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Dentistry Journal
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New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions
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New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions

A special issue of Dentistry Journal (ISSN 2304-6767).

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 18938

Special Issue Editors

Prof. Ruth E. Freeman

Website
Guest Editor
Dental Health Services Research Unit, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
Interests: dental anxiety in children and adults; inclusion oral health; oral health services for excluded groups; intensive psychotherapeutic intervention; dental staff well-being and communication.
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Gerry M. Humphris

E-Mail Website
Guest Editor
Health Psychology, School of Medicine, University of St. Andrews, St. Andrews, UK
Interests: assessment of dental anxiety; psychometrics; frequent psychological evaluation; sequential analysis; patient-centred care; health care communication; emotional expression; clinical responsiveness
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Dental anxiety is not disappearing with the advent of new methods, devices and materials to offer oral health care. However, new techniques of assessment (e.g., online) and methods of intervention abound as do the theoretical perspectives that are being investigated. The Guest Editors of this Special Issue aim to compile a set of articles that reflect some of the latest work on this topic and have invited known experts as well as generated a call for open submissions of high-quality writing and research endeavour. It is hoped that this collection will act as a reference point for scholars in the field and attract further interest to assist clinicians in assisting their patients who have a fear of dentistry. This currently has some importance as patients and clinicians battle with the additional fear of COVID-19 and its possible effect on dental anxiety.This Special Issue, therefore, will provide the reader with a synopsis of new perspectives on dental anxiety. It will present an examination of new theoretical concepts, assessments and interventions. Researchers from around the globe will use this as a forum to share their current thinking, their research activity and practical interventions in the clinical field of dental anxiety.

Prof. Ruth E. Freeman
Prof. Dr. Gerry M. Humphris
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Dentistry Journal is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dental anxiety
  • dental fear
  • theoretical perspectives
  • assessment development
  • trajectory of dental anxiety
  • dentist–patient relationship
  • clinical communication
  • psychological interventions
  • development of dental anxiety
  • life course

Published Papers (7 papers)

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10 pages, 478 KiB  
Article
The Associations among Dental Anxiety, Self-Esteem, and Oral Health-Related Quality of Life in Children: A Cross-Sectional Study
by Amjad Alharbi, Gerry Humphris and Ruth Freeman
Dent. J. 2023, 11(7), 179; https://doi.org/10.3390/dj11070179 - 21 Jul 2023
Cited by 1 | Viewed by 1208
Abstract
Background: The current evidence on the relationships among child oral health-related quality of life, dental anxiety, and self-esteem indicates that we need to investigate these relationships to improve our understanding of the associations. Therefore, the current research aimed to enhance this evidence and [...] Read more.
Background: The current evidence on the relationships among child oral health-related quality of life, dental anxiety, and self-esteem indicates that we need to investigate these relationships to improve our understanding of the associations. Therefore, the current research aimed to enhance this evidence and provide an overview of the participating children’s oral-health-related quality of life (as measured by the CPQ8–10), self-esteem (as measured by the Coopersmith SEI-SF), and dental anxiety (as measured by the CFSS_DS) and how these child-related outcome measures interacted and were related to one another. Method: A cross-sectional survey was conducted on a random sample of school children (n = 1900) aged 8 to 10 years. The questionnaire was collected through validated self-report measures: dental anxiety, COHRQoL, and self-esteem. Structural equation modelling (SEM) was used to test the strength of the association of our model to explore the relationships among these three psychological constructs. The moderating effects of age, gender, location, and the educational board were analysed for their possible influence on these relationships. Results: Significant relationships between COHRQoL and child dental anxiety and between COHRQoL and SE were detected. The relationship subscale between COHRQoL and child dental anxiety was 0.24, (p < 0.001). A stronger correlation between COHRQoL, and SE was found, with B = −0.77, (p < 0.001). Although the association between CDA and SE was small, it was statistically significant (p = 0.03). These findings provide some important background information for designing effective educational programs for children. Full article
(This article belongs to the Special Issue New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions)
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8 pages, 882 KiB  
Communication
A Bibliometric Analysis on the Early Works of Dental Anxiety
by Andy Wai Kan Yeung
Dent. J. 2023, 11(2), 36; https://doi.org/10.3390/dj11020036 - 01 Feb 2023
Cited by 3 | Viewed by 1524
Abstract
Dental anxiety has been a common phenomenon under investigation for decades. This report aimed to identify the historical roots of dental anxiety in the research literature. The literature database Web of Science Core Collection was searched to identify relevant papers on this theme. [...] Read more.
Dental anxiety has been a common phenomenon under investigation for decades. This report aimed to identify the historical roots of dental anxiety in the research literature. The literature database Web of Science Core Collection was searched to identify relevant papers on this theme. Cited reference analysis on the collected literature set was performed with CRExplorer, a dedicated bibliometric software. This analysis successfully identified the references dealing with dental anxiety in the late 1800s and early 1900s. They included essays that provided expert opinion on dental anxiety, reported semi-structured interviews to elucidate its underlying reasons, introduced psychometric scales to assess dental anxiety, and proposed theories and arguments from psychoanalytic aspects. Several references dealing with anxiety in general were also identified. To conclude, cited reference analysis was useful in revealing the historical origins of dental anxiety research. These cited references provided a concrete foundation to support subsequent dental anxiety research. Full article
(This article belongs to the Special Issue New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions)
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11 pages, 1400 KiB  
Article
Treatment of Dental Anxiety and Phobia—Diagnostic Criteria and Conceptual Model of Behavioural Treatment
by Ulla Wide and Magnus Hakeberg
Dent. J. 2021, 9(12), 153; https://doi.org/10.3390/dj9120153 - 17 Dec 2021
Cited by 7 | Viewed by 4191
Abstract
Dental anxiety and dental phobia are still prevalent among adult individuals and should be considered a dental public health issue. Dental anxiety/phobia is often described as a vicious cycle where avoidance of dental care, poor oral health, and psychosocial effects are common features, [...] Read more.
Dental anxiety and dental phobia are still prevalent among adult individuals and should be considered a dental public health issue. Dental anxiety/phobia is often described as a vicious cycle where avoidance of dental care, poor oral health, and psychosocial effects are common features, often escalating over time. Treatment should include therapy for dental anxiety/phobia and oral diseases. This paper discusses aetiology, prevalence, and diagnosis of dental anxiety/phobia and, in detail, presents a conceptual treatment model at the Dental Fears Research and Treatment Center in Gothenburg, Sweden. In addition, based on systematic reviews, evidence-based treatment for dental anxiety is revealed including the interdisciplinary approach between psychology and dentistry. Full article
(This article belongs to the Special Issue New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions)
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11 pages, 378 KiB  
Article
A Short Form of the Children’s Experiences of Dental Anxiety Measure (CEDAM): Validation and Evaluation of the CEDAM-8
by Jenny Marie Porritt, Annie Morgan, Helen Rodd, Fiona Gilchrist, Sarah R. Baker, Tim Newton and Zoe Marshman
Dent. J. 2021, 9(6), 71; https://doi.org/10.3390/dj9060071 - 15 Jun 2021
Cited by 2 | Viewed by 3125
Abstract
Background: The Children’s Experiences of Dental Anxiety Measure (CEDAM-14) is a child-centred measure of dental anxiety which assesses a range of behaviours, thoughts and feelings/physical symptoms related to dental anxiety. A short form of the CEDAM-14, which places less time burden on patients [...] Read more.
Background: The Children’s Experiences of Dental Anxiety Measure (CEDAM-14) is a child-centred measure of dental anxiety which assesses a range of behaviours, thoughts and feelings/physical symptoms related to dental anxiety. A short form of the CEDAM-14, which places less time burden on patients and clinicians, could promote the feasibility and applicability of the CEDAM in clinical settings. The aim of the study was to develop a short version of the CEDAM that can be used to assess children’s dental anxiety in clinical practice. Methods: A short version of the CEDAM was developed using a combination of item impact and regression methods. Measurement properties including floor/ceiling effects, variance, criterion validity, construct validity and internal consistency was calculated for the short form. Results: An eight-item CEDAM short form was developed (CEDAM-8) that had good psychometric properties, was significantly correlated with the CEDAM measure (r = 0.90; p < 0.01), had minimal floor and ceiling effects (3.5% and 1.2%, respectively) and was sensitive to change. Conclusion: The CEDAM-8 is a useful assessment tool for clinicians that is easy and quick to administer and could help to understand children’s experiences of dental anxiety and changes in anxiety over time and following intervention. Full article
(This article belongs to the Special Issue New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions)
9 pages, 409 KiB  
Article
Hair Cortisol Concentrations Are Associated with Dental Anxiety during Pregnancy
by Hilja Viitaniemi, Auli Suominen, Linnea Karlsson, Paula Mustonen, Susanna Kortesluoma, Kari Rantavuori, Ana João Rodrigues, Bárbara Coimbra, Hasse Karlsson and Satu Lahti
Dent. J. 2021, 9(4), 42; https://doi.org/10.3390/dj9040042 - 11 Apr 2021
Cited by 1 | Viewed by 2326
Abstract
Dental anxiety (DA) and hair cortisol concentrations (HCC) are associated with psychological symptoms and vary during pregnancy. We aimed to examine the association between HCC and DA at two points of pregnancy. Participants were pregnant mothers (n = 533) drawn from the FinnBrain [...] Read more.
Dental anxiety (DA) and hair cortisol concentrations (HCC) are associated with psychological symptoms and vary during pregnancy. We aimed to examine the association between HCC and DA at two points of pregnancy. Participants were pregnant mothers (n = 533) drawn from the FinnBrain Birth Cohort Study donating a hair sample at gestational week (gwk) 24 (n = 442) and/or at delivery (n = 176) and completed questionnaires on DA. Two groups, HCC1 and HCC2, treated as separate in the analyses, were formed according to the hair sample donation time i.e., gwk24 and delivery. 85 subjects were included in both groups. MDAS, EPDS, and SCL-90 were used to measure DA, depressive and anxiety symptoms, respectively, at gwk14 for the HCC1 group and gwk34 for the HCC2 group. The association between DA and HCC was studied with a binary logistic regression model, adjusted for anxiety and depressive symptoms, age, BMI, and smoking status. Individuals with high DA had lower HCC levels at gwk24 (OR = 0.548; 95% CI = 0.35–0.86; p = 0.009), but the association was not statistically significant at the delivery (OR = 0.611; 95% CI = 0.28–1.33; p = 0.216). The independent association between HCC and DA in pregnant women suggests that long-term cortisol levels could play a role in the endogenous etiology of DA. Further studies are however, needed. Full article
(This article belongs to the Special Issue New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions)
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14 pages, 902 KiB  
Concept Paper
Classifying Children’s Behaviour at the Dentist—What about ‘Burnout’?
by Christopher C. Donnell
Dent. J. 2023, 11(3), 70; https://doi.org/10.3390/dj11030070 - 02 Mar 2023
Cited by 1 | Viewed by 2062
Abstract
In children and young people, complex and prolonged dental treatment can sometimes be met with resistance despite previously successful treatment appointments. While this has traditionally been referred to as a ‘loss of cooperation’ or ‘non-compliance’, these children may actually be experiencing ‘burnout’, of [...] Read more.
In children and young people, complex and prolonged dental treatment can sometimes be met with resistance despite previously successful treatment appointments. While this has traditionally been referred to as a ‘loss of cooperation’ or ‘non-compliance’, these children may actually be experiencing ‘burnout’, of which many may have the potential to recover and complete their course of treatment. Burnout has been defined as “the extinction of motivation or incentive, especially where one’s devotion to a cause or relationship fails to produce the desired results”. Traditionally, burnout is experienced by those who deliver services rather than be in receipt of a service; however, the burnout concept proposed in this paper explores it as an alternative perspective to other dentally relevant psychosocial conditions and should be considered when employing appropriate behaviour management techniques and coping strategies for paediatric patients. The intention of this paper is not to establish firm grounds for this new concept in healthcare, but to start a discussion and motivate further theoretical and empirical research. The introduction of the ‘burnout triad model’ and the importance of communication aims to highlight the tripartite influence of patients, parents and professionals engaged in the central ‘care experience’ and underlines the belief that early recognition and management of potential signs of burnout may help reduce the likelihood of those involved developing the condition. Full article
(This article belongs to the Special Issue New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions)
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15 pages, 311 KiB  
Concept Paper
Trusting the Dentist—Expecting a Leap of Faith vs. a Well-Defined Strategy for Anxious Patients
by Rod Moore
Dent. J. 2022, 10(4), 66; https://doi.org/10.3390/dj10040066 - 07 Apr 2022
Cited by 3 | Viewed by 3172
Abstract
This article aimed to set into perspective the unique aspects of trust within the dentist–patient relationship by exploring the literature as well as historical aspects of dentistry in the association between trust/distrust and patient anxiety. In order to characterise this uniqueness, the assumptions [...] Read more.
This article aimed to set into perspective the unique aspects of trust within the dentist–patient relationship by exploring the literature as well as historical aspects of dentistry in the association between trust/distrust and patient anxiety. In order to characterise this uniqueness, the assumptions for trusting in dentistry are compared and contrasted with other professions using a conceptual analysis. The professions of medicine, sociology, psychology, nursing and dentistry were check listed according to the tenets of a concept analytical approach reported by Hupcey et al., in 2001. Recommendations for patient/person-centred care, as opposed to dentist-centred care, that would improve trust are specified according to the literature. These include empowering patients, practicing active listening, empathy and relationship building that might benefit dental patients in relation to the perceived risks of anxiety or induced pain. It was concluded that global distrust of dominating dentists must give way to person-centred professional strategies so that dentists and patients can tackle their dental anxiety-trust challenges, both in the public’s image of the dental profession and in clinical relationships. Future directions would be to explore incentives for dentists to change to patient/person-centred care. Full article
(This article belongs to the Special Issue New Perspectives on Dental Anxiety: Theoretical Concepts, Assessments and Interventions)
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