The variables associated with dental anxiety and their management in primary care dental clinics in Bahrain: a cross-sectional study

Abstract

Background 20–80% of adults presenting to a dental clinic experience anxiety. Negative past dental experiences and environmental factors such as the waiting area of a dental clinic or sound of a drill are commonly considered triggering factors for anxiety. Anxiety management strategies are considered a part of routine dental procedure, due to increased prevalence and compromised patient care. Hence the aim of the present study is to identify the prevalence and variables associated with dental anxiety and their management in patients visiting the primary care dental clinics in Bahrain. Method Four hundred and eighty participants were included. A 3-part questionnaire deciphered the demographic characteristics of the participants, the dental procedure undertaken, the level of anxiety, and the management strategy used by the dentist. The pre and post-treatment MDAS scores were recorded. Paired t test, ANOVA and Wilcoxon signed rank test was used to test the level of significance between the variables and the mean MDAS scores. The p ≤ 0.05 was considered statistically significant. Results The prevalence of dental anxiety was 23.7% with moderate anxiety, and 11.4% with high anxiety. Females presented with a higher mean MDAS both pre and post-treatment compared with males. A statistically significant difference between the pre and post-treatment MDAS scores were observed in educated patients less than 50 years of age. Those with unpleasant previous dental experience showed statistically significant difference. Analyses of anxiety management techniques showed that single techniques worked better than combination techniques. Rest and breaks combined with any other technique of choice showed significant reduction in the MDAS scores post treatment. Conclusion To conclude, all patients attending the dental clinic present with some level of anxiety that necessitates the dentist to use anxiety management strategies. Non-pharmacological methods that are non-invasive must be the first choice. Rests and breaks, with any technique of choice provides the best possible anxiety management. It is possible to achieve the desired anxiety reduction in single visit to complete the planned dental intervention, other than in patients who are dental phobic.

Evaluating the stress of root canal treatment in patients and dentists compared to other dental treatments: A systematic review and meta‐analysis

“…No study provided specification about which phase or form of endodontic therapy was included, except the study by Sivaramakrishnan et al. [37] which specified that only endodontic access was assessed.…”

“…At least two comparator dental treatments were assessed in all studies, except for two studies [32, 38]. The most common comparator procedure was restorative, which was assessed in 20 studies [8, 10, 12, 23, 24, 26–30, 33–42], followed by oral surgery in 17 studies [8, 10, 23–26, 30–37, 39–41], and finally cleaning in 13 studies [8, 10, 24, 31, 33–37, 39–42]. For the most popular comparator treatments, most studies did not subgroup the procedures, except for Collado et al.…”

“…Based on a critical appraisal of the information published, no included study qualified as having a low risk of bias because each study had a high risk of bias in at least one domain. Eleven studies involved an unclear risk of bias [8, 23–29, 31, 36, 42], and the remaining 12 studies had a high risk of bias [10, 12, 30, 32–35, 37–41]. The overall study quality ranged from moderate to very–low.…”

“…Furthermore, four studies reporting MDAS as an outcome measure also administered the survey instrument prior to treatment [36–39]. However, two of these studies were excluded from meta‐analysis, including the study by de España et al.…”

“…Eight studies assessed the stress within providers of dental treatment, including two assessing general dental practitioners [23,24], one assessing dental specialist practitioners [12], and the remaining five examining dental students [25][26][27][28][29]. Meanwhile, all other inluded studies assessed stress within patient groups [8,10,[30][31][32][33][34][35][36][37][38][39][40][41][42]. Eight of the included studies used questionnaires but were not in a clinical setting.…”