Correlates of dental anxiety and phobia in a sample of patients receiving dental care in a dental school setting

Background : Dental anxiety, fear, and phobia are common factors that prevent individuals from seeking dental care by delaying dental care or avoiding the visit entirely, which may cause a decline in oral health-related quality of life. Dental anxiety often has a correlation with other psychological constructs. Our aim was to examine the associations between psychological constructs, dental anxiety, and phobia, and its variations among key demographics among patients seeking dental care in a dental school setting. Methods: Baseline data from 499 patients who participated in a randomized clinical trial that evaluated the efficacy of an online intervention in managing dental anxiety was used. Subjects completed a semi- structured interview according to the Diagnostic Schedule Manual-IV (DSM-IV) criteria and self-reported measures on dental anxiety (Modified Dental Anxiety Scale), fear or avoidance of dental care (Clinical Severity Rating), sensitivity to pain (Pain Sensitivity Index), ability to tolerate distress (Distress tolerance scale), blood-injection-injury (Fear Questionnaire For Blood Injection Injury), phobia, and other psychological factors. Paired sample t-tests, ANOVA, and Multivariable Regression Models were used for analyses using R 4.3.2. Statistical significance was set at p-value < 0.05. Results : Mean age of subjects was 48.9±14.7 years old, most were female (71.6%), non-Hispanic (88.6%) with an income lower than $30,000 (40.0%) and most had completed a high school diploma /GED (26%). The majority (63.3%) reported high dental anxiety (MDAS≥19) and 64.57 % met criteria for specific phobia (CSR≥4), with mean scores of 19.53 ± 3.62 and 4.49 ± 1.69 respectively. Mean scores for FQBII, PSI, DTS, and ASI were 15.51 ± 10.15, 68.02±22.9, 44.73±13.2, and 31.0 ± 16.87 respectively. Significant differences in CSR were observed by age (p< 0.01), sex (p= 0.02), and race (p<0.01), while the psychological constructs FQBII, DTS and PSI varied significantly across age, race, and ethnicity (p<0.05). Conclusion : Dental anxiety scores were higher among participants who were African American, low-income, and women compared to Caucasians. Age, sex, income, and race demonstrated to have a strong association with dental anxiety. Subjects with high pain sensitivity and fear of blood/injections had an increased dental anxiety score.