Predictors of dental anxiety and effects of treatment with nitrous oxide and midazolam in dentally phobic patients

Abstract

The role of general anxiety measured by the Hospital Anxiety and Depression Scale (HADS), or the Spielberger Trait Anxiety scale, (STAI‐T) on dental anxiety (measured by the Corah Dental Anxiety Scale, the Kent Phobia Scale and by analogue ratings concerning specific procedures) of dentally phobic patients was examined using multiple regression analysis. HADS anxiety and STAI‐T scores were both significant predictors of Corah scores; whereas HADS depression and STAI‐T predicted Kent scores, which measure how concerns about dentistry affect emotional and social well‐being. Fear of coming for an appointment significantly contributed to both scores and was itself predicted by anxiety about having an instrument in the mouth. The effects of sedation with nitrous oxide or midazolam on the change in dental anxiety after two treatment sessions in patients with high or low HADS anxiety were compared. Both drugs resulted in significant and equal reductions in scores on the Corah scale and anxieties about an instrument in the mouth, drilling and filling, in both high and low anxiety groups. None of the groups showed a significant reduction in scores on the Kent scale or in fear of coming for an appointment.

Influence of the Serotonergic System Polymorphism on the Expression of Dental Anxiety

“…In other words, the presence of S allele is suggestible to higher score on DAS-R scale, i.e. higher expression of dental anxiety, which supports the previously noticed relations between S allele 5-HTTLPR polymorphism and anxiety, anxious people and neuroticism ( 5 - 7 ).…”

“…in a meta-analysis of 44 studies found correlation between SLC6A4 gene polymorphism and personality dimensions of anxiety, although in subsequent research conducted on mentally healthy subjects no such correlation was found ( 39 ). On the other hand, numerous studies suggest the relation between neuroticism and dental anxiety ( 5 - 7 ), as well as a higher frequency of S allele in subjects suffering from depression and anxiety disorders ( 35 ). Halonen et al in their research found a significant and positive correlation between dental anxiety and neuroticism and a significant although negative correlation with extraversion ( 5 ).…”

“…In the literature, dental anxiety is related to different factors including personality traits ( 5 - 7 ), fear of pain ( 8 - 10 ), previous traumatic experience connected to dental treatment ( 11 ), members of the family influenced by expressed dental anxiety ( 8 ), fear of blood and injury ( 12 - 15 ), genetic factors ( 16 , 17 ), socioeconomic factors ( 18 ), and alexithymia ( 19 , 20 ). Most authors found positive correlation between dental anxiety and anxious personality dimensions ( 6 - 8 ).…”

Dental anxiety and trait anxiety: an investigation of their relationship

“…In contrast, a signifi cant positive correlation between dental anxiety and trait anxiety has also been reported. 11,22 This discrepancy might be explained by methodological issues. For example, studies cited above tested small samples of patients undergoing third molar removal surgery or other dental treatment, while our data were based on a large sample involving a general population.…”

¿Por qué se le tiene miedo al dentista?: Estudio descriptivo de la posición de los pacientes de la Sanidad Pública en relación a diferentes factores subyacentes a los miedos dentales

“…La utilización de las benzodiacepinas por diferentes vías de administración (oral, rectal, intranasal, intravenosa) es frecuente y sobradamente conocida en la prevención de estos problemas [14][15][16][17] . Otra alternativa es el uso de óxido nitroso que también se muestra eficiente en la prevención de estos sucesos 16,18 . Otros profesionales obtienen una reducción sustancial de la ansiedad y el miedo dental a través de sencillas sesiones de reestructuración cognitiva, modificando las ideas negativas que los sujetos tienen, perdurando en el tiempo la reducción del miedo conseguida 17,[19][20][21][22] .…”