The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear

Abstract

Background: Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored.

Prevalence of and factors associated with dental anxiety among medical and dental students of the Northern State Medical University, Arkhangelsk, North-West Russia

“…Poor self-assessed oral health may reflect dental problems students may have, which in turn may result in DA. This corresponds to findings from other studies [8,9]. …”

“…Moreover, having experienced pain in the mouth was an independent significant factor of a higher DA in dental students. The model of the vicious cycle of dental fear, postulated by Armfield et al in 2007, hypothesised that “people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear” [9]. Although causality in the present study cannot be established, and we only assessed factors associated with DA, one might assume that our findings are in line with this model.…”

“…The prevalence of high DA varies from 2% to 30% worldwide depending on the study population, the methods applied, and the cut-off scores used [1,8]. There is strong evidence that DA is associated with dental attendance; it has been reported that individuals with higher DA tend to visit the dentist irregularly [9,10], which in turn may lead to a deterioration in oral health. Studies have demonstrated that DA is associated with poor self-reported [8,9] and clinically assigned [11,12] oral health, more decayed and missing teeth [10,11], fewer filled teeth [10,12] and worse periodontal health [13].…”

“…There is strong evidence that DA is associated with dental attendance; it has been reported that individuals with higher DA tend to visit the dentist irregularly [9,10], which in turn may lead to a deterioration in oral health. Studies have demonstrated that DA is associated with poor self-reported [8,9] and clinically assigned [11,12] oral health, more decayed and missing teeth [10,11], fewer filled teeth [10,12] and worse periodontal health [13]. In addition, DA has been related to poor self-reported general health [8], psychological disorders [14], particular temperamental or psychological traits [7] and lower education [8,12].…”

Does the trait anxiety affect the dental fear?

“…Contents of this cycle include avoidance, increased the degree of dental problems, and may lead to feelings of embarrassment and inferiority. 9,10,11 Beyond the dental health state of the individual, dental fear also could affect the dentist-patient relation causing to misdiagnosis and redundant delay during the treatment process. 12 The interaction between dental fear and trait anxiety has been examined in different types of studies.…”