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- Berggren, Ulf, 1948, et al.
(author)
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Assessment of patients with direct conditioned and indirect cognitive reported origin of dental fear.
- 1997
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In: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 105:3, s. 213-20
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Journal article (peer-reviewed)abstract
- This study investigated the reported conditioned or cognitive origin of dental phobia in 100 adult patients at a specialized dental phobia clinic. It was shown that a majority of patients reported a conditioned background to their dental fear. Patients' avoidance time and level of dental anxiety corresponded to previously reported data for fearful groups. Individuals with an arousal conditioning etiology of dental fear reported significantly longer avoidance time as compared to individuals with a cognitively learned reaction. With the exception of an elevated level of general fears, most psychometrically assessed emotional reactions were well within normal ranges. However, patients with a non-conditioned, cognitive etiology reported significantly higher levels of trait anxiety and fear of embarrassment. In addition, a separate analysis among women revealed a greater fear of physical injuries among patients with cognitive etiology.
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| 2. |
- Berggren, Ulf, 1948, et al.
(author)
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Assessment of patients with phobic dental anxiety.
- 1997
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In: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:4, s. 217-22
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Journal article (peer-reviewed)abstract
- This study investigated a screening procedure for psychologic distress in adult patients with dental phobia before treatment of dental fear. The screening procedure was performed among 191 individuals in consecutive steps and included a medical/dental history, psychologic interviewing, and testing. Data collected during this process were analyzed and compared with SCL-90(R) data. The screening process was successful in selecting individuals without major psychologic distress problems. Among the excluded patients 91% had general symptoms scores on the SCL-90(R) exceeding a normative population mean, and 95% of included patients had a mean lower than an average for psychiatric outpatients. There were statistically significant differences between included and excluded patients on all subdimensions of the SCL-90. Thus, excluded patients had higher levels of psychologic distress, poorer psychosocial background, and more psychosomatic symptoms. This was accompanied by higher levels of negative attitudes toward dentists and their performance of dentistry, whereas no significant differences were found among the dental fear measures used.
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| 3. |
- Berggren, Ulf, 1948, et al.
(author)
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Factor analysis and reduction of a Fear Survey Schedule among dental phobic patients.
- 1995
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In: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 103:5, s. 331-8
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Journal article (peer-reviewed)abstract
- A fear survey instrument, based on the Fear Survey Schedule-II and five additional fear items, was administered to 109 patients (70 women and 39 men) on a waiting list at a specialized dental fear clinic. The fear survey was analyzed to identify its factorial structure. Five fear factors, explaining 54% of the total variance, were identified concerning areas of "illness and death", "failures and embarrassment", "social situations", "physical injuries", and "animals and natural phenomena". An ad hoc reduction of items was carried out to form a shorter, more practical to use questionnaire, which resulted in factors of four or five items with loadings greater than 0.50. The factors intercorrelated significantly (rp varying between 0.33 and 0.59) and "illness and death" correlated highly with "physical injuries" (rp = 0.59) and "animals and natural phenomena" (rp = 0.56), while "failures and embarrassment" correlated highly to "social situations" (rp = 0.54). Statistically significant, but generally lower correlations were found between each factor and the dental fear measures. The highest correlations were found between fear of "physical injuries" and dental fear. There was also a high and significant correlation between sex and fear of "animals and natural phenomena".
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| 4. |
- Hakeberg, Magnus, 1954, et al.
(author)
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A 10-year follow-up of patients treated for dental fear.
- 1990
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In: Scandinavian journal of dental research. - 0029-845X. ; 98:1, s. 53-9
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Journal article (peer-reviewed)abstract
- Different types of treatment have been used in trying to reduce dental anxiety in adult patients with severe fear and avoidance behavior. However, there is an obvious shortage in long-term treatment follow-up. The present investigation reports results over a period of 10 yr of 14 patients treated for dental fear in a specialized dental fear treatment and research clinic. The aims of this project were to evaluate patients' regularity in dental behavior between 1977 and 1987, changes in and present level of dental fear and other long-standing positive/negative effects of the respective initial treatments. The 14 dental phobic patients were assigned to two treatment groups, one receiving Systematic Desensitization and one Premedication with valium before dental treatment. Pre- and posttreatment status as well as the 10-yr follow-up were evaluated by psychometric (Corah's Dental Anxiety Scale and a Mood Adjective Checklist) and physiological (Skin Conductance Response) measurements. A majority of patients (100% SD, 63% P) reported regular dental care during the period 1977-87. Positive side-effects were reported by seven patients. A significant reduction of dental fear (DAS) was found with a better effect for the SD-group. This was paralleled by a rise in mood (MACL). The SCR figures were non-significant. In conclusion, the results revealed long-standing effects with regard to a high degree of regular dental care and reduction of dental fear. In addition, positive side-effects were reported.
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| 5. |
- Hakeberg, Magnus, 1954, et al.
(author)
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Long-term effects on dental care behavior and dental health after treatments for dental fear.
- 1993
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In: Anesthesia progress. - 0003-3006 .- 1878-7177. ; 40:3, s. 72-7
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Journal article (peer-reviewed)abstract
- Three different treatments for dental fear were tested in a long-term perspective study. Twenty-nine patients with severe dental anxiety and avoidance behavior were assigned to Behavioral Therapy (BT, n = 12), PRemedication with bensodiazepine (PR, n = 8) or dental treatment under General Anesthesia (GA, n = 9). Ten years after initial treatment the patients were reexamined. Changes in dental anxiety and dental care attendance were reported. Patients' dental health status was assessed by radiographic survey. Regular dental attendance was reported by 19 patients (65.5%), with a significantly better result for the BT group (91.6%) compared to the GA group (33.3%). Reported level of dental anxiety, as measured by the Dental Anxiety Scale, revealed a significant reduction during the 10-yr period except among GA patients and those reporting irregular dental attendance behavior. A rise in mood as assessed by the Mood Adjective Checklist was revealed in the total group, with a better effect in the BT and PR groups as well as in patients who reported regular dental attendance. A substantial general improvement in oral health was seen during the 10-yr period, especially among patients receiving regular dental care. Thus, for a majority of patients in this study, directed treatment for dental anxiety and avoidance behavior made it possible to maintain regular dental care behavior during a 10-yr period.
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| 6. |
- Hakeberg, Magnus, 1954, et al.
(author)
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Multivariate analysis of fears in dental phobic patients according to a reduced FSS-II scale.
- 1995
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In: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 103:5, s. 339-44
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Journal article (peer-reviewed)abstract
- This study analyzed and assessed dimensions of a questionnaire developed to measure general fears and phobias. A previous factor analysis among 109 dental phobics had revealed a five-factor structure with 22 items and an explained total variance of 54%. The present study analyzed the same material using a multivariate statistical procedure (LISREL) to reveal structural latent variables. The LISREL analysis, based on the correlation matrix, yielded a chi-square of 216.6 with 195 degrees of freedom (P = 0.138) and showed a model with seven latent variables. One was a general fear factor correlated to all 22 items. The other six factors concerned "Illness & Death" (5 items), "Failures & Embarrassment" (5 items), "Social situations" (5 items), "Physical injuries" (4 items), "Animals & Natural phenomena" (4 items). One item (opposite sex) was included in both "Failures & Embarrassment" and "Social situations". The last factor, "Social interaction", combined all the items in "Failures & Embarrassment" and "Social situations" (9 items). In conclusion, this multivariate statistical analysis (LISREL) revealed and confirmed a factor structure similar to our previous study, but added two important dimensions not shown with a traditional factor analysis. This reduced FSS-II version measures general fears and phobias and may be used on a routine clinical basis as well as in dental phobia research.
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| 7. |
- Hakeberg, Magnus, 1954, et al.
(author)
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Prevalence of dental anxiety in an adult population in a major urban area in Sweden.
- 1992
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In: Community dentistry and oral epidemiology. - 0301-5661 .- 1600-0528. ; 20:2, s. 97-101
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Journal article (peer-reviewed)abstract
- The aims of the study were to describe the level of dental anxiety in a representative sample of an adult population, to evaluate different demographic variables in relation to dental anxiety, and to compare two measurement scales of dental anxiety. A random sample of residents (n = 830) of the city of Gothenburg (population 432,000) was selected for a telephone survey. The survey comprised different questions concerning demographic variables, dental care habits, and the level of dental anxiety. The methods of measurement of dental anxiety were a 10-point dental Fear Scale (FS) and the Corah Dental Anxiety Scale (DAS). A total of 620 interviews were completed giving a response rate of 74.7%. 41.4% of the respondents were males, 58.6% females. Females were significantly more likely to report a high dental anxiety compared with males. The prevalence of high dental anxiety in the sample as measured by the FS and DAS was 6.7% and 5.4% respectively. The correlation between the FS and DAS was 0.81. The distribution of high dental anxiety and age showed a clearly and significantly higher portion of dental anxiety in the age group 20-39 yr compared to both younger and older groups. The effect of dental anxiety on regularity of dental visits revealed a significant difference as measured by the FS. No significant correlation was found between dental anxiety and educational level or income. A majority of the respondents (82-95%) expressed a desire for establishment of a special dental fear treatment clinic without need for referral.
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| 8. |
- Hakeberg, Magnus, 1954, et al.
(author)
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Repeated measurements of mood during psychologic treatment of dental fear.
- 1997
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In: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:6, s. 378-83
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Journal article (peer-reviewed)abstract
- The aims of the present study were to analyze mood changes during psychologic treatment of dental fear by assessing the rate of improvement. Twenty-one patients who refused conventional dental treatment and reported extreme dental anxiety participated in the study. Levels of dental anxiety and mood were measured with the Dental Anxiety Scale (DAS) and a Mood Adjective Checklist (MACL). MACL included two dimensions, degree of relaxation (r) and pleasantness (h) as experienced in a dental situation. Mood was monitored at each treatment session from base line to termination of the therapy (eight measurements). Two different treatment modalities were used, one with a more cognitive approach (n = 9) and one emphasizing the relaxation component (n = 12). A hierarchical linear models approach was applied to analyze individual change with repeated measurements. The results showed that positive mood changes over time were statistically significant. The mean improvement in mood scores per week and session was estimated for MACL(r) and MACL(h) to be 0.14/week and 0.09/week, respectively. The growth was not affected by DAS levels or treatment mode. This study also illustrated a powerful method for analyzing a longitudinal clinical trial design with repeated measurements.
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