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Medicina
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Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care
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Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dentistry".

Deadline for manuscript submissions: closed (10 February 2024) | Viewed by 13441

Special Issue Editor

Prof. Dr. Marina Consuelo Vitale

E-Mail Website
Guest Editor
Unit of Orthodontics and Pediatric Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 2, Piazzale Golgi, 27100 Pavia, Italy
Interests: laser; oral surgery; photobiomodulation; oral psychophysiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Oral health is a multifaceted concept. Oral health, according to the World Dental Federation, is a fundamental component of health and physical and mental well-being. Several constituents of oral health have been associated with Dental Anxiety (DA). Dental anxiety is a common problem experienced in dental practice and it has been linked to more caries experience in adults. Poor dental status among anxious patients is often explained by avoidant behavior. Avoidant behavior can result in inadequate dental treatment, which among adults could lead to deteriorating oral health, and adults suffering from DA indicate poorer oral hygiene practices than non-anxious patients. Avoidance or enduring dental treatment with intense anxiety is one of the diagnostic criteria for specific phobia according to the American Psychiatric Association. The relationship between dental health status, anxiety and avoidance of treatment is probably complex, involving a wide range of factors from socio-economical to psychosocial aspects.

Pain is associated with anxiety in a dental setting. It remains unclear how cognitive–affective factors modulate pain and anxiety in a stressful context, such as receiving dental procedures. Pain is a complex and subjective human experience and pain reported in the dental setting is influenced by a number of different factors. In particular, dental treatments, particularly those requiring injections or procedures considered invasive, are more strongly associated with reports of pain, as are feelings of lack of control and DA. Dental anxiety is predictive of reporting pain during dental treatment.

In this Special Issue, different specialists explain the relationship between stress, pain, and individual behavior and anxiety in Dental Care.

Prof. Dr. Marina Consuelo Vitale
Guest Editor

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. Medicina 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 1800 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

  • oral health
  • dental anxiety
  • stress
  • pain
  • avoidant behavior
  • dental treatment
  • dental care

Published Papers (6 papers)

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Research

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14 pages, 1677 KiB  
Article
Dental Caries Prevention Knowledge, Attitudes, and Practice among Patients at a University Hospital in Guangzhou, China
by Rui Jiang, Jiali Yu, Rafiqul Islam, Xiang Li and Ermin Nie
Medicina 2023, 59(9), 1559; https://doi.org/10.3390/medicina59091559 - 28 Aug 2023
Cited by 2 | Viewed by 2592
Abstract
Background and Objectives: This study aimed to assess the knowledge, attitudes, and practice (KAP) of patients regarding dental caries prevention in a university hospital in Guangzhou, China. Materials and Methods: A hospital-based KAP survey was conducted in a cross-sectional manner at the [...] Read more.
Background and Objectives: This study aimed to assess the knowledge, attitudes, and practice (KAP) of patients regarding dental caries prevention in a university hospital in Guangzhou, China. Materials and Methods: A hospital-based KAP survey was conducted in a cross-sectional manner at the First Affiliated Hospital in Guangzhou, China, from 1 September to 30 September 2022. Questionnaires were distributed to eligible patients, resulting in the participation of 251 individuals. The questionnaire consisted of five sections capturing socio-demographic data and exploring participants’ knowledge, attitudes, practice, and accurate preventive dental caries knowledge. Descriptive statistics and a generalized linear model with univariate tests were used for analysis. Results: The study results show that the knowledge score 7.97 (±0.91) and attitudes score 7.67 (±0.89) among the participants were good while the practice score was 6.80 (±0.81) moderate. The majority of participants identified tooth infections (81.3%), bacteria (92%), and sugar (89.2%) as the main causes of gum bleeding and tooth decay. Brushing (96%) and fluoride (80.5%) were also recognized as essential for preventing tooth decay. Of oral diseases, 94% were recognized as potentially affecting overall health. The vast majority ranging from 92.8% to 98%, believed that oral health is crucial to overall health and that regular check-ups and proper brushing habits are beneficial. There is a significant association of gender with age (p = 0.018), occupation (p = 0.050), lifestyle habit (p = 0.012), and knowledge score; whole education is significantly associated with practice score (p = 0.050). Conclusions: The majority of patients exhibited accurate knowledge and attitudes with moderate practice towards dental caries prevention, with socio-demographic factors playing a major role. However, effective implementation of dental health education programs across the healthcare system is still required to further enhance outcomes. Full article
(This article belongs to the Special Issue Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care)
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12 pages, 1662 KiB  
Article
Pre-Treatment and Post-Treatment Dental Anxiety in Patients Visiting Intern Dental Clinic
by Abdulaziz Alsakr, Khalid Gufran, Abdullah Saad Alqahtani, Hassan Alkharaan, Alwaleed Abushanan, Banna Alnufaiy, Abdullah Alkhaldi, Tareq Alshammari and Muhannad Alanazi
Medicina 2023, 59(7), 1284; https://doi.org/10.3390/medicina59071284 - 11 Jul 2023
Viewed by 1487
Abstract
Background and Objectives: This study aimed to assess the dental anxiety of patients using the modified dental anxiety scale (MDAS) questionnaire along with examining the possible relationship between dental anxiety and sociodemographic factors. Materials and Methods: The MDAS questionnaire was used [...] Read more.
Background and Objectives: This study aimed to assess the dental anxiety of patients using the modified dental anxiety scale (MDAS) questionnaire along with examining the possible relationship between dental anxiety and sociodemographic factors. Materials and Methods: The MDAS questionnaire was used to assess the anxiety level of the patients which included a total of five questions and five options to respond to each question. MDAS questionnaire was filled out by all the patients before the dental treatment. After finishing the treatment, all the patients were given a post-treatment questionnaire to assess their anxiety levels after treatment. Descriptive statistics were performed for measuring the frequency of responses. Mann-Whitney U test was used to compare the anxiety between the gender. The chi-square test was used to identify the distribution of pre-treatment with gender and post-treatment questionnaire with gender and treatment modalities. Linear regression was used to identify the association between clinical variables and different levels of anxiety. Results: A total of 115 patients including 59 males and 56 females with a mean age of 35 ± 11.34 years were included in the current study. Female patients were significantly more anxious about dental treatment compared to male patients. Linear regression showed that age and gender have a significant association with the pre-treatment anxiety level; however, types of treatment is not associated with the MDAS. Anxiety levels decreased for the majority of the patients after the treatment and types of treatment did not show any differences with the post-treatment anxiety level. Conclusions: Age and gender play an important role in dental anxiety; however, types of treatment are not associated with pre-treatment and post-treatment dental anxiety. Full article
(This article belongs to the Special Issue Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care)
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10 pages, 1183 KiB  
Article
Pain Assessment and Need for Analgesics after Scaling and Root Planing in Patients with Stage II and Stage III Periodontitis
by Khalid Gufran, Mohammad Shoyab Khan, Abdullah Saad Alqahtani and Banna Alnufaiy
Medicina 2023, 59(7), 1203; https://doi.org/10.3390/medicina59071203 - 26 Jun 2023
Cited by 2 | Viewed by 1263
Abstract
Background and Objectives: The most common treatment procedure for periodontitis and gingivitis is scaling and root planing, which is perceived as a painful dental treatment. The current study aimed to assess pain perception and analgesics consumption after scaling and root planing (SRP) [...] Read more.
Background and Objectives: The most common treatment procedure for periodontitis and gingivitis is scaling and root planing, which is perceived as a painful dental treatment. The current study aimed to assess pain perception and analgesics consumption after scaling and root planing (SRP) in patients with stage II and stage III periodontitis. Materials and Methods: Before starting the SRP, all the periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL), were measured. The anxiety level of the patients was also assessed using the modified dental anxiety scale (MDAS) questionnaire. Pain perception of the patients was recorded with the visual analog scale (VAS) after performing the SRP. Patients were asked to mark their pain level on the VAS sheet after two hours, four hours, eight hours, 24 h, and 48 h after the periodontal treatment. The following cut-off points were used for the pain intensity in the VAS: 0 = no pain, 1–4 = mild pain, 4–6 = moderate pain, and 7–10 = severe pain. Patients were advised to take analgesics if the pain was intolerable. Multivariate logistic regression was performed to conduct the association of all dependent variables and the pain perception of patients. A nonparametric Friedman test was conducted to assess pain perception at different times. Results: A total of 52 patients including 32 males and 20 females participated in the current study, with a mean age of 43.10 ± 12.33 years. Multivariate analyses showed that MDAS and analgesic consumption is significantly associated with pain perception. Other clinical variables are not associated with pain perception. The Friedman test exhibited that pain perception is significantly associated (p < 0.05) with time. Conclusions: Analgesic consumption and anxiety level are significantly associated with pain perception after SRP treatment. Full article
(This article belongs to the Special Issue Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care)
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15 pages, 659 KiB  
Article
Assessment of Oral Health Knowledge, Attitude, Practice and DMFT Scores among Patients at King Faisal University, Al-Ahsa
by Muhammad Adeel Ahmed, Rizwan Jouhar, Muhammad Faheemuddin, Ahmed AlJafar, Hussain Alabawi, Baqer Alhumaidi and Moaiad Al Madeh
Medicina 2023, 59(4), 688; https://doi.org/10.3390/medicina59040688 - 30 Mar 2023
Cited by 4 | Viewed by 2602
Abstract
Background and Objectives: Oral health is one of the most significant issues in public health. The Decayed, Missing, and Filled Teeth (DMFT) Index is a useful tool for assessing and measuring the state of oral health in a community. This study aimed [...] Read more.
Background and Objectives: Oral health is one of the most significant issues in public health. The Decayed, Missing, and Filled Teeth (DMFT) Index is a useful tool for assessing and measuring the state of oral health in a community. This study aimed to evaluate oral health knowledge, attitudes, and practices among participants who visited a dental clinic at King Faisal University and to evaluate their DMFT scores. Materials and Methods: This cross-sectional, questionnaire-based study was conducted at the King Faisal University dental complex, Kingdom of Saudi Arabia, using a simple random sampling technique. The data were collected using a self-administered structured questionnaire in English and Arabic. All statistical analyses were carried out using the SPSS 20 software. A chi square and ANOVA test were used to assess the association. A p value of <0.05 was considered statistically significant. Results: There were a total of 260 participants, of whom 193 (74.2%) were male and 67 (25.8%) were female. Most participants, 173 (66.5%), were between the ages of 18 and 28. The majority of the participants 191 (73.5%) believed that bad oral hygiene led to gum disease. Additionally, major issues while visiting dental clinics, the importance of routine dental clinic visits, the existence of a connection between oral and general health, brushing time and frequency of change of used brush were significantly influenced by gender (p < 0.05). In terms of the DMFT index, mean numbers of decaying teeth (D) were 4.82 ± 4.15, mean numbers of missing teeth (M) were 1.56 ± 2.94, mean numbers of filled teeth (F) were 5.17 ± 5.28 and mean DMFT score was 11.56 ± 6.32, with a statistically significant difference observed (p < 0.001). Conclusions: This study concluded that, although some of the study participants neglected oral hygiene practices, the majority of participants had good knowledge and attitudes regarding the significance of oral hygiene. Owing to inadequate practices, the decayed, missing, and filled teeth scores increased with increasing age. Additionally, gender had no significant impact on the mean scores for decayed, missing, and filled teeth, although there were significant differences between age groups. Full article
(This article belongs to the Special Issue Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care)
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Review

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13 pages, 2266 KiB  
Review
The Use of Questionnaires in Pain Assessment during Orthodontic Treatments: A Narrative Review
by Marina Consuelo Vitale, Chiara Falzinella, Maria Francesca Sfondrini, Patrizia Defabianis and Andrea Scribante
Medicina 2023, 59(9), 1681; https://doi.org/10.3390/medicina59091681 - 18 Sep 2023
Viewed by 1221
Abstract
Pain is a complex multidimensional feeling combined with sensorial and emotional features. The majority of patients undergoing orthodontic treatment report various degrees of pain, which is perceived as widely variable between individuals, even when the stimulus is the same. Orthodontic pain is considered [...] Read more.
Pain is a complex multidimensional feeling combined with sensorial and emotional features. The majority of patients undergoing orthodontic treatment report various degrees of pain, which is perceived as widely variable between individuals, even when the stimulus is the same. Orthodontic pain is considered the main cause of poor-quality outcomes, patients’ dissatisfaction, and lack of collaboration up to the interruption of therapy. A deep understanding of pain and how it influences a patient’s daily life is fundamental to establishing proper therapeutic procedures and obtaining the correct collaboration. Because of its multifaced and subjective nature, pain is a difficult dimension to measure. The use of questionnaires and their relative rating scales is actually considered the gold standard for pain assessment. Choosing the most appropriate instrument for recording self-reported pain depends on a patient’s age and cognitive abilities. Although several such scales have been proposed, and a lot of them are applied, it remains uncertain which of these tools represents the standard and performs the most precise, universal, and predictable task. This review aims to give an overview of the aspects which describe pain, specifically the pain experienced during orthodontic treatment, the main tool to assess self-perceived pain in a better and more efficient way, the different indications for each of them, and their correlated advantages or disadvantages. Full article
(This article belongs to the Special Issue Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care)
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Other

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11 pages, 895 KiB  
Systematic Review
Emotional and Social Impact of Halitosis on Adolescents and Young Adults: A Systematic Review
by Raluca Briceag, Aureliana Caraiane, Gheorghe Raftu, Razvan Mihai Horhat, Iulia Bogdan, Roxana Manuela Fericean, Luai Shaaban, Malina Popa, Bogdan Andrei Bumbu, Melania Lavinia Bratu, Marius Pricop and Serban Talpos
Medicina 2023, 59(3), 564; https://doi.org/10.3390/medicina59030564 - 14 Mar 2023
Cited by 4 | Viewed by 3540
Abstract
Background and Objectives: Halitosis is a condition characterized by unpleasant breath smell that is starting to receive serious scientific attention, considering it reflects on people’s social and personal life. While most studies focus on the prevalence of halitosis, its medical etiology, and [...] Read more.
Background and Objectives: Halitosis is a condition characterized by unpleasant breath smell that is starting to receive serious scientific attention, considering it reflects on people’s social and personal life. While most studies focus on the prevalence of halitosis, its medical etiology, and the psychological impact on adults, there is a lack of evidence regarding the social impact of halitosis on the younger population. Therefore, this systematic review aimed to observe the social and emotional impact that halitosis has on adolescents and young adults. Materials and Methods: The review followed the PRISMA protocol, and four electronic databases (Scopus, Scholar, Web of Science, and ProQuest) were searched. From a total of 593 studies retrieved, only 6 were included in the study after assessing the eligibility criteria. Results: The main results showed that the levels of self-reported halitosis ranged from 23.1% to 77.5%, with an average of 44.7%, indicating a significant heterogeneity among the studies reporting this issue. Adolescents and young adults who experienced bad breath were feeling more anxious and depressed according to the non-standardized questionnaires and the standardized questionnaires (OHIP-14 and SCL-9-R). The respondents were isolated from social interactions and consequently had lower self-esteem and impaired quality of life. Conclusions: The conclusions drawn indicate the need for action on a medical level, as well as on a psychological level, in order to improve people’s oral health and help them navigate through the difficulties of maintaining social interactions as they live with halitosis. Full article
(This article belongs to the Special Issue Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care)
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