Psychometric assessment of anxiety with the Modified Dental Anxiety Scale among central Indian adults seeking oral health care to a dental school

Ind Psychiatry J. 2016 Jul-Dec;25(2):202-209. doi: 10.4103/ipj.ipj_16_16.

Abstract

Background: Anxiety toward dental treatment can cause people to delay or avoid seeking oral health care despite being in need of treatment. Therefore, recognizing such anxious patients and their appropriate management plays important aspects in clinical practice.

Aim: The aim of this study was to investigate the level of dental anxiety (DA), factors affecting it, and anxiety toward dental extraction among adults seeking dental care to a dental school in Central India.

Materials and methods: The study sample consisted of 1360 consecutive patients aged 18-70 years. Participants completed a questionnaire while in the waiting room, which included the Modified Dental Anxiety Scale (MDAS) to assess the level of DA. An additional item was included which asked participants to rate the anxiety felt on having a tooth extracted.

Results: Among the study group, 65.1% were men and 34.9% were women. Based on the MDAS score, 41.8% of the participants were identified to be less anxious, 53.2% were moderately or extremely anxious, and 5% were suffering from dental phobia. Female participants and younger patients were more anxious (P = 0.0008). Patients who were anxious had postponed their dental visit (P = 0.0008). Participants who had negative dental experience were more anxious (P = 0.03). Nearly, 83% reported anxiety toward extraction procedure. A significant association was observed between anxiety toward dental extraction and the patients' gender (P = 0.03), age (P = 0.0007), education level (P = 0.03), employment status (P = 0.0006), income (P = 0.0007), self-perceived oral health status (P = 0.03), and their history of visit to dentist (P = 0.02).

Conclusion: Majority of patients in this population revealed high levels of DA. Factors such as age, gender, education level, occupation, financial stability, and previous bad dental experience influence DA to various levels. Extraction followed by injection of local anesthetics and drilling of tooth provoked more anxiety.

Keywords: Dental anxiety; Modified Dental Anxiety Scale; extraction; phobia.