DENTAL anxiety or fear has been shown to be associated with the avoidance of regular dental care. Evidence of the adverse health consequences suggests that estimating the prevalence and severity of dental apprehension is important for dental public health.
Show me someone who is not a bit nervous about the dentist working in their mouth while sitting in the dental chair, and I will show you a horse with eight legs. The prevalence of dental anxiety is universal, and although a precise reason for it has not been scientifically confirmed, research is continuously being conducted to elucidate the phenomenon. One such study was recently conducted in Australia, and its results are believed to reflect a global trend.
Dental anxiety has been reported to have an impact on both dental status and the use of dental services. There is an association between dental anxiety and correspondingly greater levels of untreated oral disease, and patterns of care- provision, which are dominated by emergency treatment and irregular dental attendance.
When two Australian scientists studied dental anxiety by using a long (1–2 hour) semi-structured psychiatric interview followed by dental examination, the National Dental Telephone Interview Survey (from random sampling of telephone numbers by computer), and by using Corah’s Dental Anxiety Scale (13 points and above considered severe), they discovered the following:
1. The ‘dental phobics’ showed greater numbers of missing teeth, more loss of alveolar bone through gum disease, and greater denture use, when compared with other subjects.
2. The adults had fewer natural teeth.
3. Those with natural teeth had more missing teeth and fewer filled teeth, but did not differ in the number of decayed teeth.
4. They had four to five times the odds of needing immediate treatment for the relief of pain or infection.
5. The prevalence of dental fear was higher among individuals with lower educational levels and lower social class.
Individuals with high dental anxiety are likely to suffer greater impact from dental conditions, with significantly more toothache, discomfort, and avoidance of some foods. The condition may be a component in a cycle of dental disadvantage among individuals who are afflicted with it. The dental health status of the victims will progressively deteriorate unless the condition is overcome.
It follows that dentally anxious individuals are more likely to experience a marked social impact from impairing oral diseases; that is, not only are they more likely to avoid care, but they are also more likely to require it, and they suffer the dental and social consequences of not seeking it. However, the good news is that people can overcome dental anxiety to the extent that they may enjoy good oral health, just like anyone else. I will deal with the solution to dental anxiety in a later article.