Translation and Validation of Italian Version of Index of Dental Anxiety and Fear (IDAF-4C+): A Cross-Sectional Study

Dental anxiety (DA) is defined as unreasonable apprehension toward dental procedures. About 4–20% of the worldwide adult population presents DA, with peaks of 30% in the younger population. Managing patients with dental anxiety and fear with a reliable and valid instrument is necessary to understand the multidimensional dimensions of dental fear. This work aimed to validate the Index of Dental Anxiety and Fear (IDAF-4C+) into Italian. Two hundred and eighty dental students attending an Italian university were enrolled. The IDAF-4C+ was translated by experts and a native English translator, blinded to the original version. The Modified Dental Anxiety Scale (MDAS) was used to assess the validity of IDAF-4C+. Spearman correlation coefficients and Exploratory Factorial Analysis (EFA) were used. Reliability was evaluated by Cronbach’s alpha. The reliability of the Italian version of IDAF-4C+ was good (Cronbach’s alpha = 0.88). Correlation between IDAF-4C+ and MDAS ranged between 0.42 to 0.68. From EFA, one factor explained 58.76% of the common variance. Women showed a higher level of dental fear. The Italian IDAF-4C+ is a valid and reliable tool to assess DA in any clinical context. This instrument allows for a proper understanding and management of DA, and therefore a better patient oral health-related quality of life and compliance with the dentist’s instructions.

How Can We Reduce Dental Fear in Children? The Importance of the First Dental Visit

Dental fear is a common problem amongst children. It can affect children’s psychological well-being, quality of life, and oral and systemic health. The aim of this study was to identify whether the patients’ age at which visits to the paediatric dentist begin as well as the periodicity of these visits are factors that can prevent dental fear. This observational transversal study was conducted on 575 school children (average age 6.85 ± 0.78) and their mother/father/guardian. Parents completed a survey on the characteristics of dental visits and the child completed the index of dental anxiety and fear (IDAF-4C) to assess dental fear. The correlation between dental fear and age at first visit (r = −0.36 p < 0.01) and dental fear and frequency of visit (r = −0.65 p < 0.01) were statistically significant. The regression analysis performed showed that both variables predicted 44.4% of the dental fear in the child. In conclusion, the age of initiation to the paediatric dentist (before 2 years) and the periodic revisions (every 6 months or every year) could protect the child from dental fear.

Psychometric evaluation of the Lebanese Arabic version of the Dental Fear Survey: a cross-sectional study

Background Dental fear is a prevalent problem that can lead to poor dental health. The Kleinknecht’s Dental Fear Survey (DFS) is one of the used scales to assess dental fear. The present study aims to evaluate the psychometric properties of the Lebanese Arabic version of the DFS (DFS-A) and to determine the optimal cut-off to identify dental fear as well as the correlates of dental fear in a group of Lebanese adults dental patients. Methods A cross-sectional study was conducted among a group of 442 dental patients (18–65 years) recruited at 29 dental clinics from March to June 2019. Patients completed a questionnaire including questions about demographic characteristics, previous bad dental experience, trauma’s experience period, the sensation of nausea during dental treatment, the DFS-A scale, the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A), and a general question about dental fear. Results DFS-A revealed evidence of adequate psychometric properties. DFS-A scale demonstrated high internal consistency (cronbach’s alpha = 0.93). Test–retest reliability assessment demonstrated strong reproducibility of the DFS-A scale score (ICC = 0.92 with 95% CI (0.83–0.96), p value < 0.0001 (N = 30). Confirmatory factor analysis revealed a three-factor structure of the DFS-A reflecting fear associated with specific dental stimuli and procedures, patterns of dental avoidance and anticipatory anxiety, and physiologic arousal during dental treatment. A significant correlation was found between DFS-A and the MDAS-A indicating a good convergent validity. The optimal cut-off point to identify patients with and without dental fear is 41. Considering this cut-off score, the prevalence of dental fear in our sample was reported at 33.8%. Multivariable analysis showed that having previous scary and painful dental experiences, a sensation of nausea during treatment, and having dental anxiety were identified as predictors of dental fear. Conclusion The adapted Arabic version of the DFS (DFS-A) is a valid tool to evaluate dental fear among Lebanese adult patients.

Gagging Assessment Scale: A Reliable Tool For Assessing Association Between Gagging And Dental Fear In Children Prior Dental Treatment- A Cross-Sectional Pilot Study

Gagging is a normal protective defence mechanism of our body that prevents entry of foreign bodies into the airway, which can create undue havoc during dental treatment especially in children. The present study aims to assess the prevalence of gagging and any of its existing association with dental fear and anxiety in children prior to dental treatment. A cross-sectional pilot study design was conducted in South Indian children (age group: 3-10 years) having no history of underlying psychological and systemic ailment. Different assessment scales of gagging (Gagging Assessment Scale [GAS], Shorter Objective Form of Gagging Problem Assessment [GPA-SF]/OGPA), dental fear (Children’s Fear Survey Schedule Dental Subscale [CFSS-DS]) and anxiety (Modified Dental Anxiety Scale- Faces [MDASF]) were administered to evaluate their response prior to the treatment. Younger children specifically females demonstrated severity of gagging reflex, which was directly correlated to their higher perception of dental fear and anxiety. However, no conclusive evidence of an association between gagging, dental fear and anxiety was ascertained. Prior knowledge of the gagging problem in children can help clinicians to effectively modify the treatment modalities for successful outcomes, while GAS could be a reliable tool for assessing its severity in children prior to dental treatment.

An Assessment of Dental Anxiety in Patients Before and After Scaling and Polishing Procedures

Introduction As of now, there are not many investigations about the improvement of dental apprehension and dental participation in various populations over time. This investigation includes an examination of emotional appraisals of levels of dental apprehension in patients selected at the AB Shetty Memorial Institute of Dental Sciences. The investigation also aimed to discover the causes of dental apprehension as well as the effect of sexuality on the distinguished dental apprehension. Materials and Methods The level of dental apprehension was assessed using questionnaires that included 15 questions before and after the scaling and polishing procedures for 78 patients. The typical features were drawn such as gender, age, and oral hygiene habits. The data analysis was analyzed using paired t-test or Wilcoxon signed rank test to assess pre- and postanxiety levels. Results A total of 78 responses were collected, resulting in a participation rate of 100%. Despite the fact that women had significantly higher overall dental apprehension levels compared with men, the discrepancy among the two genders was substantial and could be clarified. Conclusion Dental fear was common in females, especially among those with dental problems, and a larger degree of dental fear can contribute to periodontal disease.

10-year follow-up study on attendance pattern after dental treatment in primary oral health care clinic for fearful patients

Background Dental fear may lead to avoidance of regular dental treatment. The scope of this long-term practe-based study was to monitor the dental attendance of patients who received chair-side dental and fear treatment. Methods In 2000–2006, patients in the City of Oulu, Finland, received treatment for dental fear in the Clinic for Fearful Dental Patients (CFDP) from primary health care dentists trained on this subject. Of the originally treated patients (n = 163), 152 (93%) with sufficient information in dental records made up the study population. Information on their age and sex was available. The number of dental examinations, emergency visits and missed appointments was collected covering the follow-up period of 10 years 2006–2016. For analyses, data were dichotomized according to age at baseline and preliminary outcome baseline condition of dental fear treatment evaluated in 2006. To investigate association further, Poisson regression as well as binary logistic regression models were conducted. As register keeper, the City of Oulu gave permission for this retrospective data-based study. Results Patients receiving dental fear treatment at younger age (2–10 y) had significantly more dental examinations than those treated at > 10 years. Preliminary success was associated with the number of examinations, but not with emergency visits and missed appointments. Sex was not a significant factor in later dental attendance. There was an association between few dental examinations and dental emergency care need with unsuccessful baseline outcome of dental fear treatment. Conclusions Successful dental fear treatment especially at an early age is beneficial for future dental attendance measured by the number of examinations and consequently, less need for emergency care than in the opposite case. Successful fear treatment has positive impact on later dental care and regular dental attendance.

Psychological Distress, Dental Health, and Dental Fear among Finnish University Students: A National Survey

The aim of this study was to investigate the association between dental fear, psychological distress, and perceived symptoms of teeth controlled for age, gender, educational sector, and tobacco use. The data from the Finnish University Student Health Survey 2016 targeting students (n = 10,000) of academic universities and universities of applied sciences were used. Psychological distress was measured with the Clinical Outcomes in Routine Evaluation 10 (CORE-10) and the General Health Questionnaire 12 (GHQ-12) and dental fear with the question ‘Do you feel scared about receiving dental care?’. The study included 3110 students. In logistic regression analyses those with psychological distress (measured with CORE-10 and GHQ-12) and those reporting teeth-related symptoms were more likely than their counterparts to have high dental fear. In gender-specific analyses men with psychological distress (measured with CORE-10) and women with teeth-related symptoms were more likely to have high levels of dental fear. Finnish university students with psychological distress and teeth-related symptoms were more likely to experience higher levels of dental fear than their counterparts were. The results of this study support possible common vulnerability factors that dental fear and other psychological disorders may share.