Little attention has been given to the issue of the age of onset of dental anxiety, even though it may have a bearing on the origins of this type of fear. This study aimed to identify the age of onset of dental anxiety and to identify differences by age of onset with respect to potential etiological factors, such as negative dental experiences, family history of dental anxiety, and general psychological states. Data were collected by means of two mail surveys of a random sample of the adult population. Of 1420 subjects returning questionnaires, 16.4% were dentally anxious. Half, 50.9%, reported onset in childhood, 22.0% in adolescence, and 27.1% in adulthood. Logistic regression analyses indicated that negative dental experiences were predictive of dental fear regardless of age of onset. A family history of dental anxiety was predictive of child onset only. Adolescent-onset subjects were characterized by trait anxiety and adult-onset subjects by multiple severe fears and symptoms indicative of psychiatric problems. The three groups were similar in terms of their physiological, cognitive, and behavioral responses to dental treatment. However, adolescent- and adult-onset subjects were more hostile toward and less trusting of dentists. These results indicate that child-onset subjects were more likely to fall into the exogenous etiological category suggested by Weiner and Sheehan (1990), while adult-onset subjects were more likely to fall into the endogenous category.

The ability of nicotine to decrease sensitivity to pain in humans has been a subject of dispute. Decreased sensitivity has been demonstrated in studies involving men, whereas the effect has been less obvious or absent in studies involving predominantly, or entirely, women. To determine whether there are gender differences in nicotine's hypoalgesic actions, ratings of electrocutaneous stimulation were obtained from 30 male and 44 female smokers and nonsmokers under placebo and nicotine conditions. Nicotine increased the pain threshold and tolerance ratings of men but had no effect on the pain ratings of women. Among men, there was no effect of smoking history, suggesting that the changes in pain perception reflect a direct pain-inhibitory effect of nicotine rather than a relief from acute nicotine withdrawal. Nicotine had no effect on mood or task ratings, indicating that the antinociceptive effects observed were not due to nicotine's putative mood effects.

Studies of the prevalence of dental anxiety in general population samples have produced estimates which range from a low of 2.6% to a high of 20.4%. It is not clear whether these reflect real differences among populations or whether they are the result of the use of different measures and different cut-off points. We undertook a large scale mail survey of dental anxiety in a random sample of the adult population living in Metropolitan Toronto designed to assess the performance of and agreement between three measures. These were Corah's DAS, the single item used by Milgrom and colleagues in Seattle and the ten-point fear scale used by Gatchel. These measures and their published cut-off points produced prevalence estimates of 10.9%, 23.4% and 8.2% respectively. While there was a significant association between scores on pairs of measures the agreement between them was far from perfect. Kappa values ranged from 0.37 to 0.56, indicating only fair to moderate agreement beyond chance. There was evidence to indicate that the dentally anxious subjects identified by each measure differed according to certain behavioural and other characteristics. The results of the study suggest the need to revisit the issue of measurement in studies of dental anxiety.

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On 4 days, in everyday situations, 21 female and 26 male smokers used an electronic diary to record situations and moods at times of smoking and at control nonsmoking occasions. Self-reports of particular locations, activities, posture, consumption, social context, moods, and internal states were specifically associated with smoking. Real-time assessments in everyday situations provide useful information about the interplay of environmental factors and internal states in smoking. The findings suggest that conditioning and learning processes play a role in smoking and should be considered in smoking cessation programs.

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