Nigerian dental anxiety, fear, and phobia: A prevalence review

Objective To find out the prevalence of dental anxiety and fear amongst patients in various selected dental clinics in Accra, Ghana. Study design Dental patients ( n = 279) who had either been exposed to dental treatments or had no prior dental exposure, attending four selected dental clinics in Accra were randomly sampled. They were interviewed with the Modified Dental Anxiety Scale (MDAS) used to evaluate dental anxiety, and the Dental Fear Survey (DFS) used to measure dental fear among the respondents. Results A high level of dental anxiety was found in 13.6 per cent of the study sample, while 47.3 per cent were fearful of various dental treatments. Female patients recorded a higher DFS score than males (22.84 ± 9.87 and 19.7 ± 8.15 respectively). The MDAS showed a significant difference between the sexes (X2 = 6.912, p = 0.032). The DFS showed a significant difference (F = 2.56, p = 0.039) existing within the age group, with the younger age group showing the highest DFS value. There was no significant difference between the mean scores of the MDAS and the DFS of the study group with regard to educational level. Previous dental experience did not have any impact on fear or anxiety levels ( p > 0.05) Conclusions Dental anxiety and fear has been found to be high amongst dental patients in Ghana. Females are more likely to report higher dental anxiety and fear scores than males. Dental surgeons and the whole dental team should be made aware of this situation and the appropriate treatment plan created for an anxious or fearful patient.

The aim of the study was to assess the prevalence of dental fear and anxiety among children aged 4-13 years using three fear scales, i.e., facial image scale (FIS), Nepalese version of Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Modified Child Dental Anxiety Scale (MCDAS). The study was conducted on 300 children (4-13 years) who visited the Department of Pedodontics and Preventive Dentistry. The fear and anxiety levels were measured using three fear measurement scales, i.e., FIS, Nepalese version of CFSS-DS, and MCDAS. The dental behavior observed was rated according to the Frankl's Behavior Rating Scale (FBRS). The prevalence of dental fear according to FIS was 11.9% as evident from children having FIS 4 and 5 scores. Dental fear with CFSS-DS ≥38 was identified in 49 children (21 [12.5%] male and 28 [21.21%] female). In assessment of the behavior of children in the clinics through FBRS, it was observed that the maximum number of respondents (70.6%) showed Frankl's rating 3, i.e., positive. The Nepalese versions of the CFSS-DS and the MCDAS are both reliable and valid scales for evaluating dental anxiety and fear in young children. Assessing dental anxiety and fear is useful, as behavior management can be designed accordingly for child patients.

INTRODUCTION: Anxiety is a common problem frequently experienced by patients undergoing dental procedures in every dental setting. The present study aimed to assess the prevalence of dental anxiety among the patients visiting the Out Patient Department (OPD) of a Dental Institution in Panchkula, Haryana.MATERIALS & METHOD: A sample of 600 adults (Females =298, Males = 302) with age ranging from 21 years to 65 years were enrolled in the study. The Modified Dental Anxiety Scale was used to measure dental anxiety among the study population. Chi Square test and ANOVA was used to find significant comparisons between the different variables assessed in the study. Further, Spearman’s Correlation was used to analyse these variables with the mean anxiety scores of the patients.RESULTS: The prevalence of anxiety among patients was found to be high. Reportedly the level of anxiety was found more in females than in males. It was revealed that with advancing age and higher education level, there was a decrease in level of anxiety, postponement of the dental treatment had a direct effect on dental anxiety. Previous unfavourable dental experience has a high impact on dental anxiety scores.CONCLUSION: Evaluation of anxiety levels in the subjects of this study suggests that majority of them are anxious towards dental treatment. Dental anxiety is one of the major barrier in the utilization of dental services. There is a strict need of directing efforts towards alleviation of this hindrance to provide a good quality dental care to the needy population.

Background/purpose: Fear from dental treatment is widespread distressing problem for the dentist. Anxiety may have an impact to the dentist-patient relationship and it may cause to misdiagnosis. Therefore, this study aimed to assess the levels of dental anxiety and fear among medical students at University of Thamar.Materials and methods: Dental anxiety scale (DAS) and Dental Fear Survey (DFS) were completed by one hundred undergraduate medical students. Cross-tabulations were applied to determine the levels of DAS and DFS. Pearson’s correlation was used to analyse the association among the dental anxiety measurements. Pearson’s correlation also was used to investigate the association between DAS and DFS tests. Results: The prevalence of moderate dental anxiety in this sample was 51%, while both 12% of the sample was characterized with high and severe dental anxiety. There were association for question #1 to question #3 (0.368, p = 0.000) and question #4 (0.133, p = 0.191). Furthermore, the question #2 showed association with question #3 (0.362, p = 0.000) and question #4 (0.250, p = 0.013). However, the lowest relationship (0.088, p = 0.387) was noticed between question #3 and question #4. Respondents who reported moderate dental fear were 79%, whereas 12% of the sample was characterized with high dental fear. Pearson’s correlation between DAS and DFS tests was 0.142 with p-value = 0.158.Conclusions: The overall dental anxiety and fear from dental treatment was still high. Therefore, more prevention protocols and dental health educational programs are recommended for employing in Yemeni universities.

Background: In spite of advances in dentistry, anxiety about dental treatment and thefear of pain remains public health problem and is a significant impediment todental treatment. The purpose of this study was to assess the levels of dentalanxiety in patients who referred to Al-Mustansiriyah dental clinics and Al-ShiekhOmar specialized dental center in Baghdad and their relation to their gender, age,educational level.Materials and methods: The study was done on (800) patients, aged (20-59) years inBaghdad. The survey form was prepared and translated from English to Arabiclanguages by certified translator and were filled by patients themselves withoutany help from dentists. Patients with mental retarded, those who not havingcompleted the survey form and those below 20 years and above 59 years wereexcluded. The survey was divided into 3 parts (socio-demographic information,Modified dental anxiety scale (MDAS) and Dental fear survey (DFS).Results: The present study showed that females had higher anxiety (13.57, 47.38)than males (8.98, 37.75) for Modified dental anxiety scale and Dental fear surveyrespectively. The anxiety decreased with advance of age (12.31, 11.41, 10.89,10.45 for Modified dental anxiety scale and 43.10, 41.22, 38.69, 37.93 for Dentalfear survey) in groups (1,2,3,4) respectively. The anxiety decreased with advanceof teaching, so the uneducated patients had higher mean of anxiety (14.45, 48.59)while the postgraduate patients had lower anxiety (9.10, 36.30) for Modifieddental anxiety scale and Dental fear survey respectively than others. There washigh significant difference between males and females at P-value (≤ 0.01) for bothModified dental anxiety scale and Dental fear survey scales.Analysis of variance (ANOVA) test showed high significant difference among agegroups and among education level groups at P-value (≤ 0.01) for both Modifieddental anxiety scale and Dental fear survey scales. The higher percentage ofanxiety scales was appeared in minimal anxiety score in males (56%, 48%) inModified dental anxiety scale and Dental fear survey respectively, while lessorpercentage was appeared in very high anxiety score in males (5.1%, 5.5%) inModified dental anxiety scale and Dental fear survey respectively. Pearson'scorrelation coefficient (R) showed that there was a positive relationship betweengender and anxiety scales, with statistically high significant at P-value (≤ 0.01).While, there was inverse relationship between age and anxiety scales, and between education and anxiety scales with statistically high significant at P-value (≤ 0.01)for both relations.Conclusion: The females had higher rate of anxiety than males. The anxietydecreased with advance of age and education level of patients. There was a strong(positive) relationship between gender and anxiety. While, there was inverse(negative) relationship between anxiety with age and education.

Background and Objectives: The aim of this study was to investigate the prevalence of dental anxiety, its association with self-reported oral health, and sociodemographic factors in adults that are critical for improving oral health and well-being. Materials and Methods: An online survey was conducted via social media, with 1551 adults (76.5% women, 23.5% men) participating nationwide. Data collected included demographic data, Modified Dental Anxiety Scale (MDAS) scores, and associations between dental anxiety, negative experiences, and self-reported oral health. The analysis included psychophysiological, behavioural, and emotional responses and avoidance of dental visits, using descriptive and generalised linear regression models. Results: This study found that the mean score of the MDAS was 9.70 ± 5.11 out of 25, 19.1% of the participants reported no dental anxiety, and 7.8% suffered from dental phobia. Gender, age, and socioeconomic status had no significant effect on the prevalence of anxiety. Although more than half of the participants reported negative dental experiences, particularly in childhood, anxiety levels were unaffected. However, those who rated their oral health as excellent or very good had lower anxiety scores (p = 0.008, p = 0.024). Among the dental procedures, oral surgery (58.7%) and prosthetic (restorative) dental treatments (15.2%) caused the most anxiety. Avoidance behaviour correlated with increased anxiety (p ≤ 0.001), as did postponing dental visits until severe pain occurred (p = 0.011). Conclusions: These results emphasise the significant prevalence of dental anxiety in adults, particularly for surgical procedures and drilling, posing challenges in patient management. Tailored strategies are essential to reduce anxiety, improve patient well-being, and optimise dental service delivery and treatment efficacy.

BackgroundDental anxiety continues to be a widespread problem affecting adult populations. The primary aim of our study was to evaluate the psychometric properties of the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A) and to identify the optimal cut-off for assessing dental anxiety and dental phobia among adults in Lebanon. In addition, we sought to assess dental anxiety and phobia as well as their correlates among Lebanese adult patients.MethodsA cross-sectional study was carried out on a sample of 451 dental adult patients aged between 18 and 65 years old. Information about demographic characteristics, previous bad dental experience, trauma’s experience period, perception of a periodontal problem, sensation of nausea during dental treatment, the MDAS-A scale, and the Visual Analogue Scale for anxiety (VAS-A) were collected.ResultsMDAS-A exhibited evidence of adequate psychometric properties. The optimal cut-off was 12 for dental anxiety and 14 for dental phobia. Out of the total sample, 31.5% suffered from dental anxiety while 22.4% had a dental phobia. Multivariable analysis showed that the odds of dental anxiety and phobia were higher among females compared to males. Also, patients suffering from periodontal problem perceptions, bad dental experiences during childhood and adolescence, and the sensation of nausea during dental treatment were at a higher risk of developing dental anxiety and phobia compared to their counterparts. However, a higher level of education was found to be a protective factor against dental phobia among Lebanese adult patients.ConclusionThe MDAS-A scale is a suitable tool for the routine assessment of dental anxiety and phobia among Lebanese adult patients. Identifying patients with dental anxiety at the earliest opportunity is of utmost importance for delivering successful dental care.

The current study aims to address the patient's dental anxiety (DA) And dental fear (DF) under the treatment of a general practitioner (GP) among different parameters. The cross-sectional study included 500 patients recruited from different clinics in Jazan, Saudi Arabia. Data were collected through a questionnaire-based form consisting of three parts; the first part was personal and demographic questions whereas the second and third parts were a modified dental anxiety scale (MDAS) and a dental fear survey (DFS) to measure DA and DF among patients. Spearman's correlation was used to measure the relation between DA and DF as well as Chi-square tests and logistic regression analyses for analyzing the effect of each variable on DA and DF. All patients fulfilled their eligibility criteria. A high percentage was found in moderate anxiety (36.8%) as well as in moderate fear (46.2%) among different anxiety and fear scales. The association between DA and DF was positively significant (p <0.01). There was a significant effect of gender, age, education, khat use, marital status, monthly income, and type of clinic on patients' DA and DF. There is a positive relation between MDAS and DFS, thus the DA affects the DF. Female patients had a lower DA and DF than male patients. Furthermore, the government clinics had the highest DA and DF prevalence levels for patients. Moreover, the high school-graduated patients seem to have a high DA and DF vs other patient educational levels. It would be beneficial to include an educational training program about psychological patient management in the study curriculum as well as to be offered as a special course to newly graduated dentists. This modification will aid to improve the GPs to get rid of DA and DF patients. How to cite this article: AlDhelai TA, Al-Ahmari MM, Adawi HA, et al. Dental Anxiety and Fear among Patients in Jazan, Kingdom of Saudi Arabia: A Cross-sectional Study. J Contemp Dent Pract 2021;22(5):549-556.

ABSTRACTThis study compared prevalence and risk factors of dental anxiety between men and women. The sample consisted of 244 participants (n = 122 men) aged 18 years or older who sought dental care at a public Dental Education Institution from March 2018 to November 2019. The Modified Dental Anxiety Scale was used to determine presence of dental anxiety. The following risk factors were recorded: age, years of schooling, preoperative pain, and type of dental treatment. Bivariate analysis was used to assess the difference in dental anxiety between the sexes. Multivariate logistic regression was used to analyze the association between dental anxiety and gender, regardless of the influence of other variables. Total prevalence of dental anxiety was 18% (n = 44), 22.9% (28/122) in women and 13.1% (16/122) in men (p = 0.04). Gender (odds ratio: 1.83, 95% confidence interval: 0.92–3.62) and preoperative pain (odds ratio: 2.095, 95% confidence interval: 0.97–4.49) were associatedwith dental anxiety. We concluded that women had a higher prevalence of dental anxiety. Preoperative pain was associated with dental anxiety regardless of gender.

ABSTRACTAimThis study focused on the Modified Dental Anxiety Scale to determine the prevalence of dental anxiety and assess the psychometric properties in Nigerian population.Materials and methodsIncluded in the study were 619 participants (204 males and 415 females) chosen conveniently from among the dental patients, students of post basic nursing and staff nurses, all from University of Benin Teaching Hospital, Benin City, Nigeria. The mean age was 31.34 (11.77) years. Participants completed a questionnaire containing the Modified Dental Anxiety Scale.ResultsThe prevalence of high dental anxiety was found to be 10.7% at the cut-off point ≥ 19. Cronbach's alpha for the present Nigerian sample was 0.80. Factor analysis revealed one factor with an eigenvalue greater than 2. This factor explained 55.9% of the variance of the items. In addition, the MDAS showed a significant difference between the genders, with the female (X̄ =13.86;SD= 4.64) reporting higher dental anxiety score than the male (X̄ =12.62;SD= 4.73).ConclusionMDAS demonstrated satisfactory and acceptable psychometric properties. Therefore, dental surgeons, clinical psychologists, psychiatrists and other therapists can use MDAS as an objective tool for detecting and possible management of high dental anxiety in Nigeria.How to cite this articleKoleoso ON, Akhigbe KO. Prevalence of Dental Anxiety and the Psychometric Properties of Modified Dental Anxiety Scale in Nigeria. World J Dent 2014;5(1):53-59.

BackgroundDental fear is a prevalent problem that can lead to poor dental health. The Kleinknecht’s Dental Fear Survey (DFS) is one of the used scales to assess dental fear. The present study aims to evaluate the psychometric properties of the Lebanese Arabic version of the DFS (DFS-A) and to determine the optimal cut-off to identify dental fear as well as the correlates of dental fear in a group of Lebanese adults dental patients.MethodsA cross-sectional study was conducted among a group of 442 dental patients (18–65 years) recruited at 29 dental clinics from March to June 2019. Patients completed a questionnaire including questions about demographic characteristics, previous bad dental experience, trauma’s experience period, the sensation of nausea during dental treatment, the DFS-A scale, the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A), and a general question about dental fear.ResultsDFS-A revealed evidence of adequate psychometric properties. DFS-A scale demonstrated high internal consistency (cronbach’s alpha = 0.93). Test–retest reliability assessment demonstrated strong reproducibility of the DFS-A scale score (ICC = 0.92 with 95% CI (0.83–0.96), p value < 0.0001 (N = 30). Confirmatory factor analysis revealed a three-factor structure of the DFS-A reflecting fear associated with specific dental stimuli and procedures, patterns of dental avoidance and anticipatory anxiety, and physiologic arousal during dental treatment. A significant correlation was found between DFS-A and the MDAS-A indicating a good convergent validity. The optimal cut-off point to identify patients with and without dental fear is 41. Considering this cut-off score, the prevalence of dental fear in our sample was reported at 33.8%. Multivariable analysis showed that having previous scary and painful dental experiences, a sensation of nausea during treatment, and having dental anxiety were identified as predictors of dental fear.ConclusionThe adapted Arabic version of the DFS (DFS-A) is a valid tool to evaluate dental fear among Lebanese adult patients.

Background: Dental anxiety has been associated with several negative effects on patients and communities’ oral health. The objective of this study was to assess the prevalence and factors associated with dental anxiety among primary school teachers in Ngara district, Tanzania. Methods: This descriptive cross-sectional study utilized self-administered questionnaire to collect socio-demographic and behavioural details. A Kiswahili version of the Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety. Results: The Kiswahili version of MDAS showed good face validity and reliability with standardized Cronbach’s alpha coefficient of 0.86. The prevalence of high dental anxiety (MDAS≥ 19) was 1.2%. A significant higher percentage of schoolteachers with dental anxiety was observe among those with low education; who visited a dentist at least once in the past two years; and those who visited the dentist when having a dental problem. Sex, age, marital status and perceived oral health status did not show a significant difference. Conclusion: The Kiswahili version of MDAS showed acceptable psychometrics. The prevalence of dental anxiety among school teachers in a rural district of Ngara in Tanzania was low. To maintain the low prevalence of dental anxiety and subsequently reducing it, oral health education and promotion on preventive dental heath seeking behaviours is advocated.

How to evaluate adolescents’ dental anxiety? A review of instruments

Background: Dental anxiety has been associated with several negative effects on patients and communities’ oral health. The objective of this study was to assess the prevalence and factors associated with dental anxiety among primary school teachers in Ngara district, Tanzania.Methods: This descriptive cross-sectional study utilized self-administered questionnaire to collect socio-demographic and behavioural details. A Kiswahili version of the Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety.Results: The Kiswahili version of MDAS showed good face validity and reliability with standardized Cronbach’s alpha coefficient of 0.86. The prevalence of high dental anxiety (MDAS≥ 19) was 1.2%. A significant higher percentage of schoolteachers with dental anxiety was observe among those with low education; who visited a dentist at least once in the past two years; and those who visited the dentist when having a dental problem. Sex, age, marital status and perceived oral health status did not show a significant difference.Conclusion: The Kiswahili version of MDAS showed acceptable psychometrics. The prevalence of dental anxiety among school teachers in a rural district of Ngara in Tanzania was low. To maintain the low prevalence of dental anxiety and subsequently reducing it, oral health education and promotion on preventive dental heath seeking behaviours is advocated.

Purpose: The purposes of this study were to investigate the relationship between dental anxiety amongst pregnant women and their dental attendance patterns, considering various sociodemographic factors, at health centers in the Kingdom of Saudi Arabia. Materials and Methods: Participants in this cross-sectional descriptive study were 386 pregnant women seeking care at Saudi Ministry of Health centers. A validated version of the Modified Dental Anxiety Scale (MDAS) was used to measure dental anxiety. Questionnaires including background data and dental anxiety were used and clinical data were collected. The association between oral health literacy and dental anxiety was evaluated with Spearman’s correlation coefficient. A multiple linear regression model with dental anxiety (MDAS score) as the dependent variable was developed to investigate further the relationship dental anxiety amongst pregnant women and their dental attendance patterns. Results: The prevalence of dental anxiety was very anxious (3.595). According to a multiple binary logistic regression model, previous experiences with dentists, household income, educational level, number of times and months of pregnancy, and the perception that oral care should be avoided during pregnancy were independently associated with dental anxiety. Conclusions: Dental anxiety in pregnant women is linked to social and psychological factors, in addition to oral health. Specifically, prior experiences with dentists, attitudes toward dental care, and general fear appear to have the strongest influence on dental anxiety. The prevalence of dental anxiety was high among this sample of pregnant women. The study shows that dental care providers need to pay attention to providing a supportive dental care situation, where patients should not experience pain. There is a need to understand the psychological factors associated with dental care procedures.