Reasons of Dental Anxiety Development Among Women and Men

Introduction

Good oral hygiene is an important aspect of good general well being throughout life. It can be accomplished by proper self as well as professional care amongst individuals. Regular dental visits and professional dental care gives a better oral health, opportunity of early diagnosis, and treatment of the diseases. However factors like age, sex, socioeconomic status, ethnicity, education, anxiety and fear of the patients affect the professional health seeking behavior of the patients.

This study is focused on how gender of the patient is related to anxiety. The american heritage science dictionary1 defines anxiety as” a state of apprehension resulting from the anticipation of a threatening event or a situation.” To study the level of anxiety of the population various scales can be used. The corahs dental anxiety scale has been used extensively which is simple and consists of 4 questions however the questions make it difficult to evaluate the answers. Modified dental anxiety scale, a modified version of the original CDAS is commonly used to measure dental anxiety.

1000 subjects including 500 men and 500 women were evaluated using modified dental anxiety scale. The MDAS scale is a scale which consists of 5 questions with options ranging from not anxious to extremely anxious population and gives a range from 5 to 25 to evaluate anxiety amongst people. It can be integrated into daily dental practices to screen dental anxiety amongst the population. Clinicians need to diagnose and make applicable changes in the following treatment.

Material and Method

After getting permission from ethical committee and consent from the Patients, 1000 patients were asked to answer the following questions and rated accordingly for their anxiousness on the modified dental anxiety scale. Study included 500 males and 500 females. Patients aged 18 to 65 years visiting VSPM Dental college were included for this study. Subjects not agreeing to fill the consent form were not included in the study.

To achieve the subject strength to 1000,500 males and 500 females were selected. However the ones not giving consent and giving incomplete information were not included. Hence in the final report 500 males and 499 females were assessed for their anxiety and compared. The range of the above 19 will be indicated as highly anxious patients that require special attention by dental personnel. The modified dental anxiety scale (MDAS) contains 5 multiple-choice items including the followings:

1 = If you went to your dentist for treatment tomorrow, how would you feel?

2 = If you were sitting in the waiting room, how would you feel?

3 = If you were about to have a tooth drilled, how would you feel

4 = If you were about to have your teeth scaled and polished, how would you feel?

5 = If you were about to have a local anesthetic injection in your gum, how would you feel?

Statistical analysis

Statistical analysis of the data was done using SPSS. The data was tabulated using microsoft excel sheet (windows 2007). Pearson-chi square test was applied to compare between anxiety level of males and females. P value of less than 0.05 was considered as statistically significant.By the following frequencies it’s evident that females are more anxious than men.After applying pearson chi square test, the p values for all the above questions were less than 0.05 which states that the study was significant and that females are more anxious than the males.

Results

Dental anxiety is a complex, personel, subjective and psychological phenomenon varying from individual to individual. Dental treatments involve procedures like scaling, local anaesthetic solution administration, tooth drilling, etc. Patients acceptance towards all the treatment modalities are different mainly because of the anxiety levels.

Our objective of study was to evaluate the level of anxiety in people visiting dental hospital. 1000 people were selected out of which 500 were males and 499 were females and questioned according to the modified dental anxiety scale with 5 questions related to dental treatment.

For visiting tomorrow to the dentist, about 60.9% females and 44.4% of males were not anxious. In the waiting room, about 57.5% females and 44.6% males were not anxious. For drilling of tooth for excavation of caries, about 38.9% female and 27.6% of males were not anxious. For scaling and polishing about 73.5% female and 60.8% males were not anxious. For administration of injection, 41.3% female and 28.2% of males were not anxious. All others accounted for some level of anxiety from slight to extreme level of anxiety other than those mentioned above.

Both male and female showed extreme level of anxiety with respect to the use of drill. Injections were second on the list of causing extreme anxiousness for both male and female. The data forestalls the performance of MDAS as measure of dental anxiety. More methods are available to evaluate anxiety, however general population understanding of the questions asked in this scale is interpretable. The cutoff of this scale was 19 points. The total scoring varied by sex and age groups. After knowing the anxiety levels as rated according to the MDAS scale, a discussion with patients about their feelings associated to dental treatment can be evaluated and necessary changes to be made with treatment modalities especially in those with high scores.

Discussion

The modified dental anxiety scale is considered to be valid, reliable, brief, accessible, and is performed easily4. For a dentist, knowledge of patient’s anxiety before the commencement of treatment can help reduce the anxiety of the patients. He can obtain knowledge by giving the MDAS questionare,which can be filled by the patient in 4-5 minutes easily in the waiting room.The sudy revealed that females have higher levels of anxiety as compared to males. Similar results were seen in study by Deogade SC et al5, Gerry M Humphris et al6.However the studies from Kumar S Et al 7, Appukuttan DP et al 8 suggested that there is no difference between anxiety level between males and females.

The mean total scoring presented that the maximum anxiety was observed with tooth drilling and administration of local anaesthetic solution in the teeth. A total score of more than 19 reveals that the patient is highly dentally anxious and proper measures should be taken to deal with these patients.

Conclusion

It was evaluated from the study above that females were more anxious than male and necessary changes in the treatment modalities and method of treatment should be altered with respect to females. Not just pertaining to female, the treatment modalities for highly anxious male should be taken into account. Also professionals and authorities should consider these factors when planning programs to enhance access to dental care services.