Correlations of dental anxiety and phobia in a sample of patients with high level of anxiety receiving dental care in a dental school setting in the United States.

backgroundDental anxiety, fear, and phobia are common conditions that prevent individuals from seeking dental care by delaying dental care or avoiding the visit entirely, which may cause a decline in oral health-related quality of life. Dental anxiety often has a correlation with other psychological constructs. Our aim was to examine the associations between psychological constructs, dental anxiety, and phobia and their variations among key demographics among patients seeking dental care in a dental school setting.

methodsBaseline data from 499 patients who participated in a randomized clinical trial that evaluated the efficacy of an online intervention in managing dental anxiety were used. Subjects completed a semi-structured interview using the Anxiety Disorders Interview Schedule (ADIS) according to DSM-5 criteria to assess dental phobia severity (Clinical Severity Rating [CSR]) and self-reported measures of dental anxiety (Modified Dental Anxiety Scale [MDAS]), blood-injection-injury fear (Fear Questionnaire Blood-Injection-Injury [FQ-BII]), pain sensitivity (Pain Sensitivity Index [PSI]), distress tolerance (Distress Tolerance Scale [DTS]), and anxiety sensitivity (Anxiety Sensitivity Index [ASI]). Paired sample t-tests, ANOVA, and multivariable regression models were used for analyses using R 4.3.2. Statistical significance was set at p-value < 0.05.

resultsThe mean age of subjects was 48.9 ± 14.7 years old; most were female (71.6%), non-Hispanic (88.6%), with an income lower than $30,000 (40.0%), and most had completed a high school diploma/GED (26.0%). The majority (63.3%) reported high dental anxiety (MDAS ≥ 19), and 64.57% met criteria for specific phobia (CSR ≥ 4), with mean scores of 19.5 ± 3.6 and 4.5 ± 1.7, respectively. Mean scores for FQBII, PSI, DTS, and ASI were 15.5 ± 10.2, 68.0 ± 22.9, 44.7 ± 13.2, and 31.0 ± 16.9, respectively. Significant differences in CSR were observed by age (p < 0.01), sex (p = 0.02), and race (p < 0.01), while the psychological constructs FQBII, DTS, and PSI varied significantly across age, race, and ethnicity (p < 0.05).

conclusionDental anxiety scores were higher among participants who were African American compared to Caucasians. Higher dental anxiety was also observed among women and individuals with low income. Age, sex, income, and race were demonstrated to have a strong association with dental anxiety. Subjects with high pain sensitivity and fear of blood/injections had an increased dental anxiety score.