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Associations between dental anxiety, sense of coherence, oral health-related quality of life and health behavior--a national Swedish cross-sectional survey.

Carlsson V, Hakeberg M, Wide Boman U - BMC Oral Health (2015)

Bottom Line: Also, recent studies have found an association between the psychosocial concept of sense of coherence (SOC) and DA.High DA was associated with low OHRQoL, irregular dental care and smoking.There was a statistically significant relationship between the SOC and DA in the bivariate, but not in the multivariate, analyses.

View Article: PubMed Central - PubMed

Affiliation: Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. viktor.carlsson@kronoberg.se.

ABSTRACT

Background: Dental anxiety (DA) is a common condition associated with avoidance of dental care and subsequent health-related and psychosocial outcomes, in what has been described as the vicious circle of DA. Also, recent studies have found an association between the psychosocial concept of sense of coherence (SOC) and DA. More studies are needed to verify the relationship between DA and SOC, especially using population-based samples. There is also a need for studies including factors related to the vicious circle of DA, such as oral health-related quality of life (OHRQoL), in order to further establish the correlates of DA in the general population. Therefore, the aim of this study was to investigate the relationship between DA and SOC, OHRQoL and health-related behaviour in the general Swedish population.

Methods: The survey included a randomly selected sample of the adult Swedish population (N = 3500, age 19 - 96 years.). Data was collected by means of telephone interviews. Dental anxiety was measured with a single question. The SOC measure consisted of three questions conceptualising the dimensions of the SOC: comprehensibility, manageability and meaningfulness. The data collection also included the five-item version of the Oral Health Impact Profile (OHIP-5), as a measure of OHRQoL, as well as questions on oral health-related behaviour and socioeconomic status. Statistical analyses were made with descriptive statistics and inference testing using Chi-square, t--test and logistic regression.

Results: High DA was associated with low OHRQoL, irregular dental care and smoking. There was a statistically significant relationship between the SOC and DA in the bivariate, but not in the multivariate, analyses. Dental anxiety was not associated with oral health-related behaviour or socioeconomic status.

Conclusions: This cross-sectional national survey gives support to the significant associations between high dental anxiety, avoidance of dental care and health-related outcomes, which may further reinforce the model of a vicious circle of dental anxiety. The results further indicate a weak relationship between dental anxiety and sense of coherence.

No MeSH data available.


Related in: MedlinePlus

Berggren’s vicious circle of dental anxiety [6]
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Fig1: Berggren’s vicious circle of dental anxiety [6]

Mentions: Dental anxiety is characterised by anxious thoughts about dentistry and fear reactions in the dental treatment situation. The two terms, dental anxiety and dental fear, are often used in the literature interchangeably to describe this psychological reaction pattern. In this paper, the term dental anxiety (DA) will be used consistently. Dental anxiety is common in the general population [1, 2] and is associated with several health-related outcomes. A strong characteristic of DA is the association with poor oral health [3–6] and avoidance of dental care [1, 7]. Several studies have also linked DA to poor oral health-related quality of life (OHRQoL) [8–13], as may be reflected by less satisfaction with facial and dental appearance [14], embarrassment related to dental status [15], pain and dysfunction [10]. Berggren, as well as other authors [16–18], have proposed a vicious circle of DA that starts with anxiety-related avoidance of dental care, followed by a subsequent deterioration in oral health and further consequences (see Fig. 1). Individuals who enter this vicious circle more often seek treatment because of an existing oral problem than visit for regular dental examinations [7], which potentially may increase the DA because of acute invasive treatments. Feelings of shame and inferiority due to poor oral health will eventually be part of the vicious circle [15–17]. Shame due to poor oral health is also included in the concept of OHRQoL. Further, it has also been suggested that general anxiety and depression may be applicable in the vicious circle [6].Fig. 1


Associations between dental anxiety, sense of coherence, oral health-related quality of life and health behavior--a national Swedish cross-sectional survey.

Carlsson V, Hakeberg M, Wide Boman U - BMC Oral Health (2015)

Berggren’s vicious circle of dental anxiety [6]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4556218&req=5

Fig1: Berggren’s vicious circle of dental anxiety [6]
Mentions: Dental anxiety is characterised by anxious thoughts about dentistry and fear reactions in the dental treatment situation. The two terms, dental anxiety and dental fear, are often used in the literature interchangeably to describe this psychological reaction pattern. In this paper, the term dental anxiety (DA) will be used consistently. Dental anxiety is common in the general population [1, 2] and is associated with several health-related outcomes. A strong characteristic of DA is the association with poor oral health [3–6] and avoidance of dental care [1, 7]. Several studies have also linked DA to poor oral health-related quality of life (OHRQoL) [8–13], as may be reflected by less satisfaction with facial and dental appearance [14], embarrassment related to dental status [15], pain and dysfunction [10]. Berggren, as well as other authors [16–18], have proposed a vicious circle of DA that starts with anxiety-related avoidance of dental care, followed by a subsequent deterioration in oral health and further consequences (see Fig. 1). Individuals who enter this vicious circle more often seek treatment because of an existing oral problem than visit for regular dental examinations [7], which potentially may increase the DA because of acute invasive treatments. Feelings of shame and inferiority due to poor oral health will eventually be part of the vicious circle [15–17]. Shame due to poor oral health is also included in the concept of OHRQoL. Further, it has also been suggested that general anxiety and depression may be applicable in the vicious circle [6].Fig. 1

Bottom Line: Also, recent studies have found an association between the psychosocial concept of sense of coherence (SOC) and DA.High DA was associated with low OHRQoL, irregular dental care and smoking.There was a statistically significant relationship between the SOC and DA in the bivariate, but not in the multivariate, analyses.

View Article: PubMed Central - PubMed

Affiliation: Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. viktor.carlsson@kronoberg.se.

ABSTRACT

Background: Dental anxiety (DA) is a common condition associated with avoidance of dental care and subsequent health-related and psychosocial outcomes, in what has been described as the vicious circle of DA. Also, recent studies have found an association between the psychosocial concept of sense of coherence (SOC) and DA. More studies are needed to verify the relationship between DA and SOC, especially using population-based samples. There is also a need for studies including factors related to the vicious circle of DA, such as oral health-related quality of life (OHRQoL), in order to further establish the correlates of DA in the general population. Therefore, the aim of this study was to investigate the relationship between DA and SOC, OHRQoL and health-related behaviour in the general Swedish population.

Methods: The survey included a randomly selected sample of the adult Swedish population (N = 3500, age 19 - 96 years.). Data was collected by means of telephone interviews. Dental anxiety was measured with a single question. The SOC measure consisted of three questions conceptualising the dimensions of the SOC: comprehensibility, manageability and meaningfulness. The data collection also included the five-item version of the Oral Health Impact Profile (OHIP-5), as a measure of OHRQoL, as well as questions on oral health-related behaviour and socioeconomic status. Statistical analyses were made with descriptive statistics and inference testing using Chi-square, t--test and logistic regression.

Results: High DA was associated with low OHRQoL, irregular dental care and smoking. There was a statistically significant relationship between the SOC and DA in the bivariate, but not in the multivariate, analyses. Dental anxiety was not associated with oral health-related behaviour or socioeconomic status.

Conclusions: This cross-sectional national survey gives support to the significant associations between high dental anxiety, avoidance of dental care and health-related outcomes, which may further reinforce the model of a vicious circle of dental anxiety. The results further indicate a weak relationship between dental anxiety and sense of coherence.

No MeSH data available.


Related in: MedlinePlus