Five-year incidence of dental anxiety in an adult population

Abstract

Objectives: The purpose of the study was to assess the incidence of dental anxiety and factors associated with onset in adults aged 18 years and over.

Design: A longitudinal mail survey of a random sample of the general population consisting of a baseline phase and a follow-up after five years.

Subjects: 1,422 individuals completed baseline and follow-up questionnaires concerning dental anxiety; 1,226 subjects who were not anxious at baseline were included in the analysis. A sub-sample of 747 of these subjects had also completed a psychological questionnaire at baseline.

Measures: Dental anxiety was assessed using the Dental Anxiety Scale (DAS). Other measures included the Dental Belief Survey, The Iowa Dental Control Index, a scale to measure attitudes towards pain, and measures of trait anxiety and general fearfulness. Questions were also asked about dental visiting patterns and dental treatment experiences prior to baseline and between baseline and follow-up.

Results: The five-year incidence of dental anxiety in this population was 5.8%. This varied from 12.2% in those aged 18 to 24 years at baseline to 1.7% among those aged 65 years and over at baseline. Those reporting an episodic visiting pattern between baseline and follow-up and those who avoided dental care altogether were also more likely to become anxious about dental treatment. Seven variables entered a logistic regression model predicting onset: age at baseline, DAS score at baseline, fear of pain, dental visiting pattern and three variables indicating aversive dental experiences between baseline and follow-up. These were: experiencing pain during dental treatment; being treated by a dentist in a cold or uncaring manner and being frightened or worried about things the dentist did. Data from the 747 subjects completing the baseline psychological questionnaire indicated that scores on a trait anxiety index were also predictive of onset.

Conclusion: Dental anxiety may arise during adulthood, younger adults being particularly vulnerable to onset. Both aversive conditioning experiences and pre-existing psychological states appear to be associated with the development of anxiety about dental treatment in this adult population.