Antecedents of dental anxiety: learned responses versus personality traits

Abstract

The origins of dental fear and anxiety are numerous and complex. The purpose of the present study was to evaluate the relative effects of learned responses and subjective personality traits on the development of dental anxiety. The study was carried out in kibbutzim (closed homogeneous societies) in Israel where all subjects had received dental treatment from the same dentist since childhood with no choice of dentist. Subjects were requested to fill out questionnaires concerning their dental anxiety (DAS) in the past and at present, an evaluation of their dentist in the past and at present, and a psychopathologic symptom survey (SCL-90). The results show that dental anxiety at present correlates significantly with the evaluation of the present dentist; with dental anxiety as remembered from childhood; and with the following SCL-90 scales: interpersonal sensitivity, anxiety, phobic anxiety and Positive Symptom Distress Index. The best predictors of dental anxiety at present were the evaluation of the present dentist and past dental anxiety (as remembered from childhood). The results suggest that the level of the subject's dental anxiety is affected by environmental factors (evaluation of the present dentist, memories of anxiety from childhood), and by personality traits as evaluated by the SCL-90 questionnaire.

Modulation of dental anxiety — the role of past experiences, psychopathologic traits and individual attachment patterns

“…11 This is probably because in the past, dentists who worked in the relevant Kibbutzim did not use local analgesia on a routine basis and apparently inflicted pain to their patients. Generally, the highly fearful or phobic patient scores 13 or higher on the DAS scale.…”

“…24 Present data confirm previous findings that dental anxiety is significantly associated with memories that subjects have regarding their dental experiences at childhood, as well as with several psychopathologic traits. 11 Nevertheless, it should be remembered that the patient's present anxiety can affect the description of previous experiences 41 and that data concerning the past may be inadequate at times because of faulty memory and of a retrospective bias. 42 When the variables based on memory (DASp, DESp) were excluded from the calculations, the variable which best predicted present dental anxiety was the trait of anxiety as recorded by the SCL-90R questionnaire.…”

“…1,19,20 In the present study, the Hebrew version of DAS was used, for which validity has been well established. 11,[21][22][23][24][25] Subjects were presented with both a present and past tense version of the questionnaire as previously reported. 11 The present version related to the level of dental anxiety at present (DASn) and the past version related to the level of dental anxiety as remembered from childhood (DASp).…”

“…The DES was presented to subjects in a present and past tense version, as described previously. 11 with the present version relating to the present dentist (DESn) and the past version relating to the dentist who treated subjects at childhood (DESp).…”

“…The level of dental anxiety of Kibbutz members is affected by both environmental factors (evaluation of their present dentist, memories of dental anxiety from childhood) and by several psychopathologic traits. 11 Attachment theory, initially presented by Bowlby,12 concerns the bond between the child and their caregiver. Parental responsiveness and availability to the infant in time of distress provide the child with a 'secure base' upon which to organise experience and to handle stress.…”