Abstract
Background: Dental anxiety is a common reason for avoiding dental visits and is associated with poor dental status. The short version of Dental Anxiety Inventory (SDAxI) is an easy-to-use, multi-faceted questionnaire for assessing the level of trait dental anxiety. However, there was no neurophysiological data indicating if its score associates with the state anxiety when an individual is under real/mock dental environment. We hypothesized that there exists such an association.Materials and Methods: Twenty systemic healthy adults with dental attendance experience and self-claimed free of dental phobia were recruited in this cross-sectional study, with their dental anxiety level assessed by SDAxI. Functional magnetic resonance imaging recorded their brain signals in response to audiovisual footages resembling dental scaler or turbine in action. After the brain imaging, they gave fear ratings to the footages in visual analog scale (VAS).Results: Participants’ SDAxI scores positively correlated with their responses in the insular cortex (r2 = 0.388–0.445, P < 0.005). Their SDAxI scores also positively correlated with their fear ratings of the footages (r2 = 0.415–0.555, P < 0.005).Discussion: Our findings indicated a possible neurobiological relevance of SDAxI, and reinforced its neurobiological validity in assessing dental anxiety level of dental attenders.
Highlights
There are many dental therapy scenarios and dental treatment settings that make patients feel threatened and anxious about (Oosterink et al, 2008)
Apart from correlating with activities in the insula, we demonstrated a positive linear relationship between short version of Dental Anxiety Inventory (SDAxI) scores and dental fear VAS scores of the scaler or turbine videos among the participants of the present study
The psychosocialneurophysiological associations we found in this study is coherent with the notion that people with a higher SDAxI score are naturally more anxious while having their teeth fixed or receiving treatment for gum disease underpinned by a certain neurobiological mechanism involving the insular cortex
Summary
There are many dental therapy scenarios and dental treatment settings that make patients feel threatened and anxious about (Oosterink et al, 2008). Dental anxiety is a commonly cited reason for avoidance or postponement of dental visits by patients and is associated with poor dental status and reduced oral health-related quality of life (McGrath and Bedi, 2004; Ng and Leung, 2008). To understand the neural basis of dental anxiety, the neurophysiology research field has employed neuroimaging techniques, such as functional magentic resonance imaging (fMRI), to observe brain responses triggered by stimuli mimicking dental treatment or scenarios with dental anxiety context (Lueken et al, 2011; Hilbert et al, 2014; Scharmüller et al, 2014; Schienle et al, 2014; Yeung et al, 2019). Dental anxiety hinders patients from having regular dental visits, which are essential for maintaining good oral health and quality of life.
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