals with high and low dental fear? Community Dent Oral Epidemiol. 2003; 31:116–121.

10. Jeon YS. The effect of music listening on anxiety and pain reduction of dental treatment. Korean J Music Therapy. 2004; 6:35–47.

11. Kritsidima M, Newton T, Asimakopoulou K. The effects of lavender scent on dental patient anxiety levels: a cluster randomised controlled trial. Community Dent Oral Epidemiol. 2010; 38:83–87.

12. Cummings G, Estabrooks CA. The effects of hospital restructuring that included layoffs on individual nurses who remained employed: A systematic review of impact. Int J Sociol. 2003; 23:8–53.

13. Estabrooks CA, Floyd JA, Findlay SS, O’Leary KA, Gushta M. Individual determinants of research utilization: a systematic review. J Adv Nurs. 2003; 43:506–520.

14. Estabrooks CA, Goel V, Thiel E, Pinfold P, Sawka C, Williams I. Decision aids: are they worth it? a systematic review. J Health Serv Res Policy. 2001; 6:170–182.

15. Lee JS. Education·psychology·society research methodology. Seoul: Kyoyookbook;2012. p. 174–179.

16. Carter AE, Carter G, Boschen M, AlShwaimi E, George R. Pathways of fear and anxiety in dentistry: a review. World J Clin Cases. 2014; 2:642–653.

17. Kim SK, Kim MH, Choi HJ, Hwang JG. Related factors to dental fear in some adults. J Korean Soc Dent Hyg. 2014; 14:881–886.

18. Lee HY, Na MH, Lee YH. Analysis of related factors for dental fear. J Korean Soc Dent Hyg. 2012; 12:57–65.

19. Kim JH, Jeong HJ, Kim HJ. A Study on personal temperament, dental knowledge and dental fear of high school students. Korean J Health Service Management. 2013; 7:1–12.

Fig. 1.

Flow diagram for data collection.

Fig. 2.

Percentage of the published dental fear articles over period.

Table 1.

Distribution of points of articles in domestic and internationa by Quality Assessment

Point	No. of Domestic	No. of International
4	0	3
5	1	2
6	1	6
7	6	7
8	12	13
9	17	7
10	1	0
11	1	0
Subtotal	39	38
Mean±SD	8.28±1.10	7.21±1.47

Table 2.

Quality Assessment distribution of articles studied accordin to the item of questionnaires

Questionnaire Number	Domestic (%)	International (%)
1	100.0	94.7
2	0.0	21.1
3	100.0	86.8
4	71.8	39.5
5	100.0	100.0
6	87.2	47.4
7	94.9	89.5
8	94.9	89.5
9	0.0	2.6
10	71.8	36.8
11	7.7	13.2
12	97.4	100.0
13	2.6	0.0

^* Questionnaire number was composed 13 items.

Table 3.

General characteristics of articles in this study

Characteristics	Categories	N (%)
Characteristics	Categories	Domestic	Internationa
Sample size	-199	3 (7.7)	13 (37.1)
	200-399	19 (48.7)	2 (5.7)
	400-599	6 (15.4)	5 (14.3)
	600-799	6 (15.4)	3 (8.6)
	800-999	1 (2.6)	0 (0.0)
	1000-	4 (10.3)	12 (34.3)
	Total	39 (100.0)	35 (100.0)
Sample site	Dental clinic	8 (20.0)	15 (42.9)
	School	21 (53.8)	6 (17.1)
	Work place	2 (5.1)	0 (0.0)
	National survey	0 (0.0)	9 (25.7)
	Various	5 (12.8)	1 (2.9)
	Unknown	3 (7.7)	4 (11.4)
	Total	39 (100.0)	35 (100.0)

Table 4.

The mean score according to each DFS question on articles of Korea

Classification	Division	M	SD
Evasion of dental care	Put off appointment	2.15	0.29
	Physiologic arousal	1.87	0.24
	Mean	2.01	0.26
Physiologic arousal	Muscle tenderness	2.35	0.29
	Increasing breathing rate	2.15	0.28
	Perspiration increase	2.13	0.27
	Nausea	1.74	0.25
	Heart rate increase	2.23	0.30
	Mean	2.12	0.24
Fear of specific objects	Making an appointment	2.17	0.27
or stimulations	Approaching dental offic	e 2.30	0.29
	Sitting in waiting room	2.38	0.29
	Sitting in dental chair	2.49	0.38
	Smell of dental office	2.29	0.26
	Seeing the dentist	2.15	0.27
	Seeing anesthetic needle	3.05	0.41
	Feeling anesthetic needle	e 3.14	0.46
	Seeing the drill	2.92	0.40
	Hearing the drill	2.96	0.41
	Feeling the drill	2.98	0.51
	Having teeth cleaned	2.51	0.39
	Mean	2.61	0.33
Overall (DFS 19)		2.42	0.29

Table 5.

Multiple linear regression analysis of dental fear factors and overall fear of dentistry

Variables	B	SE	β	R²	Ad R²	R² change
Constant	―.322	.295
Hearing the drill	1.039	.101	.952**	.906	.897	.906
Having teeth cleaned	.378	.138	.339*	.946	.935	.040

^* P<.05,

^** P<.01 determined from multiple linear regression analysis (Stepwise).

Appendix

Summary of included Study characteristics except references cited

Author (year)	Journal	Study population	Country/Study Site	Age (mean)	Measuring tools	Reliability/Cronbach's α	Analysis	DFS*		Quality Assessment
Author (year)	Journal	Study population	Country/Study Site	Age (mean)	Measuring tools	Reliability/Cronbach's α	Analysis	M	SD	Quality Assessment
Choi et al. (2006)	Korean J Health Edu	1607	Korea/ Schools	13-70	DFS, DBS, DHSS,	-	two-way ANOVA, Multiple regression	52.16	15.71	9
	Promotion		Church, Workplace	(32.8)	SODTD
Jeon et al. (2007)	J korean Soc Den Hyg	281	Korea/ Schools, Church, Workplace	13-70	DFS, SODTD	α=.95	t-test, ANOVA, χ², Multiple regression	52.54	18.81	8
Choi et al. (2008)	J Korean Acad Pediatr Dent	313	Korea/ Schools	13-18	DFS	-	χ², Multiple regression	50.40	17.00	7
Kwon et al. (2010)	Jour. of Kocon.a	420	Korea/ Schools	14-	DFS	α=.89-.97	frequency, ANOVA, Pearson correlation	2.66	1.23	10
Park et al. (2010)	J korean Soc Den Hyg	622	Korea/ Schools	14-16	DFS, DAS	-	frequency, ANOVA, t-test	2.02	-	7
Hwang et al.(2010)	J Dent Hyg Sci	540	Korea/ Schools	20-	DFS, MDAS	-	t-test, ANOVA, correlation	2.35	0.82	7
Sim et al. (2011)	J Korean Acad Pediatr Dent	614	Korea/ Schools	14-16	DFS	-	Mann-Whitney U, χ²	2.00	-	8
Hong et al. (2012)	J Korean Soc Den Hyg	165	Korea/ Schools	17-19	DFS	α=.76-.93	ANOVA, Multiple regression, t-test	1.40	0.53	8
Yoon et al. (2012)	Jour. of Kocona	311	Korea/ clinics	all	DFS	α=.96	frequency, t-test, ANOVA	50.4	16.5	8
Choi et al. (2013)	The J KDA	304	Korea/ Schools	14-16	DFS	-	frequency, t-test, χ²	2.51	-	7
Joo et al. (2013)	J Korean Soc Den Hyg	300	Korea/ Schools	20-	DFS	α=.96	frequency, ANOVA, t-test, Multiple regression	2.41	-	7
Jun et al. (2014)	J Dent Hyg Sci	352	Korea/ Schools	19	DFS	^-	frequenvy, t-test, ANOVA, Correlation, Multiple regression	2.36	0.96	8
Sim et al. (2014)	KJOHSM	347	Korea/ Schools	14-16	DFS	α=.95	frequency, t-test, ANOVA, Multiple regression	3.05	-	8
Mehrstedt et al. (2004)	Anesth Prog	137	Germany/ clinics	16-72	DAS, DFS, SF-36	-	t-test, Perason, χ²	2.88	-	6
Skaret et al. (2005)	Community Dent Oral Epidemiol	666	Norway	23	DSQ, DFS, DBS, GFS, DMFT	α=.77	ANOVA, Pearson, χ², Muliple regression, Logistic regression	2.20	16.40	8
Vika et al. (2008)	Int J Paediatr Dent	1385	Norway/ Schools	18	DFS, IPS-A, MQ	^-	ANOVA, Pearsion, χ², z-test, Muliple regression, Logistic regression,	2.21	17.60	8
Coolidge et al. (2008)	BMC Oral Health	195	Greece/ clinics	18-76	MDAS, DFS	α=.92-.96	t-test, Spearman, χ²	1.97	17.07	9
				(40.3)
Ulla et al. (2012)	BMC Oral Health	500	Sweden	38-50	SOC, DFS, OHPI-14	-	t-test, ANOVA, χ², Multiple regression	1.81	-	8
Spindler et al. (2014)	J Public Health Dent	102	Denmark/ clinics	(40.8)	DAS, DFS	α=.90-.95	t-test, ANOVA, χ², Pearson correlation	3.56	13.42	9
Esa et al. (2014)	BMC Oral Health	503	Island/ Schools	16	DFS, DMFT	α=.70-90	Descriptive, t-test, Mann-whitney U	2.04	12.43	9

^* DFS, dental fear survey; DBS, dentist belief survey; SODTD, self-assessments of oral disease and tissue damage; DHSS, dental hygienist satisfaction survey; DAS, dental anxiety scale; MDAS, modified dental anxiety scale; SF-36, SF-36 health survey; DSQ, dental satisfaction questionnaire; GFS, geer fear scale; IPS-A, ingection phobia scale; MQ, mutilation questionnaire-blood ungury fear and phobia; SOC, sense of coherence; OHPI-14, oral health impact profile-14. *The Dental Fear Survey includes 20 items, each rated 1-5. The results ar presented as mean sum score of as mean sum score ±SD. The mean sum score value ranged from 4 to 20.

TOOLS

Similar articles