Development and Validation of the Oral Health Values Scale.

OBJECTIVES: Oral health values, the degree to which one places importance on or demonstrates investment in improving or maintaining one's dental status, are believed to vary across individuals. Research on this construct is in its infancy, so a new Oral Health Values Scale (OHVS) was developed and validated. The aim was to create a multidimensional measure of oral health values that could be used in future epidemiological or behavioural investigations involving determinants of dental treatment-seeking behaviour and/or oral health. METHODS: The OHVS was developed in three cross-sectional phases. A 45-item pool was developed, and 12 expert raters from various oral health professions rated the items for their representativeness and relevance, as well as specificity and clarity. Based on the expert feedback, an initial 30-item scale was subsequently established and administered to a developmental sample (N = 306) using Amazon's Mechanical Turk (MTurk). The scale was further refined to be 12 items and its structure was confirmed in a validation sample (N = 308), also using MTurk. Correlations among OHVS scores and other oral health-related constructs were examined in the developmental and validation samples. RESULTS: Expert review of items for the oral health values construct and the OHVS provided initial evidence of content validity. The final 12-item scale exhibited a four-factor structure with good internal consistency, α = 0.84. The psychometric properties of the final scale were confirmed in a second sample using confirmatory factor analysis, although evidence for the OHVS's four-factor structure was mixed. Overall, OHVS scores were consistently related to other oral health constructs in anticipated ways, providing evidence of construct validity. CONCLUSIONS: The OHVS demonstrated content validity, internal consistency, and construct validity. Results suggest that the OHVS is a psychometrically sound instrument.

Believing is seeing: Changes in visual perception following treatment for height fear.

BACKGROUND AND OBJECTIVES: People who are afraid of heights may have a perceptual bias, such that they see heights as higher than they truly are. The current study tested if there is a causal relationship between treatments for height fear and changes in perceptual bias. METHODS: Specifically, the effects on perceptual bias following three height fear interventions (exposure, cognitive bias modification for interpretations, and a combination of exposure and cognitive bias modification) and a control condition were examined in individuals with an extreme fear of heights (N = 107). RESULTS: Results provided preliminary evidence that some height fear interventions reduce perceptual bias. Specifically, participants that completed exposure had a significant decrease in perceptual bias, and participants in the cognitive bias modification and combination conditions had decreases in perceptual bias at the level of non-significant trends, while no reduction occurred for the control condition. LIMITATIONS: Limitations of this study include that the hypothesis was largely informed by data from a parent study and that the effect sizes were small; thus, replicating these results is warranted. CONCLUSIONS: These findings suggest that there may be a causal relationship between height fear treatments and altered perception of heights.

Periodontal Status and Quality of Life: Impact of Fear of Pain and Dental Fear.

Background. Oral health-related quality of life (OHRQoL) is impacted by periodontal disease and orofacial pain. There is a limited research examining the impact of avoidance of care or physiological arousal related to the fear of pain response on periodontal-related OHRQoL. Methods. Data are from the Center for Oral Health Research in Appalachia family-based study focusing on 1,339 adults. Measures included a modified Periodontal Screening and Recording Index across sextants of dentition, dental fear survey, Fear of Pain Questionnaire-9, and Oral Health Impact Profile-14. Structural equation modeling was used to estimate the effects of periodontal disease screening indicators on OHRQoL including the mediating role of dental fear while accounting for fear of pain. Results. A significant total effect was found for the mandibular anterior sextant, components of dental anxiety/fear, and indicators of OHRQoL (pain and discomfort, ß = .165, p = .001; psychosocial impact, ß = .199, p < .001). The maxillary anterior region was significantly associated with pain discomfort (ß = .116, p = .017) and functionality (ß = .130, p = .011). Conclusions. Findings provide a granular perspective of periodontal disease indicators and OHRQoL. Dental avoidance/anticipatory fear and physiological arousal mediate OHRQoL in individuals who have indicators of periodontal disease in sextants that may be visible and susceptible to higher pain and psychosocial impact.