Triggers and Relievers of Dental Anxiety: Comparative Analysis of Patient Perceptions in Private and Public Dental Settings
DOI:
https://doi.org/10.36283/ziun-pjmd13-4/010Keywords:
Dental Anxiety, Public Sector, Triggers of anxiety, Waiting RoomAbstract
Background: Dental anxiety is a prevalent issue that affects a significant portion of the population, leading to avoidance of dental care. The study aimed to identify and compare the self-perceived triggering and relieving factors of dental anxiety among patients of private and public dental institutes in Punjab.
Methods: This analytical cross-sectional study was conducted between Dec 2021 and Oct 2022, on a sample of 711 physically and mentally healthy patients reporting to three private and two public dental hospitals in Punjab with a score of 11 and above on MDAS, using consecutive sampling. The former section of the questionnaire included demographics, while the latter part focused on self-reported triggers and relieving factors of dental anxiety. The data was analyzed using SPSS, and compared using the chi-square test. A p-value of ≤0.05 was taken as significant.
Results: The study included 51.3% females (n=365) and 48.7% males (n=346). Dirty instruments were a major trigger (67.1%, n=477, p=0.001), followed by stressful waiting rooms (54.4%, n=387, p=0.007) and complex procedures (49.2%, n=350, p=0.001) in public hospitals. Delayed appointments were a common trigger (41.1%, n=292) in both settings. Reassurance from the dentist (68.5%, n=487, p=0.087) and minimal waiting times (64.8%, n=461, p=0.012) were key relieving factors in both settings.
Conclusion: Dental anxiety triggers were more frequent in public settings, including dirty instruments, stressful waiting room environments, and complex procedures. In contrast, private settings showed fewer triggers. However, both public and private patients valued reassurance from the dentist and minimal waiting times as major relieving factors.
References
O’Grady A, Gray-Burrows K, Tahmassebi J. Inside the waiting room: Process drama and dramatic distancing for involving children in research on dental anxiety. Arts Health. 2022 May;14(2):149-64. https://doi.org/10.1080/17533015.2021.1894465
Chishti F, Hassan H, R. Qazi S. Dental anxiety among students of Lahore, Pakistan. Pak J Med Health Sci. 2021 Sep;15(9):2659–61. https://doi.org/10.53350/pjmhs211592659
Hoffmann B, Erwood K, Ncomanzi S, Fischer V, O'Brien D, Lee A. Management strategies for adult patients with dental anxiety in the dental clinic: a systematic review. Aust Dent J. 2022 Mar;67:S3-13. https://doi.org/10.1111/adj.12926
Enright A, Enright S. Dental anxiety and phobia – Causes, impacts, and treatment. Dent Oral Maxillofac Res. 2021 Feb;7(1):1-6. https://doi.org/10.15761/DOMR.1000384
Fux-Noy A, Zohar M, Herzog K, Shmueli A, Halperson E, Moskovitz M, et al. The effect of the waiting room's environment on the level of anxiety experienced by children prior to dental treatment: a case-control study. BMC Oral Health. 2019 Dec;19(1):294. https://doi.org/10.1186/s12903-019-0995-y
Sokoto KC, Platt LF, Alexander LA, Foxman B, Shaffer JR, Marazita ML, McNeil DW. Racism in oral healthcare settings: Implications for dental care‐related fear/anxiety and utilization among Black/African American women in Appalachia. J Public Health Dent. 2022 Mar;82:28-35. https://doi.org/10.1111/jphd.12523
Org.pk. [cited 2022 Oct 17]. Available from: https://pide.org.pk/pdfpideresearch/wp-0032-health-care-services-and-government-spending-in-Pakistan.pdf?
Almutairi FJ. Dental Anxiety among Patients Attending King Saud Hospital in Unizah: Pilot Study. Int J Dent Sci Res. 2020 Dec;8(6):155-8. http://dx.doi.org/10.12691/ijdsr-8-6-3
Butt H, Waheed Z, Khan NR, Shumyle DE, Shiekh H, Jafar T. Association of Dental Treatment Related Anxiety with Sterilization Concerns Among Patients. J Rehman Coll Dent. 2020 Dec;1(1):20-3. https://doi.org/10.52442/jrcd.v1i1.23
Abdullah MA, Shaikh BT, Ghazanfar H. Curing or causing? HIV/AIDS in health care system of Punjab, Pakistan. PLoS One. 2021 Jul;16(7):e0254476. http://dx.doi.org/10.1371/journal.pone.0254476
Vanhee T, Mourali S, Bottenberg P, Jacquet W, Vanden Abbeele A. Stimuli involved in dental anxiety: What are patients afraid of?: A descriptive study. Int J Paediatr Dent. 2020 May;30(3):276-85. http://dx.doi.org/10.1111/ipd.12595
Yuan S, Freeman R, Hill K, Newton T, Humphris G. Communication, trust and dental anxiety: A person-centred approach for dental attendance behaviours. Dent J. 2020 Oct;8(4). http://dx.doi.org/10.3390/dj8040118
Aardal V, Evensen KB, Willumsen T, Hervik Bull V. The complexity of dental anxiety and its association with oral health‐related quality of life: An exploratory study. Eur J Oral Sci. 2023 Feb;131(1):e12907. https://doi.org/10.1111/eos.12907
Song ES, Kim WH, Lee BH, Han DW, Lee JH, Kim B. Assessment of Color Perception and Preference with Eye-Tracking Analysis in a Dental Treatment Environment. Int J Environ Res Public Health. 2021 Jul;18(15):7981. http://dx.doi.org/10.3390/ijerph18157981
Hoffmann B, Erwood K, Ncomanzi S, Fischer V, O’Brien D, Lee A. Management strategies for adult patients with dental anxiety in the dental clinic: a systematic review. Aust Dent J. 2022 Mar;67 Suppl 1(S1):S3–13. http://dx.doi.org/10.1111/adj.12926
Lin C-S, Lee C-Y, Chen L-L, Wu L-T, Yang S-F, Wang T-F. Magnification of fear and intention of avoidance in non-experienced versus experienced dental treatment in adults. BMC Oral Health. 2021 Dec;21(1):328. http://dx.doi.org/10.1186/s12903-021-01682-1
Dou L, Vanschaayk MM, Zhang Y, Fu X, Ji P, Yang D. The prevalence of dental anxiety and its association with pain and other variables among adult patients with irreversible pulpitis. BMC Oral Health. 2018 Dec;18(1). http://dx.doi.org/10.1186/s12903-018-0563-x
Hassan H, Zahid F, Ameer Malik MI, Shakoor A, Yaasir Z, Zeeshan M. Hand Hygiene and Cross Infection control among dental auxiliaries working in private and public dental institutes of Punjab. Pak J Med Health Sci. 2022 Dec;16(10):711–4. https://doi.org/10.53350/pjmhs221610711
Hassan H, Ali SM, Riaz S, Aziz S, Saleem MN, Raja HZ. Prevalence of endodontic mishaps and their management in private and public dental institutes in Punjab, Pakistan. Rawal Med J. 2023 Jun;48(2):468–468. https://www.rmj.org.pk/?mno=79757
Hassan H, Rafique A, Andleeb S, Javaid M, Ahmad H, Khalid S. Post-insertion complaints associated with complete denture prosthesis in a tertiary care hospital. Rawal Med J. 2023 Mar;48(1):200–200. https://www.rmj.org.pk/?mno=81263
Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Aust Dent J. 2013;58(4):390–407. http://dx.doi.org/10.1111/adj.12118
Nithya S, Jeddy N, Radhika T, Jeddy N. Dental anxiety and influencing factors: A cross-sectional questionnaire-based survey. Indian J Dent Res. 2018 Jan;29(1):10. http://dx.doi.org/10.4103/ijdr.ijdr_33_17
Karan NB. Influence of lavender oil inhalation on vital signs and anxiety: A randomized clinical trial. Physiol Behav. 2019 Nov;211(112676):112676. http://dx.doi.org/10.1016/j.physbeh.2019.112676
Zinke A, Hannig C, Berth H. Comparing oral health in patients with different levels of dental anxiety. Head Face Med. 2018 Dec;14(1):25. http://dx.doi.org/10.1186/s13005-018-0182-4
Muneer MU, Ismail F, Munir N, Shakoor A, Das G, Ahmed AR, et al. Dental anxiety and influencing factors in adults. Healthcare (Basel). 2022 Nov;10(12):2352. http://dx.doi.org/10.3390/healthcare10122352
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