The extent and nature of dental fear and phobia in Australia

Abstract

Background: For the general dental practitioner, fearful patients are harder and more stressful to treat and are most likely to attend irregularly. This study presents updated and refined dental fear and phobia prevalence estimates in Australia as well as information on the nature of dental fear and phobia. Methods: A total of 1084 Australian adults (response rate = 71.7%) completed a mailed questionnaire. The survey contained four measures of dental fear and phobia, as well as questions regarding potentially anxiety-eliciting dental stimuli and past aversive dental experiences. Results: The prevalence of high dental fear ranged from 7.8% to 18.8%, and more incapacitating dental phobia from 0.9% to 5.4%, depending upon the scale, cut-point and specific criteria used. Dental phobia was significantly associated with blood-injection-injury (BII) concerns. The cost of dental treatment was endorsed as the most anxiety-eliciting dental situation (64.5%), followed by fear of needles ⁄ injections (46.0%) and painful or uncomfortable procedures (42.9%). Anxiety-eliciting stimuli and the type of aversive dental experiences varied significantly by gender, age, income, education, language spoken at home and dental visiting frequency. Conclusions: High dental fear and dental phobia are common in Australia although prevalence estimates are highly dependent on both the scale and cut-points used.

Management of fear and anxiety in the dental clinic: a review

“…High dental fear affects approximately one in six Australian adults 1,2 and this prevalence figure is similar to that of many Western countries around the world. [3][4][5][6][7] Among some sub-groups of the population, such as middle-aged women, the prevalence of high dental fear may be as high as one in three individuals.…”

“…22 Second, while it appears that dentally fearful people do report increased fear of pain, 23 the extent of this varies from person to person and there are numerous additional fear-evoking aspects of a dental visit unrelated to pain. 2,24 There are also more general issues, such as lack of control and the unpredictability of the dental experience, which may be central to the aetiology of a person's dental fear, and these are discussed in more detail below.…”

Evaluation of children’s dental anxiety levels at a kindergarten and at a dental clinic

“…22,24,27,28,29 In this study, most mothers were highly educated, and there was no reported history of phobic tendencies with dental treatment, so we cannot make any claims regarding a relationship between a child's dental anxiety level and their family's sociodemographic characteristics.…”

Validation and Invariance of the Dental Anxiety Scale in a Brazilian sample

“…27,30 Next, the above analyses were performed on specific participant subgroups, based on gender, age, socioeconomic level, and previous unpleasant dental experiences, which are supported by the literature as having a significant impact on dental anxiety. The literature reports that women, 16,17,19 younger patients, 17 patients at lower socioeconomic levels, 5,19 and with previous unpleasant dental experiences 18 present greater anxiety over dental treatment. These findings may reflect a pattern of response that is distinct to the items of the DAS.…”

“…The MDAS includes a question on local anesthesia, since needle fear, phobia, and anxiety is very common in the general population. [19][20][21] However, anxiety over anesthesia may be related to the use of needles in general and not directly associated with dental treatment anxiety; needle anxiety and/or phobia has been well described in the literature. 22,23,24,25 Thus, the inclusion of this item may interfere in the true assessment of dental anxiety, since procedures involving needles are not exclusive to dentistry and, while interesting, it may overestimate anxiety over dental treatment itself.…”