Methods Helping Dentists to Detect Dental Fear.

OBJECTIVES: Dental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients' self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed. METHODS: A cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new "traffic light" colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants. RESULTS: Of the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF "traffic light" system. The association between dentists' and participants' estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = -0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS. CONCLUSIONS: Colour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.

Patient and Caregiver Perceptions of Animal Assisted Activity in Orthodontics.

Dental anxiety affects up to 21% of children and 80% of adults and is associated with lifelong dental avoidance. Animal assisted activity (AAA) is widely used to reduce anxiety and pain in medical settings and has promise in dentistry. The primary objective of this study was to evaluate caregiver and patient perceptions of canine AAA in orthodontics. A cross-sectional survey consisting of pre-tested and validated questions was conducted (n = 800) including orthodontic patients (n = 352 minors, n = 204 adults) and parents/caregivers (n = 244) attending university orthodontic clinics. In this study, AAA and dog therapy were not used or tested for dental anxiety management. More than a third of orthodontic patients (37%) had moderate or greater anxiety related to care. Participants believed that therapy animals would make dental experiences more enjoyable (75%) and reduce anxiety (82%). There was little to no concern expressed regarding cleanliness (83%), allergies (81%), and safety (89%) with a therapy animal in dental settings. Almost half of the participants would preferentially select an orthodontic office offering AAA. In light of the COVID-19 pandemic, we assessed whether perceptions of AAA changed before and after the shutdown of dental offices, with no significant differences. Across patients and caregivers, the responses support the use of AAA in orthodontic settings with minimal concerns.

Self-reported factors for improving patient's dental care: A pilot study.

OBJECTIVES: Patient-centered approach can offer valuable information in improving dental care, but literature is scarce. This study aimed to evaluate self-reported factors beneficial for attendance in dental care. MATERIAL AND METHODS: Survey data were collected during the summer of 2020 comprising both structured questionnaires and an open question on factors considered beneficial for dental attendance. Voluntary patients over 15 years of age (n = 196, 98%) agreed to fill the questionnaires, and n = 112 of them (57%) also gave open commentary in an urgent dental care clinic, City of Oulu, Finland, comprising the study population. Dental fear was assessed by Modified Dental Anxiety Scale (MDAS) sum scores (min 5, max 25). All utterances (n = 181) on an open question were evaluated by inductive content analysis to create sub- and main categories. Covid-19 pandemic case counts in Finland were low at the time of the survey, but their effect on seeking dental care was asked. The distribution of patients was evaluated by cross-tabulation, considering their age, gender, and dental fear status; the significance level was p < .05. RESULTS: Females dominated slightly the study population (57%). The mean age of the respondents was 44 years. Half (50%) had moderate (MDAS score 10-18), and 10% had severe dental fear (≥19). The open responses could be categorized into four main categories. The largest main category by patient count concerned factors related to personnel (29%), followed by the patient (28%) and treatment (25%) related, and administrative factors (19%). Males chose factors falling into categories of administration and treatment while females chose patient and personnel-related factors (p = .048). Compared to the rest, fearful persons (MDAS > 9) reported more often factors related to personnel and treatment (p = .03). Of all participants, 17% reported seeking less dental care during the pandemic. CONCLUSIONS: Patients value dental personnel and treatment-related factors, specifically those with fear.

Perception and dental fear toward dental treatment among Saudi population who received Coronavirus disease-19 vaccine

Aim: To assess the perception and fear of Saudi population who took COVID-19 toward dental treatment. Methodology: A cross-sectional pilot questionnaire study with 32 questions was distributed from 18 June, 2021 till 30 June, 2021 via social-media platforms. In addition, the inclusion criteria were Saudi, above 18 years old, and who took COVID-19 vaccine. A questionnaire included sociodemographic data, COVID-19 fear scale, dental clinic avoidance structured questions, and perception scale. After developing and translating the questionnaire into Arabic, Google Form was used to create an anonymous, self-administered web-based survey. For the categorical variables, descriptive statistics of frequency distribution and percentages were calculated using SPSS. Result: A total of 580 participants completed the survey;however, 48 were exduded because they did not fit with our inclusion criteria. In regarding to the fear of COWD-19, majority of male disagree with the fear of COVID-19 statements and have less fear than female (P<0.05). Yet, in one statement Q4 people with higher income were more afraid to lose their life (P<0.05). Furthermore, Educational-level and income were two variables that showed a significant relationship with P=0.05 in terms of perception. Conclusion: Fear scale after getting the vaccine is becoming less and people started seeking dental treatment with different concerns other than pain or emergency. Educational-level and income were the cause of different perceptions in participants. Although participants with postgraduate education mainly agree that dental office has strict disinfection route, but the dentist can get and transmitted COVID-19 from/to the patient.

RELATIONSHIP KNOWLEDGE TRANSMISSION OF COVID 19 AND FEAR OF DENTAL CARE DURING PANDEMIC- A POPULATION BASED SURVEY

Introduction :Dental phobia is linked to avoiding dental checkups as well as poor oral health outcomes. During COVID-19, it is critical to analyse the distribution of dental fear and preference for emergency dental treatment across the adult population. As a result, the goal of this study was to assess dental phobia and emergency dental therapy among COVID-19 quarantined general population. Therefore the aim of this study is to determine the relationship between transmission and knowledge of COVID-19 and fear for dental treatment during pandemic among the general population. Materials and Methods: Online questionnaire using Google forms distributed through social media .The level of knowledge about coronavirus transmission was measured using a questionnaire consisting of knowledge and level of fear questions . 100 participants were the sample size. The questionnaire gives the responses and anxiety categories for dental care during pandemic. Results :100 respondents came from media users. Respondents who experienced "dental health problems" during the pandemic were 60%. The knowledge of respondents about the transmission of the COVID-19 virus in dental care was 80% and the knowledge of the fear of caring during the pandemic period was 50.67% afraid. Statistical analysis showed a significant relationship between knowledge about transmission of the COVID-19 virus and fear of dental care (p<0.005). Conclusion: The results obtained have a significant relationship between knowledge about transmission and fear for dental care during the COVID-19 pandemic among the general population.

Psychometric Testing of the Modified Dental Anxiety Scale among Iranian Adolescents during COVID-19 Pandemic.

(1) Background: The present study aimed to examine the psychometric properties of the Persian adaptation of the Modified Dental Anxiety Scale (MDAS) in Iranian adolescents. (2) Methods: Adolescents with a mean age of 15.10 (n = 3197; 47.1% males) were recruited from Qazvin city of Iran using a stratified cluster random sampling technique. All children completed the five-item Persian MDAS and information related to background characteristics. Psychometric testing was conducted using classical test theory (CTT) and Rasch models. For CTT, an item-total correlation of >0.4 was considered satisfactory while for Rasch analysis, infit and outfit mean squares (Mnsq) ranging from 0.5-1.5 were considered satisfactory. Confirmatory Factor Analysis (CFA) was conducted to confirm the unidimensional structure of MDAS using various fit indices. Differential item functioning (DIF) was evaluated based on gender and time since last dental visit. Moreover, latent class analysis (LCA) was used to classify the participants into different levels of dental fear based on their pattern of responses. Both item level reliability using Cronbachs alpha (α) and test-reliability using intraclass correlation coefficients were evaluated. (3) Results: Item-total correlations ranged from 0.69-0.78, infit MnSq ranged from 0.80 to 1.11 and the range of outfit MnSq was 0.84-1.10. The data confirmed a one-factor structure of MDAS with satisfactory fit indices. DIF analysis indicated that the scale was interpreted similarly across the genders and time since dental visit groups. LCA analysis identified three levels, low, moderate and high levels of dental anxiety. The groups with moderate and high levels of dental anxiety had more females (44.6% and 36.7%) than the group with low level of dental anxiety (18.8%; p < 0.001). α of the total scale was 0.89 and item test-retest reliability ranged from 0.72-0.86. (4) Conclusions: The Persian MDAS was unidimensional with satisfactory psychometric properties evaluated using both CTT and Rasch analysis among Iranian adolescents. The scale was stable across the genders and individuals with different dental visiting patterns. The Persian MDAS also demonstrated excellent reliability.

Adolescent Dental Fear and Anxiety: Background, Assessment, and Nonpharmacologic Behavior Guidance.

Adolescence, the period from 11 to 21 years of age, bridges the chasm between childhood and adulthood. Adolescence can be challenging as bodies, cognition, and personality go through major transformations, but it is also a time of great joy as confident adults with a clear identity develop. Dentists need to be knowledgeable about the developmental characteristics of this group because some of the cognitive and emotional changes make adolescents vulnerable to new fears. Dentists must tailor behavior guidance to this developing psyche in a way that respects independence and promotes confidence to foster lifelong positive views of dentistry.

Anxiety and facial self-contacts: possible impact on COVID-19 transmission in dental practice.

BACKGROUND: The purpose was to analyse the associations between dental and trait anxiety, fear of COVID-19 and the duration and frequency of spontaneous hand-to-face contact (self-contact). METHODS: A cross-sectional design was carried out with 128 adult patients from four dental clinics in Madrid, during the confinement, from March 15 to May 15. The patients' movements in the waiting room were monitored with Microsoft Kinect Software, also completed the Trait anxiety subscale of the STAI, the COVID-19 Fear and the S-DAI questionnaire. RESULTS: Associations were observed between the duration and frequency of facial, mask and eye contact with trait anxiety and dental fear was determined only by the frequency of this self-contact. Trait anxiety is associated with dental anxiety and with fear of COVID-19. Although facial self-contact is higher in women, it also rises in men as dental fear increases. Moreover, dental anxiety is a good predictor of trait anxiety and the incidence of facial self-contact. CONCLUSIONS: Understanding the possible associations between biopsychosocial factors, such as trait anxiety, dental anxiety and self-contact is important. It may help to prevent the spread of COVID-19 in the population as well as enabling the formulation of effective interventions to improve oral health care through the implementation of dental care programmes.