Dental anxiety and oral health-related quality of life in aggressive periodontitis patients



To measure dental anxiety levels and oral health-related qualities of life (OHRQoL) in patients with aggressive periodontitis (AgP) compared to controls and analyze their association with various demographic and clinical parameters.


Sixty consecutive patients with AgP were compared to 80 age- and sex-matched controls with no known history of periodontal disease. Collected data included demographics, smoking habits, numerical rating scale (NRS), Corah’s Dental Anxiety Scale (DAS) and Oral Health Impact Profile-14 (OHIP-14), DMFT index (Decayed, Missing and Filled Teeth), Plaque Index (PI), probing depth (PD), bleeding on probing (BOP), and radiographic bone loss.


AgP patients exhibited statistically significant higher scores in the DAS total as well as sub-scores, except from DAS 1st question. Compared to the control group, AgP patients exhibited worse OHIP-14 global as well as in all individual OHIP-14 domains scores.

Among both AgP and control patients, the physical pain domain was where the highest impact was recorded, while the lowest impact was recorded in the functional limitation domain.


AgP patients were positively associated with higher levels of dental anxiety and worse OHRQoL. Self-perception of dental anxiety and OHRQoL should be regarded as an integral element in routine diagnostic work-up process of periodontal diseases.

Statement of Clinical Relevance

Aggressive periodontitis (AgP) patients exhibited higher dental anxiety levels and worse oral health-related quality of life (OHRQoL) compared to controls. Professionals should design strategies that will cope with the dental anxiety associated with the treatment and prevent decreases in OHRQoL.

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Aggressive periodontitis


Bleeding on probing


Chronic periodontitis


Dental Anxiety Scale


Decay, Missing and Filled Teeth


Generalized aggressive periodontitis


Logistic regression (LR)


Numerical rating scale


Oral Health Impact Profile 14


Oral health-related quality of life


Plaque index


Probing depth


World Health Organization


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Author information




Each of the contributors provided substantive intellectual contribution to one or more of the activities related to this manuscript as follows:

Liran Levin: made substantial contributions to the study’s conception and design, interpretation of data, revised and approved the manuscript.

Avraham Zini: analysis and interpretation of data and approved the manuscript.

Jonathan Levine: data collection of the aggressive periodontitis group and approved the manuscript.

Maor Weiss: data collection of the aggressive periodontitis group and approved the manuscript.

Ron Lev: revised and approved the manuscript.

Avihay Hai: data collection of the control group and approved the manuscript.

Daniella Chebath-Taub: data collection of the control group and approved the manuscript.

Galit Almoznino: principal investigator, made substantial contributions to the study’s conception and design, acquisition of data, and analysis and interpretation of data; drafted the submitted the article and provided final approval of the version to be published.

Corresponding author

Correspondence to Galit Almoznino.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Levin, L., Zini, A., Levine, J. et al. Dental anxiety and oral health-related quality of life in aggressive periodontitis patients. Clin Oral Invest 22, 1411–1422 (2018).

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  • Periodontal disease
  • Aggressive periodontitis
  • Dental anxiety
  • Dental fear
  • Quality of life