Abstract
BackgroundThe Cognitive Vulnerability Model proposes that perceptions of certain characteristics of a situation are critical determinants of fear. Although the model is applicable to all animal, natural environment and situational fears, it has not yet been applied specifically to dental fear. This study therefore aimed to examine the association between dental fear and perceptions of dental visits as uncontrollable, unpredictable and dangerous.MethodsThe study used a clustered, stratified national sample of Australians aged 15 years and over. All participants were asked in a telephone interview survey to indicate their level of dental fear. Participants who received an oral examination were subsequently provided with a self-complete questionnaire in which they rated their perceptions of uncontrollability, unpredictability and dangerousness associated with dental visiting.Results3937 participants were recruited. Each of the three vulnerability-related perceptions was strongly associated with the prevalence of high dental fear. In a logistic regression analysis, uncontrollability and dangerousness perceptions were significantly associated with high dental fear after controlling for age and sex. However, unpredictability perceptions did not have a statistically significant independent association with dental fear after controlling for all other variables.ConclusionResults are mostly consistent with the Cognitive Vulnerability Model of the etiology of fear, with perceptions of uncontrollability, unpredictability and dangerousness each showing a strong bivariate relationship with high dental fear prevalence. However, more extensive measures of vulnerability perceptions would be valuable in future investigations.
Highlights
The Cognitive Vulnerability Model proposes that perceptions of certain characteristics of a situation are critical determinants of fear
Research has consistently shown that people with dental fear are more likely to delay dental appointments [7,8] and there is some evidence that this may set up a vicious cycle of dental fear, whereby delayed dental visiting allows the continued progression of oral disease which may lead to the requirement for emergency treatment which serves to exacerbate or maintain the
Study participants were from a larger computer assisted telephone interview (CATI) survey of the Australian public contacted as part of the National Survey of Adult Oral Health (NSAOH), conducted in Australia between 2004 and 2006 [31]
Summary
The Cognitive Vulnerability Model proposes that perceptions of certain characteristics of a situation are critical determinants of fear. Dental fear has a high prevalence in many western countries [13,14] yet it is the serious oral health consequences of dental fear that stand it apart from many other specific fears and which make it such an important area of study It is often assumed, by practitioners and the lay public alike, that dental fear is a result of having had a painful or unpleasant past experience associated with a dental examination or procedure. By practitioners and the lay public alike, that dental fear is a result of having had a painful or unpleasant past experience associated with a dental examination or procedure Consistent with this belief, many studies have found instances of aversive past dental experiences among dental phobics [15,16,17,18,19] and interviews with dental phobics often reveal numerous traumatic experiences, sometimes spanning decades [20]. Being afraid of the dentist appears to relate to a number of other fears [23,24,25], which we would not expect where it merely a function of learning experiences
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