Methods Helping Dentists to Detect Dental Fear

Taina Kankaala; Päivi Rajavaara; Maria Kestilä; Minna Väisänen; Hannu Vähänikkilä; Marja-Liisa Laitala; Vuokko Anttonen

doi:10.1016/j.identj.2022.06.018

Methods Helping Dentists to Detect Dental Fear

Int Dent J. 2023 Apr;73(2):228-234. doi: 10.1016/j.identj.2022.06.018. Epub 2022 Jul 30.

Authors

Taina Kankaala¹, Päivi Rajavaara², Maria Kestilä³, Minna Väisänen³, Hannu Vähänikkilä⁴, Marja-Liisa Laitala⁵, Vuokko Anttonen⁵

Affiliations

¹ Department of Cariology, Endodontology, and Paediatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Finland; Dental Teaching Unit, City of Oulu, Finland. Electronic address: taina.kankaala@oulu.fi.
² Department of Cariology, Endodontology, and Paediatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Finland; Dental Teaching Unit, City of Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital.
³ Department of Cariology, Endodontology, and Paediatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Finland.
⁴ Biostatistician Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Finland.
⁵ Department of Cariology, Endodontology, and Paediatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital.

Abstract

Objectives: Dental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients' self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed.

Methods: A cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new "traffic light" colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants.

Results: Of the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF "traffic light" system. The association between dentists' and participants' estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = -0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS.

Conclusions: Colour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.

Keywords: Dental anxiety; Dental fear; Dentist; Evaluating.

MeSH terms

COVID-19*
Cross-Sectional Studies
Dental Anxiety*
Dentists
Humans
Middle Aged
Pandemics
Surveys and Questionnaires