The extent and nature of dental anxiety in Australians experiencing homelessness.

Abstract

High dental anxiety is a major barrier to accessing dental care and has been found to be experienced to a greater extent in the homeless population. No studies have investigated the extent and nature of dental anxiety in Australians experiencing homelessness and was the aim of this study. Participants were recruited from four not-for-profit organisations in inner Brisbane using convenience and snowball sampling. The Dental Anxiety Questionnaire (DAQ) and the Index of Dental Anxiety and Fear (IDAF-4C+ ) questionnaire and oral health screening were completed by people experiencing homelessness in Brisbane, Australia, and compared to population norms. Descriptive statistics were calculated, and non-overlapping confidence intervals considered significantly different. The majority of the participants (n=66) were male, a current smoker, unemployed and living in government supported housing. Most of the participants rated their oral health as poor/fair (n=46, 71.9%) and their oral function as good or higher (n=34, 53.1%). Using the single-item DAQ, 28.2% (n=19) of people experiencing homelessness had high dental anxiety, compared to 16% of the general Australian population. The mean summed IDAF-4C+ fear module score was 18.02 (CI 15.60-20.43), which was significantly higher than the Australian population (µ=14.40, CI 13.93-14.86). The highest mean score in the IDAF-4C+ stimulus module was feeling embarrassed or ashamed as anxiety inducing (µ=2.27, CI 1.89-2.64) and was significantly different from the general Australian population (µ=1.40, CI 1.33-1.47). The poorer overall self-rated oral health by the homeless population may induce feelings of embarrassment or shame, highlighting the differing psychosocial aspect to dental anxiety experienced by this population. Managing dental anxiety is needed to improve accessing to dental care for this population. Multidisciplinary care from social workers, mental health workers and dental practitioners may be beneficial in managing fear.