Citation Information :
Al Dhelai TA, Al-Ahmari MM, Adawi HA, Aldowsari MK, Al Ahmari NM, Aldosari LI, Alqatta RF, Al Moaleem MM. Dental Anxiety and Fear among Patients in Jazan, Kingdom of Saudi Arabia: A Cross-sectional Study. J Contemp Dent Pract 2021; 22 (5):549-556.
Aim: The current study aims to address the patient's dental anxiety (DA) And dental fear (DF) under the treatment of a general practitioner (GP) among different parameters.
Materials and methods: The cross-sectional study included 500 patients recruited from different clinics in Jazan, Saudi Arabia. Data were collected through a questionnaire-based form consisting of three parts; the first part was personal and demographic questions whereas the second and third parts were a modified dental anxiety scale (MDAS) and a dental fear survey (DFS) to measure DA and DF among patients. Spearman's correlation was used to measure the relation between DA and DF as well as Chi-square tests and logistic regression analyses for analyzing the effect of each variable on DA and DF.
Results: All patients fulfilled their eligibility criteria. A high percentage was found in moderate anxiety (36.8%) as well as in moderate fear (46.2%) among different anxiety and fear scales. The association between DA and DF was positively significant (p <0.01). There was a significant effect of gender, age, education, khat use, marital status, monthly income, and type of clinic on patients’ DA and DF.
Conclusions: There is a positive relation between MDAS and DFS, thus the DA affects the DF. Female patients had a lower DA and DF than male patients. Furthermore, the government clinics had the highest DA and DF prevalence levels for patients. Moreover, the high school–graduated patients seem to have a high DA and DF vs other patient educational levels.
Clinical significance: It would be beneficial to include an educational training program about psychological patient management in the study curriculum as well as to be offered as a special course to newly graduated dentists. This modification will aid to improve the GPs to get rid of DA and DF patients.
Cappelli D, Mobley C. Prevention in clinical oral health care. 1st ed. USA: Mosby Inc; 2007.
Ohman A. Fear and anxiety, evolutionary, cognitive and clinical perceptions. In: Lewis M, Haviland-Jones JM, Barrett LF, editors. Handbook of emotions. 3rd ed. New York: The Gulliford Press; 2000. p. 573–593.
Rubin JG, Slovin M, Krochak M. The psychodynamics of dental anxiety and dental phobia. Dent Clin North Am 1988;32(4):647–656. Available from: https://pubmed.ncbi.nlm.nih.gov/3053263/
Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent 2007;17(6):391–406. DOI: 10.1111/j.1365-263X.2007.00872.x.
Cianetti S, Lombardo G, Lupatelli E, et al. Dental fear/anxiety among children and adolescents. A systematic review. Eur J Paediatr Dent 2017;18(2):121–130. DOI: 10.23804/ejpd.2017.18.02.07.
Corah NL. Development of a dental anxiety scale. J Dent Res 1969;48(4):596. DOI: 10.1177/00220345690480041801.
Humphris GM, Morrison T, Lindsay SJ. The modified dental anxiety scale: validation and United Kingdom norms. Commun Dent Health 1995;12(3):143–150. PMID: 7584581. Available from: https://pubmed.ncbi.nlm.nih.gov/7584581/
Kleinknecht RA, Klepac RK, Alexander LD. Origins and characteristics of fear of dentistry. J Am Dent Assoc (1939) 1973;86(4):842–848. DOI: 10.14219/jada.archive.1973.0165.
Allam R, Allam Y, Al-Samhan A, et al. Gender differences in anxiety levels about dentistry in Saudi Dental College students. EC Dent Sci 2018;17(6):663–667. Available from: https://www.ecronicon.com/dental-science.php
Ibrahim NK, Al-Jdani M, Al-Aamoudi N, et al. Anxiety due to dental procedures and treatment among adult patients attending outpatient clinics in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. J Med Res 2016;2(2):35–40. DOI: 10.1155/2013/647436. Epub 2013 Mar 14.
Al-Madi E, Abdellatif H. Assessment of dental fear and anxiety among adolescent females in Riyadh, Saudi Arabia. Saudi Dent J 2002;14(2):77–81. DOI: 10.4103/sjos.SJOralSci_33_19
Alaki SM, Alotaibi A, Almabadi ES. Dental anxiety in middle school children and their caregivers: prevalence and severity. J Dent Oral Hyg 2012;14(1):6–11. DOI: 10.5897/JDOH11.019.
Jumaymi AK, Faqehi WH, Hamdi SA, et al. Level of dental anxiety and its relation to khat chewing in Jazan population: a cross-sectional study. J Contemp Dent Pract 2020;21(3):253–260. DOI: 10.5005/jp-journals-10024-2767
Muhammad U, Rajan J. A cross-sectional study to assess the level of dental anxiety prevailing in undergraduate dental students in Riyadh Elm University. Saudi J Oral Sci 2020;7(1):35–39. DOI: 10.4103/sjos.SJOralSci_32_19.
Al Jasser R, Almashaan G, Alwaalan H, et al. Dental anxiety among dental, medical, and nursing students of two major universities in the central region of the Kingdom of Saudi Arabia: a cross-sectional study. BMC Oral Health 2019;19(1):56. DOI: 10.1186/s12903-019-0757-x.
Kamel A, Al-Harbi A, Al-Otaibi F, et al. Dental anxiety at Riyadh Elm University Clinics. Saudi J Oral Sci 2019;6(2):101–112. DOI: 10.4103/sjos.SJOralSci_33_19.
Alshathri NM, Dada BM, Alghofaili RM, et al. The relationship between dental anxiety level and patients’ knowledge of the procedure. Int J Dent Oral Heal 2017;3(9):105–115. DOI: 10.25141/2471-657X-2017-9.0092.
Inamdar A, Alwadaani M, Asiri A, et al. Dental anxiety in medical and dental undergraduates at Jazan University. J Oral Health Res 2014;4(3):25–30. Available from: https://www.researchgate.net/publication/264037317_Dental_anxiety_in_Medical_and_Dental_undergraduates_at_Jazan_University
Al-Towayan A, Osman KH. Prevalence of dental anxiety among medical and dental undergraduates in Gassim University. Int J Med Health Res 2018;4(3):15–18. Available from: http://www.medicalsciencejournal.com/download/776/4-2-50-560.pdf
Fayad MI, Elbieh A, Baig MN, et al. Prevalence of dental anxiety among dental patients in Saudi Arabia. J Int Soc Prev Commun Dent 2017;7(2):100–104. DOI: 10.4103/jispcd.JISPCD_19_17.
Sghaireen MG, Zwiri AM, Alzoubi IA, et al. Anxiety due to dental treatment and procedures among university students and its correlation with their gender and field of study. Int J Dent 2013;2013:647436. DOI: 10.1155/2013/647436.
Al-Khalifa K. Prevalence of dental anxiety in two major cities in the kingdom of Saudi Arabia. Saudi J Med Med Sci 2015;3(2):135–140. DOI: 10.4103/1658-631X.156421.
Al-Sowygh ZH, Alfadley A, Alsaif MA, et al. Perceived causes of stress among Saudi dental students. King Saud Univ J Dent Sci 2013;4(1):7–15. DOI: 10.1016/j.ksujds.2012.11.002.
Alshammary MAA, Alhumaid ME, Alnejeem GSE, et al. Dental anxiety among medical field students in University of Hail, Saudi Arabia. Sch J Dent Sci 2017;4(6):291–296. DOI: 10.21276/sjds.
Al-Nasser L, Yunus F, Ahmed AE. Dental anxiety and its behavioral consequences in a sample of Saudi adults. Oral Health Dent Manag 2016;2016:183–188. Available from: https://www.longdom.org/open-access/dental-anxiety-and-its-behavioral-consequences-in-a-sample-of-saudi-adults-2247-2452-1000898.pdf
Coolidge T, Arapostathis KN, Emmanouil D, et al. Psychometric properties of Greek versions of the Modified Corah Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS). BMC Oral Health 2008;8:29. DOI: 10.1186/1472-6831-8-29.
Madfa AA, Al-Zubaidi SM, Shibam AH, et al. Dental anxiety and fear among a university population in a sample from Yemen. 2020. DOI: 10.21203/rs.2.21375/v1.
El-Hakim IE-SM, Bhayat I, Shaar AA, et al. Self-assessment of dental anxiety and fear among dental students in a Saudi Arabian college. Br J Med Med Res 2016;16(5):1–7. DOI: 10.9734/BJMMR/2016/26721.
Quteish Taani DS. Dental fear among a young adult Saudian population. Int Dent J 2001;51(2):62–66. DOI: 10.1002/j.1875-595x.2001.tb00823.x.
Hakami RM, Mahfouz MS, Adawi AM, et al. Social anxiety disorder and its impact in undergraduate students at Jazan University, Saudi Arabia. Ment Illn 2017;9(2):7274. DOI: 10.4081/mi.2017.7274.
Bahhawi TA, Albasheer OB, Makeen AM, et al. Depression, anxiety, and stress and their association with khat use: a cross-sectional study among Jazan University students, Saudi Arabia. Neuropsychiatr Dis Treat 2018;14:2755–2761. DOI: 10.2147/NDT.S182744.
Ploicy WMA. WMA declaration of helsinki – ethical principles formedical research involving human subjects Brazil: World Medical Association; 2013. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/.
Al Moaleem MM, Porwal A, Al Ahmari NM, et al. Khat chewing induces a floral shift in dental material-associated microbiota: a preliminary study. Med Sci Monit 2020;26:e918219. DOI: 10.12659/MSM.918219.
Al-Namankany A, Ashley P, Petrie A. Development of the first Arabic cognitive dental anxiety scale for children and young adults. World J Meta-Anal 2014;2(3):64–70. DOI: 10.13105/wjma.v2.i3.64.
Al-Nasser L, Yunus F, Ahmed A. Validation of Arabic version of the modified dental anxiety scale and assessment of cut-off points for high dental anxiety in a Saudi population. J Int Oral Health 2016;8(1):21–26. Available from: https://www.jioh.org/article.asp?issn=0976-7428;year=2016;volume=8;issue=1;spage=21;epage=26;aulast=Al-Nasser;type=0
Corah NL, Gale EN, Illig SJ. Assessment of a dental anxiety scale. J Am Dent Assoc 1978;97(5):816–819. DOI: 10.14219/jada.archive.1978.0394.
Kleinknecht RA, Thorndike RM, McGlynn FD, et al. Factor analysis of the dental fear survey with cross-validation. J Am Dent Assoc 1984;108(1):59–61. DOI: 10.14219/jada.archive.1984.0193.
Humphris GM, Freeman R, Campbell J, et al. Further evidence for the reliability and validity of the Modified Dental Anxiety Scale. Int Dent J 2000;50(6):367–370. DOI: 10.1111/j.1875-595x.2000.tb00570.x.
Alalwan SAM, Albader FNB, Alkhalaf ZAH, et al. Dental anxiety among patients undergoing different dental treatments in college of dentistry, Riyadh Elm University. Saudi J Oral Dent Res 2018;3(12): 379–385. DOI: 10.21276/sjodr.2018.3.12.2.
Al-Saleh SA, Al-Madi EM, Al-Angari NS, et al. Survey of perceived stress-inducing problems among dental students, Saudi Arabia. Saudi Dent J 2010;22(2):83–88. DOI: 10.1016/j.sdentj.2010.02.007.