*Magdalena Czerżyńska1, Paulina Orłow2, Anna Justyna Milewska3, Magdalena Choromańska4
Dentophobia
Dentofobia
1Department of Paediatric Cardiac Surgery, Institute of Paediatrics, Collegium Medicum of the Jagiellonian University, Kraków
Head of Department: Professor Janusz H. Skalski, MD, PhD
2Graduate, Medical University of Białystok
3Department of Medical Statistics and Information Technology, Medical University of Białystok
Head of Department: Professor of Mathematics Tomasz Burzykowski, PhD
4Department of Conservative Dentistry, Medical University of Białystok
Head of Department: Professor Danuta Waszkiel, DMD, PhD
Streszczenie
Wstęp. Dentofobia to paniczny lęk przed wizytą u dentysty, zabiegami wykonywanymi w obrębie jamy ustnej. Osoba cierpiąca na dentofobię zgłasza się do gabinetu dopiero, gdy doznania bólowe uniemożliwiają normalne funkcjonowanie bądź też wskutek presji otoczenia. Zjawisko można ocenić na podstawie: obserwacji zmian fizjologicznych reakcji organizmu (ciśnienie krwi, zabarwienie skóry), sposobu zachowania oraz metodami psychologicznymi (wypełnianie kwestionariusza). Mimo rozwoju stomatologii i wzrostu świadomości społeczeństwa polskiego, problem lęku przed wizytą u dentysty jest wciąż aktualny, czego przykładem jest wysoka średnia wartość wskaźnika próchnicy PUWz (ang. DMFt). W Polsce wśród osób w wieku 18 lat wynosiła ona 8 (2013 r.).
Cel pracy. Próba ustalenia przyczyn i skali występowania dentofobii.
Materiał i metody. Badaniu ankietowemu poddano 330 pacjentów Zespołu Poradni Specjalistycznych Uniwersyteckiego Szpitala Klinicznego w Białymstoku. Zebrany materiał poddano analizie w programie Statistica 10.0 z zastosowaniem testu Ch2 (p < 0,05).
Wyniki. Złe doświadczenia z przeszłości oraz wyobrażenia na temat zabiegu są najczęstszą przyczyną strachu przed wizytą u stomatologa podawaną przez pacjentów. Lęk współistniejący z objawami somatycznymi, który może uniemożliwić podjęcie leczenia w gabinecie stomatologicznym, częściej zgłaszany jest przez kobiety. Mężczyźni częściej obawiają się bólu występującego podczas wizyty niż kobiety.
Wnioski. Zjawisko dentofobii ma złożone podłoże, stąd należy prowadzić dalsze badania w tym kierunku.
Summary
Introduction. Dental phobia is a paralyzing fear of dental visits and dental procedures. A person affected by dental phobia decides to make an appointment only when their normal functioning is impossible due to pain or when pressed by family or friends. This phenomenon can be evaluated based on changes in physiological responses (blood prese, skin colour, sweating), behaviour (mainly children) or using psychological methods (questionnaires). Despite advances in dentistry and the increasing awareness of the Polish society, the problem of dental anxiety is still unsolved. This results in high DMFt index, which was 8 (2013) for Poles aged 18 years.
Aim. The aim of the study was an attempt to determine the causes and the incidence of dental phobia.
Material and methods. A total of 330 patients of an out-patient clinic at the University Hospital of Białystok were included in the survey. Statistical analysis of the collected data was performed with Statistica 10.0. using the Chi-square test (p < 0.05).
Results. Negative past experiences and ideas about dental treatment are the most common causes of dental fear in patients. Fear coexisting with somatic symptoms, which can prevent dental treatment, was more often reported by women. Men are afraid of pain connected with dental procedures more often than women.
Conclusions. The phenomenon of dental phobia has a complex aetiology, therefore further studies are needed to investigate this issue.
Introduction
Dental phobia is a paralyzing fear of dental visits and dental procedures. The fear increases even in prosaic, unthreatening situations, such as making an appointment, thus preventing treatment. This results from the fact that people usually associate dentists with pain and suffering. This leads to chronic anxiety and fear of a dental appointment. A person affected by dental phobia decides to make an appointment only when their normal functioning is impossible due to pain or when pressed by family or friends (1, 2). Dental fear and dental anxiety are not equivalent concepts. Fear is justified by a specific situation (e.g. toothache and dental treatment), whereas anxiety (phobia) is an unreasonable and irrational fear. Dental anxiety has three components: fear of pain, injury and the unknown. This phenomenon can be evaluated based on changes in physiological responses (blood pressure, skin colour, sweating), behaviour (mainly children) or using psychological methods (questionnaires) (3). Despite advances in dentistry and the increasing awareness of the Polish society, the problem of dental anxiety is still unsolved. This results in high DMFt index, which was 8 (2013) for Poles aged 18 years and 16.9 in the age group 35-44 years (2010) (4). Knowledge on the psychological aspect of dental phobia will allow for a patient-tailored treatment approach.
Aim
The aim of the study was an attempt to determine the causes and the incidence of dental phobia.
Material and methods
A total of 330 patients of an out-patient clinic at the University Hospital of Bialystok were included in the survey. The study was conducted between 9th and 17th of December 2014. The study was approved by the Bioethics Committee of the Medical University of Bialystok as well as by the Deputy Head for Health Care of the Medical University of Bialystok. The questionnaire consisted of two parts: standard sociometric questions (i.e. age, sex, education) and questions related to dental phobia. The second part included single choice (e.g. the date of the last visit, fear assessment scored 1-5) and multiple choice (e.g. factors causing fear) questions. The study used a dental fear scale (tab. 1) developed for the purpose of the research. Statistical analysis of the collected data was performed with Statistica 10.0 using the Chi-square test (p < 0.05).
Tab. 1. Dental fear score
| Level | Description |
| 1 | anxiety, agitation |
| 2 | nervousness |
| 3 | evident nervousness, e.g. tics, shaking hands |
| 4 | fear, evident somatic symptoms preceding dental appointment, e.g. vomiting, diarrhoea,
loss of appetite |
| 5 | severe, chronic fear preventing dental visits |
Results
Table 2 presents the characteristics of the study group. Patients participating in the study were aged between 18 and 80 years. The median age was 44 years. Women predominated in the group. Most respondents lived in a city with a population of more than 100,000 (tab. 2). The majority of patients had secondary education and declared professional work as the main source of income. Higher education was mainly declared by women (34.63 vs. 29.6%). This difference was statistically significant (p = 0.0152). Professional work as the main source of income was mainly declared by women (42.93%) rather than men (40%), as confirmed by statistical analysis (p = 0.0120). There was a statistical difference between the age of the surveyed women and men (p < 0.001). Women were younger than men (fig. 1) (F: 18-80 years, median = 37 years; M: 18-80 years, median = 54 years).
Tab. 2. Characteristics of the study group
| General characteristics of the study group |
| age | median = 44
(min. 18; max. 80) |
| Sex |
| women | 205 (62.12%) |
| men | 125 (37.88%) |
| Place of residence |
| village | 49 (14.84%) |
| town with a population of up to 10,000 (small town, ST) | 79 (23.93%) |
| town with a population of up to 100,000 (medium town, MT) | 38 (11.51%) |
| county town with a population of up to 100,000 (city, DM) | 164 (49.69%) |
| Education |
| primary | 61 (18.48%) |
| secondary | 161 (48.78%) |
| higher | 108 (32.72%) |
| Source of income |
| professional work | 138 (41.81%) |
| farming | 18 (5.45%) |
| unemployment benefits | 12 (3.63%) |
| permanent or temporary benefits | 14 (4.24%) |
| state pension/old-age pension | 87 (26.36%) |
| other | 61 (18.48%) |
Fig. 1. The age of the analysed group of patients based on gender
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Piśmiennictwo
1. Strach niejedno ma imię. Dostępne na stronie: nowygabinet.pl 2014 (data dostępu: 05.02.2015 r.).
2. Kaczmarek U, Grzesiak I, Kowalczyk-Zając M, Bader-Orłowska D: Poziom lęku przed leczeniem stomatologicznym a stan uzębienia u młodzieży 18-letniej. Czas Stomatol 2008; 61: 81-87.
3. Kaczmarek U, Kanaffa-Kilijańska U, Frydecka D: Metody oceny lęku stomatologicznego u dorosłych. Dent Med Probl 2010; 47(1): 97-100.
4. Kaczmarek U, Mysiak-Dębska M, Dębska K, Grzebieluch W: Lęk stomatologiczny u studentów pierwszych lat studiów stomatologicznych i lekarskich. Dent Med Probl 2010; 47(3): 343-349.
5. Appukuttan D, Vinayagavel M, Tadepalli A: Utility and validity of a single-item visual analog scale for measuring dental anxiety in clinical practice. J Oral Scin 2014; 56(2): 151-156.
6. Vano M, Gennai S, Karapetsa D et al.: The influence of educational level and oral hygiene behaviours on DMFT index and CPITN index in an adult Italian population: an epidemiological study. Int J Dent Hyg 2014; 16: 151-157.
7. Ramraj CH, Azarpazhooh A, Dempster L et al.: Dental treatment needs in the Canadian population: analysis of a Nationwide cross-sectional survey. BMC Oral Health 2012; 12: 46.
8. Bhola R, Malhotra R: Dental Procedures, Oral Practices, and Associated Anxiety: A Study on Late-teenagers. Osong Public Health Res Perspect 2014; 5(4): 219-232.
9. Dobroś K, Hajto-Bryk J, Wnęk A et al.: The Level of Dental Anxiety and Dental Status in Adult Patients. J Int Oral Health 2014; 6(3): 11-14.
10. Obeidat SR, Alsa’di AG, Taani DS: Factors influencing dental care access in Jordanian adults. BMC Oral Health 2014; 14: 127.
11. Ragnarsson E: Dental fear and anxiety in an adult Icelandic population. Acta Odontol Scand 1998; 56(2): 100-104.
12. Chellappah NK, Vignehsa H, Milgrom P, Lam LG: Prevalence of dental anxiety and fear in children in Singapore. Community Dent Oral Epidemiol 1990; 18(5): 269-271.
13. Schwarz E, Birn H: Dental anxiety in Danish and Chinese adults-a cross-cultural perspective. Soc Sci Med 1995; 41(1): 123-130.
14. Weinstein P, Shimono T, Domoto P et al.: Dental fear in Japan: Okayama Prefecture school study of adolescents and adults. Anesth Prog 1992; 39(6): 215-220.
15. Oosterink FM, de Jongh A, Hoogstraten J: Prevalence of dental fear and phobia relative to other fear and phobia subtypes. Eur J Oral Sci 2009; 117(2): 135-143.
16. Agdal ML, Raadal M, Skaret E, Kvale G: Oral health and its influence on cognitive behavioral therapy in patients fulfilling the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for intra-oral injection phobia. Acta Odontol Scand 2010; 68(2): 98-105.
17. El-Qaderi SS, Taani DQ: Oral health knowledge and dental health practices among schoolchildren in Jerash district/Jordan. Int J Dent Hyg 2004; 2(2): 78-85.
18. Crocombe LA, Broadbent JM, Thomson WM et al.: Dental visiting trajectory patterns and their antecedents. J Public Health Dent 2011; 71(1): 23-31.
