Background:Dental anxiety is a major barrier for dental care utilization. Hence, identifying anxious individuals and their appropriate management becomes crucial in clinical practice.Aim:The study aims to assess dental anxiety, factors influencing dental anxiety, and anxiety towards tooth extraction procedure among patients attending a dental hospital in India.Materials and Methods:The study sample consisted of 1,148 consecutive patients aged 18-70 years. The assessment tools consisted of a consent form, history form, a questionnaire form containing the Modified Dental Anxiety Scale (MDAS) which was used to assess the level of dental anxiety, and an additional question on anxiety towards dental extraction procedure.Results:Among the study group, 63.7% were men and 36.3% were women. Based on the MDAS score, 45.2% of the participants were identified to be less anxious, 51.8% were moderately or extremely anxious, and 3% were suffering from dental phobia. Mean MDAS total score was 10.4 (standard deviation (SD) = 3.91). Female participants and younger subjects were more anxious (P < 0.001). Subjects who were anxious had postponed their dental visit (P < 0.001). Participants who had negative dental experience were more anxious (P < 0.05). Notably, 82.6% reported anxiety towards extraction procedure. Significant association was seen between anxiety towards extraction procedure and the respondents gender (P < 0.05), age (P < 0.001), education level (P < 0.05), employment status (P < 0.001), income (P < 0.001), self-perceived oral health status (P < 0.05), and their history of visit to dentist (P < 0.05).Conclusion:Significant percentage of population was suffering from dental anxiety in this study population. A plethora of factors like age, gender, education level, occupation, financial stability, and previous bad dental experience influences dental anxiety to various levels. Extraction followed by drilling of tooth and receiving local anesthetic injection provoked more anxiety.

The aim of this study was to test the reliability and validity of the Tamil version of the Modified Dental Anxiety Scale (MDAS). One hundred and forty-six patients attending the Outpatient Department of SRM Dental College, Chennai, India consented to participate in the study. The assessment tools consisted of a history form, Tamil version of the MDAS questionnaire and a form for Visual Analogue Scale (VAS). The Tamil version of MDAS had a good internal consistency of 0.839. The mean total score decreased with age. Females were more anxious than males (10.16 and 9.43, respectively). Uneducated, unemployed and low income subjects were more anxious than their counterparts who were educated, employed and from a higher income group. Persons who perceived their oral health as poor were more anxious. Independent t-test showed a highly significant difference in the mean total score of the respondents who had postponed their dental visit due to anxiety (t-test 6.494, P < 0.001). VAS and MDAS scores showed a highly significant correlation (r = 0.827, P < 0.001).This supported the convergent validity of MDAS. The Tamil version of MDAS showed acceptable psychometric properties. (J Oral Sci 54, 313-320, 2012)

Over the past several decades, studies have demonstrated the existence of bi-directional relationships between periodontal disease and systemic conditions. Periodontitis is a polymicrobial and multifactorial disease involving both host and environmental factors. Tissue destruction is primarily associated with hyperresponsiveness of the host resulting in release of inflammatory mediators. Pro-inflammatory cytokines play a major role in bacterial stimulation and tissue destruction. In addition, these cytokines are thought to underlie the associations between periodontitis and systemic conditions. Current research suggests that increased release of cytokines from host cells, referred to as the cytokine storm, is associated with disease progression in patients with coronavirus disease 2019 (COVID-19). An intersection between periodontitis and pulmonary disease is biologically plausible. Hence, we reviewed the evidence linking COVID-19, cytokines, and periodontal disease. Plaque control is essential to prevent exchange of bacteria between the mouth and the lungs, reducing the risk of lung disease. Understanding these associations may help identify individuals at high risk and deliver appropriate care at early stages.

Abstract:We evaluated whether a visual analog scale (VAS) was comparable to the multi-item Modified Dental Anxiety Scale (MDAS) in assessing dental anxiety in clinical practice. In total, 200 consecutive patients aged 20-70 years who presented at the dental outpatient department of SRM Dental College, Chennai were enrolled. The test-retest value for the VAS was 0.968. The Spearman rank correlations between the VAS and MDAS items and total score were significant (P < 0.001). The Spearman rank correlation between postponement of a dental visit and the VAS also showed a strong correlation (r = 0.473, P < 0.001). On linear regression analysis, the coefficient of determination showed a strong relationship between the two variables; the MDAS accounted for 74% of the variation. The regression coefficient was statistically significant (P < 0.001). On the basis of receiver-operating-characteristic curve analysis, a VAS cut-off value of ≥4.8 was selected to discriminate between patients who were and were not anxious, and a cut-off value of ≥7 was selected to identify patients with dental phobia. The weighted kappa was 69% for agreement between MDAS and the VAS in identifying patients with and without dental anxiety at cut-offs of 13 and 4.75, respectively. The VAS was found to be a valid measure and was comparable to the multi-item MDAS. (J Oral Sci 56, 151-156, 2014)

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