| 1. |
- Carlsson, Viktor, 1980, et al.
(författare)
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Associations between dental anxiety, sense of coherence, oral health-related quality of life and health behaviour - a national Swedish cross-sectional survey
- 2015
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 15
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Tidskriftsartikel (refereegranskat)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.
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| 2. |
- Carlsson, Viktor, 1980, et al.
(författare)
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Attention deficit hyperactivity disorder and dental anxiety in adults: relationship with oral health.
- 2013
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Ingår i: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 121:3 Pt 2, s. 258-63
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate the presence of attention deficit hyperactivity disorder (ADHD) in adult patients with severe dental anxiety. Specifically, we analysed the relationship among ADHD, oral health, and dental anxiety. The World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener was administered to a consecutive sample of patients referred to a dental fear research and treatment clinic. Patients completed questionnaires measuring dental anxiety (Dental Fear Survey) and self-rated oral health, and underwent a full radiographic examination. Of the total sample (n=110), 16% scored above the established ASRS cut-off point, which is indicative of having ADHD. The ADHD group showed a higher level of dental anxiety and poorer self-rated oral health. There were also indications of poorer clinical oral health in the ADHD group, but these results did not reach statistical significance. In conclusion, the results of this study indicate an increased prevalence of ADHD in highly dentally anxious adults and the need to pay special attention to these patients because of greater treatment needs and increased dental anxiety.
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| 3. |
- Carlsson, Viktor, 1980
(författare)
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Dental Anxiety in Adults - Psychosocial Aspects, Oral Health and Psychological Treatment
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to investigate relationships between dental anxiety (DA), psychosocial factors, oral health and oral health-related quality of life (OHRQoL) in adults, and to assess the efficacy of cognitive behavior therapy (CBT) as treatment for DA. Study I is a national Swedish survey, studies II and III are clinical cross-sectional studies on patients with severe DA, and study IV consists of a systematic review and a meta-analysis. In the first study, a weak relationship was found in the general population between Antonovsky’s salutogenic concept of sense of coherence (SOC) and DA. Strong relationships were found between high DA and low OHRQoL, irregular dental care and smoking. In study II, a high prevalence of attention deficit hyperactivity disorder (ADHD), as indicated by a screening questionnaire, was found in patients with severe DA. ADHD was further associated with a higher level of DA and lower self-rated/subjective oral health. There were also indications of poorer objective oral health associated with ADHD, although these relationships were not statistically significant. In study III, the results showed a substantial dissatisfaction with orofacial esthetics in patients with severe DA. Ratings of orofacial esthetics were related to both psychological and oral health. Furthermore, the results confirmed the validity of the Orofacial Esthetic Scale (OES), when used on patients with severe DA. The systematic review in study IV included randomized controlled trials evaluating CBT for severe DA, and identified ten scientific publications originating from seven different RCTs. Some support was found for CBT resulting in a clinically significant reduction in DA immediately after treatment and at follow-up after one and two years. Also, some support was found for CBT enhancing the acceptance of conventional dental treatment. These results were all based on a low quality of evidence according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system. In conclusion, DA is an important condition associated with avoidance of dental care and health-related outcomes. Dissatisfaction with orofacial esthetics and ADHD both seem to be associated with DA and in the general population a weak relationship between the SOC and DA was found. There are effective psychological methods that can reduce or eradicate DA in adult individuals, although there are substantial knowledge gaps to be investigated.
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| 4. |
- Carlsson, Viktor, 1980, et al.
(författare)
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Orofacial esthetics and dental anxiety: Associations with oral and psychological health
- 2014
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 72:8, s. 707-713
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Severe dental anxiety (DA) is associated with both oral health and psychosocial consequences in what has been described as a vicious circle of DA. The aim of this study was to investigate self-rated orofacial esthetics in patients with DA and its relationship to psychological and oral health. Materials and methods. A consecutive sample of 152 adult patients who were referred or self-referred to a specialized dental anxiety clinic filled out the Orofacial Esthetic Scale (OES) as well as measurements on DA, self-rated oral health and general anxiety and depression. Clinical measures of dental status were also obtained. Results. Compared with the general population, patients with DA had lower ratings of satisfaction on all aspects of their orofacial esthetics, which included the teeth, gingiva, mouth and face, as well as a global orofacial assessment. Furthermore, the perception of the orofacial appearance was related both to dental status and self-rated oral health, as well as to general anxiety and depression. The level of dissatisfaction with the orofacial appearance was similar for both genders, but women reported more regular dental care and better dental status. Conclusions. The results of this study clearly show less satisfaction with dental and facial appearance in patients with DA, and that the self-rating of orofacial esthetics is related to both oral and psychological health. The OES can be used to assess orofacial esthetics in patients with DA.
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| 5. |
- Wide Boman, Ulla, 1964, et al.
(författare)
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Psychological treatment of dental anxiety among adults: a systematic review.
- 2013
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Ingår i: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 121:3 Pt 2, s. 225-34
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the efficacy of behavioural interventions as treatment of dental anxiety/phobia in adults, by conducting a systematic review of randomized controlled trials (RCTs). The inclusion criteria were defined according to the Patients, Interventions, Controls, Outcome (PICO) methodology. The study samples had documented dental anxiety, measured using validated scales [the Dental Anxiety Scale (DAS) or the Dental Fear Survey (DFS)], or fulfilled the psychiatric criteria for dental phobia. Behavioural interventions included were based on cognitive behavioural therapy (CBT)/behavioural therapy (BT), and control conditions were defined as information, sedation, general anaesthesia, and placebo/no treatment. The outcome variables were level of dental anxiety, acceptance of conventional dental treatment, dental treatability ratings, quality of life and oral health-related quality of life, and complications. This systematic review identified 10 RCT publications. Cognitive behavioural therapy/behavioural therapy resulted in a significant reduction in dental anxiety, as measured using the DAS (mean difference=-2.7), but the results were based on low quality of evidence. There was also some support that CBT/BT improves the patients' acceptance of dental treatment more than general anaesthesia does (low quality of evidence). Thus, there is evidence that behavioural interventions can help adults with dental anxiety/phobia; however, it is clear that more well-designed studies on the subject are needed.
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