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Prevalence, characteristics and consequences of dental anxiety in a randomly selected sample of 645 Danish adults were explored in telephone interviews. Participation rate was 88%. Demographics, fear of specific procedures, negative dentist contacts, general fear tendency, treatment utilization and perceived oral conditions were explored by level of dental anxiety using a modified Dental Anxiety Scale (DAS). A Seattle fear survey item and a summary item from the Dental Fear Survey (DFS) were also included for fear description comparisons. Correlation between these indices (DAS-DFS: rs = 0.72; DAS-Seattle item: rs = 0.68) aided semantic validation of DAS anxiety intensity levels. Extreme dental anxiety (DAS > or = 15) was found in 4.2% of the sample and 6% reported moderate anxiety (DAS scores 14-12). Bivariate (B) and logistic regression (L) odds ratios (OR) showed that high dental anxiety was associated with gender, education and income, but not with age. Extreme dental anxiety for dentate subjects was characterized by fear of drilling (ORL = 38.7), negative dentist contacts (ORL = 9.3), general fear tendency (ORL = 3.4), avoidance of treatment (ORL = 16.8) and increased oral symptoms (ORB = 4.4). Moderate dental anxiety was also related to drilling (ORL = 22.3), but with less avoidance due to anxiety (ORL = 6.8) compared with low fear subjects.

Background: Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena.

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Dentists' perceptions about the stressfulness of dental practice, their perceptions about dental anxiety and its management were surveyed in a descriptive study. A mailed questionnaire was completed by 216 randomly selected Danish private dentists. Of these, nearly 60% perceived dentistry as more stressful than other professions. Dentist perceptions of the most intense stressors were (ranked): 1) running behind schedule, 2) causing pain, 3) heavy work load, 4) late patients and 5) anxious patients. Bivariate odds ratio (OR) analyses were undertaken to check for associations of perceived stress and other dentist variables with perceptual outcomes about anxious patients. Signs of dental anxiety were reported to be less often spotted by older (> or = 52 yr) dentists (OR=3.1) who perceived their job stress to be greater than that of other professionals (OR=3.2). Perceived causes of dental anxiety (1st, 2nd or 3rd choices tallied and then ranked) were 1) fear of pain, 2) trauma in dental treatment, 3) general psychological problems, 4) shame about dental status and 5) economic excuses. Dentists who reported that dental anxiety was primarily the result of general psychological problems in patients, usually had solo (OR=2.4) practices older than 18 years (OR=2.6) and reported high perceived stress (OR=2.2). Adjusted odds ratios for these two dentist perception outcomes about anxious patients generally improved strength of associations and confidence intervals. There were no meaningful differences by practice location or perceived public image. Also, there was no significant association between the use of pharmacological strategies for anxiety and the perceived stress of dentists. Nearly all dentists talked with anxious patients as their main treatment strategy. It was concluded that psychosocial aspects of dental practice have meaningful and often adverse associations with dentist perceptions about anxious patients. Some dentists appeared to require more knowledge about dental anxiety and managing their own stress.

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Questionnaire responses of 155 self-referred subjects with extreme dental fear were used to evaluate the reliability and clinical usefulness of some psychometric tests used in diagnosis and treatment. The Corah Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory (STAI), and a general Geer Fear Scale (GFS) were filled out by all subjects, while 80 patients with highest dental fear scores were also tested before and after dental fear treatment with the following scales; a Getz Dental Belief Survey (DBS), Dental Fear Survey (DFS), and a Mood Adjective Checklist (MACL). Cronbach's alpha measured internal consistency reliability. SPSS data analyses calculated item-remainder and test-retest correlations. Clinical usefulness of scales was judged by Spearman correlations of initial scores and test score changes after dental fear treatment. All total test scores showed high internal consistency and test-retest reliability. DFS was judged the preferred clinical measure of threatening perceptions of pain or unpleasantness specific to dental procedures. DBS and STAI-State measured confidence in relating with the dentist and situational fear associated with that relationship. GFS, STAI-Trait, and MACL discriminated levels of general fearfulness, anxiety and mood fluctuations that can impact on dental fear.

Dentists' perceptions about the stressfulness of dental practice, their perceptions about dental anxiety and its management were surveyed in a descriptive study. A mailed questionnaire was completed by 216 randomly selected Danish private dentists. Of these, nearly 60% perceived dentistry as more stressful than other professions. Dentist perceptions of the most intense stressors were (ranked): 1) running behind schedule, 2) causing pain, 3) heavy work load, 4) late patients and 5) anxious patients. Bivariate odds ratio (OR) analyses were undertaken to check for associations of perceived stress and other dentist variables with perceptual outcomes about anxious patients. Signs of dental anxiety were reported to be less often spotted by older (> or = 52 yr) dentists (OR=3.1) who perceived their job stress to be greater than that of other professionals (OR=3.2). Perceived causes of dental anxiety (1st, 2nd or 3rd choices tallied and then ranked) were 1) fear of pain, 2) trauma in dental treatment, 3) general psychological problems, 4) shame about dental status and 5) economic excuses. Dentists who reported that dental anxiety was primarily the result of general psychological problems in patients, usually had solo (OR=2.4) practices older than 18 years (OR=2.6) and reported high perceived stress (OR=2.2). Adjusted odds ratios for these two dentist perception outcomes about anxious patients generally improved strength of associations and confidence intervals. There were no meaningful differences by practice location or perceived public image. Also, there was no significant association between the use of pharmacological strategies for anxiety and the perceived stress of dentists. Nearly all dentists talked with anxious patients as their main treatment strategy. It was concluded that psychosocial aspects of dental practice have meaningful and often adverse associations with dentist perceptions about anxious patients. Some dentists appeared to require more knowledge about dental anxiety and managing their own stress.