Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors
Supriya, Rajbir Singh, Amra Ahsan
Keywords :
Dental anxiety, Dental fear, Health behavior, Health beliefs, Oral health, Oral health behaviors, Periodontitis
Citation Information :
Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024; 25 (3):280-288.
Aim: This study was undertaken with an aim to explore the influence of factors associated with anxiety and fear of dentistry on oral health behavior.
Materials and methods: A total of 84 patients aged 20–40 years visiting the dental institute for the management of gum diseases (gingivitis and periodontitis) and tooth decay (dental caries) were enrolled. Fear of dentistry and oral health behaviors were recorded employing a dental fear survey (DFS) and oral health behaviors checklist. Each of the 20-item scale of DFS was rated on a 5-point Likert scale. The oral health behavior checklist was based on oral hygiene habits, patterns of utilization of dental services, food habits, and use of tobacco products. Each of the 13-item checklist comprised a closed-ended statement with a high score corresponding to more positive oral health behavior.
Results: Domains of dental fear (avoidance of dentistry, physiological arousal, and fear of specific stimuli) and total dental fear did not predict oral hygiene habits and nutritional preferences (p > 0.05). Physiological arousal was a positive predictor of utilization of dental services (p = 0.009) and oral health behavior (p = 0.042). Oral health behaviors were found to be positively correlated with three factors of DFS.
Conclusion: Anxiety and fear of dentistry are not found to influence personal preventive oral care with reference to oral hygiene habits. Avoidance of dentistry factor of DFS is positively correlated with oral health behavior. Dental fear and anxiety do not impact oral health behaviors adversely.
Clinical significance: In this era of youth and beauty, the utilization of professional dental care services is not affected by fear of invasive nature of dental procedures. Establishing the groundwork for knowledge regarding the scope of fear appeals in anxiety for dentistry may help to augment positive oral health behaviors for effective primary prevention of oral diseases. Interactions among personality characteristics, attitudes, emotions, and health behavior need further exploration.
Lewis M, Haviland–Jones JM, Barrette LF. Handbook of Emotions, 3rd edition. New York: The Guilford Press; 2000.
Baldodia A, Sharma R, Tewari S, et al. Personality traits, oral health beliefs, and periodontal parameters in patients with periodontitis. Quintessence Int 2023;54(3):200–208. DOI: 10.3290/j.qi.b3648947.
Dewolfe AS, Governale CN. Fear and attitude change. J Abnorm Psychol 1964;69(1):119–123. DOI: 10.1037/h0041369.
Brouwer–Goossensen D, Genugten LV, Lingsma H, et al. Determinants of intention to change health-related behavior and actual change in patients with TIA or minor ischemic stroke. Patient Educ Couns. 2016;99(4):644–650. DOI: 10.1016/j.pec.2015.10.028.
Klingberg G, Berggren U, Carlsson SG, et al. Child dental fear: Cause-related factors and clinical effects. Eur J Oral Sci 1995;103(6):405–412. DOI: 10.1111/j.1600-0722.1995.tb01865.x.
Oral health behavior. In: Kirch W, editors. Encyclopedia of Public Health. Dordrecht: Springer, 2008. DOI: https://doi.org/10.1007/978-1-4020-5614-7_2445.
Gordon SM, Dionne RA, Snyder J. Dental fear and anxiety as a barrier to accessing oral health care among patients with special health care needs. Spec Care Dentist 1998;18(2):88. DOI: 10.1111/j.1754-4505.1998.tb00910.x.
Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: Exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health 2007;7:1. DOI: 10.1186/1472-6831-7-1.
Joshy G, Arora M, Korda RJ, et al. Is poor oral health a risk marker for incident cardiovascular disease hospitalisation and all-cause mortality? Findings from 172,630 participants from the prospective 45 and up Study. BMJ Open 2016;6(8):e012386. DOI: 10.1136/bmjopen-2016-012386.
Fi C, Wo W. Periodontal disease and systemic diseases: An overview on recent progresses. J Biol Regul Homeost Agents 2021;35(1 Suppl. 1):1–9. PMID: 33463138.
Silveira ER, Cademartori MG, Schuch HS, et al. Estimated prevalence of dental fear in adults: A systematic review and meta-analysis. J Dent 2021;108:103632. DOI: 10.1016/j.jdent.2021.103632.
Seligman LD, Hovey JD, Chacon K, et al. Dental anxiety: An understudied problem in youth. Clin Psychol Rev 2017;55:25–40. DOI: 10.1016/j.cpr.2017.04.004.
Bernabe E, Marcenes W, Hernandez CR, et al. Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: A systematic analysis for the global burden of disease 2017 study. J Dent Res 2020;99(4):362–373. DOI: 10.1177/002203 4520908533.
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.
Prochaska JO. Multiple health behavior research represents the future of preventive medicine. Prev Med 2008;46(3):281–285. DOI: 10.1016/j.ypmed.2008.01.015.
Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc 2000;32(5):963–975. DOI: 10.1097/00005768-200005000-00014.
Nagaya T, Yoshida H, Takahashi H, et al. Cigarette smoking weakens exercise habits in healthy men. Nicotine Tob Res 2007;9(10): 1027–1032. DOI: 10.1080/14622200701591575.
Unger JB. Stages of change of smoking cessation: Relationships with other health behaviors. Am J Prev Med 1996;12(2):134–138. PMID: 8777067.
Oliveira MA, Vale MP, Bendo CB, et al. Dental fear survey: A cross-sectional study evaluating the psychometric properties of the Brazilian Portuguese version. ScientificWorldJournal 2014; 2014:725323. DOI: 10.1155/2014/725323.
Kornfield R, Smith KC, Szczypka G, et al. Earned media and public engagement with CDC's “Tips from Former Smokers” campaign: An analysis of online news and blog coverage. J Med Internet Res 2015;17(1):e12. DOI: 10.2196/jmir.3645.
Kok G, Peters GY, Kessels LTE, et al. Ignoring theory and misinterpreting evidence: The false belief in fear appeals. Health Psychol Rev 2018;12(2):111–125. DOI: 10.1080/17437199.2017.1415767.
Kessels LT, Ruiter RA, Wouters L, et al. Neuroscientific evidence for defensive avoidance of fear appeals. Int J Psychol 2014;49(2):80–88. DOI: 10.1002/ijop.12036.
van't Riet J, Ruiter RA. Defensive reactions to health-promoting information: An overview and implications for future research. Health Psychol Rev 2013;7(Suppl. 1):S104–S136. DOI: 10.1080/17437199.2011.606782.
Tannenbaum MB, Hepler J, Zimmerman RS, et al. Appealing to fear: A meta-analysis of fear appeal effectiveness and theories. Psychol Bull 2015;141(6):1178–1204. DOI: 10.1037/a0039729.
Witte K, Allen M. A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Educ Behav 2000;27(5):591–615. DOI: 10.1177/109019810002700506.
Becker MH. The health belief model and personal health behavior. Health Educ Monogr 1974;2:324–508. DOI: http://dx.doi.org/10.1177/109019817400200407.
Rosenstock IM. Historical origins of the health belief model. Health Educ Monogr 1974;2:328–335. DOI: 10.1177/109019817400200403.
Kumar S, Tadakamadla J, Johnson NW. Effect of tooth brushing frequency on incidence and increment of dental caries: A systematic review and meta-analysis. J Dent Res 2016;95(11):1230–1236. DOI: 10.1177/0022034516655315.
Patel DR, Omar H, Terry M. Sport-related performance anxiety in young female athletes. J Pediatr Adolesc Gynecol 2010;23(6):325–335. DOI: 10.1016/j.jpag.2010.04.004.
Yerkes RMD, Dodson JD. The relation of strength of stimulus to rapidity of habit formation. J Comp Neurol Psychol 1908;18(5): 459–482. DOI: 10.1002/cne.920180503.
Apter MJ. The Experience of Motivation: The Theory of Psychological Reversals. London: Academic Press; 1982.
Tiwari S, Kulkarni P, Agrawal N, et al. Dental anxiety scales used in pediatric dentistry: A systematic review and meta-analysis. J Contemp Dent Pract 2021;22(11):1338–1345. DOI: 10.5005/jp-journals-10024-3229.
Humphris GM, Morrison T, Lindsay SJE. The modified dental anxiety scale: Validation and United Kingdom norms. Community Dent Health 1995;12(3):143–150. DOI: PMID: 7584581.