Advertisement

Clinical Oral Investigations

, Volume 10, Issue 1, pp 84–91 | Cite as

Dental anxiety in a representative sample of residents of a large German city

  • Norbert Enkling
  • G. Marwinski
  • P. JöhrenEmail author
Original Article

Abstract

In a demographic survey, 300 residents of a German city were questioned to determine the prevalence of dental anxiety. The correlation between the amount of dental anxiety and the age, sex, and education of the subjects was examined and the reasons for avoiding dentist’s appointments, the duration of this avoidance, and what the subjects desire from future dental treatment. The Hierarchical Anxiety Questionnaire (HAQ) was used to measure the amount of dental anxiety. The average level of anxiety was 28.8±10.1 according to the HAQ. Young people were more afraid than older people (p=0.007), and women were more anxious than men (p=0.004). Of the women, 72% go to the dentist regularly, but only 60% of the men do (p=0.020). A painful experience while receiving dental treatment was given by 67% as the main reason for their dental anxiety, followed by a fear of needles (35%). The people wished for the most accurate information available about the dental treatment they receive (69%), followed by a compassionate dentist (62%), and treatment that is free of pain (62%). Of the people, 11% [95% CI: (7.5%; 14.5%)] suffer from dental phobia. All dental phobics were able to state the cause of their fear and more urgently wished for help from the dentist in overcoming their anxiety than the non-phobics (p=0.030). To satisfy the needs of the phobic patients, it appears necessary to screen the phobics out of the group of all patients and then offer them adequate therapy, or refer these patients to specialised treatment centres.

Keywords

Dental anxiety/phobia Prevalence Hierarchical anxiety questionnaire 

References

  1. 1.
    (1994) Diagnostic and statistical manual IV: diagnostic criteria from DSM-IV. American Psychiatric Association, Washington, D.CGoogle Scholar
  2. 2.
    Agras S, Sylvester D, Oliveau D (1969) The epidemiology of common fears and phobia. Compr Psychiatry 10:151–156PubMedCrossRefGoogle Scholar
  3. 3.
    Azrak B, Willershausen B, Keller G (1998) Befragung der Patienten zur Akzeptanz der zahnärztlichen Behandlung in der Universitätsklinik 6:171–186Google Scholar
  4. 4.
    Barkowski D, Bartsch N, Bauch J (1996) Lebenslage, Salutogenese und erhöhtes Kariesrisiko. Prävention 19:103–106Google Scholar
  5. 5.
    Berggren U (1984) Dental fear and avoidance. Thesis, University of Gotenburg, SwedenGoogle Scholar
  6. 6.
    Berggren U, Carlsson SG (1984) A psychological therapy for dental fear. Behav Res Ther 22:487–492PubMedCrossRefGoogle Scholar
  7. 7.
    Berggren U, Linde A (1984) Dental fear and avoidance: a comparison of two modes of treatment. J Dent Res 63:1223–1227PubMedGoogle Scholar
  8. 8.
    Corah NL (1969) Development of a dental anxiety scale. J Dent Res 48:596–602PubMedGoogle Scholar
  9. 9.
    Corah NL, Gale EN, Illig SJ (1978) Assesment of a dental anxiety scale. J Am Dent Assoc 97:816–819PubMedGoogle Scholar
  10. 10.
    De Jongh A, Muris P, Ter Horst G, Van Zuuren F, Schoenmakers N, Makkes P (1995) One-session treatment of dental phobia: preparing dental phobics for treatment by reconstructuring negative cognitions. Behav Res Ther 33:947–954PubMedCrossRefGoogle Scholar
  11. 11.
    Doerr PA, Lang WP, Nyquist LV, Ronis DL (1998) Factors associated with dental anxiety. J Am Dent Assoc 129:1111–1119PubMedGoogle Scholar
  12. 12.
    Duivenvoorden HJ, Schuurs AH, Thoden v, V, Verhage F, Makkes PC, Eijkman MA (1985) Influence of repression upon the measurement of dental anxiety. Community Dent Oral Epidemiol 13:315–318PubMedCrossRefGoogle Scholar
  13. 13.
    Fiset L, Milgrom P, Weinstein P, Melnick S (1989) Common fears and their relationship to dental fear and utilization of the dentist. Anesth Prog 36:258–264PubMedGoogle Scholar
  14. 14.
    Fuks AB, Steinbock N, Zadik D (1993) The influence of social and ethnic factors on dental care habits and dental anxiety: a study in Israel. Int J Paediatr Dent 3:3–7PubMedCrossRefGoogle Scholar
  15. 15.
    Gale EN (1972) Fears of the dental situation. J Dent Res 51:964–966PubMedGoogle Scholar
  16. 16.
    Gatchel RJ, Ingersoll BD, Bowman L, Robertson MC, Walker C (1983) The prevalence of dental fear and avoidance: a recent survey study. J Am Dent Assoc 107:609–610PubMedGoogle Scholar
  17. 17.
    Hakeberg M (1992) Dental anxiety and health. Thesis, University of Gotenburg, SwedenGoogle Scholar
  18. 18.
    Hakeberg M, Berggren U, Carlsson SG (1992) Prevalence of dental anxiety in an adult population in a major urban area in Sweden. Community Dent Oral Epidemiol 20:97–101PubMedCrossRefGoogle Scholar
  19. 19.
    Hakeberg M, Gustafsson JE, Berggren U, Carlsson SG (1995) Multivariate analysis of fears in dental phobic patients according to a reduced FSS-II scale. Eur J Oral Sci 103:339–344PubMedCrossRefGoogle Scholar
  20. 20.
    Jöhren P (1999) Validierung eines Fragebogens zur Erkennung von Zahnbehandlungsangst. Zahnärzteblatt 108:104–114Google Scholar
  21. 21.
    Jöhren P, Enkling N, Sartory G (2005) Prädiktoren des Vermeidungsverhalten bei Zahnbehandlungsphobie. Dtsch Zahnärztl Z 60:161–165Google Scholar
  22. 22.
    Jöhren P, Gängler P (1999) Die Diagnostik der Zahnbehandlungsangst und der Zahnbehandlungsphobie. Zahnärztl Welt 108:668–685Google Scholar
  23. 23.
    Jöhren P, Margraf-Stiksrud J (2002) Zahnbehandlungsangst und Zahnbehandlungsphobie bei Erwachsenen. Stellungnahme der DGZMK. Deutsch Zahnärztl Z 57:9–10Google Scholar
  24. 24.
    Kleinknecht RA, Klepac RK, Alexander DA (1973) Origins and characteristics of fear of dentistry. J Am Dent Assoc 86:842–847PubMedGoogle Scholar
  25. 25.
    Kunzelmann K-H, Dünninger P (1990) Dental fear and pain: effect on patient’s perception of the dentist. Community Dent Oral Epidemiol 18:264–266PubMedCrossRefGoogle Scholar
  26. 26.
    Lindsay SJE, Jackson C (1993) Fear of routine dental treatment in adults: its nature and management. Psychol Health 8:135–153CrossRefGoogle Scholar
  27. 27.
    Malamed SF (1993) Pain and anxiety control in dentistry. J Calif Dent Assoc 21:35–39PubMedGoogle Scholar
  28. 28.
    McNally RJ (1987) Preparedness and phobias: a review. Psychol Bull 101:283–303PubMedCrossRefGoogle Scholar
  29. 29.
    Mehrstedt M, Tönnies S, Eisentraut I (2002) Zahnbehandlungsängste, Gesundheitszustand und Lebensqualität. Verhaltenstherapie und Verhaltensmedizin 23:329–340Google Scholar
  30. 30.
    Micheelis W, Bauch J (1991) Mundgesundheitszustand und -verhalten in der BRD. Deutscher Ärzteverlag, KölnGoogle Scholar
  31. 31.
    Milgrom P, Fiset L, Melnick S, Weinstein P (1988) The prevalence and practice management consequences of dental fear in a major US city. J Am Dent Assoc 116:641–647PubMedGoogle Scholar
  32. 32.
    Mineka S, Ohman A (2002) Phobias and preparedness: the selective, automatic, and encapsulated nature of fear. Biol Psychiatry 52:927–937PubMedCrossRefGoogle Scholar
  33. 33.
    Moore R, Birn H, Kirkegaard E, Brodsgaard I, Scheutz F (1993) Prevalence and characteristics of dental anxiety in Danish adults. Community Dent Oral Epidemiol 21:292–296PubMedCrossRefGoogle Scholar
  34. 34.
    Neverlien PO (1990) Normative data for Corah’s Dental Anxiety Scale (DAS) for the Norwegian adult population. Community Dent Oral Epidemiol 18:162PubMedCrossRefGoogle Scholar
  35. 35.
    Pierce KA, Kirkpatrick DR (1992) Do men lie on fear surveys? Behav Res Ther 30:415–418PubMedCrossRefGoogle Scholar
  36. 36.
    Ragnarsson E (1998) Dental fear and anxiety in an adult Icelandic population. Acta Odontol Scand 56:100–104PubMedCrossRefGoogle Scholar
  37. 37.
    Schwarz E, Birn H (1995) Dental anxiety in Danish and Chinese adults—a cross-cultural perspective. Soc Sci Med 41:123–130PubMedCrossRefGoogle Scholar
  38. 38.
    Slovin M (1997) Managing the anxious and phobic dental patient. N Y State Dent J 63:36–40PubMedGoogle Scholar
  39. 39.
    Stouthard ME, Hoogstraten J (1990) Prevalence of dental anxiety in The Netherlands. Community Dent Oral Epidemiol 18:139–142PubMedCrossRefGoogle Scholar
  40. 40.
    Strauss A, Fagerhough S, Suczek B, Wiener C (1980) Gefühlsarbeit. Ein Beitrag zur Arbeits- und Berufssoziologie. KZfSS 32:629–651Google Scholar
  41. 41.
    Thomson WM, Stewart JF, Carter KD, Spencer AJ (1996) Dental anxiety among Australians. Int Dent J 46:320–324PubMedGoogle Scholar
  42. 42.
    Wetzel W-E, Hüge I, Ehret R (1984) Soziostrukturelle Einflüsse auf die Gebißgesundheit 13-14 jähriger Schulkinder. Dtsch Zahnärztl Z 39:456–460PubMedGoogle Scholar
  43. 43.
    Willershausen B, Azrak A, Wilms S (1999) Fear of dental treatment and its possible effects on oral health. Eur J Med Res 4:72–77PubMedGoogle Scholar
  44. 44.
    Zerfowski M, Koch MJ, Niekusch U, Staehle HJ (1997) Caries prevalence and treatment needs of 7- to 10-year-old schoolchildren in southwestern Germany. Community Dent Oral Epidemiol 25:348–351PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Oral Surgery, Faculty of Dental MedicineUniversity of Witten/Herdecke, Augusta- Kranken- AnstaltBochumGermany
  2. 2.Department of Oral SurgeryUniversity of Witten/Herdecke, Augusta- Kranken-AnstaltBochumGermany
  3. 3.Dental officeBochumGermany

Personalised recommendations