The Influence of Stress and Anxiety on the Expectation, Perception and Memory of Dental Pain in Schoolchildren.

Gabriela Lamarca,Angela Monteiro Da Silva,Mario Vettore

doi:10.3390/dj6040060

Abstract

The aim of this study was to investigate the association of stress and anxiety with the expectation, perception and memory of dental pain among schoolchildren. A follow-up study involving 46 children aged 9 to 12 years was conducted in a public school in the city of Petropolis (RJ), Brazil. Demographic characteristics, stress (children’s stress scale), and state and trait anxiety (state–trait anxiety inventory) were recorded before a dental procedure to restore the occlusal surface of a permanent first molar under local anaesthetic. Dental pain was assessed using the faces pain scale before (dental pain expectation), immediately after (dental pain perception) and six weeks after (memory of dental pain) the dental procedure. Dental pain expectation scores were significantly higher than dental pain perception, independent of the levels of stress, state anxiety and trait anxiety. Children with high scores of stress (OR 1.05 95%CI 1.02–1.09), state anxiety (OR 1.15 95%CI 1.05–1.27) and trait anxiety (OR 1.18 95%CI 1.07–1.30) were more likely to report greater scores of dental pain expectation. Children anticipated more dental pain than what was actually perceived after the dental restoration. Children with greater levels of stress and anxiety have a distorted evaluation of expected dental pain before the dental procedure.

Highlights

Pain can be defined as a “noticeably uncomfortable and emotional experience associated with actual or potential tissue damage, or described at the time of such damage” [1]
The Cronbach’s alpha of the instruments employed to assess stress, state anxiety and trait anxiety were 0.863, 0.845, and 0.782, respectively
State anxiety and trait anxiety were positively correlated with dental pain expectation (ρ = 0.459, p = 0.001; ρ = 0.504, p < 0.001; ρ = 0.412, p = 0.004, respectively)

Summary

Introduction

Pain can be defined as a “noticeably uncomfortable and emotional experience associated with actual or potential tissue damage, or described at the time of such damage” [1]. As suggested by this definition, pain is always a subjective event, and the perception of pain is related to physiological, psychological, social and cultural factors [2]. Psychological factors of pain include emotional and cognitive aspects. They may exacerbate the perception of pain due to catastrophic thinking about pain, anxiety and fear associated with pain

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