Heaton Lisa J
Full Text Available Abstract Background It would be useful to have psychometrically-sound measures of dental fear for Hispanics, who comprise the largest ethnic minority in the United States. We report on the psychometric properties of Spanish-language versions of two common adult measures of dental fear (Modified Dental Anxiety Scale, MDAS; Dental Fear Survey, DFS, as well as a measure of fear of dental injections (Needle Survey, NS. Methods Spanish versions of the measures were administered to 213 adults attending Hispanic cultural festivals, 31 students (who took the questionnaire twice, for test-retest reliability, and 100 patients at a dental clinic. We also administered the questionnaire to 136 English-speaking adults at the Hispanic festivals and 58 English-speaking students at the same college where we recruited the Spanish-speaking students, to compare the performance of the English and Spanish measures in the same populations. Results The internal reliabilities of the Spanish MDAS ranged from 0.80 to 0.85. Values for the DFS ranged from 0.92 to 0.96, and values for the NS ranged from 0.92 to 0.94. The test-retest reliabilities (intra-class correlations for the three measures were 0.69, 0.86, and 0.94 for the MDAS, DFS, and NS, respectively. The three measures showed moderate correlations with one another in all three samples, providing evidence for construct validity. Patients with higher scores on the measures were rated as being more anxious during dental procedures. Similar internal reliabilities and correlations were found in the English-version analyses. The test-retest values were also similar in the English students for the DFS and NS; however, the English test-retest value for the MDAS was better than that found in the Spanish students. Conclusion We found evidence for the internal reliability, construct validity, and criterion validity for the Spanish versions of the three measures, and evidence for the test-retest reliability of the Spanish
Wiener, R Constance
The people of Appalachia-West Virginia are culturally unique and are known to have oral health disparities. The purpose of this study was to evaluate dental fear in relation to delayed dental care as a factor influencing oral health behaviors within this culture. A cross sectional study design was used. Participants were urgent care patients in a university dental clinic. The sample included 140 adults over age 18 years. The Dental Fear Survey was used to determine dental fear level. Self-report of delayed dental care was provided by the participants. The Dental Fear Survey was dichotomized at score 33, with higher scores indicating dental fear. The prevalence of dental fear was 47.1% (n=66). There was a significant association of dental fear and dental delay. The unadjusted odds ratio was 2.87 (95% CI: 1.17, 7.04; p=0.021). The adjusted odds ratio was 3.83 (95%CI: 1.14, 12.82; p=0.030), controlling for tobacco use, perceived oral health status, pain, and last dental visit. A difference in dental delay between men and women was not present in this sample. The only significant variable in delayed dental care was dental fear. In Appalachia-West Virginia, there remains a high level of dental fear, despite advances in dental care, techniques, and procedures. Copyright © 2015 The American Dental Hygienists’ Association.
D'Alessandro, Giovanni; Alkhamis, Nadia; Mattarozzi, Katia; Mazzetti, Michela; Piana, Gabriela
Dental anxiety could impede dental treatment in children. Evidence shows that parents' fear of dentists contributes to children's anxiety towards dentists. The aim of the present study was to determine whether and to what extent: a) parents' anxiety and depression personality traits, b) parent's dental fear, and c) child personality traits can predict children's dental anxiety in an Italian population. One hundred and four children (5-14 years old) and one of their parents participated in the study. Well-known and validated questionnaires were administered to children (MCDASf, CFSS-DS, TAD) and parents (FDPQ, STAI Y1, Y2, and BDI-II). Dental anxiety is significantly associated with the anxiety personality trait and depression of the child and with parental fear of dental pain. A hierarchical regression analysis showed that, regardless of age and gender, the best predictor of child dental anxiety is parent's fear of dental pain, rather than relatively stable temperaments of the child. In line with the literature concerning adults, these findings highlight the children dental anxiety as a complex phenomena consisting of different components, including the child's personality traits (anxiety trait and depression) and parents' dental fear. Clinical implications of this evidence are discussed. © 2015 American Association of Public Health Dentistry.
Risløv Staugaard, Søren; Jøssing, Marit; Krohn, Christina
Most young adults transition from childhood dental care to adult dental care without problems. However, a substantial minority leaves childhood dental care with considerable fear of dental treatment. In the present study, we hypothesized that fear of dental treatment in the young adult is influenced by memories of positive and negative childhood experiences with dental care. More specifically, we predicted that the emotional impact, sense of reliving, rehearsal, and belief in the accuracy of a negative treatment memory would be associated with increased dental fear, while positive treatment memories would show the opposite relation. One hundred thirty-six young adults leaving childhood dental care responded to a online measures of dental fear, the most negative and most positive memory of dental treatment, and symptoms of posttraumatic stress disorder. Negative memories of events that involved pain and dentist behaviors such as impatience or scolding were frequently described and significantly associated with dental fear and symptoms of posttraumatic stress. Positive memories were more frequent, but did not show a consistent relationship with dental fear. The importance of negative memories suggests an avenue for intervention against dental fear that focuses on restructuring those memories to emphasize positive aspects. © 2016 American Association of Public Health Dentistry.
Nakata, Ayumi; Sato, Yoko
Objectives. To provide an overview of the literature investigating dental fear in children during the past ten years and to review factors of child dental fear. Methods. The literature was systematically retrieved from an electronic database. The thirty four literatures which were written about the fear of dentistry, psychology and behavior during dental treatment were chosen. Results. The terms of fear being used were “Shika-kyoufu”, “Dental fear”, etc. However, the terms were not defined in...
Spencer A John
Full Text Available Abstract Background Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored. Methods The study used a telephone interview survey with interviews predominantly conducted in 2002. A random sample of 6,112 Australian residents aged 16 years and over was selected from 13 strata across all States and Territories. Data were weighted across strata and by age and sex to obtain unbiased population estimates. Results People with higher dental fear visited the dentist less often and indicated a longer expected time before visiting a dentist in the future. Higher dental fear was associated with greater perceived need for dental treatment, increased social impact of oral ill-health and worse self-rated oral health. Visiting patterns associated with higher dental fear were more likely to be symptom driven with dental visits more likely to be for a problem or for the relief of pain. All the relationships assumed by a vicious cycle of dental fear were significant. In all, 29.2% of people who were very afraid of going to the dentist had delayed dental visiting, poor oral health and symptom-driven treatment seeking compared to 11.6% of people with no dental fear. Conclusion Results are consistent with a hypothesised vicious cycle of dental fear whereby people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear.
Staugaard, Søren Risløv; Jøssing, Marit; Krohn, Christina
is influenced by memories of positive and negative childhood experiences with dental care. More specifically, we predicted that the emotional impact, sense of reliving, rehearsal, and belief in the accuracy of a negative treatment memory would be associated with increased dental fear, while positive treatment...... memories would show the opposite relation. Methods One hundred thirty-six young adults leaving childhood dental care responded to a online measures of dental fear, the most negative and most positive memory of dental treatment, and symptoms of posttraumatic stress disorder. Results Negative memories...... of events that involved pain and dentist behaviors such as impatience or scolding were frequently described and significantly associated with dental fear and symptoms of posttraumatic stress. Positive memories were more frequent, but did not show a consistent relationship with dental fear. Conclusions...
Heyman, Richard E; Slep, Amy M Smith; White-Ajmani, Mandi; Bulling, Lisanne; Zickgraf, Hana F; Franklin, Martin E; Wolff, Mark S
The prevalence and correlates of dental fear have been studied in representative population studies, but not in patients presenting for dental treatment. We hypothesized that dental fear among patients presenting at a large, urban college of dentistry would be similar to that of the population (e.g. 11% high dental fear, 17% to 35% moderate or higher fear) and that fear would be associated with avoidance of routine dental care, increased use of urgent dental care and poor oral health. Participants were 1070 consecutive patients at a large, urban dental care center. All patients completed a clinical interview, including demographics, medical history, dental history and presenting concerns, and behavioral health history. Patients were also asked to rate their dental anxiety/fear on a 1 (none) to 10 (high) scale. Over 20% of patients reported elevated anxiety/fear, of which 12.30% reported moderate and 8.75% high fear. Severity of dental anxiety/fear was strongly related to the likelihood of avoiding dental services in the past and related to myriad presenting problems. As hypothesized, the prevalence of moderate or higher fear in dental patients was considerable and closely matched that found in general population surveys. Thus, the 'dental home' is an ideal location to treat clinically significant dental anxiety/fear.
Boka, V; Arapostathis, K; Karagiannis, V; Kotsanos, N; van Loveren, C; Veerkamp, J
To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece. Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children⁁s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale. Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DSfear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DSfear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).
Berge, Karin G; Agdal, Maren L; Vika, Margrethe; Skeie, Marit S
The present study aimed to: (i) estimate the prevalence of self-reported high fear of intra-oral injections, high blood-injury fear, and injection fear; (ii) explore the overlap between high fear of intra-oral injections and high fear of dental treatment; and (iii) evaluate the possible consequence of high fear of intra-oral injections in terms of avoidance of dental care. The sample included 1,441 subjects, 10- to 16-yr of age, attending elementary schools in a county of Norway. Data were collected using questionnaires that were completed in classrooms. The survey instruments used were the Intra-Oral Injection Fear-scale, the Children's Fear Survey Schedule-Dental Subscale, the Injection Phobia scale for children, and the Mutilation Questionnaire for children. In total, 13.9% of the children reported high intra-oral injection fear. A strong association was found between fear of intra-oral injections and dental fear. When an intra-oral injection was needed, 10.6% would avoid dental treatment. In multiple regression analysis, high intra-oral injection fear was found to be associated with avoidance of dental treatment (OR = 6.52; 95% CI: 3.99-10.67). It was concluded that high fear of intra-oral injections was prevalent and might lead to avoidance of necessary dental treatment. Hence, intra-oral injection fear should be addressed before treatment of dental fear. © 2016 Eur J Oral Sci.
Negovetić Vranić, Dubravka; Ivančić Jokić, Nataša; Bakarčić, Danko; Carek, Andreja; Rotim, Željko; Verzak, Željko
Tooth injuries are serious clinical conditions. Some children experience dental trauma only once, while others are more prone to repeated tooth injuries. Repeated dental trauma occurs in 19.4% to 30% of patients. Pain and dental trauma are the most common reasons for fear and anxiety. The main objective of this study was to investigate how dental trauma, as well as repeated dental trauma affects the occurrence and development of dental fear in children. The study was conducted on a random sample of 147 subjects (88 boys and 59 girls) aged 5-8 and 9-12 years. Subjects in both age groups were divided into subroups without dental trauma, with one dental trauma and with repeated dental trauma. The validated Children’s Fear Survey Schedule – Dental Subscale was used on fear assessment. Results showed that only 12.2% of children without trauma, 33.3% with one trauma and 51.7% with repeated trauma were not afraid of injection. Older children had a significantly lower fear of injections, touch of an unknown person, choking, going to the hospital and people in white uniforms. Dentist was not the cause of fear in 65.5% of patients with repeated trauma. With each repeated injury of teeth, the degree of their fear of dental treatment was lower.
ten Berge, M; Veerkamp, J S J; Hoogstraten, J; Prins, P J M
The aim of this study was to assess the relation between parental self-reported child-rearing attitudes and dental fear in children. The parents of 51 children with high dental fear and of 56 children with low dental fear, of different age groups, completed the Amsterdam version of the Parental Attitude Research Instrument. In addition, parents were asked to rate their own dental fear. Multivariate analysis of variance (child fear x parental fear x child age) showed a significant main effect only of child dental fear on parental self-complaints (p = .03). For parental dental fear, main effects were found on overprotection and on promotion of autonomy (p fear and parental dental fear was found. Based on the present findings, it was concluded that parents may play a more secondary, mediating role in the etiological process of dental fear in children.
Lara, America; Crego, Antonio; Romero-Maroto, Martin
Dental fear is considered to be one of the most frequent problems in paediatric dentistry. According to literature, parents' levels of dental fear play a key role in the development of child's dental anxiety. HYPOTHESIS OR AIM: We have tried to identify the presence of emotional transmission of dental fear among family members and to analyse the different roles that mothers and fathers might play concerning the contagion of dental fear to children. We have hypothesized a key role of the father in the transfer of dental fear from mother to child. A questionnaire-based survey (Children's Fear Survey Schedule-Dental Subscale) has been distributed among 183 schoolchildren and their parents in Madrid (Spain). Inferential statistical analyses, i.e. correlation and hierarchical multiple regression, were carried out and possible mediating effects between variables have been tested. Our results support the hypothesis that family members' levels of dental fear are significantly correlated, and they also allow us to affirm that fathers' dental fear is a mediating variable in the relationship between mothers and children's fear scores. Together with the presence of emotional transmission of dental fear among family members, we identified the relevant role that fathers play as regards the transfer of dental fear from parents to children. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.
ten Berge, M.; Veerkamp, J.S.J.; Hoogstraten, J.
This study aimed to examine the relative importance of invasive treatment experiences in the acquisition of dental fear in children. For this purpose, the complete dental history of 401 children (aged 5-10 years) was studied. The level of dental fear in these children was assessed using the Dental
Background To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. Methods A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants’ demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. Results The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. Conclusion In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural–urban dichotomy acted as a moderator upon this relationship. PMID:24621226
Asl, Aminabadi Naser; Shokravi, Marzieh; Jamali, Zahra; Shirazi, Sajjad
Dental anxiety, fear and phobia have different etiology, response patterns, time courses, and intensities that justify a clear distinction between these constructs. Differentiation of dental anxiety, fear or phobia in practice is a critical prerequisite for developing and implementing effective treatment for children. The aim of this study was to investigate whether current researches in the pediatric dentistry appropriately discriminate the central construct of dental anxiety, fear and phobia. We also highlighted the specific methodological issues in the assessment of these issues in pediatric dentistry. A systematic search was conducted in Pubmed/medline and Scopus for articles which assessed dental anxiety, fear or phobia in children. 104 research papers were included in the review that had made a distinction between dental anxiety, fear and phobia and had not used them interchangeably. Only five studies used different clinical measures or cut-offs to discriminate between dental anxiety, fear and phobia. The dental literature appears unable to capture and also measure the multi-sided construct of dental anxiety, fear and phobia and, therefore, there was a tendency to use them interchangeably.
Hakeberg, M; Berggren, U
The most obvious consequence of a genuine dental phobic reaction is the avoidance of necessary dental care. Previous research has indicated that such avoidance results in deterioration of the oral status, which subsequently worsens patients' well-being and quality of life. The authors' previous investigations have shown overt behavioural and social effects by an increased time spent on sick leave compared with the public experience. Self-reports by patients also indicated that the time spent on sick leave was reduced after successful treatment for dental fear. The present investigation assessed the frequency of sick leave days among patients with dental fear and avoidance with regard to successful or unsuccessful treatment for dental fear (subsequent regular dental visit habits). A sub-sample of the fear group was compared with a group of matched controls. Data were collected from the official register of the National Health Insurance Board. It was revealed that the number of sick leave days was significantly reduced after treatment for dental fear among treated patients. This effect was also confirmed by a significant post-treatment difference between treated patients and those who discontinued or never started treatment. When compared with a matched control group, the positive change was further supported by a significant pre-treatment difference and a non-significant post-treatment difference.
Luoto, Anni; Tolvanen, Mimmi; Rantavuori, Kari; Pohjola, Vesa; Karlsson, Linnea; Lahti, Satu
The aim was to study longitudinal changes in dental fear among children and one of their parents separately for girls, boys, mothers and fathers over a 3.5-year period. 11-12-year-old children in Pori, Finland (n = 1691) and one of their parents were invited to participate in this longitudinal study. Dental fear was measured in 2001, 2003 and 2005 when the children were 11-12, 13-14 and 15-16-years-old, respectively. The participants were asked if they were afraid of dental care (1 = 'not afraid', 2 = 'slightly afraid', 3 = 'afraid to some degree', 4 = 'quite afraid', 5 = 'very afraid' and 6 = 'I don't know'). The participants' gender was also registered. Mean values of the change scores were studied. Prevalence and incidence of dental fear and changes in dichotomized dental fear (responses 4-5 = high dental fear and responses 1-3 = low dental fear) were studied using cross-tabulations and Cochran's Q test. Overall, the prevalence of dental fear slightly increased and female preponderance in dental fear became more evident during the follow-up. Of the mothers and children with high dental fear at the baseline, 24% and 56%, respectively, reported not to be fearful at the end of the follow-up. Dental fear seems to be more stable in adulthood than in childhood. Thus, it might be better to intervene in dental fear during childhood rather than during adulthood.
Odontophobia is a rather unique phobia with special psychosomatic components that impact on the dental health of odontophobic persons. It also has psychosocial components largely as a result of destruction of the teeth and subsequent embarrassment that can affect a person and cause a vicious cycle...... of dental fear (see fig. 1). The phenomenon is facilitated by misunderstandings and myths generated by both patients and dentists (see table 1 for examples). The most common reasons given in the literature for such strong fears of dental treatment are: 1) bad experiences in childhood for 85% of cases, 2......) feeling of powerlessness and lack of control over personal emotional reactions and over the social situation in the dental chair, 3) social learning processes in which the image of the dentist is cast in a negative light by the mass media or by the person's relatives or friends and 4) that the person has...
Júnia M. Serra-Negra
Full Text Available The aim of the present study was to evaluate the association between childhood dental experiences and dental fear in adulthood among dentistry, psychology and mathematics undergraduate students. A cross-sectional study of 1,256 students from the city of Belo Horizonte, Brazil, was performed. Students responded to the Brazilian version of the Dental Fear Survey (DFS and a questionnaire regarding previous dental experiences. Both the DFS and the questionnaire were self-administered. Association was tested using descriptive, bivariate and multivariate linear regression analysis, with a 5% significance level. Dentistry undergraduates reported lower scores than psychology (p < 0.001 and mathematics undergraduates (p < 0.05 for all three dimensions of the DFS. Negative dental experiences in childhood was associated with dimensions of Avoidance (B = 2.70, p < 0.001, Physiological arousal (B = 1.42, p < 0.001 and Fears of specific stimuli/situations (B = 3.44, p < 0.001. The reason for first visit to dentist was associated with dimensions of Physiological arousal (B = 0.76, p < 0.01 and Fears of specific stimuli/situations (B = 1.29, p < 0.01. Dentists should be encouraged to evaluate the dental fear of their patients before treatment. The DFS has been found to be an effective instrument for this purpose.
ten Berge, M.; Hoogstraten, J.; Prins, P.J.M.; Veerkamp, J.S.
OBJECTIVE: This study aimed to present normative data on dental fear for the Dutch child population, by identifying not only highly fearful children but also children at risk for developing this high dental fear. METHODS: Fear distribution of samples of high and low fearful children was studied,
El-Housseiny, Azza A; Alamoudi, Najlaa M; Farsi, Najat M; El Derwi, Douaa A
Dental fear has not only been linked to poor dental health in children but also persists across the lifespan, if unaddressed, and can continue to affect oral, systemic, and psychological health. The aim of this study was to assess the factor structure of the Arabic version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and to assess the difference in factor structure between boys and girls. Participants were 220 consecutive paediatric dental patients 6-12 years old seeking dental care at the Faculty of Dentistry, King Abdulaziz University, Saudi Arabia. Participants completed the 15-item Arabic version of the CFSS-DS questionnaire at the end of the visit. Internal consistency was assessed using Cronbach's alpha. Factor analysis (principal components, varimax rotation) was employed to assess the factor structure of the scale. The Cronbach's alpha was 0.86. Four factors with eigenvalues above 1.00 were identified, which collectively explained 64.45% of the variance. These factors were as follows: Factor 1, 'fear of usual dental procedures' consisted of 8 items such as 'drilling' and 'having to open the mouth', Factor 2, 'fear of health care personnel and injections' consisted of three items, Factor 3, 'fear of strangers', consisted of 2 items. Factor 4, 'fear of general medical aspects of treatment', consisted of 2 items. Notably, four factors of dental fear were found in girls, while five were found in boys. Four factors of different strength pertaining to dental fear were identified in Arabic-speaking children, indicating a simple structure. Most items loaded high on the factor related to fear of usual dental procedures. The fear-provoking aspects of dental procedures differed in boys and girls. Use of the scale may enable dentists to determine the item/s of dental treatment that a given child finds most fear-provoking and guide the child's behaviour accordingly.
Oosterink, F.M.D.; de Jongh, A.; Hoogstraten, J.
The purpose of the present study was to estimate the point prevalence of dental fear and dental phobia relative to 10 other common fears and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR subtypes of specific phobia. Data were also analysed to examine differences with regard to
Moore, R; Brødsgaard, I; Birn, H
This study aimed to clarify how manifestations and acquisition relate to diagnostic categories of dental fear in a population of self-referred dental fear patients, since diagnostic criteria specifically related to dental fear have not been validated. DSM III-R diagnostic criteria for phobias were used to compare with four existing dental fear diagnostic categories, referred to as the Seattle system. Subjects were 208 persons with dental fear who were telephone interviewed, of whom a subsample of 155 responded to a mailed Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory and a modified FSS-II Geer Fear Scale (GFS). Personal interviews and a Dental Beliefs Scale of perceived trust and social interaction with dentists were also used to evaluate a subsample of 80 patients selected by sex and high dental fear. Results showed that the majority of the 80 patients (66%), suffered from social embarrassment about their dental fear problem and their inability to do something about it. The largest cause of their fear (84%) was reported to be traumatic dental experiences, especially in childhood (70%). A minority of patients (16%) could not isolate traumatic experiences and had a history of general fearfulness or anxiety. Analysis of GFS data for the 155 subjects showed that fear of snakes and injuries were highest among women; heights and injections among men. Fear of blood was rarely reported. Spearman correlations between GFS individual items and DAS scores indicated functional independence between dental fear and common fears such as blood, injections and enclosures in most cases. Only in specific types of dental fear did these results support Rachman and Lopatka's contention that fears are thought to summate.(ABSTRACT TRUNCATED AT 250 WORDS)
B S Suprabha
Full Text Available Introduction: Information on the origin of dental fear and uncooperative behavior in a child patient is important for behavior management strategy. The effects of environmental factors have been comparatively less studied, especially in an Indian scenario. Objectives: To find the association of (1 age, gender, family characteristics, previous medical, and dental experiences with dental fear and behavior (2 dental fear with dental behavior. Materials and Methods: A cross-sectional questionnaire study involving 125 children aged between 7 and 14 years undergoing dental treatment under local anesthesia. The parent completed a questionnaire on family situation, medical history, and past dental experiences of the child. Child′s dental fear was recorded using Children′s Fear Survey Schedule-Dental Subscale and behavior was rated using Frankl Behaviour Rating Scale. Statistical Analysis: Data were analyzed using chi square test and binary logistic regression analysis. Results: Unpleasant experience in dental clinic and age of the child significantly influenced dental behavior. Visited pediatrician in the past one year, prior history of hospital admission, previous visit to dentist, experience at the first dental visit, and age of the child were contributing factors for dental fear. There was also significant association between dental fear levels and behavior. Conclusions: In 7 to 14 year olds, dental fear influences dental behavior, but the factors affecting them are not the same. Although dental fear decreases and dental behavior improves with age, experiences at the previous dental visits seem to influence both dental fear and behavior. Past medical experiences are likely to influence dental fear but not dental behavior.
Moore, Rod; Birn, H.; Brødsgaard, I.
anxiety by the Dental Anxiety Scale (DAS) indicated significant associations between high dental anxiety and gender (women) (Table 2) and low education (Table 3), but not income or age (Table 2). Other significant relationships with high dental fear were fear of specific dental procedures, negative......English summary: This telephone survey showed that 4.2% of Danish adults over 16 years old have extreme dental anxiety and 6% have moderate fear in a sample of 565 adults from Århus (Table 1). Common perceptions as to the causes of dental fear indicated that most believed it to be due to pain......, especially from drilling and thereafter trauma or negative experiences leading to distrust of the dentist (Table 1). It was interesting to note that although up to 40% of the sample expressed some degree of fear for dentistry, 81.1% said that they know of at least two persons who have dental fear (16.2% know...
Ujaoney, S; Mamtani, M; Thakre, T; Tote, J; Hazarey, V; Hazarey, P; Kulkarni, H
Dental fear and anxiety in early childhood are widely prevalent and contribute to dental problems and behaviour in adulthood. Novel ways to reduce dental fear and anxiety in children are needed. Our aim was to conduct an efficacy trial of a novel Camouflage Syringe to reduce dental fear and anxiety in children. randomised controlled trial of efficacy of the Camouflage Syringe. We designed a Camouflage Syringe with a toy-like appearance that veils the conventional syringe to permit topical application and injection of local anaesthesia and ensure more involvement of the patient in the treatment process. We conducted a concurrent parallel, randomised controlled trial (NCT01398007) on the efficacy of this Camouflage Syringe to reduce the dental fear and anxiety in children seeking dental treatment who required the use of local anaesthesia. Using Venham's clinical rating scale, Venham's picture test, parental stress questionnaire and recall questionnaire, the efficacy of the Camouflage Syringe to reduce dental fear and anxiety ranged from 82% to 97% for various outcomes and from 60% to 100% for prevention of related adverse outcomes. For all outcomes, the number needed to treat was close to unity. Our results strongly favour the use of Camouflage Syringe to reduce dental fear and anxiety in children.
Silveira, Ethieli Rodrigues da; Goettems, Marília Leão; Demarco, Flávio Fernando; Azevedo, Marina Sousa
This cross-sectional study evaluated the prevalence of dental fear and associated factors in schoolchildren aged 8 to 12 years old, in Pelotas, southern Brazil. Schoolchildren enrolled in 20 public and private schools were selected using a multi-stage sample design. Sociodemographic characteristics, children's dental visit and oral hygiene habits were assessed by questionnaires. The Dental Anxiety Question was used to measure dental fear prevalence. Children's clinical examination evaluated presence of dental caries (DMFT/dmft index) and gingival bleeding. Data were analyzed using Poisson regression with robust variance (prevalence ratio; 95% confidence interval). One thousand two hundred and two children were included. Dental fear prevalence was 24.6%. After the adjustment, girls [PR=1.71 (CI 95%: 1.31-2.22)], children from poorer families [PR=1.96 (CI 95%: 1.36-2.83)], those who had decayed teeth (D/d index>0)[PR=1.32 (CI 95%: 1.01-1.72), and who had never been at the dentist [PR=1.85 (CI 95%: 1.42-2.41) remained significantly associated with dental fear. The prevalence of dental fear indicates that it is a common problem among schoolchildren. Early dental care and dental caries prevention are important factors to prevent dental fear.
Kosma, I; Kevrekidou, A; Boka, V; Arapostathis, K; Kotsanos, N
This cross-sectional study was to investigate correlations between molar incisor hypomineralisation (MIH), dental caries and child dental fear. The subjects in the study were representative samples of 8 and 14 year old children from three Greek cities (total N = 2335). Dental examinations were performed by one calibrated examiner in classrooms, after the children had brushed their teeth, using an intraoral mirror and artificial room light supplemented by a penlight. All the children completed the children's fear survey schedule-dental subscale (CFSS-DS) questionnaire. MIH scores were recorded using EAPD criteria and dental caries experience by DMFS/dmfs index. Data were analysed with the Chi-squared (χ (2)), Mann-Whitney and Spearman's rank correlation coefficient tests. The mean DMFS in children with MIH (8-year olds: 1.60 ± 2.01, 14-year olds: 4.60 ± 4.41) was statistically significantly higher than children without MIH (8-year olds: 1.01 ± 1.78, 14-year olds: 3.46 ± 4.28) (p MIH had statistically significantly higher mean DMFS scores than children with mild or no MIH (p MIH status (p = 0.332). Caries experience was associated with the MIH status of the first permanent molars in both age groups (p MIH (26.5 ± 9.6) (p = 0.339), regardless of MIH severity. A positive association between MIH and dental caries was confirmed and a lack of association found between MIH and dental fear in Greek children.
Ofori, Marian A.; Adu-Ababio, F.; Nyako, E. A.; Ndanu, Tom A.
Objective: To find out the prevalence of dental anxiety and fear amongst patients in various selected dental clinics in Accra, Ghana. Study design: Dental patients (n = 279) who had either been exposed to dental treatments or had no prior dental exposure, attending four selected dental clinics in Accra were randomly sampled. They were interviewed…
van Wijk, A.J.; McNeil, D.W.; Ho, C.J.; Buchanan, H.; Hoogstraten, J.
Fear of dental pain is a highly relevant covariate in dental pain research. The present study was designed to develop a short version of the Fear of Dental Pain questionnaire (FDPQ) in order to facilitate research in this area. The original 18-item FDPQ was translated from Dutch to English, and data
Helen R. Chapman
Full Text Available Dental fear/anxiety is a widely recognised problem affecting a large proportion of the population. It can result in avoidance and/or difficulty accepting dental care. We believe that psychological intrusion may play a role in the aetiology and maintenance of dental fear for at least some individuals. In this narrative review we will take a developmental perspective in order to understand its impact across the lifespan. We will consider the nature of ‘self,’ parenting styles, the details of intrusive parenting or parental psychological control, and briefly touch upon child temperament and parental anxiety. Finally, we draw together the supporting (largely unrecognised evidence available in the dental literature. We illustrate the paper with clinical examples and discuss possibly effective ways of addressing the problem. We conclude that psychological intrusion appears to play an important role in dental fear, for at least some individuals, and we call for detailed research into the extent and exact nature of the problem. A simple means of identifying individuals who are vulnerable to psychological intrusion would be useful for dentists.
Fägerstad, Anida; Lundgren, Jesper; Arnrup, Kristina
The aim of this study was to explore dental fear in a multicultural population of child and adolescent dental patients, with background, gender, age, and socioeconomic status taken into account. A specific aim was to investigate whether the level of DF differed between patients with a non- Swedish background and patients with a Swedish background. In conjunction with a routine visit to the dental clinic, 301 patients (8-19 years old) assessed their dental fear on the Children's Fear Survey Schedule - Dental Subscale, using self-ratings. Following an interview protocol, patients' and their parents' country of birth, and parents' education and occupation/employment were registered. An interpreter was present when needed. Self-rated dental fear was almost equal among patients coming from a non-Swedish background and patients with a Swedish background. Girls scored higher than boys and younger children scored slightly higher compared to older children, but the pattern of dental fear variation was inconsistent. Socioeconomic status differed between the groups with a non-Swedish vs. a Swedish background, but no impact on dental fear was revealed. When children and adolescents with a non-Swedish vs. a Swedish background were modelled separately, female gender and younger age had an impact on dental fear only in the group with a Swedish background. No differences in dental fear were found between children and adolescents from non-Swedish vs. Swedish backgrounds. Dental fear variations according to gender and age were more pronounced in the group with a Swedish background compared to the group with a non-Swedish background. No impact of socioeconomic status could be revealed.
Full Text Available Background: Delivery of effective dental treatment to a child patient requires thorough knowledge to recognize dental fear and its management by the application of behavioral management techniques. Children′s Fear Survey Schedule - Dental Subscale (CFSS-DS helps in identification of specific stimuli which provoke fear in children with regard to dental situation. Audiovisual modeling can be successfully used in pediatric dental practice. Aim: To assess the degree of fear provoked by various stimuli in the dental office and to evaluate the effect of audiovisual modeling on dental fear of children using CFSS-DS. Materials and Methods: Ninety children were divided equally into experimental (group I and control (group II groups and were assessed in two visits for their degree of fear and the effect of audiovisual modeling, with the help of CFSS-DS. Results: The most fear-provoking stimulus for children was injection and the least was to open the mouth and having somebody look at them. There was no statistically significant difference in the overall mean CFSS-DS scores between the two groups during the initial session (P > 0.05. However, in the final session, a statistically significant difference was observed in the overall mean fear scores between the groups (P < 0.01. Significant improvement was seen in group I, while no significant change was noted in case of group II. Conclusion: Audiovisual modeling resulted in a significant reduction of overall fear as well as specific fear in relation to most of the items. A significant reduction of fear toward dentists, doctors in general, injections, being looked at, the sight, sounds, and act of the dentist drilling, and having the nurse clean their teeth was observed.
Krikken, Janneke B; van Wijk, Arjen J; ten Cate, Jacob M; Veerkamp, Jaap S J
In most studies, the parental version of the CFSS-DS is used; however, no information is available concerning the extent to which parents are able to report dental fear on behalf of their children. This study aims to assess whether parents are accurate reporters of their child's dental fear. The CFSS-DS was filled out by 326 children in a classroom setting and by 167 parents (mostly mothers) at home on behalf of their child. Intraclass correlation coefficients were used as a measure of agreement between both CFSS-DS versions, and reasons for nonagreement were assessed. Mean CFSS-DS for children was 21.15 (SD = 6.4) and for parents 23.26 (SD = 6.7). The intraclass correlation coefficient was 0.57. After selection of the 73.1% most accurate reporting parents, the ICC was 0.90. In general, parents estimate the dental fear of their children higher than their children do (P ≤ 0.001), whereas parents of high anxious children (HAC) estimate this fear lower, and parents of low anxious children (LAC) estimate this fear higher. Anxious parents (AP) estimate the dental fear of their children significantly higher than nonanxious parents (NAP) (P ≤ 0.001), but the children of AP do not estimate their own dental fear higher than children of NAP. In general, parents tend to estimate the dental fear of their children slightly higher than their children. © 2012 The Authors. International Journal of Paediatric Dentistry © 2012 BSPD, IAPD and Blackwell Publishing Ltd.
Rajwar, Anju Singh; Goswami, Mridula
There is a great need for identifying fearful children, who often present problems in patient management, thus affecting the quality of dental care rendered to them. This study is unique in the way that dental fear was assessed through three fear scales as research has suggested the use of more than one scale because each scale has its own restrictions and is open to criticism. The aim of this study was to evaluate dental fear and anxiety (DFA) among children aged 3-14 years using three fear measurement scales. The study was conducted on children (3-14 years) who visited the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences, New Delhi. The DFA levels were measured using three fear measurement scales, i.e., facial image scale (FIS), dental fear scale (DFS), and children's fear survey schedule-dental subscale (CFSS-DS). The dental behavior was estimated using the Frankl's behavior rating scale (FBRS). The prevalence of dental fear according to FIS was 14.3%, according to DFS was 22.6%, and according to CFSS-DS was 7.4%. In assessment of the behavior of children in the clinics through FBRS, it was observed that he maximum number of respondents (69.8%) showed Frankl's Rating 3 i.e. positive. In the DFS and CFSS-DS, the factor which caused most fear was "feeling the needle injected" and "injections," respectively. Assessment of dental fear is an extremely useful tool for the dental practitioner, who can use it to customize the behavioral treatment and management for child patients.
Anju Singh Rajwar
Full Text Available Introduction: There is a great need for identifying fearful children, who often present problems in patient management, thus affecting the quality of dental care rendered to them. This study is unique in the way that dental fear was assessed through three fear scales as research has suggested the use of more than one scale because each scale has its own restrictions and is open to criticism. Aim: The aim of this study was to evaluate dental fear and anxiety (DFA among children aged 3–14 years using three fear measurement scales. Methods: The study was conducted on children (3–14 years who visited the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences, New Delhi. The DFA levels were measured using three fear measurement scales, i.e., facial image scale (FIS, dental fear scale (DFS, and children's fear survey schedule-dental subscale (CFSS-DS. The dental behavior was estimated using the Frankl's behavior rating scale (FBRS. Results: The prevalence of dental fear according to FIS was 14.3%, according to DFS was 22.6%, and according to CFSS-DS was 7.4%. In assessment of the behavior of children in the clinics through FBRS, it was observed that he maximum number of respondents (69.8% showed Frankl's Rating 3 i.e. positive. In the DFS and CFSS-DS, the factor which caused most fear was “feeling the needle injected” and “injections,” respectively. Conclusion: Assessment of dental fear is an extremely useful tool for the dental practitioner, who can use it to customize the behavioral treatment and management for child patients.
Full Text Available Aims The objectives of the present survey were: 1 a systematic epidemiological investigation of dental fear and anxiety among children living in the central part of Romania and 2 to identify the most fearful aspects of dental care perceived by these children.
Spindler, Helle; Staugaard, Søren Risløv; Nicolaisen, Camilla
The objective of this study was to examine the effect of a brief cognitive-behavioral intervention for patients with dental fear in a private dental clinic. Patients presenting with subjectively reported dental fear were randomly assigned to either an immediate intervention (n = 53) or a waiting...... list (n = 51) group. Both groups received an identical intervention, but delayed by 4-6 weeks in the waiting list group. Participants were asked to fill out two self-report questionnaires of dental fear at pre- and post-intervention, and again at a 2-year follow-up assessment. Analysis of variance...... showed that dental fear was significantly reduced in the immediate intervention group (d = 1.5-2.2), compared with the waiting list group (d = 0.3-0.4). Additionally, all participants showed a significant reduction of dental fear following the brief intervention, and in the subgroup available for follow...
Schuller, A.A.; Willumsen, T.; Holst, D.
Epidemiological studies of the relationship between dental fear, use of dental services, and oral health in different age groups in a common population are scarce. Dental fear and its relationships are usually described in individuals with high dental fear only. The purposes of this study were to
Moore, R.; Brødsgaard, I.; Scheutz, F.
A telephone survey using random sample of residents of the municipality of Aarhus were interviewed about dental treatment fear and characteristics of any pre-existing anxiety. Results showed that 4.2% of 539 residents surveyed had extreme anxiety and 6% were moderately afraid. Results of dental...... anxiety, especially in the odontophobiia group, were years of avoidance of treatment and associated poor subjective perceptions of oral health. Logistic analyses revealed that although dental drilling was the identifying feature of dental anxiety characteristics, the drill could be symbolic for the many...
Full Text Available Background/Aim. Dental anxiety leads to avoidance of dental treatment and could lead to impaired oral health. The aim of this study was to determine the reliability of the Serbian version of Children’s Fear Survey Schedule Dental Subscale (CFSS-DS and the relations between dental anxiety and oral health status in a sample of Serbian schoolchildren. Methods. The CFSS-DS scale was translated into Serbian and administered to 231 (12-year old patients of the Pediatric Dental Department, Public Health Center Čukarica, Belgrade. The number of healthy, decayed, missing and filled teeth (DMFT score in children was determined by a clinical exam. Results. The average CFSS-DS score was 26.47 ± 10.33. The girls reported higher anxiety than the boys (p < 0.05. Most common fears were drilling, choking, going to the hospital and anesthesia. Lower CFSS-DS scores were recorded in children with all healthy teeth (p < 0.05. Children with higher CFSS-DS scores mostly visit the dentist due to pain or parental insistence, and those with lower anxiety scores more often visited dentist due to regular check-ups or non-invasive treatments (p < 0.01. A high value of the Cronbach's coefficient of internal consistency (α = 0.88 was found in the entire scale. Conclusion. The Serbian version of CFSS-DS questionnaire is reliable and valid psychometric instrument for evaluation of dental fear in Serbian children. Dental anxiety negatively affects dental attendance and oral health of the examined schoolchildren.
El-Housseiny, Azza A; Alsadat, Farah A; Alamoudi, Najlaa M; El Derwi, Douaa A; Farsi, Najat M; Attar, Moaz H; Andijani, Basil M
Early recognition of dental fear is essential for the effective delivery of dental care. This study aimed to test the reliability and validity of the Arabic version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). A school-based sample of 1546 children was randomly recruited. The Arabic version of the CFSS-DS was completed by children during class time. The scale was tested for internal consistency and test-retest reliability. To test criterion validity, children's behavior was assessed using the Frankl scale during dental examination, and results were compared with children's CFSS-DS scores. To test the scale's construct validity, scores on "fear of going to the dentist soon" were correlated with CFSS-DS scores. Factor analysis was also used. The Arabic version of the CFSS-DS showed high reliability regarding both test-retest reliability (intraclass correlation = 0.83, p children with negative behavior had significantly higher fear scores (t = 13.67, p fear of invasive dental procedures," "fear of less invasive dental procedures" and "fear of strangers." The Arabic version of the CFSS-DS is a reliable and valid measure of dental fear in Arabic-speaking children. Pediatric dentists and researchers may use this validated version of the CFSS-DS to measure dental fear in Arabic-speaking children.
Tuba Talo Yildirim
Full Text Available Background Dental anxiety is a widespread problem in many populations. This problem can be a barrier to dental care and may lead to poor oral health. Dental anxiety may be related to psychological status. Aims The aim of the present study was to assess the levels of dental anxiety, dental fear, Beck Depression, and state-trait anxiety according to age, gender and education level in patients at the periodontology clinic in the Diyarbakır Mouth and Dental Health Center. Study Design A total of 231 patients (115 males, 116 females filled out dental fear scale (DFS, dental anxiety scale (DAS, Beck Depression Inventory (BDI, state-trait anxiety inventory-state (STAI-S, and state-trait anxiety inventory–trait (STAI-T questionnaires, and evaluations of DFS, DAS, BDI, STAI-S, and STAI-T were conducted according to age, gender, and education level. Results The mean DFS, DAS, BDI, STAI-T, and STAI –S were 45.64, 9.15, 13.16, 38.90, and 40.18, respectively. There was a significant association among DFS, DAS, BDI, STAI-S, and STAI-T (p < 0.05. These surveys scores were significantly higher in females than males (p < 0.05. The results of this study indicated that gender age and education level have important effects on DFS, DAS, BDI, STAI-S, and STAI-T (p < 0.05. Conclusion Dental anxiety and dental fear were found to be related to psychological status (BDI, STAI-S, and STAI-T over time. There are some patients with unaddressed psychological distress.
Full Text Available Anka Coric,1 Adriana Banozic,2 Miro Klaric,3 Katarina Vukojevic,4 Livia Puljak5 1School of Medicine, University of Mostar, Health Center Mostar, Mostar, Bosnia and Herzegovina; 2Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia; 3Department of Psychiatry, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina; 4Department of Anatomy, University of Split School of Medicine, Split, Croatia; 5Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Abstract: An association between dental fear and anxiety (DFA has been confirmed for children younger than 8 years, but this association in older children is less clear. The aim of this study was to fill this knowledge gap by studying DFA in older children and their parents with validated measures. This cross-sectional study, conducted at Community Health Centre Mostar, Bosnia and Herzegovina, included 114 children and their parents. DFA, coping, and sociodemographic variables were studied using Corah Dental Anxiety Questionnaire (CDAS, Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS, Dental Cope Questionnaire, and sociodemographic questionnaire. Maternal CDAS scores had significant positive correlation with child DFA measured with CFSS-DS (r=0.35, P<0.001 and CDAS (r=0.32, P<0.001. Fathers' CDAS scores were not associated with child CFSS-DS, but showed a moderate correlation with child CDAS (r=0.19, P<0.05. There were no significant differences in children's fear and anxiety based on age, sex, or socioeconomic variables. Children used internal coping strategies most frequently and external coping strategies were rated by the children as the most effective. We did not find differences in number and type of effective coping strategies in children with high DFA compared with children with low DFA. In conclusion, there is evidence of the coexistence of dental fear in parents and older children. These findings
Pohjola, Vesa; Rekola, Aino; Kunttu, Kristina; Virtanen, Jorma I
First-year university students are in a new, independent life situation, which may affect health behaviour, including oral health habits. The aim of this study was to evaluate the association between dental fear and oral health habits, while considering the simultaneous effects of attitude toward food and treatment need at dental check-ups. The data (n = 8514) for this national cross-sectional study were collected from health registers of Finnish Student Health Service. As part of health examination all first-year university students in Finland were sent an electronic questionnaire asking about general, psychological and oral health, and health habits. Dental fear was measured by the question: "How afraid are you of visiting a dentist?" (reply alternatives: "Not at all", "Somewhat" and "Very"). Chi-square tests and Multiple logistic regression analyses were used to determine the associations between dental fear and oral health habits (tooth brushing, tobacco use, frequency of eating and drinking, eating habits and interval between dental check-ups) as well as attitude to food and treatment need at dental check-ups while controlling for age, gender, general mood and feelings in social situations. Of the oral health habits, tooth brushing and tobacco use were associated with dental fear. Those who brushed their teeth once a day or less often or used tobacco regularly were more likely to have high dental fear than those who brushed their teeth twice a day or more often or used tobacco occasionally or not at all. Students who reported not having a normal attitude to food were more likely to have high dental fear than were those reporting normal attitude to food, but the frequency of eating and drinking was not associated with dental fear. Students who reported needing treatment frequently or at every dental check-up were more likely to have high dental fear than those who reported rarely or never needing treatment. Those students with high dental fear seem to be at
Full Text Available Background & objectives: One of the difficulties of community of dentists, especially dentists dealing with children, is the pain and fear of dental treatment. The purpose of this study was to investigate the effectiveness of systematic desensitization and distraction on reducing fear and pain in children with dental problems. Methods: This is a quasi-experimental study designed with pretest-posttest multi groups according to control group. For this purpose, 45 children with dental problems referred to the dental clinic of Ardabil was selected and divided into three groups of 15 people: systematic desensitization (n=15, distraction (n=15 and control group (n=15. All of three groups answered to dental fears survey and numeric scale of pain as pre-test. Then, the therapeutic method of systematic desensitization and distraction was performed on two experimental groups. After completion of the treatments, three groups answered to dental fear survey and numeric scale of pain. Multivariate analysis of covariance was used for the analysis of the data. Results: The results showed a significant difference in the score of post-test between three groups in pain (F=197.27; p<0.001 anddental fear (F=178.36; p<0.001. LSD post hoc test results showed that systematic desensitization method was more effective in reduction of pain and the distraction method was more affective in reduction of dental fear. Conclusion: The results of this study indicate that psychological interventions of distracting and systematic desensitization can be used to reduce fear and pain at pediatric clinics.
Brahm, Carl-Otto; Lundgren, Jesper; Carlsson, Sven G; Nilsson, Peter; Hultqvist, Johanna; Hägglin, Catharina
The aims were to explore dentists' skills in dental fear, current strategies when treating fearful adult patients, and the possible need for additional education among dentists working in Sweden. A sample of 1,293 members of the Association of Public Health Dentists in Sweden were asked to respond to a Web survey concerning dental fear. The response rate was 69% (n = 889); 91% trained in Sweden and 9% trained in another country. The most frequently used pharmacological anxiety-reducing techniques were medication with a midazolame mixture (72%) and benzodiazepine tablets (77%), and the most commonly used psychological techniques were relaxation (68%), distraction (66%), and Tell-Show-Do (86%). A larger proportion of dentists trained in Sweden, compared with dentists who were trained in other countries, reported that they had received undergraduate training in dental fear. Dentists trained in Sweden more often reported competence in pharmacological and psychological anxiety-reducing techniques, compared with dentists who were trained in other countries. Higher levels of self-rated efficacy in treating fearful patients accompanied additional education in dental fear after graduation. In conclusion, Swedish dentists use a variety of techniques to meet the needs of fearful dental patients. Competence in anxiety-reducing techniques is associated with self-efficacy and the site of education. © 2013 Eur J Oral Sci.
Schuurs, A.H.B.; Hoogstraten, J.
This article reviews and assesses six dental anxiety and fear questionnaires. The construct aimed at by the questionnaires, the data collected, their reliability, validity and normative scores are considered. Some attention is given to the correlations between the questionnaires, their ambiguity,
Costa, Vanessa Polina Pereira; Correa, Marcos Britto; Goettems, Marília Leão; Pinheiro, Ricardo Tavares; Demarco, Flávio Fernando
Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers' children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads) to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children's dental fear was positively associated with mothers' presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child's perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.
Hamzah, Hajar S; Gao, Xiaoli; Yung Yiu, Cynthia K; McGrath, Colman; King, Nigel M
Internet social media offers a rich source for soliciting the public's views on health issues. This qualitative research, using You-Tube as a platform, aimed to explore the public's perspectives on management of dental fear and anxiety (DFA) in pediatric patients. Using three keywords ("dental fear," "dental phobia," and "dental anxiety"), YouTube videos were searched. Twenty-seven videos related to DFA in children and adolescents were reviewed by three investigators, including a nondental layperson. Inductive thematic analysis was adopted for interpreting the data. Several strategies were considered useful for controlling DFA in pediatric patients, including: verbal and nonverbal communication to establish closeness and effective guidance (explanation, permission-seeking, reassurance, and negotiation); desensitization to dental settings and procedures; tell-show-do; positive reinforcement; distraction by imagination and thoughtful designs of clinic; and parental presence and support. Some self-coping strategies adopted by patients alleviated their DFA, such as self-reasoning and trust-building through long-term connection. Dentists' clinical competence, favorable treatment outcomes, and state-of-the-art devices and technologies (dental lasers, intraoral camera, and adapted anaesthesia method) contributed to reducing DFA. Authentic testimonials in YouTube videos endorsed and interpreted a variety of strategies adoptable by patients, parents, and dental professionals for managing children's and adolescents' dental fears and anxieties.
Gao, Xiaoli; Hamzah, S H; Yiu, Cynthia Kar Yung; McGrath, Colman; King, Nigel M
Dental fear and anxiety (DFA) refers to the fear of and anxiety towards going to the dentist. It exists in a considerable proportion of children and adolescents and is a major dilemma in pediatric dental practice. As an Internet social medium with increasing popularity, the video-sharing website YouTube offers a useful data source for understanding health behaviors and perceptions of the public. Using YouTube as a platform, this qualitative study aimed to examine the manifestations, impacts, and origins of DFA in children and adolescents from the public's perspective. To retrieve relevant information, we searched YouTube using the keywords "dental fear", "dental anxiety", and "dental phobia". Videos in English expressing a layperson's views or experience on children's or adolescent's DFA were selected for this study. A video was excluded if it had poor audiovisual quality, was irrelevant, was pure advertisement or entertainment, or contained only the views of professionals. After the screen, we transcribed 27 videos involving 32 children and adolescents, which were reviewed by a panel of 3 investigators, including a layperson with no formal dental training. Inductive thematic analysis was applied for coding and interpreting the data. The videos revealed multiple manifestations and impacts of DFA, including immediate physical reactions (eg, crying, screaming, and shivering), psychological responses (eg, worry, upset, panic, helplessness, insecurity, resentment, and hatred), and uncooperativeness in dental treatment. Testimonials from children, adolescents, and their parents suggested diverse origins of DFA, namely personal experience (eg, irregular dental visits and influence of parents or peers), dentists and dental auxiliaries (eg, bad manner, lack of clinical skills, and improper work ethic), dental settings (eg, dental chair and sounds), and dental procedures (eg, injections, pain, discomfort, and aesthetic concerns). This qualitative study suggests that DFA in
Vanessa Polina Pereira COSTA
Full Text Available Abstract Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers’ children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p < 0.05. At data collection, the prevalence of maternal depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children’s dental fear was positively associated with mothers’ presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child’s perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.
Chhabra, N; Chhabra, A; Walia, G
Dental anxiety and fear pose a considerable challenge for the practice of clinical dentistry as these are problematic entities in the management of child patients and present a potential barrier to the utilization of oral health care services. The aim of this study was to estimate the prevalence of dental anxiety and fear among the 5-10 years aged Indian child population. A total of 523 children aged 5-10 years and their parents, visiting Krishna Dental College, Ghaziabad, India were finally recruited in this study. Dental Fear/anxiety distribution in the children was studied using the Indian parent's version of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Total fear scores were calculated separately for boys and girls and at different age levels. The collected data was statistically analyzed using a SPSS statistical program. The estimated prevalence of dental anxiety among 5 to 10 year old children in the study population was 6.3%. The overall median CFSS-DS score was 23 and the overall mean value of CFSS-DS score was 24. The prevalence of dental anxiety in children aged 5 years was 7.9%, 7.1% for 6 years old, 6.6% in 7 years old, 6.5% in 8 years old, 6.3% for 9 year old children and 5.8% in children aged 10 years. No statistically significant gender differences were found in the dental anxiety scores. The most fear provoking situations were the sight of injections, the drilling procedures by the dentist, touch of a stranger and noise of drilling by the dentist. The results of this study indicate the need for preventive health education and intervention programmes in India to prevent and reduce dental anxiety/fear and to promote children's oral health.
Vogels, W.E.J.C.; Aartman, I.H.A.; Veerkamp, J.S.J.
Objective: To assess the level of dental fear in children with a cleft lip and/or palate, to compare this level with that of a normative group testing the hypothesis that children with a cleft lip and/or palate have a higher level of dental anxiety than children from the general population, and to
Bohl, J B; Bracconi, M; Herve, C; Pirnay, P
The patient facing the dentist knows fear, anxiety. The symbolism of the mouth and teeth from childhood is an entirely specific nature of the human body. The terrifying image of dental treatment and dentist that has long been stigmatized through painting, literature, theater and cinema can change today. Many therapeutic options to the management of anxiety in dental phobia; anesthesia, conscious sedation, combined with a soothing cabinet, a caring dentist, targeted use of medications or milder alternative methods; homeopathy, herbal medicine, acupuncture, psychotherapy, places the patient's interests at the center of the caregiving relationship. But this treatment panel is also offered him the difficulty of the choice. This exercise without systematization, according to the patient with competence and kindness. Some patients may be sent or processed in collaboration with other health professionals.
Gyllensvärd, K; Qvarnström, M; Wolf, E
The aim was to analyse the care taking of dental fear patients from the perspective of the dentist, using a qualitative methodology. In total, 11 dentists from both the private and public dental service were selected through a purposive sampling according to their experience of treating dental fear patients, their gender, age, service affiliation and location of undergraduate education. Data were obtained using one semi-structured interview with each informant. The interviews were taped and verbatim transcribed. The text was analysed using qualitative content analysis. The theme, 'The transforming autodidactic process of care taking', covering the interpretative level of data content was identified. The first main category covering the descriptive level of data was 'The continuous and changing challenge', with the subcategories 'The emotional demand' and 'The financial stress'. The second main category identified was 'The repeated collection of experience', with the subcategories 'The development of resources' and 'The emotional change'. The dentists' experience of treating dental fear patients was considered a challenging self-taught process under continuous transformation. The competence and routine platform expanded over time, parallel to a change of connected emotions from frustration towards safety, although challenges remained. © 2016 John Wiley & Sons Ltd.
Klein, Ulrich; Manangkil, Rochelle; DeWitt, Peter
To investigate parents' ability to assess dental anxiety of their six- to 10-year-old children and to determine how parents' and children's fear assessments correlate with patient behavior during dental treatment. From a continuous convenience sample, 184 child/parent dyads were recruited to complete the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire prior to dental treatment. One provider treated all children, assessed their behavior, and assigned a Frankl score rating to them. Parent/child anxiety scores were compared to each other and to the behavior children presented during dental treatment. The mean dental anxiety score reported by the children was 30.30; the score reported by their parents was 2.94 points higher (P=.0016). There was poor consistency within parent/child pairs when precisely assessing dental anxiety. Parental assessments of their children's dental anxiety were a poor to fair predictor for observed behavior, whereas the children's self-assessments were fair to good. Child age was not associated with ability to assess anxiety. Parents of children with low anxiety overestimated their children's anxiety, whereas parents of children with high anxiety underestimated their children's anxiety. Parents and children showed moderate agreement assessing dental anxiety measured by the CFSS-DS. The child's score is preferable for predicting behavior.
Schiele, Miriam A; Reinhard, Julia; Reif, Andreas; Domschke, Katharina; Romanos, Marcel; Deckert, Jürgen; Pauli, Paul
Most research on human fear conditioning and its generalization has focused on adults whereas only little is known about these processes in children. Direct comparisons between child and adult populations are needed to determine developmental risk markers of fear and anxiety. We compared 267 children and 285 adults in a differential fear conditioning paradigm and generalization test. Skin conductance responses (SCR) and ratings of valence and arousal were obtained to indicate fear learning. Both groups displayed robust and similar differential conditioning on subjective and physiological levels. However, children showed heightened fear generalization compared to adults as indexed by higher arousal ratings and SCR to the generalization stimuli. Results indicate overgeneralization of conditioned fear as a developmental correlate of fear learning. The developmental change from a shallow to a steeper generalization gradient is likely related to the maturation of brain structures that modulate efficient discrimination between danger and (ambiguous) safety cues. © 2016 The Authors. Developmental Psychobiology Published by Wiley Periodicals, Inc.
Michaela Dingová; Eva Králová
Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged...
Full Text Available Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged from data analysis: development of the fear of falling, feared consequences of falling, activities curtailment, fall prevention behavior and meaning of social support in daily life. The fear of falling was described as a negative experience, directly linked to fall consequences such as physical injury, incapacitation, loss of autonomy, fear of dependence and experience of humiliating conditions. To maintain a certain level of independence in daily life, the participants chose to avoid falls by activity curtailment, organizing their lives more carefully and getting support from others. Conclusion: All participants identified that they had discovered their fear of falling after experiencing falls. The fear of falling was associated with feared consequences of a potential fall and had an impact on their daily life. The participant also mentioned other contributors to their fear of falling, including ill health and aging. Keywords: Fear of falling, older adults, perceived consequences of falls, daily life.
30 dentally fearful Ss (aged 8-12 yrs) were assigned to 1 of 3 experimental conditions (training in threat-related verbal coping responses, training in competence-related verbal coping responses, or training in an emotive-imagery procedure) or to 1 of 2 control conditions: a placebo or a
Graham, J; Gaffan, E A
Water-fearful children (non-swimmers. 5-8 yrs and adults (non-swimmers or late learners, 23-73 yr) were compared with non-fearful controls of similar swimming ability. Parallel assessments were carried out with children and adults to investigate water-related experiences, water fear and competence in parents and siblings, and the relationship of water fear to other fear dimensions. Children were assessed behaviorally and by self and mother's report, adults by self-report. In neither children nor adults was there clear evidence that fearful and non-fearful groups differed in incidence of aversive water-related experience before fear onset. Parents usually believed that children's fear was present at first contact. In both samples, we found parent-offspring and sibling resemblances in fear. Analysis of details of children's contact with parents suggested that social learning within the family decreased water fear rather than increasing it; when both child and parent showed fear, that was as likely to reflect genetic influences as modeling. Young children's water fear forms part of a generic cluster, fear of the Unknown or Danger, while in adults it becomes independent of generic fears.
Tarján, Ildikó; Gábris, Katalin
In the dental practice--for more than a 100 years--it has been a vital topic how to prevent, eliminate, or at least relieve pain and fear associated with dental treatments. 'Fogorvosi Szemle,' the scientific journal of the Hungarian Dental Association is now a 100 years old. Authors present how the approaches and methods of relieving pain and fear have changed in the past century, based on the reports published in this journal. The reports are grouped in three main topics: local anaesthetics and sedatives; ambulatory narcosis and sedative analgesia; hypnosis and hypnotherapy. Based on the publications of the last one hundred years, it can be concluded that the Hungarian dental practice has followed the trends and principles of the well-known international dental schools.
Full Text Available Background: The most frequently used measuring instrument for determination of dental fear in children nowadays is the children’s fear survey schedule-dental scale (CFSS-DS. Purpose: The purpose of this study was to explore the reliability and validity of the scale with Indonesian trans adapted version of the scale, thus the scale can be reliable to be used in other similar research in Indonesia. Methods: Total of 113 participants, who were parent’s 3 to 12 years old children. Children were divided into two age groups, group I 3-6 year old (83 children and group II 7-12 year old (30 children. Eighty three children from the first group were divided into first dental visit group (30 children and non first dental visit group (53 children. Test-retest approach was applied to 30 first dental visit children aged 3-6 year old. Original scale was translated to Indonesian language. Result: The result showed the high value of the Cronbach’s coefficient of internal consistency α=0.956. Three factors were extracted by screen test method with Eigen values higher than 1, which explained 93.05% variance of results. Conclusion: CFSS-DS scale is reliable and valid psychometric instrument for dental fear evaluation in children in Bahasa Indonesia. The differences between this study and those of others may appear due to many factors. Normal 0 false false false EN-US X-NONE X-NONE
The patterns of fears of institutionalized mentally retarded adults were studied in a sample of i2 moderately retarded men and women between the ages of 21-49. The direct questioning method was employed. Two interviews were held, two weeks apart; the first interview elicited the Ss' fears, while the second concerned the fears of their friends. A total of 146 responses were obtained, and these were categorized according to the types of fears: supernatural-natural events, animals, physical injury, psychological stress, egocentric responses, and no fears. The Ss displayed a higher percentage of fears in the preoperational stage than in the concrete operational stage. In a comparison of male to female fears, only one category, that of fears of animals, reached significance. The study suggested that the same developmental trend of fears that appears in normal children appears in the retarded as well, and these fears follow Piaget's level of cognitive development, proceeding from egocentric perceptions of causality to realistic cause and effect thinking.
Dukyoo Jung, PhD, RN
Full Text Available Fear of falling has been reported in a high percentage of community-dwelling elderly who both do and don't have a history of falling. The aims of this review are to: (a elucidate the definition of fear of falling; (b clarify measurements of fear of falling based on its definition; and (c describe the risk factors for fear of falling. Despite the importance of the percentage and the consequences of fear of falling, its definition is still vague and warrants clarification. Based on a literature review, major fear of falling measurements involve the evaluation of fear of falling and use of a fall efficacy scale. Using a correct definition of fear of falling, nurses working close with older adults need to identify the different definitions of fear of falling and fall efficacy scale. In addition, nurses who work closely with older adults should encourage them to increase or maintain modifiable factors by maximizing their basic health status and enhancing their physical activity to decrease fear of falling.
Krikken, Janneke B; de Jongh, Ad; Veerkamp, Jaap S J; Vogels, Wilma; Cate, Jacob M Ten; van Wijk, Arjen J
To determine changes in dental anxiety levels of cleft lip and/or palate (CL/P) children and to explore the role of coping strategies in the development of their dental anxiety. Prospective study. Free University Medical Center Amsterdam. A sample of CL/P children (at T1: n = 153, 4 to 18 years, 67 girls; at T2: n = 113, 7 to 21 years, 51 girls). Data were available at both time points for 102 children. Dental anxiety and coping strategies were assessed at the start of the study (T1; mean age: 9.8 years, standard deviation 4.1) and 3 years later (T2; mean age: 13.4 years, standard deviation 3.8). These scores were compared to a normative group of Dutch children. The severity of dental anxiety was indexed using the Parental Version of the Dental Subscale of the Children's Fear Survey Schedule. Dental coping strategies were assessed with the Dental Cope Questionnaire. Overall, dental anxiety decreased to a level equal to normative scores of Dutch children. However, 5% of the children became more anxious. At T2, children used significantly fewer coping strategies. Children whose level of dental anxiety increased significantly used more destructive coping strategies than children whose level of dental anxiety decreased significantly or remained stable. Results suggest that dental anxiety levels of most CL/P children gradually decline over time. Whereas some coping strategies have the potential to be protective, more destructive coping strategies may put children at greater risk for developing and maintaining their dental anxiety.
Josefsson, Eva; Lindsten, Rune; Hallberg, Lillemor R-M
Although many countries offer some publicly funded orthodontic treatment for children, not all conditions receive treatment and some adolescents enter adulthood with persisting poor dental aesthetics or malocclusions. The aim of this study was to generate a theory highlighting the main concerns of young adults, either native-born or of immigrant background, with poor dental aesthetics and the measures they adopt to manage their condition in everyday life. A qualitative method, classic grounded theory, was applied in order to generate a substantive theory highlighting the main concerns and managing mechanisms of 13 strategically selected 19- and 20-year-olds with poor dental aesthetics. Open interviews were conducted with each participant, the topics covering different aspects of social and dental conditions. A core category and three conceptual categories were generated. The core category was labelled "Being under the pressure of social norms" and was related to categories explaining three different ways in which these young adults handle their main concern: (1) avoiding showing their teeth; (2) minimizing the importance of appearance; and (3) seeking orthodontic treatment. The theory offers the potential for improved understanding of young adults who, despite poor dental aesthetics, are managing well with life, and also of those who have not adjusted well. In early adolescence it may be problematic to make decisions about orthodontic treatment. Undisclosed dental fear can be an important barrier. Some of the young adults in the present study would probably benefit from treatment.
Coldwell, S E; Getz, T; Milgrom, P; Prall, C W; Spadafora, A; Ramsay, D S
This paper describes CARL (Computer Assisted Relaxation Learning), a computerized, exposure-based therapy program for the treatment of dental injection fear. The CARL program operates primarily in two different modes; in vitro, which presents a video-taped exposure hierarchy, and in vivo, which presents scripts for a dentist or hygienist to use while working with a subject. Two additional modes are used to train subjects to use the program and to administer behavioral assessment tests. The program contains five different modules, which function to register a subject, train subjects to use physical and cognitive relaxation techniques, deliver an exposure hierarchy, question subjects about the helpfulness of each of the therapy components, and test for memory effects of anxiolytic medication. Nine subjects have completed the CARL therapy program and 1-yr follow-up as participants in a placebo-controlled clinical trial examining the effects of alprazolam on exposure therapy for dental injection phobia. All nine subjects were able to receive two dental injections, and all reduced their general fear of dental injections. Initial results therefore indicate that the CARL program successfully reduces dental injection fear.
Michael Lukas Meier
Full Text Available Experimental fear conditioning in humans is widely used as a model to investigate the neural basis of fear learning and to unravel the pathogenesis of anxiety disorders. It has been observed that fear conditioning depends on stimulus salience and subject vulnerability to fear. It is further known that the prevalence of dental-related fear and phobia is exceedingly high in the population. Dental phobia is unique as no other body part is associated with a specific phobia. Therefore, we hypothesized that painful dental stimuli exhibit an enhanced susceptibility to fear conditioning when comparing to equal perceived stimuli applied to other body sites. Differential susceptibility to pain-related fear was investigated by analyzing responses to an unconditioned stimulus (UCS applied to the right maxillary canine (UCS-c versus the right tibia (UCS-t. For fear conditioning, UCS-c and USC-t consisted of painful electric stimuli, carefully matched at both application sites for equal intensity and quality perception. UCSs were paired to simple geometrical forms which served as conditioned stimuli (CS+. Unpaired CS+ were presented for eliciting and analyzing conditioned fear responses. Outcome parameter were 1 skin conductance changes and 2 time-dependent brain activity (BOLD responses in fear-related brain regions such as the amygdala, anterior cingulate cortex, insula, thalamus, orbitofrontal cortex and medial prefrontal cortex.A preferential susceptibility of dental pain to fear conditioning was observed, reflected by heightened skin conductance responses and enhanced time-dependent brain activity (BOLD responses in the fear network. For the first time, this study demonstrates fear-related neurobiological mechanisms that point towards a superior conditionability of tooth pain. Beside traumatic dental experiences our results offer novel evidence that might explain the high prevalence of dental-related fears in the population.
Kira Anayansi SINGH
Full Text Available Nosso objetivo foi avaliar medo, ansiedade e controle relacionados ao tratamento odontológico. Os sujeitos foram 364 crianças da faixa etária de 7 a 13 anos. Três questionários com questões de múltipla escolha foram aplicados em grupos de 10 crianças. O primeiro questionário destinou-se à avaliação do medo ao tratamento odontológico e outras situações. Foi traduzido e adaptado do "Childs Fear Survey Schedule"9 e contém 15 itens. O segundo questionário contém 20 itens relacionados as situações potencialmente produtoras de ansiedade. Foi traduzido e adaptado do "State Trait Anxiety Inventory for Children"16. O terceiro questionário contém 40 itens sendo 20 relacionados ao controle percebido e 20 ao controle desejado e foi traduzido e adaptado do "Child Dental Control Assessment"19. Em relação ao medo e ansiedade, a média dos escores foi mais elevada para o sexo feminino do que para o sexo masculino (P The aim of this study was to test fear, anxiety and control related to dental treatment. The subjects were 364 children with ages between 7 and 13 years. Three questionnaires with multiple choice questions were applied in groups of 10 children. The first instrument was the 15-item dental subscale from the Childrens Fear Survey Schedule9. The subjects rated their level of fear on a 5-point scale. The second survey instrument was the 20-item subscale from the State Trait Anxiety Inventory for Children16. This measure was used to capture how anxious the child was, in general. The third instrument was the Child Dental Control Assessment19. It contained 20 items to assess perceived control and 20 items to assess desired control. The results of the survey indicated that dental fear and anxiety were slightly higher for females when compared with male subjects (P < 0.05. Older children (11 to 13 years old obtained higher fear scores than younger ones (7 to 9 years old. Concerning perceived control, the results indicate that
Singhal, Astha; Damiano, Peter; Sabik, Lindsay
Dental coverage for adult enrollees is an optional benefit under Medicaid. Thirty-one states and the District of Columbia have expanded eligibility for Medicaid under the Affordable Care Act. Millions of low-income adults have gained health care coverage and, in states offering dental benefits, oral health coverage as well. Using data for 2010 and 2014 from the Behavioral Risk Factor Surveillance System, we examined the impact of Medicaid adult dental coverage and eligibility expansions on low-income adults' use of dental care. We found that low-income adults in states that provided dental benefits beyond emergency-only coverage were more likely to have had a dental visit in the past year, compared to low-income adults in states without such benefits. Among states that provided dental benefits and expanded their Medicaid program, regression-based estimates suggest that childless adults had a significant increase (1.8 percentage points) in the likelihood of having had a dental visit, while parents had a significant decline (8.1 percentage points). One possible explanation for the disparity is that after expansion, newly enrolled childless adults might have exhausted the limited dental provider capacity that was available to parents before expansion. Additional policy-level efforts may be needed to expand the dental care delivery system's capacity. Project HOPE—The People-to-People Health Foundation, Inc.
Wu, Lingli; Gao, Xiaoli
Dental fear and anxiety (DFA) is a major issue affecting children's oral health and clinical management. This study investigates the association between children's DFA and family related factors, including parents' DFA, parenting styles, family structure (nuclear or single-parent family), and presence of siblings. A total of 405 children (9-13 years old) and their parents were recruited from 3 elementary schools in Hong Kong. Child's demographic and family-related information was collected through a questionnaire. Parents' and child's DFA were measured by using the Corah Dental Anxiety Scale (CDAS) and Children Fear Survey Schedule-Dental Subscale (CFSS-DS), respectively. Parenting styles were gauged by using the Parent Authority Questionnaire (PAQ). DFA was reported by 33.1% of children. The mean (SD) CFSS-DS score was 29.1 (11.0). Children with siblings tended to report DFA (37.0% vs. 24.1%; p = 0.034) and had a higher CFSS-DS score (29.9 vs. 27.4; p = 0.025) as compared with their counterpart. Children from single-parent families had lower CFSS-DS score as compared with children from nuclear families (β = - 9.177; p = 0.029). Subgroup analysis showed a higher CFSS-DS score among boys with siblings (β = 7.130; p = 0.010) as compared with their counterpart; girls' from single-parent families had a lower CFSS-DS score (β = - 13.933; p = 0.015) as compared with girls from nuclear families. Children's DFA was not associated with parents' DFA or parenting styles (p > 0.05). Family structure (nuclear or single-parent family) and presence of siblings are significant determinants for children's DFA. Parental DFA and parenting style do not affect children's DFA significantly.
Dunne, Güler; Askew, Chris
Children can learn to fear stimuli vicariously, by observing adults' or peers' responses to them. Given that much of school-age children's time is typically spent with their peers, it is important to establish whether fear learning from peers is as effective or robust as learning from adults, and also whether peers can be successful positive models for reducing fear. During a vicarious fear learning procedure, children (6 to 10 years; N = 60) were shown images of novel animals together with images of adult or peer faces expressing fear. Later they saw their fear-paired animal again together with positive emotional adult or peer faces. Children's fear beliefs and avoidance for the animals increased following vicarious fear learning and decreased following positive vicarious counterconditioning. There was little evidence of differences in learning from adults and peers, demonstrating that for this age group peer models are effective models for both fear acquisition and reduction. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Krikken, J.B.; van Wijk, A.J.; ten Cate, J.M.; Veerkamp, J.S.J.
Background. In most studies, the parental version of the CFSS-DS is used; however, no information is available concerning the extent to which parents are able to report dental fear on behalf of their children. Aim. This study aims to assess whether parents are accurate reporters of their child’s
dental fear adequately and continued to be reduced even after a year at a private dentist of the patients' choosing. Conclusion: The phenomenon of dental fear illustrates that new technological developments in dentistry must be accompanied by improved social and psychological understanding in the future......Inspite of technological development in dentistry, historically there has always been a new set of instruments or procedures to provide people with symbols of fear (Figs. 2 and 3). The dental consequences of treatment avoidance due to fear are often dramatic (Fig. 4). Diagnosis of the problem....... Rod's Notes: 9 Feb 2005: The thoughts in this article are found throughout the doktor afhandling text and especially about dentists working with patient expectations about technology is as true today 12 years after as at that time. Perhaps the article can be reshaped for the meetings with the Danish...
Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.
Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828
Hill, K B; Chadwick, B; Freeman, R; O'Sullivan, I; Murray, J J
The importance of understanding barriers to dental attendance of adults in the UK was acknowledged in the first Adult Dental Health Survey in 1968 and has been investigated in all subsequent ADH surveys. In 1968, approximately 40% of dentate adults said they attended for a regular check-up; by 2009 this was 61%. Attendance patterns were associated with greater frequency of toothbrushing, use of additional dental hygiene products, lower plaque and calculus levels. Just under three-fifths of adults said they had tried to make an NHS dental appointment in the previous five years. The vast majority (92%) successfully received and attended an appointment, while a further 1% received an appointment but did not attend. The remaining 7% of adults were unable to make an appointment with an NHS dentist. The majority of adults were positive about their last visit to the dentist, with 80% of adults giving no negative feedback about their last dentist visit. Cost and anxiety were important barriers to care. Twenty-six percent of adults said the type of treatment they had opted for in the past had been affected by the cost and 19% said they had delayed dental treatment for the same reason. The 2009 survey data demonstrated a relationship between dental anxiety and dental attendance. Adults with extreme dental anxiety were more likely to attend only when they had trouble with their teeth (22%) than for a regular check-up.
Isong, Inyang A; Rao, Sowmya R; Holifield, Chloe; Iannuzzi, Dorothea; Hanson, Ellen; Ware, Janice; Nelson, Linda P
Dental care is a significant unmet health care need for children with autism spectrum disorders (ASD). Many children with ASD do not receive dental care because of fear associated with dental procedures; oftentimes they require general anesthesia for regular dental procedures, placing them at risk of associated complications. Many children with ASD have a strong preference for visual stimuli, particularly electronic screen media. The use of visual teaching materials is a fundamental principle in designing educational programs for children with ASD. To determine if an innovative strategy using 2 types of electronic screen media was feasible and beneficial in reducing fear and uncooperative behaviors in children with ASD undergoing dental visits. We conducted a randomized controlled trial at Boston Children's Hospital dental clinic. Eighty (80) children aged 7 to 17 years with a known diagnosis of ASD and history of dental fear were enrolled in the study. Each child completed 2 preventive dental visits that were scheduled 6 months apart (visit 1 and visit 2). After visit 1, subjects were randomly assigned to 1 of 4 groups: (1) group A, control (usual care); (2) group B, treatment (video peer modeling that involved watching a DVD recording of a typically developing child undergoing a dental visit); (3) group C, treatment (video goggles that involved watching a favorite movie during the dental visit using sunglass-style video eyewear); and (4) group D, treatment (video peer modeling plus video goggles). Subjects who refused or were unable to wear the goggles watched the movie using a handheld portable DVD player. During both visits, the subject's level of anxiety and behavior were measured using the Venham Anxiety and Behavior Scales. Analyses of variance and Fisher's exact tests compared baseline characteristics across groups. Using intention to treat approach, repeated measures analyses were employed to test whether the outcomes differed significantly: (1) between
Zwetchkenbaum, Samuel; Oh, Junhie
Under the Affordable Care Act (ACA) Medicaid expansion since 2014, 68,000 more adults under age 65 years were enrolled in Rhode Island Medicaid as of December 2015, a 78% increase from 2013 enrollment. This report assesses changes in dental utilization associated with this expansion. Medicaid enrollment and dental claims for calendar years 2012-2015 were extracted from the RI Medicaid Management Information System. Among adults aged 18-64 years, annual numbers and percentages of Medicaid enrollees who received any dental service were summarized. Additionally, dental service claims were assessed by provider type (private practice or health center). Although 15,000 more adults utilized dental services by the end of 2015, the annual percentage of Medicaid enrollees who received any dental services decreased over the reporting periods, compared to pre-ACA years (2012-13: 39%, 2014: 35%, 2015: 32%). From 2012 to 2015, dental patient increases in community health centers were larger than in private dental offices (78% vs. 34%). Contrary to the Medicaid population increase, the number of dentists that submitted Medicaid claims decreased, particularly among dentists in private dental offices; the percentage of RI private dentists who provided any dental service to adult Medicaid enrollees decreased from 29% in 2012 to 21% in 2015. Implementation of Medicaid expansion has played a critical role in increasing the number of Rhode Islanders with dental coverage, particularly among low-income adults under age 65. However, policymakers must address the persistent and worsening shortage of dental providers that accept Medicaid to provide a more accessible source of oral healthcare for all Rhode Islanders. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-Ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi
To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.
Karyne Barreto Gonçalves Marques
Full Text Available Objective: To identify the main causing factors of fear and anxiety of children previously to dental treatment. Methods: A descriptive and qualitative study held in the municipal district of Acaraú - CE with 10 children aged 4 to 6 years old, who did not present strong pain between August and September, 2006. At first, we applied the modified VPT (Venham Picture Test, an instrument containing a set of figures of children in different emotional states, which were presented to each child so that he pointed to what he considered to be further identified at the time. The second test, held before the consultation, consisted in asking to the children to free-hand draw the dental office, the dentist and auxiliary personnel asking to each child: what do you think about the dental office and the dentist? The drawings were submitted to idiographic analysis and categorized in units of significance for interpretation. Results: Three children on VPT and nine children on the drawings presented an increased level of anxiety. Causing factors such as the motor (high speed rotation, tooth extraction and white clothes could be found. Final considerations: By means of drawing we were able to efficiently obtain results in identifying some factors that cause fear and anxiety to the child patient. The modified VPT showed to be quick, easy to apply and acceptable to children, but sometimes was contradictory with the drawings.
Full Text Available The present study explored the relationship between alexithymia and adult attachment. There were 100 participants aged 18–30 years (63 females who completed the following questionnaires: demographics, Revised Adult Attachment Scale (RAAS, Depression Anxiety Stress Scales (DASS-21, Fear of Intimacy Scale (FIS, and Toronto Alexithymia Scale 20 (TAS-20. Findings revealed predicted associations of TAS-20 alexithymia scores with insecure attachment as assessed by RAAS (i.e., lower scores on Close and Depend, and higher scores on Anxiety, fear of intimacy as assessed by FIS, and the DASS-21 index of negative mood. After controlling for age, gender and negative mood, fear of intimacy mediated the association of alexithymia with insecure attachment. Limitations of the study and implications of the findings are discussed.
Besnard, Antoine; Sahay, Amar
The generalization of fear is an adaptive, behavioral, and physiological response to the likelihood of threat in the environment. In contrast, the overgeneralization of fear, a cardinal feature of posttraumatic stress disorder (PTSD), manifests as inappropriate, uncontrollable expression of fear in neutral and safe environments. Overgeneralization of fear stems from impaired discrimination of safe from aversive environments or discernment of unlikely threats from those that are highly probable. In addition, the time-dependent erosion of episodic details of traumatic memories might contribute to their generalization. Understanding the neural mechanisms underlying the overgeneralization of fear will guide development of novel therapeutic strategies to combat PTSD. Here, we conceptualize generalization of fear in terms of resolution of interference between similar memories. We propose a role for a fundamental encoding mechanism, pattern separation, in the dentate gyrus (DG)–CA3 circuit in resolving interference between ambiguous or uncertain threats and in preserving episodic content of remote aversive memories in hippocampal–cortical networks. We invoke cellular-, circuit-, and systems-based mechanisms by which adult-born dentate granule cells (DGCs) modulate pattern separation to influence resolution of interference and maintain precision of remote aversive memories. We discuss evidence for how these mechanisms are affected by stress, a risk factor for PTSD, to increase memory interference and decrease precision. Using this scaffold we ideate strategies to curb overgeneralization of fear in PTSD. PMID:26068726
Gao, Yu; Raine, Adrian; Venables, Peter H; Dawson, Michael E; Mednick, Sarnoff A
Amygdala dysfunction is theorized to give rise to poor fear conditioning, which in turn predisposes to crime, but it is not known whether poor conditioning precedes criminal offending. This study prospectively assessed whether poor fear conditioning early in life predisposes to adult crime in a large cohort. Electrodermal fear conditioning was assessed in a cohort of 1,795 children at age 3, and registration for criminal offending was ascertained at age 23. In a case-control design, 137 cohort members with a criminal record were matched on gender, ethnicity, and social adversity with 274 noncriminal comparison members. Statistical analyses compared childhood fear conditioning for the two groups. Criminal offenders showed significantly reduced electrodermal fear conditioning at age 3 compared to matched comparison subjects. Poor fear conditioning at age 3 predisposes to crime at age 23. Poor fear conditioning early in life implicates amygdala and ventral prefrontal cortex dysfunction and a lack of fear of socializing punishments in children who grow up to become criminals. These findings are consistent with a neurodevelopmental contribution to crime causation.
All children in Sweden are entitled to regular, free dental care up to 20 years of age. While dental caries generally continues to decline, still there is a pronounced skewness in caries prevalence. Furthermore, the reported increase in dental erosion in young adults is cause for concern. The aim was to study the prevalence of dental caries and dental erosion in a cohort of Swedish 20 year-olds, with special reference to the influence of previous caries experience and lifestyle as well as parental, socioeconomic and psychosocial factors. The study was prospective, longitudinal and cross-sectional in design and based on registration of caries lesions, dental erosion, body adiposity status, saliva sampling, interviews, and questionnaires at 20 years of age. Data were available for the same cohort at 1, 3, 6 and 15 years of age. 499 subjects (74 percent of the original cohort) were included. Five individuals were subsequently excluded, leaving a final sample of 494. 74 percent of the subjects had initial and/or manifest caries lesions and/or restorations. The mean number of DimFS was 5.8 and the mean number of DmFS on occlusal surfaces of molars was 1.1. There was a strong relationship between caries activity at 3 and 6 years of age and approximal caries prevalence in premolars and molars at 20 years of age. Overweight/obese individuals had significantly higher caries prevalence than normal weight individuals. Parental, socioeconomic and psychosocial factors during infancy were related to approximal caries at age 20. Dental erosion was found in 75 percent of the individuals: 18 percent of these had extensive erosion. There was a significant association between caries and dental erosion. A relationship was found between dental erosion and lifestyle factors and overweight/obesity. There is a strong relationship between caries prevalence at age 20 and caries experience in early childhood. Young adults show a high prevalence of dental erosion, but the severity is
Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn
Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer…
Full Text Available Aim: To assess the impact of dental fear on different domains of oral health-related quality of life (OHRQoL among school going and non-school going children in the Indian scenario. Materials and Methods: The study sample consisted of 279 school children and 257 non-school going children thus making a total sample of 536 children. The sampling frame comprised of 12-15-year-old children attending two upper primary public schools and non-school going children working at shops or not working in Udaipur city, India. Information on dental fear and OHRQoL was obtained by personal interviews by a single trained and calibrated examiner through a structured questionnaire. Intercooled STATA version 9.2 was employed to perform statistical analysis. The level of significance was set at 5%. Results: Mean dental fear scores among school going (35.41 [11.79] and non-school going (47.59 [3.80] children revealed that dental fear was significantly (P ≤ 0.05 higher among non-school going than among school going children. In school going children, the likelihood of having poor oral symptoms, functional limitation and poorer social and emotional well being were significantly (P ≤ 0.05 lesser as compared with non-school going children. Conclusions: Fear has a significant impact on different domains of OHRQoL, except emotional well being, among non-school going children.
Katsouda, Maria; Provatenou, Efthymia; Arapostathis, Konstantinos; Coolidge, Trilby; Kotsanos, Nikolaos
No studies assessing the association between gagging and dental fear are available in pediatric samples. To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
López-Cevallos, Daniel F; Lee, Junghee; Donlan, William
Migrant and seasonal farmworkers face many health risks with limited access to health care and promotion services. This study explored whether fear of deportation (as a barrier), and church attendance (as an enabling factor), were associated with medical and dental care use among Mexican-origin farmworkers. Interviews were conducted with 179 farmworkers who attended mobile services provided by a local federally-qualified health center (FQHC) in partnership with area churches, during the 2007 agricultural season. The majority of respondents (87 %) were afraid of being deported, and many (74 %) attended church. Although about half of participants reported poor/fair physical (49 %) and dental (58 %) health, only 37 % of farmworkers used medical care and 20 % used dental care during the previous year. Fear of deportation was not associated with use of medical or dental care; while church attendance was associated with use of dental care. Findings suggest that despite high prevalence of fear of deportation, support by FQHCs and churches may enable farmworkers to access health care services.
Richman, David M.; Dotson, Wesley H.; Rose, Chad A.; Thompson, Samuel; Abby, Layla
This study identified (a) patterns of fearful stimuli for children and young adults with autism spectrum disorder (ASD), (b) the severity of the fear, and (c) whether excessive fear or the absence of fear negatively affected the participant's quality of life. A web-based survey was used to distribute a modified and extended version of the Fear…
Hägglin, Catharina; Boman, Ulla Wide
Severe dental fear/phobia (DF) is a problem for both dental care providers and for patients who often suffer from impaired oral health and from social and emotional distress.The aim of this paper was to present the Swedish model for DF treatment within the National Health Insurance System, and to describe the dental phobia treatment and its outcome at The Dental Fear Research and Treatment Clinic (DFRTC) in Gothenburg. A literature review was made of relevant policy documents on dental phobia treatment from the National Health Insurance System and for Västra Götaland region on published outcome studies from DFRTC. The treatment manual of DFRTC was also used. In Sweden, adult patients with severe DF are able to undergo behavioral treatment within the National Health Insurance System if the patient and caregivers fulfil defined criteria that must be approved for each individual case. At DFRTC dental phobia behavioral treatment is given by psychologists and dentists in an integrated model. The goal is to refer patients for general dental care outside the DFRTC after completing treatment. The DF treatment at DFRTC has shown positive effects on dental fear, attendance and acceptance of dental treatment for 80% of patients. Follow-up after 2 and 10 years confirmed these results and showed improved oral health. In addition, positive psychosomatic and psychosocial side-effects were reported, and benefits also for society were evident in terms of reduced sick-leave. In conlusion, in Sweden a model has been developed within the National Health Insurance System helping individuals with DF. Behavioral treatment conducted at DFRTC has proven successful in helping patients cope with dental care, leading to regular attendance and better oral health.
Full Text Available Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored.To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan.This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-to-face interviews.A total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling.Fear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people.
Lee, JuHee; Choi, MoonKi; Kim, Chang Oh
To identify factors influencing falls and the fear of falling among older adults with chronic diseases in Korea. The fear of falling and falls in older adults are significant health problems towards which healthcare providers should direct their attention. Further investigation is needed to improve nursing practice specifically decreasing risk of falls and the fear of falling in Korea. Descriptive, cross-sectional survey. A convenience sample of 108 patients was recruited at the geriatric outpatient department of a tertiary hospital in Seoul, Korea. Demographic characteristics, comorbidities, medication use, fall history, level of physical activity, activities of daily living, mobility, muscle strength, and a fear of falling were investigated. Student's t tests, chi-square tests and multiple linear regressions were used in statistical analysis. Thirty-six participants (33.3%) among 108 subjects reported experiencing ≥1 falls in the past year. Marital status and the use of antipsychotics were associated with falls, while other factors were not significantly related to falls. Only benign prostatic hypertrophy and polypharmacy were significantly related to the fear of falling in the analysis of the relationships between chronic disease, medication use and fear of falling. In the regression model, the number of comorbidities, level of physical activity, activities of daily living and mobility were predictors of a fear of falling. Medication use was marginally significant, in the model. Increasing physical activity, functional fitness and physical independence is important to decrease the fear of falling, and to encourage active and healthy lives in older adults. The findings from this study provide evidence for the development of nursing interventions for older adults. We recommend early screening for a fear of falling and nursing interventions to decrease the fear of falling through enhancing physical activity level and function. © 2017 John Wiley & Sons Ltd.
Kelekar, Uma; Naavaal, Shillpa
Poor oral health is associated with lost hours at work or school, which may affect a person's productivity. The objective of our study was to estimate work or school hours lost to dental visits among adults aged 18 and older by the types of visits (emergency or unplanned; routine, planned, or orthodontic; or cosmetic) and to determine the factors associated with hours lost. We used the most recent Oral Health Supplement data, from the 2008 National Health Interview Survey (NHIS), to estimate the total hours lost at work or school for dental visits among adults in the United States. The associations of the hours lost in unplanned and planned dental visits with socioeconomic characteristics, oral health status, and affordability were calculated. We used χ 2 tests and logistic regression to determine associations at P work or school hours were lost annually for dental care in the United States, of which 92.4 million hours were for emergency (unplanned) care (0.99 h/adult), 159.8 million for routine (planned) care or orthodontic care (1.71 h/adult), and 68.6 million for cosmetic care (0.73 h/adult). Adults with poor oral health were more likely to lose one or more hours in unplanned dental visits (OR = 5.60; 95% confidence interval [CI], 3.25-9.63) than those who reported very good oral health. Not being able to afford dental care was positively associated with more work hours lost in unplanned care (odds ratio [OR] = 2.56; 95% CI, 1.76-3.73). Compared with Hispanic adults, non-Hispanic white adults (OR = 2.09; 95% CI, 1.40-3.11) and non-Hispanic Asian adults and adults of other races/ethnicities (OR =1.91; 95% CI, 1.06-3.47) were more likely to lose any hours for planned care. Consistently, those with more than a high school education were more likely to lose any hours in planned care (OR = 1.39; 95% CI, 1.06-1.83) than those with a high school education or less. Dental problems result in hours lost from work and may adversely affect a person's productivity. There is
Sep 3, 2017 ... Objectives: To determine the prevalence of dental caries and treatment needs in an adult female Nigerian population. Methods: In this cross-sectional study, adult females attending outreach programmes were examined for dental caries using the. Decayed Missing and Filled Teeth caries index (DMFT).
Askew, Chris; Dunne, Güler; Özdil, Zehra; Reynolds, Gemma; Field, Andy P
Enhanced fear learning for fear-relevant stimuli has been demonstrated in procedures with adults in the laboratory. Three experiments investigated the effect of stimulus fear-relevance on vicarious fear learning in children (aged 6-11 years). Pictures of stimuli with different levels of fear-relevance (flowers, caterpillars, snakes, worms, and Australian marsupials) were presented alone or together with scared faces. In line with previous studies, children's fear beliefs and avoidance preferences increased for stimuli they had seen with scared faces. However, in contrast to evidence with adults, learning was mostly similar for all stimulus types irrespective of fear-relevance. The results support a proposal that stimulus preparedness is bypassed when children observationally learn threat-related information from adults.
Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi
Abstract To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults. Cross-sectional study between 2011 and 2013. Community in which residents voluntarily attended a health examination. We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination. We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance. The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P < .01), had longer 5 times chair stand time (P < .01), and more falls in the previous year (P < .05), pain (P < .01), and comorbidity (P < .05). Multivariate logistic regression analysis identified advanced age (odds ratios [OR], 1.57; 95% confidence interval [CI], 1.03–2.39), falls in the previous year (OR, 2.44; 95%CI, 1.29–4.64), and pain (OR, 1.82; 95%CI, 1.03–3.22) in men, and advanced age (OR, 1.59; 95%CI, 1.13–2.24), longer 5 times chair stand times (OR, 1.28; 95%CI, 1.04–1.59), falls in the previous year (OR, 2.59; 95%CI, 1.54–4.34), and pain (OR, 1.65; 95%CI, 1.06–2.55) in women as being independently associated with fear of falling. The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling. PMID:29369207
Montero-Pedrazuela, Ana; Fernández-Lamo, Iván; Alieva, María; Pereda-Pérez, Inmaculada; Venero, César; Guadaño-Ferraz, Ana
Hypothyroidism is the most common hormonal disease in adults, which is frequently accompanied by learning and memory impairments and emotional disorders. However, the deleterious effects of thyroid hormones deficiency on emotional memory are poorly understood and often underestimated. To evaluate the consequences of hypothyroidism on emotional learning and memory, we have performed a classical Pavlovian fear conditioning paradigm in euthyroid and adult-thyroidectomized Wistar rats. In this experimental model, learning acquisition was not impaired, fear memory was enhanced, memory extinction was delayed and spontaneous recovery of fear memory was exacerbated in hypothyroid rats. The potentiation of emotional memory under hypothyroidism was associated with an increase of corticosterone release after fear conditioning and with higher expression of glucocorticoid and mineralocorticoid receptors in the lateral and basolateral nuclei of the amygdala, nuclei that are critically involved in the circuitry of fear memory. Our results demonstrate for the first time that adult-onset hypothyroidism potentiates fear memory and also increases vulnerability to develop emotional memories. Furthermore, our findings suggest that enhanced corticosterone signaling in the amygdala is involved in the pathophysiological mechanisms of fear memory potentiation. Therefore, we recommend evaluating whether inappropriate regulation of fear in patients with post-traumatic stress and other mental disorders is associated with abnormal levels of thyroid hormones, especially those patients refractory to treatment.
Full Text Available Hypothyroidism is the most common hormonal disease in adults, which is frequently accompanied by learning and memory impairments and emotional disorders. However, the deleterious effects of thyroid hormones deficiency on emotional memory are poorly understood and often underestimated. To evaluate the consequences of hypothyroidism on emotional learning and memory, we have performed a classical Pavlovian fear conditioning paradigm in euthyroid and adult-thyroidectomized Wistar rats. In this experimental model, learning acquisition was not impaired, fear memory was enhanced, memory extinction was delayed and spontaneous recovery of fear memory was exacerbated in hypothyroid rats. The potentiation of emotional memory under hypothyroidism was associated with an increase of corticosterone release after fear conditioning and with higher expression of glucocorticoid and mineralocorticoid receptors in the lateral and basolateral nuclei of the amygdala, nuclei that are critically involved in the circuitry of fear memory. Our results demonstrate for the first time that adult-onset hypothyroidism potentiates fear memory and also increases vulnerability to develop emotional memories. Furthermore, our findings suggest that enhanced corticosterone signaling in the amygdala is involved in the pathophysiological mechanisms of fear memory potentiation. Therefore, we recommend evaluating whether inappropriate regulation of fear in patients with post-traumatic stress and other mental disorders is associated with abnormal levels of thyroid hormones, especially those patients refractory to treatment.
Montero-Pedrazuela, Ana; Fernández-Lamo, Iván; Alieva, María; Pereda-Pérez, Inmaculada; Venero, César; Guadaño-Ferraz, Ana
Hypothyroidism is the most common hormonal disease in adults, which is frequently accompanied by learning and memory impairments and emotional disorders. However, the deleterious effects of thyroid hormones deficiency on emotional memory are poorly understood and often underestimated. To evaluate the consequences of hypothyroidism on emotional learning and memory, we have performed a classical Pavlovian fear conditioning paradigm in euthyroid and adult-thyroidectomized Wistar rats. In this experimental model, learning acquisition was not impaired, fear memory was enhanced, memory extinction was delayed and spontaneous recovery of fear memory was exacerbated in hypothyroid rats. The potentiation of emotional memory under hypothyroidism was associated with an increase of corticosterone release after fear conditioning and with higher expression of glucocorticoid and mineralocorticoid receptors in the lateral and basolateral nuclei of the amygdala, nuclei that are critically involved in the circuitry of fear memory. Our results demonstrate for the first time that adult-onset hypothyroidism potentiates fear memory and also increases vulnerability to develop emotional memories. Furthermore, our findings suggest that enhanced corticosterone signaling in the amygdala is involved in the pathophysiological mechanisms of fear memory potentiation. Therefore, we recommend evaluating whether inappropriate regulation of fear in patients with post-traumatic stress and other mental disorders is associated with abnormal levels of thyroid hormones, especially those patients refractory to treatment. PMID:22039511
Shaw, A J; Niven, N
Dental fear and anxiety in children and adolescents is a common problem. Hypnosis has been shown to be useful in the treatment of these patients. This paper briefly reviews conventional management skills before considering the application of hypnosis. Following a definition of hypnosis, the concepts of relaxation, restricted awareness, blunting of critical faculties and the enhanced capacity to respond to suggestion are outlined. Consideration is given to the induction of hypnosis and its general application in an informal and formal manner. The application of more specific techniques, such as the use of hypnoanalgesia to reduce physical discomfort and the development of coping strategies to help children overcome their fears, are discussed. It has been widely shown that hypnosis is a useful adjunct in dentistry. However, it is unfortunate that hypnosis is not more widely used as it has the potential for making conventional dental management more acceptable and reducing the number of children requiring general anaesthesia.
Kvale, G.; Klingberg, G.; Moore, R.
a basic understanding of psychological reactions such as anxiety and phobia. In the current paper, dental anxiety and phobia are understood as learned behavioral patterns originating from one’s adaptive fear responses. These patterns include cognitions and physiological reactions as well as behavioural...
Oner Ozdas, Didem; Kazak, Magrur
It is evidently shown that colour has physical, psychological and sociological effects on human beings. There are many studies showing the effects of colours on brain activity. Colour preferences may change from childhood to adulthood and are significantly different in various age groups. The aim of this study was to evaluate the adults and children in their preference for mouthrinses in various colours under stress condition during a dental treatment session. 240 adults and 263 children were included in the study. Three transparent cups were filled with water, two of which were coloured green/pink rinsing by dissolving a tablet in the water. Cups were placed near the dental unit. During dental treatment sessions, patients were told to rinse their mouth with whichever cup they preferred. Preferred colour of cup, gender and age of patient, number of sessions were recorded. Data were statistically analysed by SPSS 15.0 programme and chi-square tests. Half of all cases preferred water. In adults, while females statistically significantly preferred water, males chose cups with coloured contents (pcoloured contents in multi-dental treatment sessions, children regularly preferred water (pcolours of cups affected choices made by adults and children. Female adults and children were not interested in trying colourful mouthrinses, while male adults were curious about trying colourful mouthrinses during dental treatment sessions under stress condition. Copyright © 2016 Elsevier Inc. All rights reserved.
Quinteros, Maria E; Cáceres, Dante D; Soto, Alex; Mariño, Rodrigo J; Giacaman, Rodrigo A
To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. A sample of 453 adults, 35-44 years of age, and 438 older adults, 65-74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population - 41.7% of adults and 31.5% of older adults - received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P dental damage from caries. Although rurality and use of services do not seem to affect caries experience, they are associated with differences in fillings and missing teeth. © 2014 FDI World Dental Federation.
Horner-Johnson, Willi; Dobbertin, Konrad
People with disabilities experience barriers to dental care, which may vary depending on type of disability and disability complexity (e.g., impact on activities of daily living). The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. We conducted cross-sectional analysis of 2002-2011 data from the Medical Expenditure Panel Survey. Multivariable logistic regression analyses compared adults ages 18-64 in five disability type groups (physical, cognitive, vision, hearing, or multiple disabilities) to those with no disabilities, and compared people with complex activity limitations to those without complex limitations. All disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. All disability groups except those with cognitive disabilities had increased odds of receiving dental checkups less than once a year. Similarly, all disability groups were at increased risk of both delayed and unmet needs for dental care. Odds ratios were generally highest for people with multiple types of disabilities. There are significant disparities in having dental insurance and receiving dental care for adults with disabilities, especially those with multiple types of disabilities, after controlling for socioeconomic and demographic differences. Further, disparities in care were apparent even when controlling for presence of dental insurance. © 2016 American Association of Public Health Dentistry.
Machado, Luciene Petcov; Camargo, Maria Beatriz Junqueira; Jeronymo, José Carlos Milanez; Bastos, Gisele Alsina Nader
To estimate the prevalence of regular use of dental care services by adults and older adults residing in vulnerable community and to identify associated factors. A population-based cross-sectional study was carried out with 3,391 adults and older adults residing in areas of social vulnerability in Porto Alegre, Southern Brazil, from July to December of 2009. A systematic sampling method was used the selection probability proportional to the population of each of the the 121 census sectors. The outcome for regular use of dental care services was defined as regular use of dental services, regardless of the presence of dental problems. A standardized questionnaire was administered, which included demographic, socioeconomic, type of dental care services, self-perception of dental health and self-perceived needs variables. A chi-square test for heterogeneity was used for bivariate analyses, and a Poisson regression with a robust variance and Wald tests were performed for the adjusted analysis. The prevalence of regular use of dental services was 25.7%. The prevalence was higher among people with >12 years schooling (PR 2.48 [95%CI:1.96;3.15]), higher income (PR 1.95[95%CI: 1.03;1.53]), use of private health services (PR 1.43 [95%CI: 1.20;1.71]),excellent self-perceived oral health (PR 4.44 [95%CI: 3.07;6.42]) and a self-perceived need for consultation related to routine checkup (RP 2.13 [95%CI: 1.54;2.96]). Inequalities were found in the regular use of dental services. Integrated approaches that raise awareness of oral health, improve self-care and expand access to dental services, may contribute to increase the use of dental services on a regular basis.
Chang, Hsiao-Ting; Chen, Hsi-Chung; Chou, Pesus
Background Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored. Objectives To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan. Methods This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ? 65 years. The measurements inc...
Armfield, Jason M; Ketting, Manon
It has been proposed that avoidance of dental visits might be the main determinant of poor oral health outcomes in people with high dental anxiety (HDA). This study aimed to determine the predictors of dental avoidance among people with HDA and also whether these predictors differed from those found in people with lower dental anxiety (LDA). Study participants (n = 596; response rate = 41.1%) comprised a random cross-sectional sample of the Australian adult population who completed a mailed self-complete questionnaire containing items relating to the use and accessibility of dental services, trust in dental professionals, dental anxiety, dental experiences, self-perceived oral health, vulnerability-related perceptions of visiting the dentist, and psychological health. Multiple imputation was used to replace missing values and statistically significant variables in bivariate analyses were entered into a multivariable logistic generalized linear model. More than two-thirds of participants with HDA were currently avoiding or delaying a dental visit. Among people with HDA, dental avoidance was independently and significantly predicted by difficulty paying a $300 dental bill, having no or only little trust in the last-visited dentist, perceived treatment need and dental anxiety. Among people with LDA, only perceived treatment need and dental anxiety predicted avoidance. In addition to their high anxiety, a number of additional barriers to dental visiting were found for people with HDA. These barriers, especially cost and communication issues with dentists, need to be addressed to assist people with HDA obtain necessary, regular dental care. (c) 2015 APA, all rights reserved).
Maupome, Gerardo; Aguirre-Zero, Odette; Westerhold, Chi
The objectives of this study were to identify dental hygiene themes voiced by adults and teenagers of Mexican origin [or Mexican Americans (MAs)] and place these themes within the larger landscape of oral health and dental care perceptions. Interviews with urban-based MAs were analyzed to identify barriers, beliefs, and behaviors influencing engagement in dental hygiene practices. Adult (n = 16, ages 33-52) and teenage (n = 17, ages 14-19) MAs reported themes pertaining to structural factors (financial and economic-related barriers, the dual challenges of reduced access to care vis-à-vis successfully navigating the dental care system, and the effects of reduced social support derived from migration) and to individual factors (different agendas between MAs and health systems for dental care utilization and indications for oral self-care, including limited dental hygiene instruction from professionals and larger impacts from school-based and mass media). Also, prior experiences with dental hygiene, prevention, and associated themes were characterized by a range of attitudes from fatalistic to highly determined agency. Good family upbringing was instrumental for appropriate dental hygiene, anteceding good oral health; and outlining a loose structure of factors affecting oral health such as diet, having "weak" teeth, or personal habits. Themes from adults and teenagers in the Midwest United States were generally similar to other groups of MA parents and younger children. Dental hygiene was not salient relative to other oral health and dental care matters. Several opportunities for improvement of knowledge and enhancing motivation for dental hygiene practices were identified, both within and outside professional resources. © 2014 American Association of Public Health Dentistry.
Amarasena, N; Kapellas, K; Skilton, M R; Maple-Brown, L J; Brown, A; O'Dea, K; Celermajer, D S; Jamieson, L M
Few studies have examined dental caries experience in Aboriginal adults. The objectives of this study were to describe the dental caries experience of some Aboriginal Australian adults residing in the Northern Territory, and to determine associations with dental caries experience. A convenience sample of Aboriginal adults from Australia's Northern Territory was dentally examined. Self-reported oral health information was collected through a questionnaire. Data were available for 312 participants. The per cent of untreated decayed teeth (per cent DT >0) was 77.9 (95% CI 73.0 to 82.1), the mean DT was 3.0 (95% CI 2.6 to 3.4), the prevalence of any caries experience (the per cent DMFT >0) was 95.5 (95% CI 92.6 to 97.3) and the mean DMFT was 9.7 (95% CI 8.9 to 10.5). In multivariable analyses, unemployment and not brushing teeth the previous day were associated with the per cent DT >0. Problem-based dental attendance was associated with both the mean DT and the per cent DMFT >0. Older age, residing in the capital city, being non-incarcerated, last visiting a dentist caries experience among this convenience sample of Aboriginal Australian adults was very high. Most factors associated with dental caries were social determinants or dental service access-related. © 2015 Australian Dental Association.
Haikal, Desirée Sant'Ana; Roberto, Luana Leal; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista de; Ferreira, Efigênia Ferreira E
This study aimed to analyze the validity of self-perceived dental caries and associated factors in a sample of 795 adults (35-44 years). The dependent variable was self-perceived dental caries, and the independent variables were combined in blocks. Three logistic models were performed: (1) all adults; (2) adults with a formal diagnosis of caries; and (3) adults without such caries. Self-perceived dental caries showed 77.7% sensitivity, 58% specificity, 65% accuracy, 52% positive predictive value, and 81% negative predictive value. In Model 1, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, formal diagnosis of caries, self-perceived need for treatment, toothache, and dissatisfaction with oral health and general health. In Model 2, self-perceived dental caries was associated with time of use of dental services, self-perceived need for treatment, and dissatisfaction with oral health and general health. In Model 3, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, self-perceived need for treatment, and dissatisfaction with oral health. Self-perceived dental caries showed limited utility as a diagnostic method.
Reasons for delayed reporting for oral care were negligence (53.5%); poor dental services or visited but not treated (19.4%); financial reasons (14.8%); and dental fear (12.3%). Seventy seven percent of respondents who had toothache due to advanced dental caries were aware that the aching tooth was decayed, of which, ...
Lourenço-Matharu, L; Papineni McIntosh, A; Lo, J W
The primary aim of this study was to assess whether parents' own anxiety and their perception of their child's dental fear and child's general fear can predict preoperatively their child's behaviour during dental treatment under oral sedation. The secondary aim was to assess whether the child's age, gender and ASA classification grade are associated with a child's behaviour under oral sedation. Cross-sectional prospective study. The Corah's Dental Anxiety Scale (DAS), Children's Fear Survey Schedule Dental-Subscale (CFSS-DS) and Children's Fear Survey Schedule Short-Form (CFSS-SF) questionnaires were completed by parents of children undergoing dental treatment with oral midazolam. Behaviour was rated by a single clinician using the overall behaviour section of the Houpt-Scale and scores dichotomised into acceptable or unacceptable behaviour. Data were analysed using χ (2), t test and logistic regression analysis. In total 404 children (215 girls, 53 %) were included, with the mean age of 4.57 years, SD = 1.9. Behaviour was scored as acceptable in 336 (83 %) and unacceptable in 68 (17 %) children. The level of a child's dental fear, as perceived by their parent, was significantly associated with the behaviour outcome (p = 0.001). Logistic regression analysis revealed that if the parentally perceived child's dental fear (CFSS-DS) rating was high, the odds of the child exhibiting unacceptable behaviour under oral sedation was two times greater than if their parents scored them a low dental fear rating (OR 2.27, 95 % CI 1.33-3.88, p = 0.003). CFSS-DS may be used preoperatively to help predict behaviour outcome when children are treated under oral sedation and facilitate treatment planning.
Katherine A. Lawson OTR, LMSSW, PhD
Full Text Available Background: Falls are the fifth leading cause of death for adults aged 65 years and older. Several intrinsic and extrinsic fall risk factors have been identified, butthere is less understanding of the impact of a fear of falling on falls. Seventy percent of recent fallers and 40% percent of non-fallers report a fear of falling. Therefore, the purpose of this study was to examine the correlation between a fear of falling and a history of falls, as well as the impact on the functional independence of community-dwelling older adults receiving home health services. Methods: The participants completed the Falls Efficacy Scale, the Modified Timed Up and Go Test, self- reported fear of falling, and the KATZ ADL-staircase. The participants were primarily Hispanic females. Results: There was not a significant correlation between a fear of falling and a history of falls. Only participants' age, gender, and the number of medical diagnoses were predictive of past falls. There was a moderate correlation between impaired functional mobility and dependence with activities of daily living (ADL. Additionally, a fear of falling was associated with dependence to perform ADLs as measured objectively. Conclusion: Future studies need to examine the effectiveness of interventions that include dual-task challenges during therapeutic interventions and ADL retraining to reduce fall risk among older adults.
Dijkstra, Pieternel; Barelds, Dick P.H.; Buwalda, Femke
Despite the common nature of blushing and the feelings of discomfort that often accompany it, to date. no studies have yet examined the relationship between personality characteristics and the fear of blushing. The present study fills this gap in the literature, by examining, in a sample of adults
Jamieson, Lisa M; Mejía, Gloria C; Slade, Gary D; Roberts-Thomson, Kaye F
To determine predictors of untreated dental decay among 15-34-year-olds in Australia. Data were from Australia's National Survey of Adult Oral Health, a representative survey that utilized a three-stage, stratified clustered sampling design. Models representing demographic, socioeconomic, dental service utilization and oral health perception variables were tested using multivariable logistic regression to produce odds ratios. An estimated 25.8% (95% CI 22.4-29.5) of 15-34-year-old Australians had untreated dental decay. After controlling for other covariates, those who lived in a location other than a capital city had 2.0 times the odds of having untreated dental decay than their capital city-dwelling counterparts (95% CI 1.29-3.06). Similarly, those whose highest level of education was not a university degree had 2.1 times the odds of experiencing untreated dental decay (95% CI 1.35-3.31). Perceived need of extractions or restorations predicted untreated coronal decay, with 2.9 times the odds for those who perceived a treatment need over those with no such treatment need perception (95% CI 1.84-4.53). Participants who experienced dental fear had 2.2 times the odds of having untreated dental decay (95% CI 1.38-3.41), while those who reported experiencing toothache, orofacial pain or food avoidance in the last 12 months had 1.9 times the odds of having untreated dental decay than their counterparts with no such oral health-related quality-of-life impact (95% CI 1.20-2.92). The multivariate model achieved a 'useful' level of accuracy in predicting untreated decay (area under the ROC curve = 0.74; sensitivity = 0.63; specificity = 0.73). In the Australian young adult population, residential location, education level, perceived need for dental care, dental fear, toothache, orofacial pain or food avoidance together were predictors of untreated dental decay. The prediction model had acceptable specificity, indicating that it may be useful as part of a triage system for
Doenni, V M; Song, C M; Hill, M N; Pittman, Q J
A large body of evidence has been brought forward connecting developmental immune activation to abnormal fear and anxiety levels. Anxiety disorders have extremely high lifetime prevalence, yet susceptibility factors that contribute to their emergence are poorly understood. In this research we investigated whether an inflammatory insult early in life can alter the response to fear conditioning in adulthood. Fear learning and extinction are important and adaptive behaviors, mediated largely by the amygdala and its interconnectivity with cortico-limbic circuits. Male and female rat pups were given LPS (100μg/kg i.p.) or saline at postnatal day 14; LPS activated cFos expression in the central amygdala 2.5h after exposure, but not the basal or lateral nuclei. When tested in adulthood, acquisition of an auditory cued or contextual learned fear memory was largely unaffected as was the extinction of fear to a conditioned context. However, we detected a deficit in auditory fear extinction in male and female rats that experienced early-life inflammation, such that there is a significant delay in fear extinction processes resulting in more sustained fear behaviors in response to a conditioned cue. This response was specific to extinction training and did not persist into extinction recall. The effect could not be explained by differences in pain threshold (unaltered) or in baseline anxiety, which was elevated in adolescent females only and unaltered in adolescent males and adult males and females. This research provides further evidence for the involvement of the immune system during development in the shaping of fear and anxiety related behaviors. Copyright © 2016 Elsevier Inc. All rights reserved.
Aim: To determine the prevalence of dental caries among adult patients attending University of Port Harcourt Teaching Hospital Dental centre and to compare it with previously reported results. Methods: A ... A self-administered anonymous questionnaire was used to get the socio-demographic data of the patients.
Verploegen, V J N; Schuller, A A
Dental erosion occurs often among adolescents and young adults in the Netherlands. This problem requires attention because its consequences are irreversible. In this study (part of the 'Dental Research and Practice in the North Netherlands' project) a questionnaire was distributed to 331 young adults (age 20 to 25) from 25 dental practices. The goal of the study was to find out how much young adults know about dental erosion and how they wish to receive dental information. The results show that much is still unknown about dental erosion among young adults and that the extent of knowledge depended of the level of education and on information on dental erosion that had already been received. Participants preferred to receive information in a conversation with an oral healthcare professional, with the support of printed matter.
Friedlander, Arthur H; Yagiela, John A; Mahler, Michael E; Rubin, Robert
Few published reports in the dental literature have focused on adult attention-deficit/hyperactivity disorder (ADHD) and its dental implications. The authors conducted a MEDLINE search for the period 2000 through 2005 using the terms "adult" and "attention-deficit" to define ADHD's pathology, medical treatment and dental implications. ADHD is a developmental condition that affects slightly more than 4 percent of the adult U.S. population. Its symptoms include inattention, hyperactivity and impulsivity that can cause personal, social, occupational and leisure-time dysfunction. Medications used to treat the disorder include stimulants, selective noradrenergic uptake inhibitors and tricyclic antidepressants. The oral health of people with ADHD may be compromised by inattention and impulsivity that impair home care regimens and can lead to cigarette addiction, which may cause oral cancer and damage the periodontium, and excessive ingestion of caffeinated sugar-laden soft drinks that promote dental caries. To safely care for this patient population, dentists must be familiar with the stimulant and nonstimulant medications used to treat adult ADHD, because these drugs can cause adverse orofacial and systemic reactions and interact adversely with dental therapeutic agents.
Askew, C.; Dunne, G.; Ozdil, A.; Reynolds, G.; Field, A.P.
Enhanced fear learning for fear-relevant stimuli has been demonstrated in procedures with adults in the laboratory. Three experiments investigated the effect of stimulus fear-relevance on vicarious fear learning in children (aged 6-11 years). Pictures of stimuli with different levels of fear-relevance (flowers, caterpillars, snakes, worms, and Australian marsupials) were presented alone or together with scared faces. In line with previous studies, children's fear beliefs and avoidance prefere...
Cicirelli, Victor G
Previously overlooked factors in elders' depressive symptomatology were examined, including death fear, sibling death, and sibling closeness. Participants were 150 elders (61 men, 89 women) aged 65-97 years with at least one sibling. Measures were proportion of deceased siblings, sibling closeness, the Death Fear Subscale of the Death Attitude Profile-Revised, and the Center for Epidemiological Studies-Depression scale (20-item adult form). Age and education were exogenous variables in a structural equation model. Death fear, sibling closeness, and proportion of dead siblings were directly related to depression, with path coefficients of .42, -.24, and .13, respectively. Proportion of dead siblings had indirect effects on depression, as did age and education. Depressive symptomatology in old age is influenced by death fear related to sibling death as well as by poor relationships with them; it must be understood within a situational context including death fear and sibling relationships.
Solomon, Deborah; Katz, Ralph V; Bush, Anneke C; Farley, Victoria K; McGerr, Trevor J; Min, Hoon; Carbonella, Anthony M; Kayne, Joseph D
This study sought to determine whether the self-perceived image of a young adult's anterior dental esthetics is linked with periodontal health, dental caries, and oral hygiene practices. Two hundred subjects were assessed via a clinical examination, including intraoral photographs. The subjects were questioned about their demographics and oral hygiene practices and given the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) to measure their self-perceived variables related to dental esthetics. A high PIDAQ score indicates a negative image of one's own dental esthetics, while a low PIDAQ score indicates a positive outlook. A self-perceived negative psychosocial impact of anterior dental esthetics was detected in subjects with higher levels of dental caries and visible gingival inflammation in the anterior region of the mouth.
Karyne Barreto Gonçalves Marques
Full Text Available Objective: To identify the main causing factors of fear and anxiety of children previously to dental treatment. Methods: A descriptive and qualitative study held in the municipal district of Acaraú - CE with 10 children aged 4 to 6 years old, who did not present strong pain between August and September, 2006. At first, we applied the modified VPT (Venham Picture Test, an instrument containing a set of figures of children in different emotional states, which were presented to each child so that he pointed to what he considered to be further identified at the time. The second test, held before the consultation, consisted in asking to the children to free-hand draw the dental office, the dentist and auxiliary personnel asking to each child: what do you think about the dental office and the dentist? The drawings were submitted to idiographic analysis and categorized in units of significance for interpretation. Results: Three children on VPT and nine children on the drawings presented an increased level of anxiety. Causing factors such as the motor (high speed rotation, tooth extraction and white clothes could be found. Final considerations: By means of drawing we were able to efficiently obtain results in identifying some factors that cause fear and anxiety to the child patient. The modified VPT showed to be quick, easy to apply and acceptable to children, but sometimes was contradictory with the drawings.
Gazal, Giath; Tola, Ahmed W; Fareed, Wamiq M; Alnazzawi, Ahmad A; Zafar, Muhammad S
To evaluate the value of using the visual information for reducing the level of dental fear and anxiety in patients undergoing teeth extraction under LA. A total of 64 patients were indiscriminately allotted to solitary of the study groups following reading the information sheet and signing the formal consent. If patient was in the control group, only verbal information and routine warnings were provided. If patient was in the study group, tooth extraction video was showed. The level of dental fear and anxiety was detailed by the patients on customary 100 mm visual analog scales (VAS), with "no dental fear and anxiety" (0 mm) and "severe dental distress and unease" (100 mm). Evaluation of dental apprehension and fretfulness was made pre-operatively, following visual/verbal information and post-extraction. There was a substantial variance among the mean dental fear and anxiety scores for both groups post-extraction (p-value < 0.05). Patients in tooth extraction video group were more comfortable after dental extraction than verbal information and routine warning group. For tooth extraction video group there were major decreases in dental distress and anxiety scores between the pre-operative and either post video information scores or postoperative scores (p-values < 0.05). Younger patients recorded higher dental fear and anxiety scores than older ones (P < 0.05). Dental fear and anxiety associated with dental extractions under local anesthesia can be reduced by showing a tooth extraction video to the patients preoperatively.
Hänsel Petersson, G; Ericson, E; Twetman, S
OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....
Sarita, P.T.N.; Witter, D.J.; Kreulen, C.M.; Matee, M.I.N.; Hof, M.A. van 't; Creugers, N.H.J.
PURPOSE: This study assessed decayed/missing/filled teeth (DMFT), presence of occlusal units, and prevalence of shortened dental arches in a Tanzanian adult population. MATERIALS AND METHODS: The dental state of samples of the Tanzanian population was studied. Oral examinations were conducted on
Cicirelli, Victor G
Previously overlooked factors in elders' depressive symptomatology were examined, including death fear, sibling death, and sibling closeness. Participants were 150 elders (61 men, 89 women) aged 65--97 years with at least one sibling. Measures were proportion of deceased siblings, sibling closeness, the Death Fear Subscale of the Death Attitude Profile--Revised, and the Center for Epidemiological Studies--Depression scale (20-item adult form). Age and education were exogenous variables in a s...
Maurício Antônio Oliveira
Full Text Available Objective. The aim of this study was to evaluate the psychometric properties of the Brazilian version of the Dental Fear Survey (DFS, previously translated to the Brazilian Portuguese language and validated. Methods. A cross-sectional study with 1,256 undergraduates from the city of Belo Horizonte, Brazil, was carried out. The DFS and a questionnaire about previous dental experiences were self-administered. Data analysis involved descriptive statistics, principal components analysis (PCA, confirmatory factor analysis (CFA, internal consistency and test-retest reliability, and construct, discriminant, and convergent validity. Results. PCA identified a three-factor structure. CFA confirmed the multidimensionality of the Brazilian version of the DFS. A modified model of the Brazilian version of the DFS fits better than the hypothesized model. The Cronbach’s alpha coefficient for the total DFS scale was 0.95. Conclusion. The DFS demonstrated acceptable construct validity, convergent validity, and discriminant validity. These results supported the reliability and validity of the DFS among Brazilian undergraduates.
Robin, O; Alaoui-Ismaïli, O; Dittmar, A; Vernet-Maury, E
Subjective individual experiences seem to indicate that odors may form strong connections with memories, especially those charged with emotional significance. In the dental field, this could be the case with the odorant eugenol, responsible for the typical clinging odor impregnating the dental office. The odor of eugenol could evoke memories of unpleasant dental experiences and, therefore, negative feelings such as anxiety and fear, since eugenates (cements containing eugenol) are used in potentially painful restorative dentistry. This hypothesis was tested by evaluating the emotional impact of the odor of eugenol through autonomic nervous system (ANS) analysis. The simultaneous variations of six ANS parameters (two electrodermal, two thermovascular and two cardiorespiratory), induced by the inhalation of this odorant, were recorded on volunteer subjects. Vanillin (a pleasant odorant) and propionic acid (an unpleasant one) served as controls. After the experiment, subjects were asked to rate the pleasantness versus unpleasantness of each odorant on an 11-point hedonic scale. The patterns of autonomic responses, obtained for each odorant and each subject, were transcribed into one of the six basic emotions defined by Ekman et al. (happiness, surprise, sadness, fear, anger and disgust). Results were compared between two groups of subjects divided according to their dental experience (fearful and non-fearful dental care subjects) and showed significant differences only for eugenol. This odorant was rated as pleasant by non-fearful dental subjects but unpleasant by fearful dental subjects. The evoked autonomic responses were mainly associated with positive basic emotions (happiness and surprise) in non-fearful dental subjects and with negative basic emotions (fear, anger, disgust) in fearful dental subjects. These results suggest that eugenol can be responsible for different emotional states depending on the subjects' dental experience, which seems to confirm the
Sayfan, Liat; Lagattuta, Kristin Hansen
Three-, 5-, and 7-year-olds and adults (N = 64) listened to stories depicting 2 protagonists of different ages (infant and child or child and grownup) that encounter an entity that looks like a real (e.g., a snake) or an imaginary (e.g., a ghost) fear-inducing creature. Participants predicted and explained each protagonist's intensity of fear.…
Trohel, Gilda; Bertaud-Gounot, Valérie; Soler, Marion; Chauvin, Pierre; Grimaud, Olivier
Oral health has improved in France. However, there are still inequalities related to the socio-economic status. The aim of this study was to measure the prevalence of dental care needs in an adult population and to identify the demographic, socio-economic and behavioral variables that may explain variations in this parameter. A cross-sectional analysis of the French SIRS cohort (n = 2,997 adults from the Paris region; 2010 data) was carried out to determine the prevalence of self-reported dental care needs relative to demographic, socio-economic and behavioral variables. A logistic regression model was used to identify the variables that were most strongly associated with the level of need. In 2010, the prevalence of the need for dental care in the SIRS cohort was 35.0% (95% CI [32.3-37.8]). It was lower in people with higher education levels (31.3% [27.9-34.6]), without immigrant background (31.3% [28.0-34.6]) and with comprehensive health insurance (social security + complementary health cover; 32.8% [30.2-35.4]). It decreased as the socio-economic status increased, but without following a strict linear change. It was also lower among individuals who had a dental check-up visit in the previous two years. In multivariate analyses, the socioeconomic variables most strongly associated with the need for dental care were: educational attainment (OR = 1.21 [1.02-1.44]), income level (OR = 1.66 [1.92-2.12]) and national origin (OR = 1.53 [1.26-1.86]). These results confirm that the prevalence of dental care needs is higher among adults with low socio-economic status. Education level, income level and also national origin were more strongly associated with the need for dental care than insurance cover level.
Moore, Rod; Abrahamsen, Randi; Brødsgaard, I
Effects of hypnotherapy (HT) and self-hypnosis training on extreme dental anxiety in adults aged 19-65 years were compared with group therapy (GT) and individual desensitization (SD) using scales of dental anxiety, dental beliefs, and fear of a next dentist (after specialist treatment). All...... experimental groups were demographically comparable and showed reduced anxiety and improved dental beliefs compared with 51 control patients. The 25 HT patients did not differ significantly in numbers of dropouts during training compared with the 30 GT patients or 68 SD patients. For patients completing...... (8/32), but not GT (15/30). Hypnotizability was found to vary from patient to patient, with a direct relationship to time saved. But hypnotizability had an inverse relationship to STAI general anxiety level for those who went on to dentists after 1 year. Transference effects were noted for most HT...
Kreider, Brent; Moeller, John; Manski, Richard J.; Pepper, John
We evaluate the impact of dental insurance on the use of dental services using a potential outcomes identification framework designed to handle uncertainty created by unknown counterfactuals – that is, the endogenous selection problem – as well as uncertainty about the reliability of self-reported insurance status. Using data from the Health and Retirement Study, we estimate that utilization rates of adults older than 50 would increase from 75% to around 80% under universal dental coverage. PMID:24890257
Leung, Doris Y P; Chen, Joanne M T; Lou, Vivian W Q; Wong, Eliza M L; Chan, Aileen W K; So, Winnie K W; Chan, Carmen W H
Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy
van Wijk, A.J.; Hoogstraten, J.
Anxious people tend to overestimate the intensity of aversive events such as fear and pain. When an aversive event has been experienced personally, prediction is based on experience and is possibly less subject to bias due to anxiety. Therefore, it was hypothesized that subjects will overestimate
Aldossary, Arwa; Harrison, Victoria E; Bernabé, Eduardo
There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long-term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥ 16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular-attenders) based on their responses to three questions on lifetime dental-attendance patterns. The association between dental-attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth (DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio-economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long-term dental attendance and caries experience was found in adjusted models. Former and never regular-attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular-attenders. No differences in DMFT or its components were found between current and always regular-attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses. © 2014 Eur J Oral Sci.
Abdulwahab, Mohammad; Al-Sayegh, Fatima; Boynes, Sean G; Abdulwahab, Hawra; Zovko, Jayme; Close, John
The objective of this study was to examine the public health relevance of the prevalence of dental fear in Kuwait and the resultant barrier that it creates regarding access to dental care. The study analysis demonstrated a high prevalence of dental fear and anxiety in the Kuwaiti population and a perceived need for anesthesia services by dental care providers. The telephone survey of the general population showed nearly 35% of respondents reported being somewhat nervous, very nervous, or terrified about going to the dentist. In addition, about 36% of the population postponed their dental treatment because of fear. Respondents showed a preference to receive sedation and anesthesia services as a means of anxiety relief, and they were willing to go to the dentist more often when such services were available. People with high fear and anxiety preferred to receive some type of medication to relieve their anxiety. In conclusion, the significance and importance of the need for anesthesia services to enhance the public health of dental patients in Kuwait has been demonstrated, and improvements are needed in anesthesia and sedation training of Kuwaiti dental care providers. PMID:20843223
Xiang, Xiaoling; Lee, Wonik; Kang, Sung-wan
To examine whether serious psychological distress (SPD), a nonspecific indicator of past year mental health problems, was associated with subsequent dental care utilization, dental expenditures, and unmet dental needs. We analyzed data from panel 13 thru 15 of the Medical Expenditure Panel Survey -Household Component (n=31,056). SPD was defined as a score of 13 or higher on the Kessler Psychological Distress Scale (K6). Logistic regression, zero-inflated negative binomial model, and generalized linear model (GLM) with a gamma distribution were used to test the study hypotheses. Adults with SPD had, in the subsequent year, 35 percent lower odds of adhering to annual dental checkups and a twofold increase in the odds of having unmet dental needs. Although adults with SPD did not have significantly more dental visits than those without SPD, they spent 20 percent more on dental care. SPD was a modest independent risk factor for lack of subsequent preventive dental care, greater unmet dental needs, and greater dental expenditures. In addition to expanding adult dental coverage, it is important to develop and evaluate interventions to increase the utilization of dental care particularly preventive dental services among people with mental illness in order to improve oral health and reduce dental expenditures among this vulnerable population. © 2014 American Association of Public Health Dentistry.
Aartman, I.H.A.; de Jongh, A.; Makkes, P.C.; Hoogstraten, J.
The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to
Álvarez, Licet; Liberman, Judith; Abreu, Soledad; Mangarelli, Carolina; Correa, Marcos B; Demarco, Flávio Fernando; Lorenzo, Susana; Nascimento, Gustavo G
This study aimed to assess dental caries status and associated factors in Uruguayan adults and elders using data from the first Uruguayan National Oral Health Survey. Data were representative of the country as a whole. Socio-demographic information was collected with a closed questionnaire. Dental caries was assessed by clinical examination using the DMFT index. The final sample consisted of 769 participants. Mean DMFT was 15.20 and 24.12 for the 35-44 and 65-74-year age groups, respectively. Mean number of decayed teeth was 1.70 in adults and 0.66 in elders. Multivariate analyses showed higher prevalence of dental caries associated with age 65-74 years, low socioeconomic status, use of public dental services, presence of gingivitis; for decayed teeth, age 35-44 years, low socioeconomic status, use of public dental services, infrequent tooth brushing, need for oral health care, and presence of root caries showed higher severity. Uruguayan adults and elders from disadvantaged backgrounds concentrated a heavier burden of dental caries.
Tiwari, Nishidha; Tiwari, Shilpi; Thakur, Ruchi; Agrawal, Nikita; Shashikiran, N D; Singla, Shilpy
Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure. Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure. Shapiro-Wilk test, McNemar's test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (test is easy and fast to apply on children and reduces the chair-side time.
Full Text Available Introduction: Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. Aims: The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS, and anxiety with colored version of modified facial affective scale (MFAS - three faces along with physiologic responses (pulse rate and oxygen saturation obtained by pulse oximeter before and during pulpectomy procedure. Settings and Design: Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate of children obtained by pulse oximeter before and during the pulpectomy procedure. Statistical Analysis Used: Shapiro-Wilk test, McNemar′s test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. Results: The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (<0.05 before pulpectomy procedure. Conclusions: The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time.
Анатолий Иванович Бабенко
Conclusion. The presented information and analytical technology of the use of the personalized database of territorial dental polyclinic has allowed revealing not only the nature of appealing of adult population for the dental care, but also defining the demand for dental technologies of the general, therapeutic and surgical profiles, establishing the significance of separate types of technologies in quantitative expression.
Romero-Maroto, M; Santos-Puerta, N; González Olmo, M J; Peñacoba-Puente, C
To analyse the relationship between different dimensions of dental appearance impact and self-esteem in adult patients undergoing orthodontic treatment, with special attention to the possible mediating role of anxiety. A quasi-experimental design was used with a matched control group (without orthodontic treatment). In each group (experimental and control), there were 85 patients. The impact of dental appearance was measured using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). State anxiety was assessed with the State Anxiety Inventory (STAI-S) and self-esteem with Rosenberg's self-esteem scale. In both groups (experimental and control), self-esteem correlates negatively, ranging between 0.26 and 0.43, with all dimensions of dental appearance impact (except for the positive dental self-confidence dimension, where all correlations were positive). Anxiety correlates positively, ranges between 0.35 and 0.44, with social impact, psychological impact and aesthetic concern, although it maintains no significant correlations with dental self-confidence. Nevertheless, in patients undergoing orthodontic treatment, anxiety plays a mediating role between dental impact dimensions and self-esteem, whilst for the control group anxiety only plays a mediator role between psychological impact and self-esteem. Anxiety plays a fundamental role in the effect of perceived dental impact on self-esteem in adult patients undergoing orthodontic treatment. These results have important practical implications for the design of bio-psycho-social intervention programs that contemplate cognitive-affective variables as an essential part of orthodontic treatment in adults. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Tan, Jiali; Xu, Xin; Lin, Jiong; Fan, Li; Zheng, Yuting; Kuang, Wei
Stem cell-based therapies are considered as a promising treatment for many clinical usage such as tooth regeneration, bone repairation, spinal cord injury, and so on. However, the ideal stem cell for stem cell-based therapy still remains to be elucidated. In the past decades, several types of stem cells have been isolated from teeth, including dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHED), periodontal ligament stem cells (PDLSCs), dental follicle progenitor stem cells (DFPCs) and stem cells from apical papilla (SCAP), which may be a good source for stem cell-based therapy in certain disease, especially when they origin from neural crest is considered. In this review, the specific characteristics and advantages of the adult dental stem cell population will be summarized and the molecular mechanisms of the differentiation of dental stem cell during tooth development will be also discussed.
Chen, Xi; Clark, Jennifer J J
This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry, or other postgraduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.
Brantsaeter, Margrethe; Tahamtani, Fernanda M.; Nordgreen, Janicke
Exaggerated fear-reactions are associated with injurious flying, smothering, feather pecking and other events that compromise animal welfare in laying hens. The aim of this study was to test the hypothesis that chicks with access to litter during the first five weeks of life would be less fearful...... as adult hens compared to birds reared without access to litter. The hypothesis was tested in a national on-farm study in commercial aviary flocks in Norway. Five rearing farmers divided the pullets into two groups within their rearing houses. While the chicks were enclosed inside the aviary rows during...... reared with paper) were visited. During the visit, the fearfulness of the adult birds was tested in a stationary person test and a novel object test. The data was analysed by ANOVA or logistic regression as appropriate. The access to litter during rearing did not influence the number of birds...
English summary: This chapter contributes in simple terms to a better understanding of dental fears and provides among other things the following advice for patients: 1) Ask questions. It saves you and the dentist time in the long run. 2) Make precise deals and make sure you know that the dentist...... understands your expectations. 3) Take frequent pauses and set up handsignals if you have to stop in the middle of treatment....
Lawal, Folake; Alade, Omolola
Experience and awareness of adult females concerning dental caries is important in its prevention particularly in children because of their natural role as care givers. To determine the prevalence of dental caries and treatment needs in an adult female Nigerian population. In this cross-sectional study, adult females attending outreach programmes were examined for dental caries using the Decayed Missing and Filled Teeth caries index (DMFT). Socio-demographic variables were also recorded and statistical analysis done with SPSS software. A total of 430 females aged 16 to 59 years participated in the outreach programme out of which 109 (25.3%) had a DMFT score > 0. Mean DMFT was 0.7 ± 1.6. Fifty-five (12.8%) participants had decayed teeth, 78 (18.1 %) had missing teeth and 10(2.3%) had filled teeth. The treatment need was 34.3%, restorative index was 13.3% and significant caries index was 2.0. There were significant differences in caries experience based on age, marital status and educational qualifications of participants p caries among the study group was low but the treatment need was high. Younger females, singles and those with lower educational qualifications had a higher dental caries experience.
Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro
Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.
Morishita, Shiho; Watanabe, Yutaka; Ohara, Yuki; Edahiro, Ayako; Sato, Emiko; Suga, Takeo; Hirano, Hirohiko
The aim of the present study was to assess the need for oral hygiene management by dental professionals among older adults requiring long-term care, and to collect basic data for building a dental treatment framework on a regional level. Although healthcare providers are aware of the importance of oral care for older adults requiring long-term care, reports claim that the provision of oral care is insufficient, and a framework is being built for the provision of oral hygiene management by dental professionals. A survey on lifestyle and oral health was carried out on 372 older adults requiring long-term care in one town in Japan. Binomial logistic regression analysis was carried out to assess factors affecting the need for oral hygiene management. A total of 66.1% of participants required oral hygiene management. The Barthel Index, Clinical Dementia Rating, oral hygiene status and other factors differed significantly with the presence or absence of oral hygiene management need. In addition to variables related to oral hygiene status (dental plaque and tongue coating), factors that significantly affected oral hygiene management need included the Clinical Dementia Rating (odds ratio 2.63, 95% confidence interval 1.08-6.41). The results of the present study suggest that the need for oral hygiene management by dental professionals increases as dementia advances. However, current systems that provide regional dental care are structured based on the level of care need and the degree of independence. A dementia perspective needs to be added to these systems. Geriatr Gerontol Int 2016; 16: 956-962. © 2015 Japan Geriatrics Society.
Full Text Available Abstract Background Since 2002, adults have been able to choose oral health care services in the public sector or in the private sector in Finland. Though various subsidies for care exist in both sectors, the Public Dental Service (PDS is a cheaper option for the patient but, on the other hand, there are no waiting lists for private care. The aim of this study was to assess middle-aged adults' use of dental services, willingness to pay (WTP and ability to pay (ATP for unexpected, urgent dental treatment. Methods Postal questionnaires on use of dental services were sent to a random sample of 1500 47-59 year old adults living in three large municipalities in the Helsinki region. The initial response rate was 65.8%. Two hypothetical scenarios were presented: "What would be the highest price you would be prepared to pay to have a lost filling replaced immediately, or, at the latest, the day after losing the filling?" and " How much could you pay for unexpected dental expenses at two weeks notice, if you suddenly needed more comprehensive treatment?" Logistic regression analysis was used to analyse factors related to WTP and ATP. Results Most respondents (89.6% had visited a dentist recently and a majority (76.1% had used private services. For immediate replacement of a lost filling, almost all respondents (93.2% were willing to pay the lower price charged in the PDS and 46.2% were willing to pay the private fee. High income and no subjective need for dental treatment were positively associated with the probability of paying a higher price. Most respondents (93.0% were able to pay a low fee, EUR 50 and almost half (41.6% at least EUR 300 for unexpected treatment at short notice. High income and male sex were associated with high ATP. Conclusion There was a strong and statistically significant relationship between income and WTP and ATP for urgent dental care, indicating that access to publicly provided services improved equity for persons with low
Zini, A; Sgan-Cohen, H D; Marcenes, W
To report dental caries status, related health behaviours and social determinants among a representative sample of adults residing in Jerusalem. This cross-sectional study was conducted using a stratified sample of 254 Jewish and married adults aged 35-44 years in Jerusalem. Dental caries status was examined according to DMFT, percentage of caries-free persons and of people maintaining all their natural teeth (no teeth missing due to caries). The results were analysed by the independent variables and interpreted by weighted caries scores for the total Jerusalem population. The mean age was 38.63 years. Weighted DMFT was found to be 10.59; 6.8% of the population were caries-free; 67.1% demonstrated maintenance of all natural teeth. Level of education was the distal factor, associated with number of natural teeth, DMFT and untreated decay. Mediating behavioural determinants included dental attendance, plaque level and sugar consumption. The findings of this study demonstrated that caries experience among Jewish married adults in Jerusalem was moderate with low unmet dental caries needs. Additionally, data confirmed that a low level of education was a strong distal social determinant of caries experience, which affected dental health status via a pathway mediated by behavioural factors. Copyright © 2012 S. Karger AG, Basel.
Seelman, Kristie L.; Colón-Diaz, Matthew J.P.; LeCroix, Rebecca H.; Xavier-Brier, Marik; Kattari, Leonardo
Abstract Purpose: There are many barriers to reliable healthcare for transgender people that often contribute to delaying or avoiding needed medical care. Yet, few studies have examined whether noninclusive healthcare and delaying needed medical care because of fear of discrimination are associated with poorer health among transgender adults. This study aims to address these gaps in the knowledge base. Methods: This study analyzed secondary data from a statewide survey of 417 transgender adults in the Rocky Mountain region of the United States. Independent variables included noninclusive healthcare from a primary care provider (PCP) and delay of needed medical care because of fear of discrimination. Dependent variables assessed general health and mental health. Results: Transgender individuals who delayed healthcare because of fear of discrimination had worse general health in the past month than those who did not delay or delayed care for other reasons (B=−0.26, pdiscrimination, having a noninclusive PCP was not significantly associated with either general health or mental health. Conclusion: This study suggests a significant association between delaying healthcare because of fear of discrimination and worse general and mental health among transgender adults. These relationships remain significant even when controlling for provider noninclusivity, suggesting that fear of discrimination and consequent delay of care are at the forefront of health challenges for transgender adults. The lack of statistical significance for noninclusive healthcare may be related to the measurement approach used; future research is needed to develop an improved tool for measuring transgender noninclusive healthcare. PMID:28861545
Full Text Available Abstract Background About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental care utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes. Methods Data included secondary enrollment and demographic data from Washington Dental Service (WDS and Group Health Cooperative (GH, clinical data from GH, and dental-utilization data from WDS claims during 2002–2006. Dental and medical records from WDS and GH were linked for enrolees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups. Results We found that adults with diabetes had lower odds of visiting a dentist (OR = 0.74, p 0.001. Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxes (OR = 0.77, fillings (OR = 0.80 and crowns (OR = 0.84 (p 0.005 for all and higher odds of receiving periodontal maintenance (OR = 1.24, non-surgical periodontal procedures (OR = 1.30, extractions (OR = 1.38 and removable prosthetics (OR = 1.36 (p Conclusions Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes.
Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A
To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Sonoda, C; Ebisawa, M; Nakashima, H; Sakurai, Y
A dose-response relationship between toothbrushing frequency and the incidence of dental caries has not been confirmed. Furthermore, no longitudinal study about this relationship has considered dental caries experience at baseline, which is an important factor influencing the frequency of future caries. To elucidate the association between the incidence of dental caries and toothbrushing frequency after adjusting for dental caries experience at baseline in a Japanese population. The 92 recruits of the Japan Maritime Self-Defense Force in Kure, Japan, in 2011 were followed up for 3 years. They underwent oral examination at the annual checkups and answered questions about toothbrushing frequency. The multiple logistic regression analysis was used to analyze the incidence of dental caries and to identify independent effects of toothbrushing frequency and dental caries experience at baseline. Furthermore, the relative importance of the incidence of dental caries was investigated among other independent variables using the partial adjusted R² score. Logistic regression analysis showed that toothbrushing frequency alone did not influence the increment in decayed, missing, and filled teeth (DMFT). However, DMFT at baseline alone was associated with the increment in DMFT (crude odds ratio, OR, 1.20, 95% confidence interval, CI, 1.08,1.33). In the fully adjusted model, only DMFT at baseline was associated with the increment in DMFT (adjusted OR 1.23, 95%CI 1.09,1.38). After three years, the incidence of dental caries in young adult Japanese males was influenced by DMFT at baseline, rather than toothbrushing frequency. Copyright© 2017 Dennis Barber Ltd.
Arora, Garima; Mackay, Daniel F; Conway, David I; Pell, Jill P
Oral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services. We used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators. The study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and dental services. The differences could be partially explained by reported differences in dietary sugar.
Halsband, Ulrike; Wolf, Thomas Gerhard
Visiting the dentist is often accompanied by apprehension or anxiety. People, who suffer from specific dental phobia (a disproportional fear of dental) procedures show psychological and physiological symptoms which make dental treatments difficult or impossible. For such purposes, hypnosis is often used in dental practice as an alternative for a number of treatments adjuvant or instead of sedation or general anaesthetics, as medication is often associated with risks and side effects. This is the first study to address the effects of a brief dental hypnosis on the fear processing structures of the brain in dental phobics using functional magnetic resonance imaging (fMRI). 12 dental phobics (DP; mean 34.9years) and 12 healthy controls (CO; mean 33.2years) were scanned with a 3T MRI whole body-scanner observing brain activity changes after a brief hypnotic invervention. An fMRI event-related design symptom provocation task applying animated audio-visual pseudorandomized strong phobic stimuli was presented in order to maximize the fearful reactions during scanning. Control videos showed the use of familiar electronic household equipment. In DP group, main effects of fear condition were found in the left amygdala and bilaterally in the anterior cingulate cortex (ACC), insula and hippocampu (Rhypnosis DP showed a significantly reduced activation in all of these areas. Reduced neural activity patterns were also found in the control group. No amygdala activation was detected in healthy subjects in the two experimental conditions. Compared to DP, CO showed less bilateral activation in the insula and ACC in the awake condition. Findings show that anxiety-provoking stimuli such as undergoing dental surgery, endodontic treatments or insufficient anaesthetics, can be effectively reduced under hypnosis. The present study gives scientific evidence that hypnosis is a powerful and successful method for inhibiting the reaction of the fear circuitry structures. Copyright © 2016
Rocha, C M; Kruger, E; Whyman, R; Tennant, M
To model the geographic distribution of current (and treated) dental decay on a high-resolution geographic basis for the Auckland region of New Zealand. The application of matrix-based mathematics to modelling adult dental disease-based on known population risk profiles to provide a detailed map of the dental caries distribution for the greater Auckland region. Of the 29 million teeth in adults in the region some 1.2 million (4%) are suffering decay whilst 7.2 million (25%) have previously suffered decay and are now restored. The model provides a high-resolution picture of where the disease burden lies geographically and presents to health planners a method for developing future service plans.
Full Text Available Background: Dental caries remains the most important dental health problem in developing countries. In India the prevalence of dental caries is reported to be about 50-60%. Most of the Indian studies have been carried out in school children and very few in adults. This study aimed to estimate the prevalence of dental caries in the adult population (aged 35-44 years and in the elderly (60 years and above in an urban resettlement colony in New Delhi. Methodology: A community-based cross-sectional study was carried out in Dakshinpuri, New Delhi, from January to February 2007. A local adaptation of the WHO questionnaire was used. Oral examination was done and dentition status was recorded by trained investigators and according to the standard procedures. Results: A total of 452 participants were enrolled in the study. The prevalence of dental caries in the 35-44 years age-group was 82.4% and it was 91.9% in those ≥60 years. The DMF index was 5.7 ± 4.7 in the 35-44 years age-group and 13.8 ± 9.6 in the ≥60 years age-group. Of the participants, 27.9% were currently using tobacco. A statistically significant association was found between tobacco consumption and dental caries ( P = 0.026. The awareness about good and bad dental practices was found to be low among the study participants. One-fifth of the individuals with dental problems relied on home remedies. Conclusion: The prevalence of dental caries among adults is high in this population. There is a need to generate awareness about oral health and the prevention of dental caries and to institute measures for the provision of dental care services at the primary level.
Hughes, Anne K; Alford, Kristen R
HIV infection among older adults is increasing. Previous research suggests that many older adults do not see themselves as at risk for HIV and that many subscribe to myths related to HIV transmission. In this focus group study (N = 48) we solicited the beliefs that older adults held about HIV. The older adults in this study were knowledgeable about how HIV is typically transmitted. However, we also identified that they subscribed to misconceptions regarding casual contact transmission and were fearful of transmission from the medical system. Educational efforts aimed at older adults must be tailored to address these persistent misconceptions.
Angelo, Zavattini; Polyvios, Charalambous
Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations.
Coolidge, Trilby; Hillstead, M Blake; Farjo, Nadia; Weinstein, Philip; Coldwell, Susan E
Hispanics comprise the largest ethnic minority group in the United States. Previous work with the Spanish Modified Dental Anxiety Scale (MDAS) yielded good validity, but lower test-retest reliability. We report the performance of the Spanish MDAS in a new sample, as well as the performance of the Spanish Revised Dental Beliefs Survey (R-DBS). One hundred sixty two Spanish-speaking adults attending Spanish-language church services or an Hispanic cultural festival completed questionnaires containing the Spanish MDAS, Spanish R-DBS, and dental attendance questions, and underwent a brief oral examination. Church attendees completed the questionnaire a second time, for test-retest purposes. The Spanish MDAS and R-DBS were completed by 156 and 136 adults, respectively. The test-retest reliability of the Spanish MDAS was 0.83 (95% CI = 0.60-0.92). The internal reliability of the Spanish R-DBS was 0.96 (95% CI = 0.94-0.97), and the test-retest reliability was 0.86 (95% CI = 0.64-0.94). The two measures were significantly correlated (Spearman's rho = 0.38, p Spanish MDAS was higher. The significant relationships between dental attendance and questionnaire scores, as well as the difference in caries severity seen in those with high fear, add to the evidence of this scale's construct validity in Hispanic samples. Our results also provide evidence for the internal and test-retest reliabilities, as well as the construct validity, of the Spanish R-DBS.
Liu, Peng; Yue, Ji; Han, Shufang; Deng, Tianzheng; Fu, Chongjian; Zhu, Guoxiong; Chen, Dong
We explored the epidemiological risk factors for dental caries to help explain differences in the prevalence of adult dental caries. We examined 841 people for the presence of Helicobacter pylori in their dental plaque and for dental caries. Of the 841 subjects, 574 (68.25%) were infected with H pylori, and 516 (61.36%) were diagnosed with dental caries. Among the 574 subjects with H pylori, the prevalence of dental caries was 73.52% (422/574), while the prevalence among the 267 cases without H pylori was 35.21% (94/267). A correlation existed between the presence of H pylori and the occurrence of dental caries (χ(2) = 112.8, P pylori had a higher mean dental plaque index than those without. In conclusion, H pylori infection in the oral cavity is associated with dental caries and poor dental hygiene.
Maruyama, S; Koyazu, T
Young children can feel great anxiety and/or fear when facing their dental examination and treatment, and may refuse to be examined. To help children overcome these emotions, we originated a method called "Dental Drawings and Coloring". We investigated whether the new method might be effective for 207 children between the ages of two and four who had completed treatment and had returned for their first check-up, about three months later. Results showed that using the method of "Dental Drawings and Coloring" worked fairly effectively in alleviating their anxiety and fear.
Heyman, R E; Wojda, A K; Eddy, J M; Haydt, N C; Geiger, J F; Slep, A M Smith
Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials-with 2 meta-analyses finding strong average effect sizes ( d > 1)-CBT has received almost no dissemination beyond the specialty clinics that tested it. The challenge, then, is not how to treat dental fear but how to disseminate and implement such an evidence-based treatment in a way that recognizes the rewards and barriers in the US health care system. This mixed-method study investigated the potential of disseminating CBT through care from a mental health provider from within the dental home, a practice known as evidence-based collaborative care (EBCC). Two preadoption studies were conducted with practicing dentists drawn from a self-organized Practice-Based Research Network in the New York City metropolitan area. The first comprised 3 focus groups ( N = 17), and the second involved the administration of a survey ( N = 46). Focus group participants agreed that CBT for dental fear is worthy of consideration but identified several concerns regarding its appeal, feasibility, and application in community dental practices. Survey participants indicated endorsement of factors promoting the use of EBCC as a mechanism for CBT dissemination, with no factors receiving less than 50% support. Taken together, these findings indicate that EBCC may be a useful framework through which an evidence-based treatment for dental fear treatment can be delivered.
Montero-Pedrazuela, Ana; Fern?ndez-Lamo, Iv?n; Alieva, Mar?a; Pereda-P?rez, Inmaculada; Venero, C?sar; Guada?o-Ferraz, Ana
Hypothyroidism is the most common hormonal disease in adults, which is frequently accompanied by learning and memory impairments and emotional disorders. However, the deleterious effects of thyroid hormones deficiency on emotional memory are poorly understood and often underestimated. To evaluate the consequences of hypothyroidism on emotional learning and memory, we have performed a classical Pavlovian fear conditioning paradigm in euthyroid and adult-thyroidectomized Wistar rats. In this ex...
Askew, Chris; Cakır, Kübra; Põldsam, Liine; Reynolds, Gemma
Disgust is a protective emotion associated with certain types of animal fears. Given that a primary function of disgust is to protect against harm, increasing children's disgust-related beliefs for animals may affect how threatening they think animals are and their avoidance of them. One way that children's disgust beliefs for animals might change is via vicarious learning: by observing others responding to the animal with disgust. In Experiment 1, children (ages 7-10 years) were presented with images of novel animals together with adult faces expressing disgust. Children's fear beliefs and avoidance preferences increased for these disgust-paired animals compared with unpaired control animals. Experiment 2 used the same procedure and compared disgust vicarious learning with vicarious learning with fear faces. Children's fear beliefs and avoidance preferences for animals again increased as a result of disgust vicarious learning, and animals seen with disgust or fear faces were also rated more disgusting than control animals. The relationship between increased fear beliefs and avoidance preferences for animals was mediated by disgust for the animals. The experiments demonstrate that children can learn to believe that animals are disgusting and threatening after observing an adult responding with disgust toward them. The findings also suggest a bidirectional relationship between fear and disgust with fear-related vicarious learning leading to increased disgust for animals and disgust-related vicarious learning leading to increased fear and avoidance. (c) 2014 APA, all rights reserved.
Anderson, Christina N; Noar, Seth M; Rogers, Brandi D
Although routine dental checkups are important for both oral and overall health, several factors influence young adults' use or nonuse of dental services. The two studies included in this report tested the theory of reasoned action (TRA), the theory of planned behavior (TPB), and an expanded TPB model in predicting young adults' routine dental checkups. Additionally, the study tested the perceived message effectiveness of TPB-based messages. Results support the use of an expanded TPB model (particularly adding satisfaction with the dentist and environmental constraints to the traditional model) for an understanding of routine dental checkup intention and behavior, and, most notably, provide support for the use of subjective norm-based messages to prompt dental checkups. This study lays the groundwork for a health communication campaign encouraging routine dental checkups among young adults. The use of targeting and tailoring to design effective oral health media campaign messages is discussed.
Miranda, Camila Dal-Bó Coradini; Peres, Marco Aurélio
This study aimed to estimate the prevalence of dental services utilization by adults and to identify associated socioeconomic, demographic, behavioral, and self-awareness factors. A cross-sectional population-based study was conducted with adults living in the urban area of Florianópolis, Santa Catarina State, Brazil, in 2009. Associations were tested between use of dental services and predisposing, enabling, and needs-based variables. Multivariate analysis was conducted using Poisson regression with estimates of prevalence ratios and was stratified by place of last dental appointment. Prevalence of dental services utilization was 66% (95%CI: 62.9-70.7). Dental visits were 20% more frequent among women and 72% more frequent among individuals with more schooling (the latter in both public and private dental services). Individuals with private dental plans used dental services 13% more than those without. Schooling was the most important variable in predicting utilization. The study's results show the importance of monitoring associated factors in order to promote more equitable use of dental services.
Jamieson, Lisa M; Roberts-Thomson, K F; Sayers, S M
To determine dental caries risk indicators among a birth cohort of Australian Aboriginal young adults (n=442). Data were from the Aboriginal Birth Cohort study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Models representing demographic, socioeconomic, behavioural, dental service utilization and clinical oral health variables were tested using multivariate regression. The percent DT>0 was 72.9 (95% CI 68.7-77.1), mean DT was 4.19 (95% CI 3.8-4.6), percent DMFT>0 was 77.4 (95% CI 73.5-81.3) and mean DMFT was 4.84 (95% CI 4.4-5.3). After controlling for other covariates, risk indicators for percent DT>0 included soft drink consumption every day or a few times a week (PR 1.25, 95% CI 1.08-1.45), not consuming milk every day or a few times a week (PR 1.16, 95% CI 1.04-1.30) and sweet consumption every day or a few times a week (PR 1.18, 95% CI 1.04-1.33). Risk indicators for mean DT included sweet consumption every day or a few times a week (B=1.14, 95% CI 0.27-2.02), nonownership of a toothbrush (B=0.91, 95% CI 0.10-1.87) and presence of plaque (B=2.46, 95% CI 0.96-3.96). Those with 4 + occupants in their house the previous night had 1.2 times the prevalence of having DMFT>0 than their counterparts with less household occupants (95% CI 1.01-1.49). Percent DMFT>0 was also associated with consumption of soft drink every day or a few times a week (PR 1.18, 95% CI 1.04-1.34) and consumption of sweets every day or a few times a week (PR 1.23, 95% CI 1.10-1.37). Mean DMFT was higher among those who consumed sweets every day or a few times a week (B = 0.13, 95% CI 0.05-0.22) and who had dental anxiety (B=0.10, 95% CI 0.01-0.19). In an Australian Aboriginal young adult cohort, risk indicators for dental caries included social determinants such as household size, dietary behaviours such as regular consumption of soft drink and sweets, dental behaviour such as nonownership of a toothbrush and
Full Text Available Introduction: Utilization of dental service is a concept of expressing the extent of interaction between the service provider and the people for whom it is indented. However, one of the major issues in social welfare is the equitable provision of these services to the population. Aim: To determine the perceived barriers affecting access to the dental services in the dental institute. Materials and Methods: A cross-sectional survey was conducted in the dental institute during the month of February in the year 2014 using decision-making trial and evaluation laboratory (DEMATEL method. The study sample included the 364 subjects. The required data were collected using a specially designed and pretested questionnaire. The data were analyzed using SPSS 18.0 (SPSS Inc., Chicago, IL, USA and MATLAB 7.6.0. The mean, standard deviations were used to describe the data, and inferential statistics included one-way ANOVA and DEMATEL. Results: The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access dental services. Based on subjects′ responses to the questions, the cost (54.75% agreed or strongly agreed was identified as the most important factor affecting the access to dental health care followed by dentist-patient relationship (48.57%, inconvenience (36.55%, fear (23.70%, and organization (14.02%. The difference was found to be statistically significant (P = 0.0001. When the hierarchy of the affecting and affected factors was calculated, based on the factor analysis by using DEMATEL method, the cost (R−J = 0.16 and organization (R−J = 1.15, were certain affecting determinant which influenced the access to dental services and inconvenience. Conclusion: The major barriers to oral health care utilization among our patients were cost, fear, and organization. Policymakers, administrators, and insurance organizations have a major role. Hence, the policies should be fair and
de Haas, Elske N; Kops, Marjolein S; Bolhuis, J Elizabeth; Groothuis, Ton G G; Ellen, Esther D; Rodenburg, T Bas
Fearfulness of an individual can affect its sensitivity to stress, while at the same time the social situation in which an animal lives can affect its fear level. It is however unknown what the long-term effects of high fearfulness on sensitivity to stress are, on individual or group level in laying hens. We hypothesize that increased fearfulness at a young age results in increased sensitivity to stress at an adult age, and that this relation can differ between groups, due to differences in group composition. Therefore, we studied the relation between fearfulness in an Open Field (OF) test at six weeks of age and plasma-corticosterone (CORT) levels after a 5-min Manual Restraint test (MR) at 33 weeks of age, and assessed behavior in the home pen. We used birds from a low mortality line, selected for four generations on low mortality due to feather pecking and cannibalism and a control line (n=153 in total, eight pens/line). These lines are known to differ in fearfulness and stress physiology. Chicks from the low mortality line were more active in the OF compared to chicks from the control line. Chicks that showed a fearful response (no walking, no vocalizing) in the OF test had higher CORT at 33 weeks of age than chicks that walked and/or vocalized in the OF test and had higher activity in the home pen as adults. On group level, a passive response in the OF was related to high CORT levels after MR. Presence of at least one fearful bird in a group led to higher CORT in the other group mates compared to birds from groups with no fearful birds present. Birds from groups in which more than 50% of birds had severe comb lesions had higher CORT levels compared to birds from groups with less than 50% of birds affected. High fearfulness of laying hen chicks can on individual level have a long-term effect on stress sensitivity. The presence of fearful birds in a group as well as signs of social instability in a group, indicated by comb lesions, can affect sensitivity to
Disgust is a protective emotion associated with certain types of animal fears. Given that a primary function of disgust is to protect against harm, increasing children’s disgust-related beliefs for animals may affect how threatening they think animals are and their avoidance of them. One way that children’s disgust beliefs for animals might change is via vicarious learning: by observing others responding to the animal with disgust. In Experiment 1, children (ages 7–10 years) were presented with images of novel animals together with adult faces expressing disgust. Children’s fear beliefs and avoidance preferences increased for these disgust-paired animals compared with unpaired control animals. Experiment 2 used the same procedure and compared disgust vicarious learning with vicarious learning with fear faces. Children’s fear beliefs and avoidance preferences for animals again increased as a result of disgust vicarious learning, and animals seen with disgust or fear faces were also rated more disgusting than control animals. The relationship between increased fear beliefs and avoidance preferences for animals was mediated by disgust for the animals. The experiments demonstrate that children can learn to believe that animals are disgusting and threatening after observing an adult responding with disgust toward them. The findings also suggest a bidirectional relationship between fear and disgust with fear-related vicarious learning leading to increased disgust for animals and disgust-related vicarious learning leading to increased fear and avoidance. PMID:24955571
Jaafar, N; Abdul Razak, I
Different groups of people will view and use modern dental services differently. This is determined by their traditional beliefs and cultural background. The aim of this study is to identify variations in utilization among adults in the three major ethnic groups in Malaysia. Dental records of 500 adults attending the University dental center were randomly selected and analyzed by sex and ethnic group. Results from this pilot study clearly indicate that different ethnic groups tend to use certain types of services more than others. Similarly, there is evidence of variation in the type of dental service preferred between males and females. The implications of these findings for dental health educators, program planners and further research is emphasized in order to promote a more positive pattern of utilization among the various ethnic groups.
Hall Brown, Tyish; Mellman, Thomas A
African Americans residing in stressful urban environments have high rates of insomnia and short sleep duration, both of which are associated with adverse health outcomes. However, limited data exist that explore factors influencing inadequate sleep in this high-risk population. This study sought to evaluate the contributions of demographics, trauma, posttraumatic stress disorder (PTSD) symptoms, sleep fears, and neighborhood stress to both insomnia and short sleep in urban African American young adults. Data were analyzed from self-report measures completed by 378 participants 18-35 years of age. PTSD symptom severity and sleep fears were independently associated with insomnia severity, and sleep fears was associated with sleep duration. Results have implications for preventative health intervention strategies for urban African American young adults.
Jones, Deborah J; Munro, Cindy L; Grap, Mary Jo
The purpose of this study was to describe the pattern of dental plaque accumulation in mechanically ventilated adults. Accumulation of dental plaque and bacterial colonisation of the oropharynx is associated with a number of systemic diseases including ventilator associated pneumonia. Data were collected from mechanically ventilated critically ill adults (n=137), enrolled within 24 hours of intubation. Dental plaque, counts of decayed, missing and filled teeth and systemic antibiotic use was assessed on study days 1, 3, 5 and 7. Dental plaque averages per study day, tooth type and tooth location were analysed. Medical respiratory, surgical trauma and neuroscience ICU's of a large tertiary care centre in the southeast United States. Plaque: all surfaces >60% plaque coverage from day 1 to day 7; molars and premolars contained greatest plaque average >70%. Systemic antibiotic use on day 1 had no significant effect on plaque accumulation on day 3 (p=0.73). Patients arrive in critical care units with preexisting oral hygiene issues. Dental plaque tends to accumulate in the posterior teeth (molars and premolars) that may be hard for nurses to visualise and reach; this problem may be exacerbated by endotracheal tubes and other equipment. Knowing accumulation trends of plaque will guide the development of effective oral care protocols. Published by Elsevier Ltd.
Costa, Simone M.; Martins, Carolina C.; Bonfim, Maria de Lourdes C.; Zina, Lívia G.; Paiva, Saul M.; Pordeus, Isabela A.; Abreu, Mauro H. N. G.
Increasing evidence suggests that socioeconomic factors may be associated with an increased risk of dental caries. To provide better evidence of the association between dental caries in adults and socioeconomic indicators, we evaluated the relation between these two conditions in a thorough review of the literature. Seven databases were systematically searched: Pubmed, Cochrane, Web of Science, Bireme, Controlled Trials, Clinical Trials and the National Institute for Health and Clinical Excellence. No restrictions were placed on the language or year of publication. The search yielded 41 studies for systematic review. Two independent reviewers screened the studies for inclusion, extracted data and evaluated quality using the Newcastle-Ottawa scale. The following socioeconomic indicators were found: educational level, income, occupation, socio-economic status and the community index. These indicators were significantly associated with a greater occurrence of dental caries: the subject’s education, subject’s income, subject’s occupation and the Gini coefficient. A high degree of heterogeneity was found among the methods. Quality varied across studies. The criteria employed for socioeconomic indicators and dental caries should be standardized in future studies. The scientific evidence reveals that educational level, income, occupation and the Gini coefficient are associated with dental caries. PMID:23202762
Nochajski, Thomas H; Waldrop, Deborah P; Davis, Elaine L; Fabiano, Jude A; Goldberg, Louis J
Our study considered dental students' general attitudes towards older persons using the Aging Semantic Differential. The influence of age, gender, cohort, education, and academic exposure on general attitudes towards older adults was evaluated using a total of 328 dental students across all four years of academic standing. Students were assessed in the fall and spring semesters. The results showed differential responding on the four subscales, with slight positive ratings on the autonomy, acceptability, and integrity subscales and a slight negative rating for instrumentality. Females expressed more negative attitudes than their male counterparts, with no age differences. There was also no significant impact from a specific, didactic educational component offered to the fourth-year students. However, the fourth-year students were the only group to show positive changes across the full academic year. The results suggest that general attitudes can be changed, but didactic (classroom) forms of education alone are insufficient to meaningfully modify students' perceptions of the elderly. Exposure to older adults in a clinical setting appears to be a critical element, as the fourth-year students received much greater exposure to older patients and more intensified interface with their mentors.
Krikken, J B; Vanwijk, A J; Tencate, J M; Veerkamp, J S
To examine the relationship between self-reported parental rearing style, parent's assessment of their child's dental anxiety and the dental history of children. Parents of primary school children were asked to complete questionnaires about their parenting style, using four different questionnaires. Parents also completed the Child Fear Survey Schedule Dental Subscale (CFSS-DS) on behalf of their child and a questionnaire about the dental history of their child. 454 interview forms were available for analysis. Minor associations were found between dental anxiety and parenting style. Anxious parents were more permissive and less restrictive in their parenting style. Parents of children who did not visit their dentist for regular check-ups reported more laxness and less restrictiveness. Children who had a cavity at the time of investigation, children who had suffered from toothache in the past and children who did not have a nice and friendly dentist reported more dental anxiety. No clear associations between parenting style and dental anxiety were found. Known causes of dental anxiety were confirmed.
Snyder John J
Full Text Available Abstract Background Dental caries is one of the primary causes of tooth loss among adults. It is estimated to affect a majority of Americans aged 55 and older, with a disproportionately higher burden in disadvantaged populations. Although a number of treatments are currently in use for caries prevention in adults, evidence for their efficacy and effectiveness is limited. Methods/Design The Prevention of Adult Caries Study (PACS is a multicenter, placebo-controlled, double-blind, randomized clinical trial of the efficacy of a chlorhexidine (10% w/v dental coating in preventing adult caries. Participants (n = 983 were recruited from four different dental delivery systems serving four diverse communities, including one American Indian population, and were randomized to receive either chlorhexidine or a placebo treatment. The primary outcome is the net caries increment (including non-cavitated lesions from baseline to 13 months of follow-up. A cost-effectiveness analysis also will be considered. Discussion This new dental treatment, if efficacious and approved for use by the Food and Drug Administration (FDA, would become a new in-office, anti-microbial agent for the prevention of adult caries in the United States. Trial Registration Number NCT00357877
Sharmila J Patil
Full Text Available Background: Fear and pain are the factors producing stress and there is evidence that dental fear acquired in childhood may persist to influence adult behavior. Dental treatment is often considered as anxiety producing and stressful. Aim: To assess the levels of stress displayed by the healthy children undergoing routine dental procedures like oral examination, restoration, and extraction by analyzing salivary levels of cortisol before, during, and after the procedures. Materials and Methods: Twenty healthy children aged between 4 and 8 years having their first dental visit and requiring at least one restoration and one extraction were selected. In each patient, three procedures were carried out: (i Routine dental examination, (ii restoration, and (iii extraction. Unstimulated salivary samples were collected 10 min before, during the procedure, and 30 min after each procedure at three different visits for comparison of cortisol production in response to anxiety and stress over time. Total 180 samples were collected to determine salivary cortisol levels using UBI-MAGIWEL TM kit and the readings were noted. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS software with paired t-test, two independent sample t-tests, and analysis of variance (ANOVA were used to analyze the findings. Results: A correlation between salivary cortisol and stress in dental procedure was noticed. Cavity preparation is more stressful procedure in children, so alternative methods can be used in anxious children. Stress associated with extraction persists to a postoperative period. No correlation exists in between Corah′s anxiety scale and salivary cortisol.
A survey of attitudes, knowledge and practice of dentists in London towards child protection. Are children receiving dental treatment at the Eastman Dental Hospital likely to be on the child protection register?
Al-Habsi, S A; Roberts, G J; Attari, N; Parekh, S
To investigate the attitudes, knowledge and practices of general dental practitioners (GDPs), specialists and consultants in paediatric dentistry in London, towards child protection. Additionally, to determine if children attending paediatric dental casualty at the Eastman Dental Hospital (EDH) and those who need treatment of caries under general anaesthesia (GA) are on the child protection register (CPR). The survey was conducted by postal questionnaires with 14 closed questions. A total of 228 dentists were invited to participate in the study. Children who attended EDH and required treatment under GA or at paediatric dental casualty were checked against the CPR. The respond rate was 46% (105/228). Overall 15% (16/105) of dentists had seen at least one patient with suspected child abuse in the last six months, but only 7% (7/105) referred or reported cases to child protection services. Reasons for dentists not referring included: fear of impact on practice (10%; 11/105); fear of violence to child (66%; 69/105); fear of litigation (28%; 29/105); fear of family violence against them (26%; 27/105); fear of consequences to the child (56%; 59/105); lack of knowledge regarding the procedures for referral (68%; 71/105); and lack of certainty about the diagnosis (86%; 90/105). Of the 220 children attending for dental GA and casualty from October 2004 to March 2005, one child was found to be on the CPR. More information and training is required to raise awareness of the potential importance of the role of dentists in child protection. Improved communication between dental and medical departments is important for safeguarding children.
Gamwell, Kaitlyn; Nylocks, Maria; Cross, Dorthie; Bradley, Bekh; Norrholm, Seth D; Jovanovic, Tanja
Fear conditioning studies in adults have found that posttraumatic stress disorder (PTSD) is associated with heightened fear responses and impaired discrimination. The objective of the current study was to examine the association between PTSD symptoms and fear conditioned responses in children from a highly traumatized urban population. Children between 8 and 13 years old participated in a fear conditioning study in addition to providing information about their trauma history and PTSD symptoms. Results showed that females showed less discrimination between danger and safety signals during conditioning compared to age-matched males. In boys, intrusive symptoms were predictive of fear responses, even after controlling for trauma exposure. However, in girls, conditioned fear to the danger cue was predictive of self-blame and fear of repeated trauma. This study suggests there are early sex differences in the patterns of fear conditioning and that these sex differences may translate to differential risk for trauma-related psychopathology. © 2015 Wiley Periodicals, Inc.
Full Text Available Deva Priya Appukuttan Department of Periodontics, Sri Ramakrishna Mission Dental College and Hospital, Chennai, India Abstract: Dental anxiety and phobia result in avoidance of dental care. It is a frequently encountered problem in dental offices. Formulating acceptable evidence-based therapies for such patients is essential, or else they can be a considerable source of stress for the dentist. These patients need to be identified at the earliest opportunity and their concerns addressed. The initial interaction between the dentist and the patient can reveal the presence of anxiety, fear, and phobia. In such situations, subjective evaluation by interviews and self-reporting on fear and anxiety scales and objective assessment of blood pressure, pulse rate, pulse oximetry, finger temperature, and galvanic skin response can greatly enhance the diagnosis and enable categorization of these individuals as mildly, moderately, or highly anxious or dental phobics. Broadly, dental anxiety can be managed by psychotherapeutic interventions, pharmacological interventions, or a combination of both, depending on the level of dental anxiety, patient characteristics, and clinical situations. Psychotherapeutic interventions are either behaviorally or cognitively oriented. Pharmacologically, these patients can be managed using either sedation or general anesthesia. Behavior-modification therapies aim to change unacceptable behaviors through learning, and involve muscle relaxation and relaxation breathing, along with guided imagery and physiological monitoring using biofeedback, hypnosis, acupuncture, distraction, positive reinforcement, stop-signaling, and exposure-based treatments, such as systematic desensitization, “tell-show-do”, and modeling. Cognitive strategies aim to alter and restructure the content of negative cognitions and enhance control over the negative thoughts. Cognitive behavior therapy is a combination of behavior therapy and cognitive therapy
Dehghani, Mohsen; Mohammadi, Somayyeh; Sharpe, Louise; Khatibi, Ali
Expecting pain can be perceived as a threat may involve recruitment of cognitive strategies (such as attentional avoidance) which might help the person to reduce distress. The ecological validity of the paradigms aiming to study the attentional biases toward or away from threatening stimuli by manipulating the perception of threat in experimental settings has been questioned. Therefore, the current study aims to investigate the attentional bias toward or away from the threat when a confrontation with a real threatening and painful condition would be expected (i.e., dental treatment). One hundred and twenty-seven patients referred to three dentistry clinics for a dental treatment (experiment participants) and 30 individuals with no dental complaints (control participants) completed this study. Patients were randomly allocated to a high pain expectancy (HPE: n = 65) or a low pain expectancy (LPE: n = 62) expectancy condition. All participants completed questionnaires of distress, fear of pain, and fear of dental pain. Furthermore, they participated in a dot-probe task that assessed their attention to painful faces, dental pictures, and happy faces. In addition, before the treatment, participants reported their anticipated pain intensity and after the treatment, they reported the pain intensity that they perceived during the treatment using two separate visual analog scales. Patients in the HPE group showed a bias away from dental pictures compared to LPE and control group participants. HPE group patients also reported greater pain intensity during the treatment compared to LPE patients. Greater attentional bias away from dental pictures among HPE patients was associated with higher levels of fear of pain, fear of dental pain, and stress. Avoidance of highly salient threatening images can be seen as an unhelpful emotion-regulation strategy that individuals use to manage their fears. However, in this study, avoidance was associated with poorer outcomes.
Full Text Available Expecting pain can be perceived as a threat may involve recruitment of cognitive strategies (such as attentional avoidance which might help the person to reduce distress. The ecological validity of the paradigms aiming to study the attentional biases toward or away from threatening stimuli by manipulating the perception of threat in experimental settings has been questioned. Therefore, the current study aims to investigate the attentional bias toward or away from the threat when a confrontation with a real threatening and painful condition would be expected (i.e., dental treatment. One hundred and twenty-seven patients referred to three dentistry clinics for a dental treatment (experiment participants and 30 individuals with no dental complaints (control participants completed this study. Patients were randomly allocated to a high pain expectancy (HPE: n = 65 or a low pain expectancy (LPE: n = 62 expectancy condition. All participants completed questionnaires of distress, fear of pain, and fear of dental pain. Furthermore, they participated in a dot-probe task that assessed their attention to painful faces, dental pictures, and happy faces. In addition, before the treatment, participants reported their anticipated pain intensity and after the treatment, they reported the pain intensity that they perceived during the treatment using two separate visual analog scales. Patients in the HPE group showed a bias away from dental pictures compared to LPE and control group participants. HPE group patients also reported greater pain intensity during the treatment compared to LPE patients. Greater attentional bias away from dental pictures among HPE patients was associated with higher levels of fear of pain, fear of dental pain, and stress. Avoidance of highly salient threatening images can be seen as an unhelpful emotion-regulation strategy that individuals use to manage their fears. However, in this study, avoidance was associated with poorer outcomes.
Peres, Marco A; Iser, Betine Pinto Moehlecke; Peres, Karen Glazer; Malta, Deborah Carvalho; Antunes, José Leopoldo Ferreira
This study aimed to assess the prevalence of dental pain among adults and older people living in Brazil's State capitals. Information was gathered from the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL) in 2009 (n = 54,367). Dental pain was the outcome. Geographic region, age, gender, race, schooling, private health coverage, smoking, and soft drink consumption were the explanatory variables. Multilevel Poisson regression models were performed. Prevalence of dental pain was 15.2%; Macapá and São Luís had prevalence rates greater than 20%; all capitals in the South and Southeast, plus Cuiabá, Campo Grande, Maceió, Recife, and Natal had prevalence rates less than 15%. Factors associated with increased prevalence of dental pain were the North and Northeast regions, female gender, black/brown skin color, lack of private health insurance, smoking, and soft drink consumption. Dental pain is a public health problem that should be monitored by health surveillance systems.
Tan, Ji-Wei; Duan, Ting-Ting; Zhou, Qi-Xin; Ding, Ze-Yang; Jing, Liang; Cao, Jun; Wang, Li-Ping; Mao, Rong-Rong; Xu, Lin
Prenatal opiate exposure causes a series of neurobehavioral disturbances by affecting brain development. However, the question of whether prenatal opiate exposure increases vulnerability to memory-related neuropsychiatric disorders in adult offspring remains largely unknown. Here, we found that rats prenatally exposed to morphine (PM) showed impaired acquisition but enhanced maintenance of contextual fear memory compared with control animals that were prenatally exposed to saline (PS). The impairment of acquisition was rescued by increasing the intensity of footshocks (1.2 mA rather than 0.8 mA). Meanwhile, we also found that PM rats exhibited impaired extinction of contextual fear, which is associated with enhanced maintenance of fear memory. The impaired extinction lasted for 1 week following extinction training. Furthermore, PM rats exhibited reduced anxiety-like behavior in the elevated plus-maze and light/dark box test without differences in locomotor activity. These alterations in PM rats were mirrored by abnormalities in synaptic plasticity in the Schaffer collateral-CA1 synapses of the hippocampus in vivo. PS rats showed blocked long-term potentiation and enabled long-term depression in CA1 synapses following contextual fear conditioning, while prenatal morphine exposure restricted synaptic plasticity in CA1 synapses. The smaller long-term potentiation in PM rats was not further blocked by contextual fear conditioning, and the long-term depression enabled by contextual fear conditioning was abolished. Taken together, our results provide the first evidence suggesting that prenatal morphine exposure may increase vulnerability to fear memory-related neuropsychiatric disorders in adulthood. © 2014 Society for the Study of Addiction.
Mondloch, Catherine J
The current research investigated the influence of body posture on adults' and children's perception of facial displays of emotion. In each of two experiments, participants categorized facial expressions that were presented on a body posture that was congruent (e.g., a sad face on a body posing sadness) or incongruent (e.g., a sad face on a body posing fear). Adults and 8-year-olds made more errors and had longer reaction times on incongruent trials than on congruent trials when judging sad versus fearful facial expressions, an effect that was larger in 8-year-olds. The congruency effect was reduced when faces and bodies were misaligned, providing some evidence for holistic processing. Neither adults nor 8-year-olds were affected by congruency when judging sad versus happy expressions. Evidence that congruency effects vary with age and with similarity of emotional expressions is consistent with dimensional theories and "emotional seed" models of emotion perception. 2011 Elsevier Inc. All rights reserved.
Chakradhar, Kuracha; Doshi, Dolar; Kulkarni, Suhas; Reddy, Bandari Srikanth; Reddy, Sahithi; Srilatha, Adepu
Background Oral health is not merely the absence of oral disease and dysfunction, but also influences the subject's social life and dento-facial self confidence. Objective To assess and correlate self perceived psychosocial impact of dental aesthetics among young adults based on gender. Subjects A convenience sample of Young adults of degree college in the age group of 18-23 years of Hyderabad city, India. Method Self perceived psychosocial impact of dental aesthetics was assessed using the psychosocial impact of dental aesthetics questionnaire (PIDAQ). The dental aesthetic index (DAI) was used to evaluate dental aesthetics among participants which includes 10 parameters of dento-facial anomalies related to both clinical and aesthetic aspects of the anterior teeth. Results The majority of the study population were 18 years of age (96; 31.4%) with a mean age of 19.2 ± 1.1 years. When the mean total score and individual domain scores of PIDAQ was compared based on gender, females showed higher statistical mean (p ≤ 0.05) for all except the psychology impact domain (p = 0.12). Based on DAI grading and gender, among both males [70 (32.9%)] and females [31 (33.3%)] the majority of them had a DAI score of ≤25 (grade1; normal/minor dental malocclusion). A significant negative correlation was observed between DAI, with PIDAQ and its domains (p ≤ 0.05) except for the dental self confidence (p = 0.72). Conclusion This study had examined the relationship between self-perceived psychosocial impact and dental aesthetics. So, early preventive or interceptive procedures should be carried out to prevent further psychosocial impacts on human life.
Åstrøm, Anne N; Lie, Stein Atle; Gülcan, Ferda
Understanding factors that affect dental attendance behavior helps in constructing effective oral health campaigns. A socio-cognitive model that adequately explains variance in regular dental attendance has yet to be validated among younger adults in Norway. Focusing a representative sample of younger Norwegian adults, this cross-sectional study provided an empirical test of the Theory of Planned Behavior (TPB) augmented with descriptive norm and action planning and estimated direct and indirect effects of attitudes, subjective norms, descriptive norms, perceived behavioral control and action planning on intended and self-reported regular dental attendance. Self-administered questionnaires provided by 2551, 25-35 year olds, randomly selected from the Norwegian national population registry were used to assess socio-demographic factors, dental attendance as well as the constructs of the augmented TPB model (attitudes, subjective norms, descriptive norms, intention, action planning). A two-stage process of structural equation modelling (SEM) was used to test the augmented TPB model. Confirmatory factor analysis, CFA, confirmed the proposed correlated 6-factor measurement model after re-specification. SEM revealed that attitudes, perceived behavioral control, subjective norms and descriptive norms explained intention. The corresponding standardized regression coefficients were respectively (β = 0.70), (β =0.18), (β = - 0.17) and (β =0.11) (p planning and action planning (β =0.19) predicted dental attendance behavior (p behavioral control on behavior through action planning and through intention and action planning, respectively. The final model explained 64 and 41% of the total variance in intention and dental attendance behavior. The findings support the utility of the TPB, the expanded normative component and action planning in predicting younger adults' intended- and self-reported dental attendance. Interventions targeting young adults' dental
Moore, R.; Brødsgaard, I.
Results of group therapy (GT) for extreme dental anxiety were compared with individual treatment (IT). Scales used measured dental anxiety, beliefs or trust in dentists, and fear of the next dentist after specialist treatment which showed reduced dental anxiety and improved dental beliefs compared...... with a static control group of 45 patients. The 30 GT patients showed no significant difference in dropouts during training compared with the 68 IT patients, but for patients who completed treatment, GT (n = 24) had greater dental anxiety reduction than IT subjects (n = 60). GT patients required fewer therapist...
Schrader, Anne-Marie Voss
% are not flossing their teeth (32% in controls; OR = 1.32; P = 0.239); and 39% are not physically active (24% in controls; OR = 1.63; P = 0.069). CONCLUSIONS: While in general there was no significant differences in overall health behaviors between SVP patients and controls, SVP patients are less physically active......Substance Use, Dental Hygiene, and Physical Activity in Adult Patients with Single Ventricle Physiology. Overgaard D, Schrader AM, Lisby KH, King C, Christensen RF, Jensen HF, Moons P. Author information OBJECTIVES: The study aims to describe substance use, dental hygiene, and physical activity...... in adult survivors with single ventricle physiology (SVP) and to compare the behaviors with matched controls, while the patients are particularly at risk for general health problems. DESIGN: The present study is part of a larger research project on long-term outcomes in adult patients with SVP. A cross...
Arntz, A; van Eck, M; Heijmans, M
In a study of 40 subjects, who twice underwent extensive dental treatment, the relationships between expectations and experiences of pain and of anxiety were investigated. Inaccurate expectations were adjusted in the same way as observed in the laboratory. Especially anxious subjects expected more pain and anxiety than they experienced, and they appeared to need more experiences before their predictions became accurate. In the course of time, the expectations (and memories) of anxious subjects returned to their original more inaccurate level of prediction. The results suggest that the old schema is ultimately reinstated if disconfirmations are few and far between. Anxious subjects did not experience more pain, but they did experience more anxiety than fearless subjects. Detailed investigation of processes of change after disconfirmation showed that anxiety experienced during treatment is a factor that plays a part in maintaining the problem of inaccurate expectations and fear of treatment. Theoretical and clinical implications of these findings are discussed.
Dai, F F; Liu, Y; Xu, T M; Chen, G
To explore a cone beam computed tomography (CBCT)-independent method for mandibular digital dental cast superimposition to evaluate three-dimensional (3D) mandibular tooth movement after orthodontic treatment in adults, and to evaluate the accuracy of this method. Fifteen post-extraction orthodontic treatment adults from the Department of Orthodontics, Peking University School and Hospital of Stomatology were included. All the patients had four first premolars extracted, and were treated with straight wire appliance. The pre- and post-treatment plaster dental casts and craniofacial CBCT scans were obtained. The plaster dental casts were transferred to digital dental casts by 3D laser scanning, and lateral cephalograms were created from the craniofacial CBCT scans by orthogonal projection. The lateral cephalogram-based mandibular digital dental cast superimposition was achieved by sequential maxillary dental cast superimposition registered on the palatal stable region, occlusal transfer, and adjustment of mandibular rotation and translation obtained from lateral cephalogram superimposition. The accuracy of the lateral cephalogram-based mandibular digital dental cast superimposition method was evaluated with the CBCT-based mandibular digital dental cast superimposition method as the standard reference. After mandibular digital dental cast superimposition using both methods, 3D coordinate system was established, and 3D displacements of the lower bilateral first molars, canines and central incisors were measured. Differences between the two superimposition methods in tooth displacement measurements were assessed using the paired t-test with the level of statistical significance set at Pdigital dental cast superimposition methods in 3D displacements of the lower first molars, and sagittal and vertical displacements of the canines and central incisors; transverse displacements of the canines and central incisors differed by (0.3±0.5) mm with statistical significance
Gujjar, Kumar Raghav; Sharma, Ratika; Jongh, Ad De
popularity as an effective treatment for anxiety disorders. The purpose of this article is to determine the applicability of VRET in the treatment of dental phobia of two patients. Two case examples of female dental patients, aged 56 and 24 years, who met the criteria for dental phobia according to the Phobia Checklist, illustrate the use of VRET in the dental setting. VRET that is used as a psychological treatment for dental fear and dental phobia can potentially be given by a non-specialist (for example dental assistant), thereby making it a cost-effective therapy for the treatment of dental phobia. Clinical relevance: This article is the first of its kind to demonstrate Virtual Reality Exposure Therapy (VRET) in the treatment of dental anxiety.
Full Text Available The transition to adulthood is a developmental period marked by increased stress, especially among African Americans. In addition to stress related to emerging adulthood, neighborhood fear may contribute to depressive symptoms for African Americans. We examined gender differences in longitudinal associations between changes in perceived neighborhood fear, parental support, and depressive symptoms among African American youth who were in transition to adulthood. Five hundred and thirteen African American youths (235 males and 278 females were included in the study. An increase in perceived neighborhood fear was associated with an increase in depressive symptoms, and change in perceived maternal support was predictive of depressive symptoms among males, but not females. The findings suggest that policies and programs should help parents provide support to young adult children who live in violent neighborhoods as a strategy to prevent depressive symptoms during emerging adulthood.
Capriola, Nicole N.; Maddox, Brenna B.; White, Susan W.
Social anxiety disorder (SAD) is a common comorbidity for individuals with autism spectrum disorder (ASD). The present study examined the cardinal cognitive component of SAD, fear of negative evaluation (FNE), in adolescents and adults with ASD (n = 44; 59 % with social anxiety) and those without ASD (n = 69; 49 % with social anxiety). Group (ASD…
Richardson, G Mark; Clemow, Scott R; Peters, Rachel E; James, Kyle J; Siciliano, Steven D
Little has been published on the chemical exposures and risks of dental restorative materials other than from dental amalgam and composite resins. Here we provide the first exposure and risk assessment for gold (Au) alloy and ceramic restorative materials. Based on the 2001-2004 US National Health and Nutrition Examination Survey (NHANES), we assessed the exposure of US adults to the components of Au alloy and ceramic dental restorations owing to dental material wear. Silver (Ag) is the most problematic component of Au alloy restorations, owing to a combination of toxicity and proportional composition. It was estimated that adults could possess an average of four tooth surfaces restored with Au alloy before exceeding, on average, the reference exposure level (REL) for Ag. Lithium (Li) is the most problematic component of dental ceramics. It was estimated that adults could possess an average of 15 tooth surfaces restored with ceramics before exceeding the REL for Li. Relative risks of chemical exposures from dental materials decrease in the following order: Amalgam>Au alloys>ceramics>composite resins.
Estafan, D J
Although needle-administered local anesthesia has been an essential tool of modern dentistry, it has also been responsible for many patients' fears of dental visits. Several new techniques have recently evolved that may offer viable alternatives. Two of these operate via electronic mechanisms that interfere with pain signals, two others involve transmucosal modes of administration, and a fifth technique involves an intraosseous pathway for anesthesia administration. Each of these techniques has different indications for dental procedures, but none is intended to replace needle administration in dentistry. This overview highlights the salient features of these alternative dental anesthesia techniques.
Jesse Daniel Cushman
Full Text Available Postnatal-neurogenesis (PNN contributes neurons to olfactory bulb (OB and dentate gyrus (DG throughout juvenile development, but the quantitative amount, temporal dynamics and functional roles of this contribution have not been defined. By using transgenic mouse models for cell lineage tracing and conditional cell ablation, we found that juvenile neurogenesis gradually increased the total number of granule neurons by approximately 40% in OB, and by 25% in DG, between two weeks and two months of age, and that total numbers remained stable thereafter. These findings indicate that the overwhelming majority of net postnatal neuronal addition in these regions occurs during the juvenile period and that adult neurogenesis contributes primarily to replacement of granule cells in both regions. Behavioral analysis in our conditional cell ablation mouse model showed that complete loss of PNN throughout both the juvenile and adult period produced a specific set of sex-dependent cognitive changes. We observed normal hippocampus-independent delay fear conditioning, but excessive generalization of fear to a novel auditory stimulus, which is consistent with a role for PNN in psychopathology. Standard contextual fear conditioning was intact, however, pre-exposure dependent contextual fear was impaired suggesting a specific role for PNN in incidental contextual learning. Contextual discrimination between two highly similar contexts was enhanced; suggesting either enhanced contextual pattern separation or impaired temporal integration. We also observed a reduced reliance on olfactory cues, consistent with a role for OB PNN in the efficient processing of olfactory information. Thus, juvenile neurogenesis adds substantively to the total numbers of granule neurons in OB and DG during periods of critical juvenile behavioral development, including weaning, early social interactions and sexual maturation, and plays a sex-dependent role in fear memories.
Chanpong, B; Haas, D. A; Locker, D
The aim of this study was to assess the need and demand for sedation or general anesthesia (GA) for dentistry in the Canadian adult population. A national telephone survey of 1101 Canadians found that 9.8% were somewhat afraid of dental treatment, with another 5.5% having a high level of fear. Fear or anxiety was the reason why 7.6% had ever missed, cancelled, or avoided a dental appointment. Of those with high fear, 49.2% had avoided a dental appointment at some point because of fear or anxi...
Arnrup, Kristina; Broberg, Anders G; Berggren, Ulf; Bodin, Lennart
Current treatment of children with dental behaviour management problems (DBMP) is based on the presupposition that their difficulties are caused by dental fear, but is this always the case? The aim of this study was to study temperamental reactivity, negative emotionality, and other personal characteristics in relation to DBMP in 8- to 12-year-old children. Forty-six children referred because of DBMP (study group) and 110 children in ordinary dental care (reference group) participated. The EASI tempramental survey assessed temperamental reactivity and negative emotionality, the Child Behaviour Questionnaire internalizing and externalizing behaviour problems, and the Children's Fear Survey Schedule general and dental fears. Cluster analyses and tree-based modelling were used for data analysis. Among the five clusters identified, one could be characterized as 'balanced temperament'. Thirty-five per cent of the reference group compared to only 7% of the study group belonged to this cluster. Negative emotionality was the most important sorting variable. Children referred because of DBMP differed from children in ordinary dental care, not only in dental fear level, but also in personal characteristics. Few of the referred children were characterized by a balanced temperament profile. It is important to consider the dual impact of emotion dysregulation and emotional reactivity in the development of DBMP.
Wu, Jay; Shih, Cheng-Ting; Ho, Chang-hung; Liu, Yan-Lin; Chang, Yuan-Jen; Min Chao, Max; Hsu, Jui-Ting
Dental cone beam computed tomography (CBCT) provides high-resolution tomographic images and has been gradually used in clinical practice. Thus, it is important to examine the amount of radiation dose resulting from dental CBCT examinations. In this study, we developed an in-house anthropomorphic adult head phantom to evaluate the level of effective dose. The anthropomorphic phantom was made of acrylic and filled with plaster to replace the bony tissue. The contour of the head was extracted from a set of adult computed tomography (CT) images. Different combinations of the scanning parameters of CBCT were applied. Thermoluminescent dosimeters (TLDs) were used to measure the absorbed doses at 19 locations in the head and neck regions. The effective doses measured using the proposed phantom at 65, 75, and 85 kVp in the D-mode were 72.23, 100.31, and 134.29 μSv, respectively. In the I-mode, the effective doses were 108.24, 190.99, and 246.48 μSv, respectively. The maximum percent error between the doses measured by the proposed phantom and the Rando phantom was l4.90%. Therefore, the proposed anthropomorphic adult head phantom is applicable for assessing the radiation dose resulting from clinical dental CBCT.
Capurro, Diego Alberto; Davidsen, Michael
The goal of this analysis was to describe socioeconomic inequalities in dental health among Spanish middle-aged adults, and the role of behavioral and psychosocial factors in explaining these inequalities. This cross-sectional study used survey data from the 2006 Spanish National Health Survey and focused on adults ages 30 - 64. The outcome was dental health status based on the presence of self-reported dental problems. We used education, income, and occupational class as indicators of socioeconomic position and applied logistic regression analysis to estimate associations. We included behavioral and psychosocial variables in the models and compared non-adjusted to adjusted estimates to assess their potential role in explaining socioeconomic gradients. Results showed clear socioeconomic gradients in dental health among middle-aged adults. The percentage of people who reported more dental problems increased among those with lower levels of education, income, and occupation. These gradients were statistically significant (p socioeconomic position. Substantial unexplained associations remained significant after adjusting the model by behavioral and psychosocial variables. This study shows significant socioeconomic gradients in dental health among middle-aged adults in Spain. Behavioral and psychosocial variables were insufficient to explain the inequalities described, suggesting the intervention of other factors. Further research should incorporate additional explanations to better understand and comprehensively address socioeconomic inequalities in dental health.
Jälevik, Birgitta; Klingberg, Gunilla
In a previous study, 9-year-old children with severe Molar Incisor Hypomineralization (MIH) had undergone dental treatment of their first molars nearly ten times as often as children in a control group. They also showed more management problems (BMP) and fear and anxiety (DFA). To assess the long-term outcomes of dental treatments, dental anxiety, and patients' satisfaction in adolescents with MIH. Sixty-seven patients, identical with those in the baseline study, were studied at age 18-years. The participants answered the Children's Fear Survey Schedule - Dental Subscale the Dental Visit Satisfaction Scale (DVSS). Data were compiled from the dental records concerning dental health, number of restorative treatments and BMP. Molar Incisor Hypomineralization group had a significantly higher DMFT, and had undergone treatment of their permanent first molars 4.2 times as often as the controls. BMP was still significantly more common in the MIH group. However, DFS was reduced in MIH group and increased in the control groups. The DVSS scores did not differ between the groups. Conclusions. Patients with severe MIH had a poorer dental health and were still more treatment consuming at age 18-years. However, their dental fear was now at the same level as the controls. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.
Carlo Eduardo Medina-Solís
Full Text Available Oral diseases are a major burden on individuals and health systems. The aim of this study was to determine whether consumption of tobacco and alcohol were associated with the prevalence of oral/dental problems in Mexican adults. Using data from the National Performance Evaluation Survey 2003, a cross-sectional study part of the World Health Survey, dental information from a representative sample of Mexico (n = 22,229, N = 51,155,740 was used to document self-reported oral/dental problems in the 12 months prior to the survey. Questionnaires were used to collect information related to sociodemographic, socioeconomic, and other risk factors. Three models were generated for each age group (18–30, 31–45 and 46–98 years. The prevalence of oral/dental conditions was 25.7%. Adjusting for sex, schooling, socioeconomic position, diabetes, and self-reported health, those who used tobacco (sometimes or daily (OR = 1.15, p = 0.070; OR = 1.24, p < 0.01; and OR = 1.16, p < 0.05, for each age group respectively or alcohol (moderate or high (OR = 1.26, p < 0.001; OR = 1.18, p < 0.01 and OR = 1.30, p < 0.001, for each age group respectively had a higher risk of reporting oral/dental problems. Because tobacco and alcohol use were associated with self-reported oral/dental problems in one out of four adults, it appears advisable to ascertain how direct is such link; more direct effects would lend greater weight to adopting measures to reduce consumption of tobacco and alcohol for the specific purpose of improving oral health.
Karadayl, Beytullah; Ozaslan, Abdi; Afsin, Hueseyin; Karadayi, Suekriye
In this study, we aimed to develop dental charts for Turkish children and young adults of both genders within the age group of 4.5-22.5 years according to tooth mineralization and eruption in a format similar to that proposed by AlQahtani et al. In total, 753 digital panoramic radiographs from 350 males and 403 females were assessed. The permanent teeth were evaluated according to the classification system described by Demirjian et al. The eruption stage was assessed with Bengston's system, which was modified by AlQahtani et al at four points. Teeth generally developed earlier in females than in males. This was particularly notable in the age group of 5-14 years. However, this difference was usually visible in only one stage, not in all teeth. It has been determined that the mixed dentition period ended with the shedding of the second deciduous molars in both genders. The dental charts presented here included information that could be beneficial to dental clinicians in making appropriate diagnosis and planning orthodontic and surgical procedures. These charts also provided datasets for preliminary dental age estimation in Turkish children and young adults.
Karadayl, Beytullah; Ozaslan, Abdi [University of Istanbul, Cerrahpasa Faculty of Medicine, Forensic Medicine Department, Istanbul (Turkey); Afsin, Hueseyin [University of Istanbul, Cerrahpasa Faculty of Medicine, Forensic Medicine Department, Istanbul (Turkey); Karadayi, Suekriye [Public Health Agency, Istanbul (Turkey)
In this study, we aimed to develop dental charts for Turkish children and young adults of both genders within the age group of 4.5-22.5 years according to tooth mineralization and eruption in a format similar to that proposed by AlQahtani et al. In total, 753 digital panoramic radiographs from 350 males and 403 females were assessed. The permanent teeth were evaluated according to the classification system described by Demirjian et al. The eruption stage was assessed with Bengston's system, which was modified by AlQahtani et al at four points. Teeth generally developed earlier in females than in males. This was particularly notable in the age group of 5-14 years. However, this difference was usually visible in only one stage, not in all teeth. It has been determined that the mixed dentition period ended with the shedding of the second deciduous molars in both genders. The dental charts presented here included information that could be beneficial to dental clinicians in making appropriate diagnosis and planning orthodontic and surgical procedures. These charts also provided datasets for preliminary dental age estimation in Turkish children and young adults.
Oliver, Chicora F.; Kabitzke, Patricia; Serrano, Peter; Egan, Laura J.; Barr, Gordon A.; Shair, Harry N.; Wiedenmayer, Christoph
We examined the neural substrates of fear memory formation and maintenance when repeated recall was used to prevent forgetting in young animals. In contrast to adult rats, juveniles failed to show contextual fear responses at 4 d post-fear conditioning. Reconsolidation sessions 3 and 6 d after conditioning restored contextual fear responses in…
McDonnell, William M; Nelson, Douglas S; Schunk, Jeff E
Surges in patient volumes compromise emergency departments' (EDs') ability to deliver care, as shown by the recent H1N1 influenza (flu) epidemic. Media reports are important in informing the public about health threats, but the effects of media-induced anxiety on ED volumes are unclear. The aim of this study is to examine the effect of widespread public concern about flu on ED use. We reviewed ED data from an integrated health system operating 18 hospital EDs. We compared ED visits during three 1-week periods: (a) a period of heightened public concern regarding flu before the disease was present ("Fear Week"), (b) a subsequent period of active disease ("Flu Week"), and (c) a week before widespread concern ("Control Week"). Fear Week was identified from an analysis of statewide Google electronic searches for "swine flu" and from media announcements about flu. Flu Week was identified from statewide epidemiological data. Data were reviewed from 22 608 visits during the study periods. Fear Week (n = 7712) and Flu Week (n = 7687) were compared to Control Week (n = 7209). Fear Week showed a 7.0% increase in visits (95% confidence interval, 6-8). Pediatric visits increased by 19.7%, whereas adult visits increased by 1%. Flu Week showed an increase over Control Week of 6.6% (95% confidence interval, 6-7). Pediatric visits increased by 10.6%, whereas adult visits increased by 4.8%. At a time of heightened public concern regarding flu but little disease prevalence, EDs experienced substantial increases in patient volumes. These increases were significant and comparable to the increases experienced during the subsequent epidemic of actual disease. Copyright © 2012 Elsevier Inc. All rights reserved.
Magda Lima Álvarez
Full Text Available A la consulta estomatológica acuden muchos pacientes con miedo al tratamiento y al sillón dental. Es por eso que nos motivamos a revisar la literatura para establecer la diferencia de los términos que empleamos para referirnos a estas situaciones dentales, precisar su prevalencia según edad y sexo, relacionar la etiología y los posibles tratamientos, así como su prevención. Se estableció la diferencia entre miedo, ansiedad y fobia dental, predominan entre el 5 y 31,5% de la población y aumenta con la edad, sin diferencias significativas de sexo. Las etiologías más frecuentes son experiencias traumáticas pasadas y la actitud aprendida de su entorno. Los tratamientos incluyen el control de la ansiedad con terapia del comportamiento y medicamentosa. En la prevención debe tenerse en cuenta los consejos a pacientes para superar el miedo al dentista y la responsabilidad del odontólogo, las cualidades requeridas del equipo de tratamiento y las características del consultorio dental.To dentistry consultation many patients go with fear to the treatment and to the dental armchair. That is why we were motivated to revise literature to establish the difference of the terms we use to refer to these dental situations, to specify their prevaling according to age and sex, to relate the ethiology and their possible treatments, as well as their prevention. We found out that fear, anxiety and dental phobia prevail between the 5 to 31º.5% of the population, and increase with age, without significant differences of sex. The most frequent ethiologies are past traumatic experiences and the learned attitude of their environment. The treatments include anxiety control with therapy of behavior and medicine. In prevention it should be kept in mind the advice to patients to surpass the fear to dentistry and the odontologist responsibility, the required qualities of the treatment team and the characteristics of the dental clinic.
Luo, Huabin; Bell, Ronny A; Wright, Wanda; Wu, Qiang; Wu, Bei
The authors assessed the trends of annual dental visits in dentate adults with diabetes or prediabetes or no diabetes, and assessed whether the racial and ethnic disparities in dental visits changed from 2004 through 2014. Data for this analysis came from the Behavioral Risk Factor Surveillance System, a US health survey that looks at behavioral risk factors that was developed by the Centers for Disease Control and Prevention in cooperation with state health departments. Respondents indicated whether they had a dental visit in the past 12 months. Weighted proportions were calculated for annual dental visits in adults by diabetes status, and trends were assessed by racial and ethnic groups. From 2004 through 2014, the proportion of annual dental visits declined from 66.1% to 61.4% (trend P = .02) in the diabetes group, 71.9% to 66.5% (trend P = .01) in the no diabetes group, and 66.0% to 64.9% (trend P = .33) in the prediabetes group. Age, income, and health insurance were moderators of the association between diabetes status and dental visits. Overall, the racial and ethnic disparity in dental visits did not change significantly during the period. Dental visits and services were less frequent in people with diabetes and prediabetes. Racial and ethnic disparities in use of dental services persisted during the observed period. All patients, especially those with diabetes, are encouraged to visit a dentist at least annually. It is important for health care providers, such as primary care physicians and dental care and public health professionals, to make concerted efforts to promote oral health care in diabetes management. Improving access to dental services is vital to achieving this goal. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.
Wetselaar, P.; Vermaire, J.H.; Lobbezoo, F.
This case report describes a patient who is referred by his home physician to a centre for special dental care because of the presence of severe oral pain with an existing dental phobia. The patient has Asperger's Syndrome. Besides his extreme fear for dental treatment and several deep carious
Makino, Keitaro; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao; Shimada, Hiroyuki
Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence. Copyright © 2017 John Wiley & Sons, Ltd.
Lukasse, Mirjam; Vangen, Siri; Øian, Pål
Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth.......Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth....
Suryakant C Deogade
Full Text Available Background: Anxiety toward dental treatment can cause people to delay or avoid seeking oral health care despite being in need of treatment. Therefore, recognizing such anxious patients and their appropriate management plays important aspects in clinical practice. Aim: The aim of this study was to investigate the level of dental anxiety (DA, factors affecting it, and anxiety toward dental extraction among adults seeking dental care to a dental school in Central India. Materials and Methods: The study sample consisted of 1360 consecutive patients aged 18–70 years. Participants completed a questionnaire while in the waiting room, which included the Modified Dental Anxiety Scale (MDAS to assess the level of DA. An additional item was included which asked participants to rate the anxiety felt on having a tooth extracted. Results: Among the study group, 65.1% were men and 34.9% were women. Based on the MDAS score, 41.8% of the participants were identified to be less anxious, 53.2% were moderately or extremely anxious, and 5% were suffering from dental phobia. Female participants and younger patients were more anxious (P = 0.0008. Patients who were anxious had postponed their dental visit (P = 0.0008. Participants who had negative dental experience were more anxious (P = 0.03. Nearly, 83% reported anxiety toward extraction procedure. A significant association was observed between anxiety toward dental extraction and the patients' gender (P = 0.03, age (P = 0.0007, education level (P = 0.03, employment status (P = 0.0006, income (P = 0.0007, self-perceived oral health status (P = 0.03, and their history of visit to dentist (P = 0.02. Conclusion: Majority of patients in this population revealed high levels of DA. Factors such as age, gender, education level, occupation, financial stability, and previous bad dental experience influence DA to various levels. Extraction followed by injection of local anesthetics and drilling of tooth provoked more anxiety.
Cho, Dalnim; Park, Crystal L
We examined whether (1) fear of cancer recurrence was related to lower health-related quality of life and (2) perceived growth moderated the link between fear of recurrence and health-related quality of life. About 292 adolescent and young adult cancer survivors (diagnosed with cancer at ages 15-34) completed a cross-sectional survey. Fear of recurrence was related to poorer physical and mental health-related quality of life. The negative association between fear of recurrence and mental health-related quality of life was moderated by perceived growth. Fostering perceived growth may mitigate the adverse associations of fear of recurrence and health-related quality of life.
Full Text Available Anxiety is a special variety of fear, experienced in anticipation of threatening stimuli. While some research workers have said that the response of a child improves with the number of visits, many have felt otherwise. The present study is yet another effort to find the patterns of anxiety in children during sequential dental visits. The main aim was to determine the physiological and behavioral variations during sequential dental visits and its impact on age and sex. The study was conducted at the outpatient Department of Pedodontics and preventive dentistry, Meenakshi Ammal Dental College and Hospital, Chennai to evaluate the physiological and behavioural measures of stress and anxiety in children. One hundred and fifteen children, between four and eleven years of age who reported for dental treatment were selected for the study.
Masuda, Katsuhiko; Nemoto, Hirotoshi; Nakano, Kazuhiko; Naka, Shuhei; Nomura, Ryota; Ooshima, Takashi
Infective endocarditis (IE) is known to be a life-threatening disease and invasive dental procedures are considered to be important factors. Oral amoxicillin (AMPC) is widely used for prophylaxis in patients with heart disorders who are at risk for IE. However, there is only limited information regarding the inhibition of oral bacteria by AMPC. Dental plaque specimens were obtained from 120 healthy Japanese adult subjects, then diluted and streaked onto selective medium for oral streptococci. The minimum inhibitory concentration (MIC) of AMPC was evaluated using a macro-dilution method by Clinical Laboratory Standard Institute (2006). Seven strains with an MIC of AMPC of 16μg/mL or more were isolated from 5 subjects. The bacterial species were confirmed by sequence analysis of 16S rRNA from each strain, which demonstrated that most were Streptococcus sanguinis, followed by Streptococcus oralis. Dental plaque specimens collected from these 5 subjects again after an interval of 2-3 months possessed no strains with an MIC of AMPC of 16μg/mL or more. These findings suggest that strains with a high MIC of AMPC are present in the oral cavities of Japanese adults, though they may be transient rather than inhabitants. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Humphris, Gerry; Spyt, James; Herbison, Alice G; Kelsey, Thomas W
Dental anxiety of patients is a common feature of the everyday experience of dental practice. This article advocates the use of regular assessment of this psychological construct to assist in patient management. Various tools, such as the Modified Dental Anxiety Scale (MDAS), are available to monitor dental anxiety that are quick to complete and easy to interpret. Patient burden is low. A new mobile phone assessment system (DENTANX) is being developed for distribution. This application and other psychological interventions are being investigated to assist patients to receive dental care routinely. Clinical relevance: This article provides evidence and expert opinion on the worth of regular dental anxiety assessment in dental practice using structured tools, such as the Modified Dental Anxiety Scale, and consideration of psychological intervention development.
Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions
Galeotti, Angela; Garret Bernardin, Annelyse; D'Antò, Vincenzo; Viarani, Valeria; Cassabgi, Giorgio
Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients. Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score. Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment. Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia. PMID:27747238
Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions
Full Text Available Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients. Methods. 472 noncooperating patients (aged 4 to 17 were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score. Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment. Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.
Wu, Andrew; Switzer-Nadasdi, Rhonda
Dental caries is a highly prevalent, yet preventable disease that is commonly overlooked in the adult population. It is strongly related to health-related behaviors and knowledge, and therefore, is potentially receptive to a behavioral health intervention. However, prevention strategies that target health behaviors in adults are fundamentally different from those in children, whom most current intervention strategies for dental caries target. This study attempts to pilot design, implement, and assess health behavior intervention tools for adults, in order to improve their oral health. To increase knowledge about dental caries by 80% and increase positive self-reported oral hygiene behaviors by 80% in low-income adult participants at Interfaith Dental Clinic by piloting novel interventional and educational tools based on the Transtheoretical Model of Health Behavior. A convenience sample of newly registered participants to the Interfaith Dental Clinic between August 2011 and May 2013, were interviewed on each participant's first appointment, exposed to the interventional tools, and subsequently interviewed at their next appointment. A control group, comprised of participants who had completed their caries care as deemed by the clinic and had not been exposed to the interventional tools, were also interviewed on their last appointment before graduating the clinic's program. A total of 112 participants were exposed to the intervention, and forty-two participants comprised the control group. Follow-up for the intervention group was 20.5% (n = 23). Knowledge about the cause of caries increased by 29.9%, and positive self-reported oral hygiene behaviors increased by 25.4%. A Wilcoxon rank sum test showed no significance between the interview scores of the post-intervention group and that of the control group (p = 0.18 for knowledge, p = 0.284 for behaviors). Qualitative results show the vast majority of participants blamed diet for cause of caries, that this participant
Carr, Imogen; Szabó, Marianna
Worry in adults has been conceptualized as a thinking process involving problem-solving attempts about anticipated negative outcomes. This process is related to, though distinct from, fear. Previous research suggested that compared to adults, children's experience of worry is less strongly associated with thinking and more closely related to fear.…
Research designed to determine the number and kind of dimensions- underlying self-reports of animal fears is relatively rare. To contribute further knowledge to this area of study, Davey's methodology [Davey, G. C. L. (1994a). Self-reported fears to common indigenous animals in an adult UK
Full Text Available Objective: To characterize the adult population of the city of Corrientes (Argentina in relation to dental health insurance according to sociodemographic and dental variables. Materials and Methods: A descriptive cross-sectional study was conducted in the city of Corrientes (Argentina. Information regarding the study variables was collected through the application of a structured survey. Sample size was determined by establishing a 95% confidence level (381 subjects between 35 and 44 years of age. The direct face-to-face observation technique was used for data collection. A simple random sample design was applied for the selection of the homes to be surveyed, which was complemented by a non-probabilistic sampling using quotas for the selection of the individuals to be interviewed from the 2010 Population Census data. Results: Of the total of the participants, 56.4% had dental health insurance. Health insurance was significantly associated with a higher socioeconomic level OR: 1.90 (95% CI 1.26-2.87, p=0.01; greater probability of having had a consultation in the 12 months prior to the interview OR: 1.74 (95% CI 1.13-2.68, p=0.01, going to the dentist for dental treatments OR: 1.5 (95% CI 1.02-2.43, p=0.03, or because of pain or an emergency problem OR: 1.59 (95% CI 1.05-2.42, p=0.02, and presenting better oral hygiene self-care. Conclusions: There are oral health inequities in the adult population of the city of Corrientes (Argentina. Having dental health insurance is associated with a higher socioeconomic level, having more frequent dental consultations to get dental treatment and in emergency situations, as well as presenting better oral hygiene self-care.
Full Text Available In this review paper we wanted to summarize all the aspects which could affect the behavior of the child patients in the dental office. At the beginning, the factors that are related to the child patients are mentioned. Various segments of child psychological, cognitive, physiological and other kinds of development are discussed. Also, the reasons for dental fear and anxiety (DFA and dental behavior problems (DBP were analyzed, and how the child dental patients could cope with them. Finally, types of patients according to their behavior in the dental office were discussed. Furthermore, the influences of child patients’ parents were studied, including parenting styles, as well as factors related to dentist, dental team and the dental office. Finally, critical evaluation of administration of assets to measure the presence of DFA and DBP is provided. Every part of the text was corroborated by the results from our own and other authors’ recent bibliography data.
Full Text Available The question of what motivates individuals to assume healthy eating habits remains unanswered. The purpose of this descriptive survey is to explore health-related feared possible selves in relation to dietary beliefs and behavior in adults. A convenience sample of 74 middle-aged employees of a health maintenance organization completed self-administered questionnaires. Health-related feared selves, current health perception, knowledge of diet-health association, dietary self-efficacy, dietary intention and intake were measured. Health-related fears were the most frequently reported feared selves, but very few of those represented illnesses and none were related to dietary intake. The number of health and body weight related fears was significantly associated with lower dietary self-efficacy and weaker intention to eat in a healthy manner. Multivariate analysis showed self-efficacy to be the only significant predictor of dietary intention. These adults may not have perceived being at risk for diet-associated illnesses, and so their feared selves did not motivate them to eat in a healthy manner. Research on the effect of hoped for health related possible selves and the perceived effectiveness of diet in reducing health risk are recommended.
Jones, Carolyn E.
Traumatic experiences early in life can contribute to the development of mood and anxiety disorders that manifest during adolescence and young adulthood. In young rats exposed to acute fear or stress, alterations in neural development can lead to enduring behavioral abnormalities. Here, we used a modified extinction intervention (retrieval+extinction) during late adolescence (post-natal day 45 [p45]), in rats, to target auditory Pavlovian fear associations acquired as juveniles (p17 and p25). The effects of adolescent intervention were examined by assessing freezing as adults during both fear reacquisition and social transmission of fear from a cagemate. Rats underwent testing or training at three time points across development: juvenile (p17 or p25), adolescent (p45), and adult (p100). Retrieval+extinction during late adolescence prevented social reinstatement and recovery over time of fears initially acquired as juveniles (p17 and p25, respectively). Adolescence was the only time point tested here where retrieval+extinction prevented fear recall of associations acquired 20+ days earlier. PMID:27634147
Full Text Available Introduction: Dental anxiety is an abnormal fear or dread of visiting the dentist for preventive care or therapy and unwarranted anxiety over dental procedures. It is a common problem that affects people of all ages and appears to develop mostly in childhood and adolescence. The present study assesses dental anxiety among children in a nonclinical setting among Saudi Arabian children who underwent preventive treatment procedure using Abeer Children Dental Anxiety Scale (ACDAS. Materials and Methods: The children attending an oral health program were screened for oral health problems and preventive treatment such as topical fluoride applications. The dental anxiety among children was assessed using ACDAS. Results: A total of 51 children participated in the research. The results showed that maximum children were not scared of dentist in nonclinical setting and had low dental anxiety levels. Overall, 74% of the child subjects had ACDAS scores below 26. Conclusions: Knowing the degree of anxiety of dental children is important to guide them through their dental experience and carry on the preventive dental treatments at an early age in nonclinical setting. Their level of cooperation will improve, and anxiety will be reduced as well. Further research is required to compare dental anxiety levels in children between clinical and nonclinical setting.
Full Text Available Dental treatment represents a stress factor for most children. The aim of the study was to analyse the variation of salivary alpha-amylase concentration in children after a video viewing on dental treatments. In this study, 7 to 10 year-old school children were evaluated (n=119. Unstimulated whole saliva was collected before and after viewing a 15 min video on dental treatments performed on children. Changes in salivary alpha-amylase levels have been assessed. Video viewing on dental procedures led to a significant increase of the alpha-amylase level in the whole sample group. This was noticeable in terms of gender as well as age groups. From the viewpoint of age and gender, girls displayed significantly higher levels of amylase in all age groups, while this could be observed only in younger boys. In conclusion, analysis of salivary alpha-amylase revealed that the sight of dental treatment represents a significant source of stress among children.
Sanders, Jeff; Mayford, Mark
Fluoxetine is a medication used to treat Major Depressive Disorder and other psychiatric conditions. These experiments studied the effects of chronic fluoxetine treatment on the contextual versus auditory fear memory of mice. We found that chronic fluoxetine treatment of adult mice impaired their contextual fear memory, but spared auditory fear memory. Hippocampal perineuronal nets, which are involved in contextual fear memory plasticity, were unaltered by fluoxetine treatment. These data point to a selective inability to form contextual fear memory as a result of fluoxetine treatment, and they suggest that a blunting of hippocampal-mediated aversive memory may be a therapeutic action for this medication. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
AN ANALYSIS OF FEAR AND PREJUDICE WAS MADE THROUGH A SERIES OF ATTITUDE QUESTIONNAIRES, PRIVATE INTERVIEWS CONDUCTED BY TRAINED PSYCHOLOGISTS, AND A SERIES OF PSYCHOLOGICAL TESTS. RESULTS SHOWED THAT PREJUDICE STARTED IN THE FIRST FEW YEARS OF A CHILD'S LIFE THROUGH HIS RELATIONSHIP WITH HIS PARENTS. THE ADULTS LOW IN PREJUDICE HAD STABLE OUTLOOKS…
Armfield, J.M.; Ketting, M.
Objectives: It has been proposed that avoidance of dental visits might be the main determinant of poor oral health outcomes in people with high dental anxiety (HDA). This study aimed to determine the predictors of dental avoidance among people with HDA and also whether these predictors differed from
Full Text Available Pain is not the sole reason for fear of dentistry. Anxiety or the fear of unknown during dental treatment is a major factor and it has been the major concern for dentists for a long time. Therefore, the main aim of this study was to evaluate and compare the two distraction techniques, viz, audio distraction and audiovisual distraction, in management of anxious pediatric dental patients. Sixty children aged between 4-8 years were divided into three groups. Each child had four dental visits - screening visit, prophylaxis visit, cavity preparation and restoration visit, and extraction visit. Child′s anxiety level in each visit was assessed using a combination of four measures: Venham′s picture test, Venham′s rating of clinical anxiety, pulse rate, and oxygen saturation. The values obtained were tabulated and subjected to statistical analysis. It was concluded that audiovisual distraction technique was more effective in managing anxious pediatric dental patient as compared to audio distraction technique.
This Danish Doctoral Dissertation in the science of Odontology contains 7 chapters: 1) Introduction to a social perspective on dental treatment, anxiety and pain throughout time, 2) research models and methods to study dental anxiety and clinical pain phenomena, 3) the fear of dental treatment...... .. what it is and what it is not and how many have it, 4) clinical pain treatment, psychosocial aspects in relation to anxiety, 4) patients and dentists' roles, pain perception and anxiety, 6) psychosocial aspects of managing anxiety and pain phenomena, and 7) Conclusions and proposals for the future...
Brondani, Mario A; Phillips, J Craig; Kerston, R Paul; Moniri, Nardin R
Tooth decay and other oral diseases can be highly prevalent among people living with HIV/AIDS (PLWHA). Even though dental professionals are trained to provide equal and non-judgemental services to all, intentional or unintentional biases may exist with regard to PLWHA. We conducted qualitative descriptive research using individual interviews to explore the experiences of PLWHA accessing dental care services in Vancouver, Canada. We interviewed 25 PLWHA, aged 23-67 years; 21 were men and 60% reported fair or poor oral health. Thematic analysis showed evidence of both self-stigma and public stigma with the following themes: fear, self-stigma and dental care; overcoming past offences during encounters with dental care professionals; resilience and reconciliation to achieve quality care for all; and current encounters with dental care providers. Stigma attached to PLWHA is detrimental to oral care. The social awareness of dental professionals must be enhanced, so that they can provide the highest quality care to this vulnerable population.
Blood, Gordon W; Blood, Ingrid M
Psychosocial disorders have been reported in adults who stutter, especially social anxiety disorder. Social anxiety has been linked to childhood victimization. It is possible that recalled childhood victimization could be linked to psychosocial problems reported in some adults who stutter. Participants were 36 adults who stutter and 36 adults who do not stutter (mean age=21.9 years). The Retrospective Bullying Questionnaire was completed for primary school, secondary school and university environments for physical, verbal, relational and cyber bullying. Participants were categorized into one of five groups (bully, victim, bully-victim, bystander and uninvolved) based ontheir responses. Participants completed four psychosocial scales: social interaction anxiety, fear of negative evaluation, self-esteem and satisfaction with life scales. The two groups differed with adults who stutter having higher social interaction anxiety, fear of negative evaluation and satisfaction with life. Analyses of variance revealed that victims had the highest scores among both groups on all four scales. Adults who recalled being victimized during childhood were more likely, regardless of whether they stutter or did not stutter, to have poorer psychosocial scale scores. These results show the lingering effects of childhood victimization, common in some children who stutter, may contribute to the reported psychosocial problems in adulthood. The need for early intervention for children who are bullied and future research with larger samples is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.
Crocombe, L A; Brennan, D S; Slade, G D; Loc, D O
To ascertain whether interdental cleaning behaviours of Australian adults were associated with lower levels of plaque, gingivitis and periodontal disease. Data were obtained from the National Survey of Adult Oral Health 2004-06. Outcome variables were three indicators of oral hygiene outcomes (the presence or not of dental plaque, dental calculus and gingivitis) and two of periodontal disease (the presence or not of at least one tooth with a periodontal pocket or clinical attachment loss of ≥ 4 mm). The independent variable was classified into the following three groups: regularly clean interproximally 'at least daily' (daily+); 'less than daily' (dental plaque (dental calculus (dental plaque and gingivitis, although there was no significant association between regular interdental cleaning and clinical attachment loss. © 2011 John Wiley & Sons A/S.
Ginat-Frolich, Rivkah; Klein, Zohar; Katz, Omer; Shechner, Tomer
Generalization is an adaptive learning mechanism, but it can be maladaptive when it occurs in excess. A novel perceptual discrimination training task was therefore designed to moderate fear overgeneralization. We hypothesized that improvement in basic perceptual discrimination would translate into lower fear overgeneralization in affective cues. Seventy adults completed a fear-conditioning task prior to being allocated into training or placebo groups. Predesignated geometric shape pairs were constructed for the training task. A target shape from each pair was presented. Thereafter, participants in the training group were shown both shapes and asked to identify the image that differed from the target. Placebo task participants only indicated the location of each shape on the screen. All participants then viewed new geometric pairs and indicated whether they were identical or different. Finally, participants completed a fear generalization test consisting of perceptual morphs ranging from the CS + to the CS-. Fear-conditioning was observed through physiological and behavioural measures. Furthermore, the training group performed better than the placebo group on the assessment task and exhibited decreased fear generalization in response to threat/safety cues. The findings offer evidence for the effectiveness of the novel discrimination training task, setting the stage for future research with clinical populations. Copyright © 2017 Elsevier Ltd. All rights reserved.
Umamaheshwari, N; Asokan, Sharath; Kumaran, Thanga S
The child's perception of the dental environment is a significant factor causing dental anxiety. If the color of the dental environment can have a positive impact on the child's behavior, it is possible that those colors may add to the comfort of a child, thus reducing dental anxiety. To evaluate the association between color and emotions of children in a pediatric dental set-up. A total of 300 children aged 6-12 years were divided into 2 groups: Younger children (6-9 years, n = 156) and older children (9-12 years, n = 144). All the children were asked to shade two cartoon faces representing happiness and fear with their most preferred color. For the positive emotion, 44% (n = 132) of the children preferred yellow, followed by blue 32.67% (n = 98). For negative emotion, 56.67% (n = 170) of the children preferred black and 42.67% (n = 128) preferred red. Association between color and emotion was highly significant (P color research to dental anxiety in children visiting a dental clinic. The use of child friendly colors like yellow and blue in the dental work place could enhance a positive dental attitude in the child's mind.
Northridge, Mary E; Schenkel, Andrew B; Birenz, Shirley; Estrada, Ivette; Metcalf, Sara S; Wolff, Mark S
To help eliminate reported racial/ethnic and socioeconomic inequities in oral health care, listening to the perspectives of racial/ethnic minority older adults on their experiences with dental school clinics is needed. The aim of this study was to examine the experiences of African American, Puerto Rican, and Dominican older adults who attend senior centers in upper Manhattan, New York City, regarding the care received at dental school clinics. Focus groups were conducted from 2013 to 2015 with 194 racial/ethnic minority men and women aged 50 years and older living in upper Manhattan. All of the 24 focus group sessions were digitally audiorecorded and transcribed for analysis. Groups conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Seven subthemes were manifest in the data related to these adults' positive experiences with dental school clinics: excellent outcomes and dentists, painless and safe treatment, affordable care, honest and reputable, benefits of student training, accepting and helpful, and recommended by family and friends. Negative experiences centered around four subthemes: multiple visits required for treatment, loss of interpersonal communication due to use of technology, inconvenient location, and perceived stigma with Medicaid. This study provided novel evidence of the largely positive experiences with dental schools of racial/ethnic minority senior center attendees. Interventions targeted at the organization and provider level, including organizational motivation, resources, staff attributes, climate, and teamwork plus payment programs and services, insurance and affordability, and provider- and system-level supports, may improve health care processes and patient experiences of care.
Randall, Cameron L; Wright, Casey D; Chernus, Jonathan M; McNeil, Daniel W; Feingold, Eleanor; Crout, Richard J; Neiswanger, Katherine; Weyant, Robert J; Shaffer, John R; Marazita, Mary L
Acute and chronic orofacial pain can significantly impact overall health and functioning. Associations between fear of pain and the experience of orofacial pain are well-documented, and environmental, behavioral, and cognitive components of fear of pain have been elucidated. Little is known, however, regarding the specific genes contributing to fear of pain. A genome-wide association study (GWAS; N = 990) was performed to identify plausible genes that may predispose individuals to various levels of fear of pain. The total score and three subscales (fear of minor, severe, and medical/dental pain) of the Fear of Pain Questionnaire-9 (FPQ-9) were modeled in a variance components modeling framework to test for genetic association with 8.5 M genetic variants across the genome, while adjusting for sex, age, education, and income. Three genetic loci were significantly associated with fear of minor pain (8q24.13, 8p21.2, and 6q26; p pain total score and each of the FPQ-9 subscales. Multiple genes were identified as possible candidates contributing to fear of pain. The findings may have implications for understanding and treating chronic orofacial pain.
Kwok, Boon Chong; Mamun, Kaysar; Chandran, Manju; Wong, Chek Hooi
Abstract Background Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contri...
Khan, Aishah; Thapa, Janani R; Zhang, Donglan
This study aimed to assess the relationship between rural or urban residence and having a usual source of care (USC), and the utilization of preventive dental checkups among adults. Cross-sectional analysis was conducted using data from the Medical Expenditure Panel Survey 2012. We performed a logit regression on the relationship between rural and urban residence, having a USC, and having at least 1 dental checkup in the past year, adjusting for sociodemographic characteristics and health status. After controlling for covariates, rural adult residents had significantly lower odds of having at least 1 dental checkup per year compared to their urban counterparts (odds ratio [OR] = 0.73, 95% confidence interval [CI]: 0.62-0.86, P rural and urban residents, having a USC was significantly associated with an 11% (95% CI = 9%-13%) increase in the probability of having a preventive dental checkup within a year. Individuals with a USC were more likely to obtain a preventive dental visit, with similar effects in rural and urban settings. We attributed the lower odds of having a checkup in rural regions to the lower density of oral health care providers in these areas. Integration of rural oral health care into primary care may help mitigate the challenges due to a shortage of oral health care providers in rural areas. © 2017 National Rural Health Association.
... Materials Contact Us Home Research Data & Statistics Dental Caries (Tooth Decay) Dental caries (tooth decay) remains the most prevalent chronic disease ... adults, even though it is largely preventable. Although caries has significantly decreased for most Americans over the ...
... Contact Us Home Research Data & Statistics Share Dental Caries (Tooth Decay) Dental caries (tooth decay) remains the most prevalent chronic disease ... adults, even though it is largely preventable. Although caries has significantly decreased for most Americans over the ...
Moore, R.; Brødsgaard, I.
Results of group therapy (GT) for extreme dental anxiety were compared with individual treatment (IT). Scales used measured dental anxiety, beliefs or trust in dentists, and fear of the next dentist after specialist treatment which showed reduced dental anxiety and improved dental beliefs compared...... with a static control group of 45 patients. The 30 GT patients showed no significant difference in dropouts during training compared with the 68 IT patients, but for patients who completed treatment, GT (n = 24) had greater dental anxiety reduction than IT subjects (n = 60). GT patients required fewer therapist...... hours per patients than did either of the two IT methods, but time saved in GT did not reach significance over clinical rehearsal IT. Results at 1- yr follow-up after specialist treatment indicated that dropouts were significantly greater in group therapy. Rehearsal IT performed best for sustained...
Young, WR; Williams, AM
This article was made available through the Brunel Open Access Fund. It is widely reported that fear of falling (FOF) has a profound and largely detrimental effect on balance performance in older adults. However, the mechanisms by which FOF influence postural stability are poorly understood. In the current article, we use psychological theory to explain FOF-related changes to postural control. First, we review literature describing associations between FOF and the 'stiffening' strategies o...
Arlette Suzy Setiawan
Full Text Available Background: Dental anxiety is a prevalent problem faced by dentists till nowadays, especially in treating child patients. Several methods in managing anxiety are available, but there is no single method can be applied extensively. Purpose: This article was aimed to describe the application of social learning theory in preventing or reducing dental anxiety in children. Literature review: Anxiety and fear are psych feelings that is experienced by a person. A child developed these feelings by learning from their own past experienced or by information obtained from their environment. If fear and anxiety can be learned by a child, thus the opposite term which is preventing the feelings is assumed can be also offered to learned. This application actually being applied in the field of dentistry as modeling, but the exploration of how this process is due is often being ignored. Conclusion: Social learning theory provides an easy preventive approach and effective intervention that can be applied to children in 4-9 years old to reduce dental anxiety.Latar belakang: Kecemasan pada perawatan gigi merupakan hal yang paling sering dijumpai dan merupakan masalah yang dihadapi oleh dokter gigi sampai saat ini, terutama pada pasien anak. Berbagai metode penatalaksanaan kecemasan banyak tersedia, namun tidak satu pun metode yang dapat diterapkan secara luas. Tujuan: Makalah ini disusun untuk membahas mengenai aplikasi teori belajar sosial dalam mencegah kecemasan pada anak saat perawatan gigi. Tinjauan pustaka: Rasa cemas dan takut merupakan perasaan psikis yang dialami seorang individu. Perasaan ini pada seorang anak lebih banyak didapat dari proses belajar dalam menyerap informasi berdasarkan pengalaman pribadi ataupun informasi dari lingkungan sekitar. Bila rasa cemas dan takut dapat dipelajari oleh seorang anak, maka diasumsikan bahwa menghindari timbulnya perasaan ini dapat pula diajarkan pada anak. Aplikasi hal tersebut sebenarnya telah diterapkan di bidang
Steenen, Serge A.; van Wijk, Arjen J.; van Westrhenen, Roos; de Lange, Jan; de Jongh, Ad
Undergoing an extraction has been shown to pose a significantly increased risk for the development of chronic apprehension for dental surgical procedures, disproportionate forms of dental anxiety (that is, dental phobia), and symptoms of post-traumatic stress. Evidence suggests that intrusive
S.A. Steenen (Serge A.); A.J. van Wijk (Arjen); R. van Westrhenen (Roos); J. de Lange (Jan); A. de Jongh (Ad)
textabstractBackground: Undergoing an extraction has been shown to pose a significantly increased risk for the development of chronic apprehension for dental surgical procedures, disproportionate forms of dental anxiety (that is, dental phobia), and symptoms of post-traumatic stress. Evidence
Yang, S E; Park, Y G; Han, K; Min, J A; Kim, S Y
The purpose of this study was to evaluate the relationships between the prevalence of depression and dental pain using a well characterised, nationally representative, population-based study. This study analysed data from the 2012 Korea National Health and Nutrition Examination Survey (n = 4886). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Depression was defined as the participant having been diagnosed as depression during the previous year. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI), controlling for a range of covariates. Results demonstrated that participants included in 'root canal treatment is necessary' showed higher prevalence of self-reported dental pain; in particular, participants with depression presented more dental pain than those without depression. After adjusting for sociodemographic factors, self-reported dental pain increased in participants with depression. The AOR (95% CI) for having self-reported dental pain was 1·58 (1·08-2·33) in dentists' diagnosis of no dental pain/depression group, 1·62 (1·32-1·98) in dentists' diagnosis of dental pain/no depression group and 2·84 (1·10-7·37) in dentists' diagnosis of dental pain/depression group. It was concluded that depression was associated with dental pain after adjustment for potential confounders in Korean adults. Thus, dentists should consider the possible presence of psychopathology when treating patients with dental pain. © 2015 John Wiley & Sons Ltd.
Studies of hunter-gatherer oral pathology, particularly in Australia, often focus upon dental wear and caries or assume that historic studies of Aboriginal people reflect the precontact past. Consequently the range of population variation has been underestimated. In this paper dental pathology from human remains from Roonka are compared with a model of dental pathology derived from historic studies. The aim is to identify aspects of dental pathology indicative of regional or intra-population diversity. Adult dentitions (n = 115) dating from the mid to late Holocene were recorded for the following conditions: dental wear, caries, periapical voids, calculus, periodontal disease and antemortem tooth loss. Statistical analysis was used to identify patterns of dental pathology and to identify causal relationships between conditions. Dental wear is marked while dental caries rates are extremely low. Other indications of dental pathology are uncommon (<7% of teeth affected). Temporal heterogeneity is apparent: there are 3 young adults with caries who died in the postcontact period. There is also a small group of middle age to old adults with disproportionate abscessing and pulp exposure who may represent temporal variation or heterogeneity in individual frailty. The results confirm dental wear as the major cause of dental pathology in this group and that, at a general level, historic accounts do correspond with this archeological sample. However, intra-sample heterogeneity is apparent while 2 dental conditions, calculus and periodontal disease, along with the pattern of sex differences deviate from expectation, demonstrating that to identify regional variation attention needs to be paid to the dentoalveolar complex as a whole. © 2017 Wiley Periodicals, Inc.
Gujjar, Kumar Raghav; van Wijk, Arjen; Sharma, Ratika; de Jongh, Ad
Virtual reality exposure therapy (VRET) has been used to treat a variety of fears and phobias. To determine the feasibility (i.e. safety and efficacy) of using VRET to treat dental phobia. Safety was evaluated by determining any adverse events or symptom exacerbation. Efficacy of VRET was evaluated by comparing the reduction in dental anxiety scores (measured 16 times within a 14-week study period, and at 6-month follow-up), and its behavioural effects with that of an informational pamphlet (IP) on ten randomized patients with dental phobia using a controlled multiple baseline design. Participants' heart rate response during VRET, and their experience post-VRET, were indexed. No personal adverse events or symptom exacerbation occurred. Visual analysis and post-hoc intention-to-treat analysis showed a significantly greater decrease in dental anxiety scores [higher PND (percentage of non-overlap data) scores of 100% and lower POD (percentage of overlap data) of 0%, Modified Dental Anxiety Scale, F (1,8) = 8.61, p = 0.019, and Dental Fear Scale, F (1,8) = 10.53, p = 0.012], and behavioural avoidance in the VRET compared with the IP group [d = 4.2 and -1.4, respectively). There was no increase in average heart rate during VRET. Of the nine treatment completers, six (four from the VRET group and two from the IP group) no longer had dental phobia at 6-month follow-up. Four of the five VRET participants, but none of the IP participants, scheduled a dental treatment appointment following the intervention. VRET is a feasible alternative for patients with dental phobia.
Fear of dental injection, cost of treatment, feeling of insecurity when the dentist ... of the individual, disability, transportation, residence/ ... order to reduce mental stress. .... Feel insecure .... and young adults have a greater prevalence of fear.
Ayub Irmadani Anwar
Management of child behavior begins when the children enters the dental environment and continues until they leave it . Fear of dentist and dental treatment have been considered a major hindrance to provide a quality dental services. Establish a friendly relationship with children is important for dentist to combat patient’s fears and to deliver effective and efficient treatment. The aim of this study was to assess children’s feelings and attitudes toward their dentist in Halim...
Moeller, John F.; Chen, Haiyan
Objectives. We examined why older US adults without dental care coverage and use would have lower use rates if offered coverage than do those who currently have coverage. Methods. We used data from the 2008 Health and Retirement Study to estimate a multinomial logistic model to analyze the influence of personal characteristics in the grouping of older US adults into those with and those without dental care coverage and dental care use. Results. Compared with persons with no coverage and no dental care use, users of dental care with coverage were more likely to be younger, female, wealthier, college graduates, married, in excellent or very good health, and not missing all their permanent teeth. Conclusions. Providing dental care coverage to uninsured older US adults without use will not necessarily result in use rates similar to those with prior coverage and use. We have offered a model using modifiable factors that may help policy planners facilitate programs to increase dental care coverage uptake and use. PMID:24328635
Holliday, Erica D; Gould, Thomas J
Adolescent onset of nicotine abuse is correlated with worse chances at successful abstinence in adulthood. One reason for this may be due to enduring learning deficits resulting from nicotine use during adolescence. Previous work has indicated that chronic nicotine administration beginning in late adolescence (PND38) caused learning deficits in contextual fear when tested in adulthood. The purpose of this study was to determine if chronic nicotine treatment during adolescence would alter sensitivity to nicotine's cognitive enhancing properties in adulthood. C57BL/6J mice received saline or chronic nicotine (12.6mg/kg/day) during adolescence (postnatal day 38) or adulthood (postnatal day 54) for a period of 12 days. Following a 30-day protracted abstinence, mice received either an acute injection of saline or nicotine (0.045, 0.18, and 0.36mg/kg) prior to training and testing a mouse model of contextual fear. It was found that chronic nicotine administration in adult mice did not alter sensitivity to acute nicotine following a protracted abstinence. In adolescent mice, chronic nicotine administration disrupted adult learning and decreased sensitivity to acute nicotine in adulthood as only the highest dose tested (0.36mg/kg) was able to enhance contextual fear learning. These results suggest that adolescent nicotine exposure impairs learning in adulthood, which could increase the risk for continued nicotine use in adulthood by requiring administration of higher doses of nicotine to reverse learning impairments caused by adolescent nicotine exposure. Results from this study add to the growing body of literature suggesting chronic nicotine exposure during adolescence leads to impaired learning in adulthood and demonstrates that nicotine exposure during adolescence attenuates the cognitive enhancing effects of acute nicotine in adulthood, which suggests altered cholinergic function. © The Author 2016. Published by Oxford University Press on behalf of the Society for
Syed, S.; Bilal, S.; Dawani, N.; Rizvi, K
Objective: To evaluate the dental anxiety levels and to assess its correlation with self-assessed dental status and treatment needs of patients. Methods: The study was conducted at the Out Patient Department of Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Karachi. Using non-probability quota sampling, the study included the first 32 patients between 18 and 35 years of age, visiting the facility. Over a period of one month (22 working days) 704 patients comprised the study population. They were interviewed using a structured questionnaire to self-assess their dental anxiety levels, oral health status and treatment needs. The data was analysed using SPSS 17.0 with descriptive frequencies and chi-square test. Results: Of the total participants, 650 (92.32%) patients provided consent. Average dental anxiety scale score was 12.46, representing high anxiety score. There were 174 (26.8%) smokers; only 234 (36%) had visited a dentist less than a year ago; 385 (59.2%) considered their dental health to be satisfactory; 306 (47.1%) thought of their treatment needs to be little'; 222 (34.2%) brushed their teeth twice daily. Dental anxiety was statistically significant with treatment needs and dental status. Relation of tooth-brushing with last dental visit and treatment needs was also found to be significant. Conclusion: A high level of dental anxiety was observed among the study population. The dental professionals should seek ways to help dentally anxious individuals. (author)
Quiñones, María M; Maldonado, Lizette; Velazquez, Bethzaly; Porter, James T
Patients with post-traumatic stress disorder (PTSD) tend to show signs of a relatively increased inflammatory state suggesting that activation of the immune system may contribute to the development of PTSD. In the present study, we tested whether activation of the innate immune system can disrupt acquisition or recall of auditory fear extinction using an animal model of PTSD. Male adolescent rats received auditory fear conditioning in context A. The next day, an intraperitoneal injection of lipopolysaccharide (LPS; 100 μg/kg) prior to auditory fear extinction in context B impaired acquisition and recall of extinction. LPS (100 μg/kg) given after extinction training did not impair extinction recall suggesting that LPS did not affect consolidation of extinction. In contrast to cued fear extinction, contextual fear extinction was not affected by prior injection of LPS (100 μg/kg). Although LPS also reduced locomotion, we could dissociate the effects of LPS on extinction and locomotion by using a lower dose of LPS (50 μg/kg) which impaired locomotion without affecting extinction. In addition, 15 h after an injection of 250 μg/kg LPS in adult rats, extinction learning and recall were impaired without affecting locomotion. A sub-chronic treatment with candesartan, an angiotensin II type 1 receptor blocker, prevented the LPS-induced impairment of extinction in adult rats. Our results demonstrate that activation of the innate immune system can disrupt auditory fear extinction in adolescent and adult animals. These findings also provide direction for clinical studies of novel treatments that modulate the innate immune system for stress-related disorders like PTSD. Copyright © 2015 Elsevier Inc. All rights reserved.
Farag, Zahra Hassan Abdelaziz; Awooda, Elhadi Mohieldin
Asthma is a chronic inflammatory condition affecting the airways leading to spasm and swelling of the airways. The medications taken for the treatment of asthma can result in dental erosion and dentin hypersensitivity. The aims of this study were to investigate the severity of dental erosion amongst adult asthmatics according to: gender, type and duration of medication taken and to compare dental erosion and dentin hypersensitivity between asthmatics and non-asthmatics. Comparative, cross-sectional hospital based study among 40 asthmatics (M=15 & F=25) and 40 non-asthmatics (M=18 & F=22) in the age range of 18-60 year selected purposefully from Al-Shaab Teaching Hospital in Khartoum city. The Basic Erosive Wear Index was used for dental erosion assessment. Dentine hypersensitivity was determined by giving ice cold water and rated using the Visual Analogue Scale. Chi-square and Student's t-test were used for statistical analysis with P value ≤.05. There was an association between severity of dental erosion and presence of asthma (P=0.03), where asthmatics had a higher degree of erosion (moderate and severe) and non-asthmatics a lower degree. No significant association was found between dental erosion and gender, type and duration of medication among asthmatics group. A statistically significant difference was revealed in the degree of dentin hypersensitivity (P=0.00) among asthmatics (35.13%) and non-asthmatics (14.13%). Asthmatic patients had a higher degree of dental erosion and dentin hypersensitivity compared to non-asthmatics. Among asthmatic patients there was no association between severity of dental erosion and gender, type and duration medication was taken for.
Gilbert, Paul; McEwan, Kirsten; Catarino, Francisca; Baião, Rita; Palmeira, Lara
In a non-clinical population, fears of compassion and fear of happiness have both been found to be highly correlated with alexithymia and depression. This study sought to explore these processes and their links with adult attachment and social safeness and pleasure in a depressed group. A total of 52 participants suffering from moderate to severe depression completed measures of fears of happiness, compassion from others and for self, in addition to measures of alexithymia, attachment, social safeness, and depression, anxiety, and stress. Fears of compassion and happiness were highly correlated with alexithymia, adult attachment, and depression, anxiety, and stress. Fear of happiness was found to be the best predictor of depression, anxiety, and stress, whereas fear of compassion from others was the best predictor of adult attachment. A path analysis showed that fears of positive emotion fully mediate the link between alexithymia and depression. This clinical sample had higher mean scores in fears of positive emotions, alexithymia, and depression, anxiety, and stress than a previously studied student sample. This study adds to the evidence that fears of positive emotions are important features of mental health difficulties. Unaddressed, these fears can block positive emotions and may lead to emotional avoidance of positive affect thus contributing as blocks to successful therapy. Therapies for depression may therefore profitably assess and desensitize the fear of positive emotions. © 2013 The British Psychological Society.
Haeri-Araghi, Hesam; Safarzadeh-Khosroshahi, Shadab; Mirzadeh, Monirsadat
Background Dental caries are the most common mouth infectious disease and also chronic disease of childhood. Saliva plays different roles in oral cavity; for example, salivary immunoglobulins play significant role in body and oral immunity. Various studies were conducted on the different effects of IgA on oral cavity, especially dental caries, and reported controversial results. The current study aimed to compare salivary IgA level at different stages of dental caries in adults. Material and Methods A total of 40 adults, aged 20 to 40 years, referred to the department of oral medicine at Qazvin Faculty of Dentistry, were selected voluntarily based on the number of decayed teeth. Their unstimulated saliva was collected by the spitting method. The cases were assigned to 4 groups each of 10, based on the number of decayed teeth, as follows: Group 1: Caries free, Group 2: With 1 or 2 decayed teeth, Group 3: With 3 or 4 decayed teeth, and Group 4: With 5 or more decayed teeth. None of the cases had systemic diseases or the history of using medicines which affect the quality or quantity of saliva. The salivary IgA level of the cases was measured immunoturbidometrically and analyzed by ANOVA and t test. Results Significant difference was observed between the groups 1 and 4, but there was no significant difference between the other groups. Conclusions According to the results of the current study, the salivary IgA can be considered as an index for the function of immune system, which may be increased by the number of decayed teeth. In fact, the increase of salivary IgA is just the response of immune system to the accumulation of microorganisms and may be the attempt of body to control them. Key words:Saliva, IgA, Dental caries. PMID:29670718
Full Text Available INTRODUCTION: Dental students may be a particularly vulnerable group exposed to the risk of acquiring infections through occupational injuries.OBJECTIVE: To investigate the perceptions with regard to their occupational exposure to potentially infectious biologic materials.MATERIAL AND METHOD: Interviews were conducted by means of a script with open questions. The speeches were recorded, transcribed and qualitative analysis was performed with the aid of QUALIQUANTISOFT® software. The Collective Subject Discourse (CSD was obtained.RESULT: The feeling most frequently experienced was related to the fear of contagion. Most accidents occurred during the handling of sharp dental instruments. Respondents attributed the occurrence of accidents especially the lack of attention, carelessness while handling sharp instruments, and lack of use of Personal Protective Equipment. As regards the measures taken right after the exposure, they "washed the local area". Other respondents reported they "continued the dental treatment". They complained mostly about the fear of having been infected, and because they had to leave the faculty to take blood exams for HIV screening. As part of the learning experience the injured reported they paid more attention when handling sharp instruments. The students informed that any type of injury due to contact with contaminated material must be notified. However, they were neglectful about reporting their own injury.CONCLUSION: Education strategies for preventive measures related to occupational exposure must be restructured, because the knowledge and the fear of contagion among dental students were not always sufficient for a complete adherence to treatment protocols and notification.
Cameron L. Randall
Full Text Available Background. Acute and chronic orofacial pain can significantly impact overall health and functioning. Associations between fear of pain and the experience of orofacial pain are well-documented, and environmental, behavioral, and cognitive components of fear of pain have been elucidated. Little is known, however, regarding the specific genes contributing to fear of pain. Methods. A genome-wide association study (GWAS; N=990 was performed to identify plausible genes that may predispose individuals to various levels of fear of pain. The total score and three subscales (fear of minor, severe, and medical/dental pain of the Fear of Pain Questionnaire-9 (FPQ-9 were modeled in a variance components modeling framework to test for genetic association with 8.5 M genetic variants across the genome, while adjusting for sex, age, education, and income. Results. Three genetic loci were significantly associated with fear of minor pain (8q24.13, 8p21.2, and 6q26; p<5×10-8 for all near the genes TMEM65, NEFM, NEFL, AGPAT4, and PARK2. Other suggestive loci were found for the fear of pain total score and each of the FPQ-9 subscales. Conclusions. Multiple genes were identified as possible candidates contributing to fear of pain. The findings may have implications for understanding and treating chronic orofacial pain.
Weinstein, P; Raadal, M; Naidu, S; Yoshida, T; Kvale, G; Milgrom, P
While the psychological literature shows that perceptions of uncontrollability contribute to anxiety and other pathologies, interventions that enhance perceived control have been shown to reduce anxiety. This study attempted to assess a brief videotape to enhance child perceived control in a dental setting. 101 children aged 7-9 years completed warm-up procedures and viewed either: a) the experimental intervention, a 2 minutes video of a dentist explaining what an injection will feel like and proposing hand raising as a signal mechanism; or b) the control condition, a 2 minutes video of Disneyland. Fear of dental injections was assessed on a 10 cm visual analogue scale before and after the intervention. In the experimental group there was a significant fear reduction from pre- to post-intervention, while this was not the case in the control group. Children with higher pre-existing levels of fear benefited more from the intervention than children with lower levels of fear. The results of this pilot study suggest that intervention packages that impact child control have promise in lowering anxiety.
Guiney, H; Woods, N; Whelton, H; Morgan, K
The objective of this study was to identify the predictors of utilisation of dental care services in Ireland. The 2007 Irish Survey of Lifestyle, Attitudes and Nutrition is a cross-sectional study, conducted in 2006/2007 (n = 10,364), by interviews at home to a representative sample of adults aged 18 years or over. Multivariate logistic regression was used to investigate the influence of socioeconomic, predisposing and enabling factors on the odds of males and females having a dental visit in the past year. The significant predictors of visiting the dentist in the past year were for males: having 3rd level education, employment status, earning 50,000 euros or more, location of residence, use of a car, brushing frequently, and dentition status. For females, the predictors were being between 25-34 or 55-64 years-old, education level, earning 50,000 euros or more, location of residence, use of a car, brushing frequently and dentition status. Predictors of the use of dental services vary by gender. Predictors common to both genders were education level, higher income, location of residence, use of a car, brushing frequently and dentition status. Many of the predictors of dental visiting in the past year are also related to social inequalities in health. These predictors may be useful markers of impact for policies designed to address inequalities in access to oral health services.
Bradt, J; Teague, A
Anxiety is a significant issue in the dental care of adults and children. Dental anxiety often leads to avoidance of dental care which may result in significant deterioration of oral and dental health. Non-pharmacological anxiety management interventions such as music listening are increasingly used in dental care. Although efficacy for music's anxiolytic effects has been established for pre-operative anxiety, findings regarding the use of music listening for dental anxiety are inconclusive, especially for children. The use of music for passive distraction may not be adequate for children and highly anxious adults. Instead, interventions offered by a trained music therapist may be needed to optimize music's anxiolytic impact. Music therapy interventions are individualized to the patient's presenting needs and geared at enhancing patients' active engagement in the management of their anxiety. Interventions may include (i) active refocusing of attention, (ii) music-guided deep breathing, (iii) music-assisted relaxation, and (iv) music-guided imagery. In addition, music therapists can teach patients music-based anxiety management skills prior to dental treatments, offer them the opportunity to express emotions related to the upcoming procedure, and help them gain a sense of control and safety. Clinical guidelines for the use of music listening by dental practitioners are offered. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Michalska, Kalina J; Machlin, Laura; Moroney, Elizabeth; Lowet, Daniel S; Hettema, John M; Roberson-Nay, Roxann; Averbeck, Bruno B; Brotman, Melissa A; Nelson, Eric E; Leibenluft, Ellen; Pine, Daniel S
The eye region of the face is particularly relevant for decoding threat-related signals, such as fear. However, it is unclear if gaze patterns to the eyes can be influenced by fear learning. Previous studies examining gaze patterns in adults find an association between anxiety and eye gaze avoidance, although no studies to date examine how associations between anxiety symptoms and eye-viewing patterns manifest in children. The current study examined the effects of learning and trait anxiety on eye gaze using a face-based fear conditioning task developed for use in children. Participants were 82 youth from a general population sample of twins (aged 9-13 years), exhibiting a range of anxiety symptoms. Participants underwent a fear conditioning paradigm where the conditioned stimuli (CS+) were two neutral faces, one of which was randomly selected to be paired with an aversive scream. Eye tracking, physiological, and subjective data were acquired. Children and parents reported their child's anxiety using the Screen for Child Anxiety Related Emotional Disorders. Conditioning influenced eye gaze patterns in that children looked longer and more frequently to the eye region of the CS+ than CS- face; this effect was present only during fear acquisition, not at baseline or extinction. Furthermore, consistent with past work in adults, anxiety symptoms were associated with eye gaze avoidance. Finally, gaze duration to the eye region mediated the effect of anxious traits on self-reported fear during acquisition. Anxiety symptoms in children relate to face-viewing strategies deployed in the context of a fear learning experiment. This relationship may inform attempts to understand the relationship between pediatric anxiety symptoms and learning. © 2017 Association for Child and Adolescent Mental Health.
Capurro, Diego Alberto; Davidsen, Michael
BACKGROUND: The goal of this analysis was to describe socioeconomic inequalities in dental health among Spanish middle-aged adults, and the role of behavioral and psychosocial factors in explaining these inequalities. METHODS: This cross-sectional study used survey data from the 2006 Spanish Nati...
Chou, Kee-Lee; Chi, Iris
The objective of the current study is to investigate the link between depression and fear of falling in Hong Kong Chinese older adults in primary are settings. Using longitudinal data collected on 321 Chinese primary care patients 65 years of age and older, the authors investigated the reciprocal relationship between fear of falling and depression and examined whether functional disability and social functioning mediated the link between fear of falling and depression. Participants were recruited from three primary care units in Hong Kong. Subjects were assessed in Cantonese by two trained assessors with Minimum Data Set-Home Care twice over a period of one year. Findings revealed that fear of falling at baseline significantly predicted depression at 12 month follow-up assessment after age, gender, marital status, education and depression at baseline were adjusted, but depression at baseline did not predict fear of falling at 12 months after fear of falling at baseline was adjusted. Moreover, social functioning mediated the impact of fear of falling on depression. The findings presented here indicate that fear of falling potentially increases the risk of depression in Chinese older adults in primary care settings.
Waldman, H. Barry; Perlman, Steven P.; Cinotti, Debra A.
Repeated studies of graduating dental students indicate limited preparation to provide services for individuals with special healthcare needs. By the end of the 1990s and into the present decade, more than half of the U.S. dental schools provided less than five hours of class room presentations and about three quarters of the schools provided 0-5…
Kleinhauz, M; Eli, I
A common cause of stress among dental patients is the patient's fear of losing control in face of the "helplessness provoking" dental situation. Although hypno-relaxation and hypnosis serve as efficient tools to aid in the administration of dental treatment to such patients, some of them may view hypnosis as a further relinquishing of control to the hypnotist and thus resist hypnotic induction, despite their willingness to try to use hypnosis for therapeutic reasons. To avoid this resistance, a "self-control" induction method is suggested that enables the patient to remain in control throughout the process. This technique minimizes the threat of losing one's autonomy and thus enables treatment of these patients.
in society with caries risk due to age- and medication-induced salivary reduction. However, a general disease may not always have a negative influence on dental health. Therefore, a regular individual caries risk assessment is of utmost importance for clinical decision-making and tailoring of recall......Caries is a biofilm-mediated noncommunicable disease fueled by dietary sugar, neglected oral hygiene, and reduced saliva flow. General diseases may influence the oral environment through its pathogenesis, medication, and/or the caring of the condition. Associations between caries and chronic...... diseases are mainly derived from case–control studies with various sample sizes and quality of matching. Few observational studies are available and the majority of all research is conducted in childhood and among older adults. There is an increased caries risk for subjects with obesity, severe asthma...
Dattilo, John; Martire, Lynn; Gottschall, Jinger; Weybright, Elizabeth
There is a need to provide interventions that are of interest to older adults who are not inclined to participate in conventional exercise programs and that can improve balance and fear of falling. One purpose of this pilot study was to assess feasibility and acceptability of an eight-week (3x/wk, 90-minute sessions) multifaceted, small group,…
Grytten, Jostein; Holst, Dorthe; Skau, Irene
The aim of this study was to describe the effect of income on demand and utilization of dental services according to household income in the adult population. The data were collected using a questionnaire, which was sent to a random sample of Norwegians aged 20 years or older living at home, 1861 persons in total. Demand was measured according to whether the person had been to the dentist during the last year. Utilization was measured as expenditure for dental treatment for those who had been to the dentist during the last year. The independent variables were the respondents' household income, age, gender, education, dental status and the mean fee for a dental consultation in the municipality. In the first stage, we carried out a logistic regression analysis of the log odds of having demanded dental services during the last year. In the second stage, we carried out a multiple regression analysis of expenditure for dental treatment for those who had been to the dentist during the last year. Altogether, 80% of the respondents had been to the dentist during the last year. Demand during the last year varied most according to dental status. There was little difference between men and women. The results of the logistic regression showed that the probability of having been to the dentist was 0.82 for those with a household income of €25 000 and 0.85 for those with a household income of €100 000. Mean expenditure for dental treatment was €355. There was no statistically significant relationship between household income and expenditure for dental treatment. Differences in demand for dental services according to household income are small, and there are no differences in utilization according to income. The findings are interesting, because in a population in which people have to pay almost all the costs for dental treatment themselves, one would expect the income differences in demand and utilization to be greater. © 2012 John Wiley & Sons A/S.
Yehia El Batawi, Hisham
ABSTRACT Hemophilia, among other bleeding disorders, raises concerns for dental service providers who routinely use sharp hand and rotary instruments, address highly vascular soft tissue and provide dental extractions. In pediatric dentistry, dealing with fearful or irritable children increases the possibility of trauma and subsequent bleeding risks in hemophilic pediatric dental patients. In the current report, we discuss how anesthetic, pediatric and dental management may contribute to the ...
Xiao, Li; Ide, Ryoji; Saiki, Chikako; Kumazawa, Yasuo; Okamura, Hisashi
The adult mammalian central nerve system has fundamental difficulties regarding effective neuroregeneration. The aim of this study is to investigate whether human dental pulp cells (DPCs) can promote neuroregeneration by (i) being differentiated toward neuronal cells and/or (ii) stimulating local neurogenesis in the adult hippocampus. Using immunostaining, we demonstrated that adult human dental pulp contains multipotent DPCs, including STRO-1, CD146 and P75-positive stem cells. DPC-formed spheroids were able to differentiate into neuronal, vascular, osteogenic and cartilaginous lineages under osteogenic induction. However, under neuronal inductive conditions, cells in the DPC-formed spheroids differentiated toward neuronal rather than other lineages. Electrophysiological study showed that these cells consistently exhibit the capacity to produce action potentials, suggesting that they have a functional feature in neuronal cells. We further co-cultivated DPCs with adult mouse hippocampal slices on matrigel in vitro. Immunostaining and presto blue assay showed that DPCs were able to stimulate the growth of neuronal cells (especially neurons) in both the CA1 zone and the edges of the hippocampal slices. Brain-derived neurotrophic factor (BDNF), was expressed in co-cultivated DPCs. In conclusion, our data demonstrated that DPCs are well-suited to differentiate into the neuronal lineage. They are able to stimulate neurogenesis in the adult mouse hippocampus through neurotrophic support in vitro.
Conyers, Carole; Miltenberger, Raymond G; Peterson, Blake; Gubin, Amber; Jurgens, Mandy; Selders, Andrew; Dickinson, Jessica; Barenz, Rebecca
Fear of dental procedures deters many individuals with mental retardation from accepting dental treatment. This study was conducted to assess the effectiveness of two procedures, in vivo desensitization and video modeling, for increasing compliance with dental procedures in participants with severe or profound mental retardation. Desensitization increased compliance for all 5 participants, whereas video modeling increased compliance for only 1 of 3 participants.
Lindenberger, Brigitt L; Plag, Jens; Schumacher, Sarah; Gaudlitz, Katharina; Bischoff, Sophie; Bobbert, Thomas; Dimeo, Fernando; Petzold, Moritz B; Kirschbaum, Clemens; Dudás, Zsuzsa; Ströhle, Andreas
Physical activity has shown to be effective in anxiety disorders. For specific phobia, no studies are available that systematically examined the effects of an aerobic exercise intervention on phobic fear within a randomized-controlled design. Therefore, we investigated the acute effect of a standardized aerobic training on clinical symptoms of dental phobia as well as on stress-related neurobiological markers. Within a crossover design, 30 patients with dental phobia (mean age: 34.1 years; mean score of the Dental Anxiety Scale: 18.8) underwent two minor dental interventions separated by 7 days. Dental treatment was performed after 30 min of physical activity at either 20% VO 2 max (control) or 70% VO 2 max (intervention), respectively. To control for habituation, patients were randomly assigned to one of the two conditions prior to the first intervention. Moreover, saliva samples were collected at five times in order to determine changes in salivary cortisol (sC) and alpha-amylase (sAA) due to treatment. In comparison to baseline, aerobic exercise within 70% VO 2 max significantly reduced clinical anxiety and sC concentrations before, during, and after the dental treatment. In contrast, the control condition led to decreased sAA levels at different time points of measurement. Habituation occurred at the second study day, independent of the order. Our study provides evidence for an effect of moderate-intense exercise on clinical symptoms and sC in patients with dental phobia. Therefore, acute aerobic exercise might be a simple and low-cost intervention to reduce disorder-specific phobic fear. © 2017 Wiley Periodicals, Inc.
Simons, Laura E; Sieberg, Christine B; Carpino, Elizabeth; Logan, Deirdre; Berde, Charles
An important construct in understanding pain-related disability is pain-related fear. Heightened pain-related fear may result in behavioral avoidance leading to disuse, disability, and depression; whereas confrontation of avoided activities may result in a reduction of fear over time and reengagement with activities of daily living. Although there are several measures to assess pain-related fear among adults with chronic pain, none exist for children and adolescents. The aim of the current study was to develop a new tool to assess avoidance and fear of pain with pediatric chronic pain patients: the Fear of Pain Questionnaire, child report (FOPQ-C), and Fear of Pain Questionnaire, parent proxy report (FOPQ-P). After initial pilot testing, the FOPQ-C and FOPQ-P were administered to 299 youth with chronic pain and their parents at an initial multidisciplinary pain treatment evaluation. The FOPQ demonstrated very strong internal consistency of .92 for the child and parent versions. One-month stability estimates were acceptable and suggested responsivity to change. For construct validity, the FOPQ correlated with generalized anxiety, pain catastrophizing, and somatization. Evidence of criterion-related validity was found with significant associations for the FOPQ with pain, healthcare utilization, and functional disability. These results support the FOPQ as a psychometrically sound measure. Pain-related fear plays an important role in relation to emotional distress and pain-related disability among children and adolescents with chronic pain. Identification of patients with high levels of fear avoidance of pain with the FOPQ will inform how to proceed with psychological and physical therapy interventions for chronic pain. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
Tjørnelund, Karen B; Jonsson, Lena M; Kortegaard, Hanne; Arnbjerg, Jens; Nielsen, Søren S; Bertelsen, Mads F
Dental ailments, mandibular swelling, and dentoalveolar abscesses are common in tapirs, but knowledge about prevalence or etiology of these lesions in the Tapiridae family in general, and in lowland tapirs (Tapirus terrestris) in particular, is scarce. A recent study identified resorptive lesions of unknown etiology as a common problem in the Malayan tapir (Tapirus indicus). In order to investigate the type and prevalence of dental lesions occurring in lowland tapirs, and to compare these with findings with the Malayan tapir, skulls and teeth from 46 deceased lowland tapirs were visually and radiographically examined. The specimens were divided into subpopulations according to age (juveniles, young adults, adults) and origin (free-range or captive). Dental lesions were identified in 24% (11/46) of the study population. The most common pathologic findings were complicated dental fractures with associated periapical reaction (15%) and periapical reactions of various degrees without associated detectable dental pathology (13%). All these lesions likely originated from dental trauma. As in Malayan tapirs, juveniles had significantly fewer lesions than adults. This study shows that dental lesions present frequent problems for lowland tapirs, occurring both in captive and in free-ranging individuals, and indicates that increasing age should be considered a risk factor for the development of these lesions. Notably, the predominant dental problems in lowland tapirs and Malayan tapirs are not the same.
Beauvais, Audrey; Beauvais, John E
Falls and the fear of falling are major health concerns among older adults. The purpose of this study was to assess the effects of an evidence-based fall prevention program on the fear of falling and health-related quality of life among community-dwelling elders. The program consisted of 6 classes that covered topics such as risk factors for falls, balance exercises, medications, safe footwear, and home safety. Of those elders who were most fearful at baseline, the fall prevention program decreased their fear of falling and improved 1 dimension of their health-related quality of life.
Kloetzel, Megan K; Huebner, Colleen E; Milgrom, Peter
Oral health is essential to overall health in the prenatal period. Pregnancy is not a time to delay dental care. Several studies have shown an association between periodontal disease and poor pregnancy outcomes including preterm birth. Interventions to provide periodontal treatment to pregnant women yield inconsistent results regarding preterm birth but have established the safety of periodontal therapy during pregnancy. Postpartum women in poor dental health readily transmit the tooth decay pathogen Streptococcus mutans from their saliva to their infants, resulting in increased risk of early childhood caries. Preventive services and treatment for acute problems should be recommended, fears allayed, and women referred. Dental radiographs may be performed safely with the use of appropriate shielding. Nonemergent interventions are best provided between 14 and 20 weeks' gestation for comfort and optimal fetal safety. Most gravid women do not seek dental care. Increased interprofessional communication to encourage dentists to treat pregnant women will reduce the number of women without care. In states where it is available, Medicaid coverage of dental services for pregnant women is typically allowed during pregnancy and for 2 months postpartum. Women's health providers should understand the importance of protecting oral health during pregnancy and educate their patients accordingly. © 2011 by the American College of Nurse-Midwives.
Kim, Cheol-Sin; Han, Sun-Young; Lee, Seung Eun; Kang, Jeong-Hee; Kim, Chul-Woung
Objectives: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. Methods: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). Results: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (pdental care utilization for other reasons in the final model. Conclusions: This study’s findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination. PMID:26265665
Full Text Available One of the most distressing aspects of dentistry for pediatric patients is the fear and anxiety caused by the dental environment, particularly the dental injection. The application and induction of local anesthetics has always been a difficult task, and this demands an alternative method that is convenient and effective. Electronic dental anesthesia, based on the principal of transcutaneous electric nerve stimulation (TENS, promises to be a viable mode of pain control during various pediatric clinical procedures. Therefore, the aim of the present study was to evaluate the effectiveness of TENS and to compare its efficacy with 2% lignocaine during various minor pediatric dental procedures. Pain, comfort and effectiveness of both the anesthetics were evaluated using various scales and no significant difference was observed between 2% lignocaine and TENS in the various pain scales, while TENS was perceived to be significantly effective in comfort and efficacy as judged by the operator and quite comfortable as judged by the patient himself/herself.
Full Text Available Abstract Background Dental general anaesthesia (DGA is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age ( Results The DGA patients (n=349 were aged 2.3 to 67.2 years. Immigrants predominated in the youngest age group (p Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA.
Full Text Available The amygdala is a critical brain region for auditory fear conditioning, which is a stressful condition for experimental rats. Adult neurogenesis in the dentate gyrus (DG of the hippocampus, known to be sensitive to behavioral stress and treatment of the antidepressant fluoxetine (FLX, is involved in the formation of hippocampus-dependent memories. Here, we investigated whether neurogenesis also occurs in the amygdala and contributes to auditory fear memory. In rats showing persistent auditory fear memory following fear conditioning, we found that the survival of new-born cells and the number of new-born cells that differentiated into mature neurons labeled by BrdU and NeuN decreased in the amygdala, but the number of cells that developed into astrocytes labeled by BrdU and GFAP increased. Chronic pretreatment with FLX partially rescued the reduction in neurogenesis in the amygdala and slightly suppressed the maintenance of the long-lasting auditory fear memory 30 days after the fear conditioning. The present results suggest that adult neurogenesis in the amygdala is sensitive to antidepressant treatment and may weaken long-lasting auditory fear memory.
Joganic, Jessica L
Non-human primate growth trajectories are often used to estimate the age and life history traits of fossil taxa. The exclusive use of chimpanzee growth patterns to estimate developmental stages for the earliest hominins is problematic because incomplete lineage sorting in the hominoid clade has produced a mosaic human genome that contains different regions shared with any one of the great apes. The accidental death of a sub-adult male western lowland gorilla (Gorilla gorilla gorilla) provides not only an opportunity to compare the degree of dentoskeletal maturation in this individual with published data from conspecifics, but also insight into gorilla growth and development as it applies to modeling that of early hominins. Dental stage was assessed for a sub-adult male western lowland gorilla by comparing dental eruption and calcification to established relative age categories. Ectocranial suture fusion, epiphyseal union, and long bone dimensions were compared to growth standards for wild male gorillas of a similar dental stage to determine developmental timing variability. Results suggest that greater variability exists in developmental rates and patterns and in morphological parameters than is often acknowledged. These results have implications for selecting appropriate models for studying extinct taxa. Ecological and physical characteristics shared between humans and gorillas may make gorilla life history equally valid in a comparative framework and encourage non-exclusive use of chimpanzee life history for paleoanthropological models. © 2015 Wiley Periodicals, Inc.
Oh, Eunmi; Hong, Gwi-Ryung Son; Lee, Seonhye; Han, Soojeong
To explore the prevalence and predicting factors of fear of falling (FOF) among community-living older adults in Korea. Secondary data analysis of the 2011 Korean National Elderly Living Conditions and Welfare Desire Survey was used. Logistic regression analysis was conducted to examine the predictors of FOF. In total, 75.6% of older adults with normal cognition have FOF. Factors associated with an increased risk of FOF in older adults are previous experience with falling (OR = 3.734, 95% CI = 2.996-4.655), limitations in the performance of exercise involving lower extremities (OR = 2.428, 95% CI = 2.063-2.858), being female (OR = 2.335, 95% CI = 2.023-2.694), having more than three chronic diseases (OR = 1.994, 95% CI = 1.625-2.446), limitations in instrumental activities of daily living (IADLs) (OR = 1.745, 95% CI = 1.230-2.477), limitations in the performance of exercise involving upper extremities (OR = 1.646, 95% CI = 1.357-1.997), living without a spouse (OR = 1.626, 95% CI = 1.357-1.948), having poor self-rated health (OR = 1.571, 95% CI = 1.356-1.821), limitations in muscle strength (OR = 1.455, 95% CI = 1.150-1.841), age (≥75 years) (OR = 1.320, 95% CI = 1.150-1.516), lower levels of education (0-6 years) (OR = 1.231, 95% CI = 1.075-1.409), and life satisfaction (OR = 1.104, 95% CI = 1.065-1.114). A multidimensional construct of general characteristics, physical, and psychosocial variables act as risk factors for FOF. Preventive intervention should be developed to decrease the FOF among Korean older adults.
Lee, Seonhye; Oh, Eunmi; Hong, Gwi-Ryung Son
Background : Although fear of falling (FOF) has been studied since FOF has negative consequences for the elderly, there is limited information about the risk factors of FOF, including the environment. The purpose of this study was to describe individual and environmental factors of FOF between those with and without a fall history from an ecological aspect and to examine whether individual and environmental factors differently affect the FOF according to the state of fall history in community-dwelling older adults in Korea. Methods : Data from the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults were used. Participants were 7730 older adults. Hierarchical logistic regression analysis was conducted to examine the predictors of FOF. Results : According to the ecological model, female and discomfort with the neighborhood environment were significantly associated with greater odds of reporting FOF in both older adults with fall history and those without. A significant interaction was not observed between any variable of FOF in participants with and without a fall history. Conclusions : An ecological model including individual and environmental factors should be considered when conducting research and designing programs and decision policies related to FOF for older adults with and without a history of falling.
Hänsel Petersson, Gunnel; Ericson, Ewa; Isberg, Per-Erik
Abstract Objectives. To investigate the caries risk profiles in young adults and to compare the risk classification using the Public Dental Service (PDS) guidelines with a risk assessment program, the Cariogram. Materials and methods. All 19-year-old patients registered at eight public dental...... clinics were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects representing 10% of all 19 year-olds attending dental care at the PDS in Skåne, Sweden. A risk classification of each patient was made by the patient's regular team according...... to the PDS guidelines. A research team collected whole saliva samples and information from a questionnaire and a structured interview in order to calculate risk according to the Cariogram model. Results. The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk...
Kim, Eun Kyung; Han, Won Jeong; Choi, Jin Woo; Jung, Yun Hoa; Yoon, Suk Ja; Lee, Jae Seo
The objectives of this study were to survey the radiographic exposure parameters, to measure the patient doses for intraoral dental radiography nationwide, and thus to establish the diagnostic reference levels (DRLs) in intraoral dental X-ray examination in Korea. One hundred two intraoral dental radiographic machines from all regions of South Korea were selected for this study. Radiographic exposure parameters, size of hospital, type of image receptor system, installation duration of machine, and type of dental X-ray machine were documented. Patient entrance doses (PED) and dose-area products (DAP) were measured three times at the end of the exit cone of the X-ray unit with a DAP meter (DIAMENTOR M4-KDK, PTW, Freiburg, Germany) for adult mandibular molar intraoral dental radiography, and corrections were made for room temperature and pressure. Measured PED and DAP were averaged and compared according to the size of hospital, type of image receptor system, installation duration, and type of dental X-ray machine. The mean exposure parameters were 62.6 kVp, 7.9 mA, and 0.5 second for adult mandibular molar intraoral dental radiography. The mean patient dose was 2.11 mGy (PED) and 59.4 mGycm2 (DAP) and the third quartile one 3.07 mGy (PED) and 87.4 mGycm 2 (DAP). Doses at university dental hospitals were lower than those at dental clinics (p 2 (DAP) as the DRLs in adult mandibular molar intraoral dental radiography in Korea.
Full Text Available Objective: Proper positioning of the child patient, can not only have positive ramifications for the operator′s posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. Study Design: The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Results: Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. Conclusion: During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.
Chanpong, B; Haas, D A; Locker, D
The aim of this study was to assess the need and demand for sedation or general anesthesia (GA) for dentistry in the Canadian adult population. A national telephone survey of 1101 Canadians found that 9.8% were somewhat afraid of dental treatment, with another 5.5% having a high level of fear. Fear or anxiety was the reason why 7.6% had ever missed, cancelled, or avoided a dental appointment. Of those with high fear, 49.2% had avoided a dental appointment at some point because of fear or anxiety as opposed to only 5.2% from the no or low fear group. Regarding demand, 12.4% were definitely interested in sedation or GA for their dentistry and 42.3% were interested depending on cost. Of those with high fear, 31.1% were definitely interested, with 54.1% interested depending on cost. In a hypothetical situation where endodontics was required because of a severe toothache, 12.7% reported high fear. This decreased to 5.4% if sedation or GA were available. For this procedure, 20.4% were definitely interested in sedation or GA, and another 46.1% were interested depending on cost. The prevalence of, and preference for, sedation or GA was assessed for specific dental procedures. The proportion of the population with a preference for sedation or GA was 7.2% for cleaning, 18% for fillings or crowns, 54.7% for endodontics, 68.2% for periodontal surgery, and 46.5% for extraction. For each procedure, the proportion expressing a preference for sedation or GA was significantly greater than the proportion having received treatment with sedation or GA (P sedation and GA in the Canadian adult population.
Tumolo, Jessica M; Kutlu, Munir Gunes; Gould, Thomas J
Post-traumatic stress disorder (PTSD) is a devastating disorder with symptoms such as flashbacks, hyperarousal, and avoidance of reminders of the traumatic event. Exposure therapy, which attempts to extinguish fear responses, is a commonly used treatment for PTSD but relapse following successful exposure therapy is a frequent problem. In rodents, spontaneous recovery (SR), where extinguished fear responses resurface following extinction treatment, is used as a model of fear relapse. Previous studies from our lab showed that chronic nicotine impaired fear extinction and acute nicotine enhanced SR of contextual fear in adult male mice. In addition, we showed that acute nicotine's effects were specific to SR as acute nicotine did not affect recall of contextual fear conditioning in the absence of extinction. However, effects of chronic nicotine administration on SR are not known. Therefore, in the present study, we investigated if chronic nicotine administration altered SR or recall of contextual fear in adult male and female C57BL/6J mice. Our results showed that chronic nicotine significantly enhanced SR in female mice and significantly decreased SR in males. Chronic nicotine had no effect on recall of contextual fear in males or females. Female sham mice also had significantly less baseline SR than male sham mice. Overall, these results demonstrate sex differences in SR of fear memories and that chronic nicotine modulates these effects on SR but nicotine does not alter recall of contextual fear. Copyright © 2018 Elsevier B.V. All rights reserved.
Shaeesta, Khaleelahmed Bhavikatti; Prabhuji, M Lv; Shruthi, J R
During the sacred month of Ramadan, Muslims abstain from the consumption of food from dawn until dusk. Extended fasting hours produce changes in the body's metabolism during this period. A majority of the population who fast also restrict themselves from undergoing dental treatments due to a fear of breaking the fast. Even among health professionals, a certain amount of uncertainty prevails about the implications of treating a patient who is fasting. To help clinicians carry out safe and effective treatment without hampering a patient's religious beliefs, the present article focuses on the effect of Ramadan fasting on the body's metabolism and the ramifications for treatment aspects, including medications and dental procedures.
Bernabé, Eduardo; Humphris, Gerry; Freeman, Ruth
To evaluate the contribution of dental anxiety to social gradients in different oral health outcomes and whether social gradients in oral health persist once dental anxiety is removed from the population examined. Data from 9035 British adults were analysed. Participants' socioeconomic position (SEP) was measured through education and household income. Dental anxiety was measured with the Modified Dental Anxiety Scale. Poor subjective oral health, oral impacts on quality of life and edentulism among all adults and the number of teeth, the number of decayed, missing and filled surfaces (DMFS) and sextants with pocketing among dentate adults were the oral health outcomes. The contribution of dental anxiety to absolute and relative social inequalities in each oral health outcome (measured with the Slope and Relative Index of Inequality [SII and RII], respectively) was estimated from regression models without and with adjustment for dental anxiety and quantified with the percentage attenuation. Interactions between each SEP indicator and dental anxiety were used to test what would happen if dental anxiety were removed from the whole population. The largest contribution of dental anxiety to explaining oral health inequalities was found for education gradients in perceived outcomes (11%-13%), but dental anxiety explained social gradients in edentulism. Among dentate adults, dental anxiety accounted for anxiety-free adults but were significant at higher levels of dental anxiety. Little support was found for the role of dental anxiety in explaining social inequalities in various perceived and clinical oral health measures. Oral health inequalities were found among both nondentally anxious and anxious participants. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Nicholson, Janice I.; Pearson, Quinn M.
Many children are dealing with adult fears, such as death, crime, and war at early ages. School counselors can help children cope with these fears using stories from children's literature. The role that children's literature can play in teaching these coping skills is discussed along with strategies for choosing books. (Contains 33 references.)…
Kabitzke, Patricia A.; Wiedenmayer, Christoph P.
Predator odors have been found to induce unconditioned fear in adult animals and provide the opportunity to study the mechanisms underlying unlearned and learned fear. Predator threats change across an animal’s lifetime, as do abilities that enable the animal to learn or engage in different defensive behaviors. Thus, the objective of this study was to determine the combination of factors that successfully induce unlearned fear to predator odor across development. Infant, juvenile, adolescent,...
Stubbs, Brendon; Patchay, Sandhi; Soundy, Andy; Schofield, Pat
Physical inactivity and sedentary behavior (SB) are leading causes of mortality. We investigated if older adults with chronic musculoskeletal pain (CMP) are more sedentary than a group of similar age and sex without CMP and possible contributory factors to this. In this multisite observational study, 285 community-dwelling older adults (response rate 71%) took part. One hundred forty-four had CMP (78.4 years, 65.9% female), and 141 formed the comparison group without CMP. Details regarding falls were collected, and all participants completed the brief pain inventory (BPI), modified version of the survey of activities and fear of falling in elderly scale (mSAFFE), and the International Physical Activity Questionnaire (IPAQ) to measure SB. Data were analyzed with hierarchical regression analysis. Older adults with CMP spent approximately 3 1/2 hours a day more being sedentary than the comparison group (11.5 hours vs 7.9, Psedentary than those of a similar sex and age without CMP. It appears that the avoidance of activities due to fear of falling is a significant contributory factor to SB in older adults with CMP. Wiley Periodicals, Inc.
Full Text Available Because existing instruments for assessing surgical fear seem either too general or too limited, the Surgical Fear Questionnaire (SFQ was developed. The aim of this study is to assess the validity and reliability of the SFQ.Based on existing literature and expert consultation the ten-item SFQ was composed. Data on the SFQ were obtained from 5 prospective studies (N = 3233 in inpatient or day surgery patients. These data were used for exploratory factor analysis (EFA, confirmatory factor analysis (CFA, reliability analysis and validity analysis.EFA in Study 1 and 2 revealed a two-factor structure with one factor associated with fear of the short-term consequences of surgery (SFQ-s, item 1-4 and the other factor with fear of the long-term consequences of surgery (SFQ-l, item 5-10. However, in both studies two items of the SFQ-l had low factor loadings. Therefore in Study 3 and 4 the 2-factor structure was tested and confirmed by CFA in an eight-item version of the SFQ. Across all studies significant correlations of the SFQ with pain catastrophizing, state anxiety, and preoperative pain intensity indicated good convergent validity. Internal consistency (Cronbach's alpha was between 0.765-0.920 (SFQ-total, 0.766-0.877 (SFQ-s, and 0.628-0.899 (SFQ-l. The SFQ proved to be sensitive to detect differences based on age, sex, education level, employment status and preoperative pain intensity.The SFQ is a valid and reliable eight-item index of surgical fear consisting of two subscales: fear of the short-term consequences of surgery and fear of the long-term consequences.
Alameri, S S; Aarts, J M; Smith, M; Waddell, J N
To provide a snapshot of the New Zealand dental technology industry and influencing factors. Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry. A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees. The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems. Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.
Slouzkey, Ilana; Maroun, Mouna
The basolateral amygdala (BLA), medial prefrontal cortex (mPFC) circuit, plays a crucial role in acquisition and extinction of fear memory. Extinction of aversive memories is mediated, at least in part, by the phosphoinositide-3 kinase (P[subscript 3]K)/Akt pathway in adult rats. There is recent interest in the neural mechanisms that mediate fear…
Shahnavaz, Shervin; Rutley, Sara; Larsson, Karin; Dahllöf, Göran
There is a high prevalence of dental anxiety in children and adolescents. Cognitive behavioral therapy is emerging as a treatment option. The purpose of this study is to explore how children with dental anxiety and their parents experience cognitive behavioral therapy (CBT) in dentistry. We interviewed 12 children and one of their parents and conducted a thematic analysis of the transcribed interviews. Perspective shift emerged as overarching theme in our thematic analysis. This theme consisted of three main themes, which were mastery, safety, and reduced fear. Six subthemes were also identified according to our analyses. Mastery includes two subthemes, gradual exposure and autonomy and control. Subthemes and sources for safety feeling were therapeutic alliance and changed appraisal. The theme reduced fear also consisted of two subthemes; reduced anticipatory anxiety and coping. The results show that parents and children had positive experiences of CBT and its outcome and were able to benefit from this psychological treatment when dealing with dental anxiety. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Boyd, Linda D; Bailey, Angela
To advance the profession of dental hygiene, graduate education is necessary to support growth in research, education, administration, and practice in the discipline and to sustain credibility in a climate in which other health professions require entry-level master's and doctoral degrees. The purpose of this study was to explore what dental hygienists perceive as barriers to pursuing a graduate degree. A survey was developed based on the literature and other national surveys. Data were collected from 160 respondents to the survey: 50 percent held an entry-level baccalaureate degree in dental hygiene, while the rest held an entry-level associate degree (48 percent) or certificate (2 percent) in dental hygiene. All respondents had completed a bachelor's degree. The top five barriers these respondents identified in pursuing graduate education were as follows: 1) cost of graduate education, 2) family responsibilities are too great, 3) concerns about personal funding to pay for graduate education, 4) finding time for graduate school while working, and 5) fear of thesis research. Dental hygiene is one of the few health professions that still have entry-level degrees at the associate and baccalaureate levels. The profession needs to reduce such barriers to enable dental hygienists to pursue graduate education and thus ensure an adequate supply of future leaders, educators, and researchers.
Chaffee, Benjamin W; Cheng, Jing; Featherstone, John D B
Consensus guidelines support non-operative preventives for dental caries management; yet, their use in practice is far from universal. The purpose of this study was to evaluate the effectiveness of non-operative anti-caries agents in caries prevention among high caries risk adults at a university clinic where risk-based caries management is emphasized. This retrospective observational study drew data from the electronic patient records of non-edentulous adult patients deemed to be at high risk for dental caries during baseline oral evaluations that were completed between July 1, 2007 and December 31, 2012 at a dental university in the United States. We calculated and compared adjusted mean estimates for the number of new decayed or restored teeth (DFT increment) from baseline to the next completed oral evaluation (N = 2,724 patients with follow-up) across three categories of delivery of non-operative anti-caries agents (e.g., high-concentration fluoride toothpaste, chlorhexidine rinse, xylitol products): never, at a single appointment, or at ≥2 appointments ≥4 weeks apart. Estimates were adjusted for patient and provider characteristics, baseline dental status, losses-to-follow-up, and follow-up time. Approximately half the patients did not receive any form of non-operative anti-caries agent. Most that received anti-caries agents were given more than one type of product in combination. One-time delivery of anti-caries agents was associated with a similar DFT increment as receiving no such therapy (difference in increment: -0.04; 95% CI: -0.28, 0.21). However, repeated, spaced delivery of anti-caries agents was associated with approximately one decayed or restored tooth prevented over 18 months for every three patients treated (difference in increment: -0.35; 95% CI: -0.65, -0.08). These results lend evidence that repeatedly receiving anti-caries agents can reduce tooth decay among high-risk patients engaged in regular dental care.
Full Text Available This article considers the relationship between the text and accompanying illustrations in Clive Barker’s children’s novel The Thief of Always: A Fable. This tale of abduction was published in the social background of fear around the child predator of the early 1990s and incorporates ideas of monstrous villainy, loss of childhood innocence, and insatiable desires. As a fable, Thief is a cautionary tale that not only teaches that childhood years are precious and are not to be wished away or squandered in idle leisure, but also of the dangers that some adults pose to children. Problematically, an honest and frank discussion of adult sexual desires toward children would despoil the very innocence that is trying to be protected; thus, a lesson such as this must be sublimated within the story. Yet, it is the illustrations, and more specifically the way in which the illustrations corroborate and contradict the plot of this story that reveals an underlying ambivalence toward the figure of the child and an echoing duality present in both the child and the child predator.
Nash, David A; Friedman, Jay W; Kardos, Thomas B; Kardos, Rosemary L; Schwarz, Eli; Satur, Julie; Berg, Darren G; Nasruddin, Jaafar; Mumghamba, Elifuraha G; Davenport, Elizabeth S; Nagel, Ron
In 1921, New Zealand began training school dental nurses, subsequently deploying them throughout the country in school-based clinics providing basic dental care for children. The concept of training dental nurses, later to be designated dental therapists, was adopted by other countries as a means of improving access to care, particularly for children. This paper profiles six countries that utilise dental therapists, with a description of the training that therapists receive in these countries, and the context in which they practice. Based on available demographic information, it also updates the number of dental therapists practising globally, as well as the countries in which they practice. In several countries, dental therapy is now being integrated with dental hygiene in training and practice to create a new type of professional complementary to a dentist. Increasingly, dental therapists are permitted to treat adults as well as children. The paper also describes the status of a current initiative to introduce dental therapy to the United States. It concludes by suggesting that dental therapists can become valued members of the dental team throughout the world, helping to improve access to care and reducing existing disparities in oral health.
Pourat, Nadereh; Choi, Moonkyung Kate; Chen, Xiao
Preventive dental health services are intended to reduce the likelihood of development of tooth decay and the need for more intensive treatment overtime. The evidence on the effectiveness of preventive dental care in reducing treatment services and expenditures is lagging for adults, particularly those with lower incomes and chronic conditions. We assessed the impact of preventive dental services on dental treatment service use and expenditures overall and by category of service. We calculated the annual numbers of preventive (periodic diagnostic and prophylactic procedures) and treatment (restorative, surgery, prosthodontic, endodontic, and periodontic) services per beneficiary using Medicaid enrollment and claims data for beneficiaries with three categories of conditions (diabetes, heart disease, and respiratory disease) from 10 largest California counties. We used Cragg hurdle exponential regression models controlling for past service use, demographics, length of enrollment, and county. We found that using preventive services in 2005-2007 was associated with higher likelihood and number of treatment dental services used, but associated with lower treatment expenditures in 2008. The reduction in expenditures was noted only in restorative, prosthodontics, and periodontic services. The findings provide much needed evidence of the contribution of preventive dental care in maintaining oral health of low-income adults with chronic conditions and potential for savings to the Medicaid program. Providing lower cost preventive dental care to the individuals with chronic conditions would achieve better oral health and lower treatment expenditures. © 2018 American Association of Public Health Dentistry.
Trotta, Lucia; Biagi, Federico; Bianchi, Paola I; Marchese, Alessandra; Vattiato, Claudia; Balduzzi, Davide; Collesano, Vittorio; Corazza, Gino R
Coeliac disease is a condition characterized by a wide spectrum of clinical manifestations. Any organ can be affected and, among others, dental enamel defects have been described. Our aims were to study the prevalence of dental enamel defects in adults with coeliac disease and to investigate a correlation between the grade of teeth lesion and clinical parameters present at the time of diagnosis of coeliac disease. A dental examination was performed in 54 coeliac disease patients (41 F, mean age 37 ± 13 years, mean age at diagnosis 31 ± 14 years). Symptoms leading to diagnosis were diarrhoea/weight loss (32 pts.), anaemia (19 pts.), familiarity (3 pts.); none of the patients was diagnosed because of enamel defects. At the time of evaluation, they were all on a gluten-free diet. Enamel defects were classified from grade 0 to 4 according to its severity. Enamel defects were observed in 46/54 patients (85.2%): grade 1 defects were seen in 18 patients (33.3%) grade 2 in 16 (29.6%), grade 3 in 8 (14.8%), and grade 4 in 4 (7.4%). We also observed that grades 3 and 4 were more frequent in patients diagnosed with classical rather than non-classical coeliac disease (10/32 vs. 2/20). However, this was not statistically significant. This study confirms that enamel defects are common in adult coeliac disease. Observation of enamel defects is an opportunity to diagnose coeliac disease. Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Chaffee, Benjamin W.; Cheng, Jing; Featherstone, John DB
Background Consensus guidelines support non-operative preventives for dental caries management; yet, their use in practice is far from universal. The purpose of this study was to evaluate the effectiveness of non-operative anti-caries agents in caries prevention among high caries risk adults at a university clinic where risk-based caries management is emphasized. Methods This retrospective observational study drew data from the electronic patient records of non-edentulous adult patients deeme...
Elisa M. Nabel
Full Text Available Early temporary windows of heightened brain plasticity called critical periods developmentally sculpt neural circuits and contribute to adult behavior. Regulatory mechanisms of visual cortex development –the preeminent model of experience-dependent critical period plasticity- actively limit adult plasticity and have proved fruitful therapeutic targets to reopen plasticity and rewire faulty visual system connections later in life. Interestingly, these molecular mechanisms have been implicated in the regulation of plasticity in other functions beyond vision. Applying mechanistic understandings of critical period plasticity in the visual cortex to fear circuitry may provide a conceptual framework for developing novel therapeutic tools to mitigate aberrant fear responses in post traumatic stress disorder. In this review, we turn to the model of experience-dependent visual plasticity to provide novel insights for the mechanisms regulating plasticity in the fear system. Fear circuitry, particularly fear memory erasure, also undergoes age-related changes in experience-dependent plasticity. We consider the contributions of molecular brakes that halt visual critical period plasticity to circuitry underlying fear memory erasure. A major molecular brake in the visual cortex, perineuronal net formation, recently has been identified in the development of fear systems that are resilient to fear memory erasure. The roles of other molecular brakes, myelin-related Nogo receptor signaling and Lynx family proteins– endogenous inhibitors for nicotinic acetylcholine receptor, are explored in the context of fear memory plasticity. Such fear plasticity regulators, including epigenetic effects, provide promising targets for therapeutic interventions.
Thomson, W.M.; Williams, S.M.; Broadbent, J.M.; Poulton, R.; Locker, D.
To date, the evidence supporting the benefits of dental visiting comes from cross-sectional studies. We investigated whether long-term routine dental visiting was associated with lower experience of dental caries and missing teeth, and better self-rated oral health, by age 32. A prospective cohort study in New Zealand examined 932 participants’ use of dentistry at ages 15, 18, 26, and 32. At each age, routine attenders (RAs) were identified as those who (a) usually visited for a check-up, and (b) had made a dental visit during the previous 12 months. Routine attending prevalence fell from 82% at age 15 to 28% by 32. At any given age, routine attenders had better-than-average oral health, fewer had teeth missing due to caries, and they had lower mean DS and DMFS scores. By age 32, routine attenders had better self-reported oral health and less tooth loss and caries. The longer routine attendance was maintained, the stronger the effect. Routine dental attendance is associated with better oral health. PMID:20093674
Staberg, Marie; Norén, Jörgen G; Johnson, Mats; Kopp, Svenny; Robertson, Agneta
Attention deficit hyperactivity disorder (ADHD) is a common psychiatric condition characterized by age-inappropriate levels of inattention, hyperactivity-impulsiveness or a combination of these. The aim of this study was to analyze parental attitudes to and experience of dental care, oral hygiene and dietary habits in children/adolescents with ADHD. Twenty- six parents of 31 subjects, 20 boys and 11 girls, aged 5-19 years with ADHD registered at the Gothenburg Child Neuropsychiatric Clinic, were invited. The parents answered a questionnaire regarding different oral problems when visiting the Clinic of Pediatric Dentistry, Gothenburg, for an oral examination of their child. The parents felt the dental care at the Public Dental Service was good, but noted a lack of knowledge regarding child neuropsychiatry among the dental staff which may influence the dental treatment. Fifteen parents reported their children had experienced mouth pain and 15 reported their child had suffered from both discomfort and pain from local anesthesia. Thirteen of the children had a dental trauma and 12 parents reported pain in connection to the dental treatment. Pain related to filling therapy was stated by 11 parents. According to the parents, five children suffered from dental fear but 15 reported the child had a general fear. Pursuant to the parents, the beverage for dinner was mainly milk or water, while sweet drinks were more frequent when thirsty. Seventeen parents reported their children had poor oral hygiene or could not manage to brush their teeth and 14 of the 31 children only brushed once a day or less. The results show that the parents experience a lack of child neuropsychiatric knowledge, care and patience from the dental staff, which may influence the treatment. Oral hygiene/tooth brushing is neglected and the frequent consumption of sugar is difficult for the parents to handle.
Cheng, Pei-Hsun; Snyder, Brooke; Fillos, Dimitri; Ibegbu, Chris C; Huang, Anderson Hsien-Cheng; Chan, Anthony W S
Chimpanzee dental pulp stem/stromal cells (ChDPSCs) are very similar to human bone marrow derived mesenchymal stem/stromal cells (hBMSCs) as demonstrated by the expression pattern of cell surface markers and their multipotent differentiation capability. ChDPSCs were isolated from an incisor and a canine of a forty-seven year old female chimpanzee. A homogenous population of ChDPSCs was established in early culture at a high proliferation rate and verified by the expression pattern of thirteen cell surface markers. The ChDPSCs are multipotent and were capable of differentiating into osteogenic, adipogenic and chondrogenic lineages under appropriate in vitro culture conditions. ChDPSCs also express stem cell (Sox-2, Nanog, Rex-1, Oct-4) and osteogenic (Osteonectin, osteocalcin, osteopontin) markers, which is comparable to reported results of rhesus monkey BMSCs (rBMSCs), hBMSCs and hDPSCs. Although ChDPSCs vigorously proliferated during the initial phase and gradually decreased in subsequent passages, the telomere length indicated that telomerase activity was not significantly reduced. These results demonstrate that ChDPSCs can be efficiently isolated from post-mortem teeth of adult chimpanzees and are multipotent. Due to the almost identical genome composition of humans and chimpanzees, there is an emergent need for defining the new role of chimpanzee modeling in comparative medicine. Teeth are easy to recover at necropsy and easy to preserve prior to the retrieval of dental pulp for stem/stromal cells isolation. Therefore, the establishment of ChDPSCs would preserve and maximize the applications of such a unique and invaluable animal model, and could advance the understanding of cellular functions and differentiation control of adult stem cells in higher primates.
Azodo, C C; Ezeja, E B; Ehikhamenor, E E
To determine the prevalence of workplace violence in Oral healthcare centres against Nigerian dental professionals. A questionnaire-based cross-sectional survey of 175 randomly selected dental professionals working in Oral healthcare centres of University Teaching Hospitals in Southern Nigeria was conducted. The survey response rate was 78.9%. The respondents were dentists (58.0%), dental nurses (18.1%), dental technologists (12.3%), dental therapists (8.0%) and dental record officers (3.6%). The prevalence of violence in Nigerian Oral healthcare centres was 31.9%. There was no statistically significant difference in the prevalence of violence against dentist and dental auxiliaries. Violence was often associated with long waiting time (27.3%), cancellation of appointment (13.6%), outcome of patient's treatment (11.4%), alcohol intoxication (9.1%), psychiatric patient (6.8%,) patient's bill (4.5%) and others (27.3%). Non-physical violence in form of loud shouting (50.0%) threat (22.7%), sexual harassment (6.8%) and swearing (2.3%) constituted the majority while physical violence in form of bullying and hitting constituted the remaining 18.2%. The main perpetrators of the violence were patients (54.5%) and patient's relatives/friends (18.2%). The expressed impact of violence among the respondents include fear (18.2%), impaired job performance (15.9%), psychological problems (13.6%) and off duty (9.1%). No impact was declared by 43.2% of respondents. The prevalence of workplace violence in Oral healthcare centres against dental professionals in Southern Nigeria was significant and had a substantial effect on dental professionals' well-being thus necessitating urgent attention.
Struyf, Dieter; Zaman, Jonas; Hermans, Dirk; Vervliet, Bram
The current experiment investigated whether overgeneralization of fear could be due to an inability to perceptually discriminate the initial fear-evoking stimulus from similar stimuli, as fear learning-induced perceptual impairments have been reported but their influence on generalization gradients remain to be elucidated. Three hundred and sixty-eight healthy volunteers participated in a differential fear conditioning paradigm with circles of different sizes as conditioned stimuli (CS), of which one was paired to an aversive IAPS picture. During generalization, each subject was presented with one of 10 different sized circles including the CSs, and were asked to categorize the stimulus as either a CS or as novel after fear responses were recorded. Linear mixed models were used to investigate differences in fear generalization gradients depending on the participant's perception of the test stimulus. We found that the incorrect perception of a novel stimulus as the initial fear-evoking stimulus strongly boosted fear responses. The current findings demonstrate that a significant number of novel stimuli used to assess generalization are incorrectly identified as the initial fear-evoking stimulus, providing a perceptual account for the observed overgeneralization in panic and anxiety disorders. Accordingly, enhancing perceptual processing may be a promising treatment for targeting excessive fear generalization. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Forcadell, Eduard; Torrents-Rodas, David; Vervliet, Bram; Leiva, David; Tortella-Feliu, Miquel; Fullana, Miquel A
Fear extinction models have a key role in our understanding of anxiety disorders and their treatment with exposure therapy. Here, we tested whether individual differences in fear extinction learning and fear extinction recall in the laboratory were associated with the outcomes of an exposure therapy analog (ETA). Fifty adults with fear of spiders participated in a two-day fear-learning paradigm assessing fear extinction learning and fear extinction recall, and then underwent a brief ETA. Correlational analyses indicated that enhanced extinction learning was associated with better ETA outcome. Our results partially support the idea that individual differences in fear extinction learning may be associated with exposure therapy outcome, but suggest that further research in this area is needed. Copyright © 2017 Elsevier B.V. All rights reserved.
Kuhn, Cynthia M.; LaBar, Kevin S.; Zorawski, Michael; Blanding, Nineequa Q.
We examined the relationship between stress hormone (cortisol) release and acquisition and consolidation of conditioned fear learning in healthy adults. Participants underwent acquisition of differential fear conditioning, and consolidation was assessed in a 24-h delayed extinction test. The acquisition phase was immediately followed by an 11-min…
Chanpong, B; Haas, D. A; Locker, D
The aim of this study was to assess the need and demand for sedation or general anesthesia (GA) for dentistry in the Canadian adult population. A national telephone survey of 1101 Canadians found that 9.8% were somewhat afraid of dental treatment, with another 5.5% having a high level of fear. Fear or anxiety was the reason why 7.6% had ever missed, cancelled, or avoided a dental appointment. Of those with high fear, 49.2% had avoided a dental appointment at some point because of fear or anxiety as opposed to only 5.2% from the no or low fear group. Regarding demand, 12.4% were definitely interested in sedation or GA for their dentistry and 42.3% were interested depending on cost. Of those with high fear, 31.1% were definitely interested, with 54.1% interested depending on cost. In a hypothetical situation where endodontics was required because of a severe toothache, 12.7% reported high fear. This decreased to 5.4% if sedation or GA were available. For this procedure, 20.4% were definitely interested in sedation or GA, and another 46.1% were interested depending on cost. The prevalence of, and preference for, sedation or GA was assessed for specific dental procedures. The proportion of the population with a preference for sedation or GA was 7.2% for cleaning, 18% for fillings or crowns, 54.7% for endodontics, 68.2% for periodontal surgery, and 46.5% for extraction. For each procedure, the proportion expressing a preference for sedation or GA was significantly greater than the proportion having received treatment with sedation or GA (P < 0.001). In conclusion, this study demonstrates that there is significant need and demand for sedation and GA in the Canadian adult population. PMID:15859442
Lam, Annie; Kiyak, Asuman; Gossett, Allison M; McCormick, Lawrence
To describe the health conditions, dental problems, and use of xerogenic medications among dental patients in adult day health (ADH) centers. Cross-sectional descriptive study. ADH centers in King County, Washington. ADH clients who were patients of a mobile dental service. Pharmacist-conducted chart reviews and in-person medication reviews with patients. Demographic description, mean numbers of medical and dental problems, medications, xerogenic medications used per subject, and identification of xerogenic medications by therapeutic class. At five sites, 97 patients were interviewed (average age 73.8 +/- 11.8 years, 61% female); ethnicities included: Asian-American (37.1%), Caucasian (30.9%), Russian (29%), and African-American (3%). Mean numbers of chronic health problems, medications, and xerogenic medications per patient were 5.2 +/- 2.7, 10.9 +/- 4.4, and 3.3 +/- 1.8, respectively. Antidepressants were the most commonly used xerogenic medication, followed by antipsychotics, antiemetics, analgesics, and antihistamines. Among 74 patients who received dental treatment, 33 (44.6%) wore dentures. Among 58 patients with teeth, a mean number of 2.8 dental problems per patient was identified. Dental caries (51.7%) was the most prevalent problem, followed by periodontitis (29.3%), soft tissue lesions (10.3%), gingivitis (5.2%), and candidiasis (3.4%). Multiple systemic diseases, use of multiple xerogenic medications, and poor oral health were prevalent among the ADH clients in this study. However, self-reports of dry mouth were unrelated to number of xerogenic medications or oral conditions. Further research is needed to determine the association between self-reported dry mouth, chronic health conditions, use of xerogenic medications, tooth loss, and/or denture use.
IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care
Background Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care. Methods/Design This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0–3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI. Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases. The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the
IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care.
Clarkson, Jan E; Ramsay, Craig R; Averley, Paul; Bonetti, Debbie; Boyers, Dwayne; Campbell, Louise; Chadwick, Graham R; Duncan, Anne; Elders, Andrew; Gouick, Jill; Hall, Andrew F; Heasman, Lynne; Heasman, Peter A; Hodge, Penny J; Jones, Clare; Laird, Marilyn; Lamont, Thomas J; Lovelock, Laura A; Madden, Isobel; McCombes, Wendy; McCracken, Giles I; McDonald, Alison M; McPherson, Gladys; Macpherson, Lorna E; Mitchell, Fiona E; Norrie, John Dt; Pitts, Nigel B; van der Pol, Marjon; Ricketts, David Nj; Ross, Margaret K; Steele, James G; Swan, Moira; Tickle, Martin; Watt, Pauline D; Worthington, Helen V; Young, Linda
Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care. This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0-3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self
Armita eGolkar; Martin eBellander; Andreas eOlsson; Arne eÖhman
Recent advances in the field of fear learning have demonstrated that a single reminder exposure prior to extinction training can prevent the return of extinguished fear by disrupting the process of reconsolidation. These findings have however proven hard to replicate in humans. Given the significant implications of preventing the return of fear, the purpose of the present study was to further study the prerequisites for the putative effects of disrupting reconsolidation. In two experiments, w...
Objective: To investigate the association between root caries and social and dental behaviour amongst adults in a selected suburband adult population. Methods: The setting, study design and root caries diagnosis were as described in the first part of this three part series. Subjects\\' social and dental health behaviour were ...
Tanner, Margaret K; Hake, Holly S; Bouchet, Courtney A; Greenwood, Benjamin N
Extinction-based exposure therapy is the most common behavioral therapy for anxiety and trauma-related disorders, but fear tends to resurface even after successful extinction. Identification of novel strategies to enhance fear extinction and reduce fear relapse is of paramount importance to mental health. Exercise can enhance cognitive function, but it is not yet well understood whether exercise can be an effective augmentation strategy for fear extinction. In the current review, we present the current state of knowledge on the effects of exercise on fear extinction. Effects of exercise duration, explanations for conflicting results, and potential mechanisms, focusing on a hypothesized role for dopamine, are all discussed. We also provide new data suggesting that the timing in which acute exercise occurs relative to fear extinction, is a crucial variable in determining whether exercise can enhance fear extinction. Clinical implications and ideas to guide future research endeavors in this area are provided. Copyright © 2018 Elsevier Inc. All rights reserved.
Arrica, Mariantonietta; Carta, Giovanna; Cocco, Fabio; Cagetti, Maria Grazia; Campus, Guglielmo; Ierardo, Gaetano; Ottolenghi, Livia; Sale, Silvana; Strohmenger, Laura
Objective To explore the potential presence of a social/behavioural gradient in dental health among Italian adults using a cross-sectional study. Methods Caries indices were recorded among 480 subjects (52.9% men, 47.1% women) who also completed a structured self-administered social and behavioural questionnaire. A social/behavioural gradient was generated as the sum of the worst circumstances recorded on the questionnaire (cariogenic diet, smoking, lowest occupational profile, brushing teeth < twice daily, lowest educational level, uneven dental examination attendance). Results Caries figures (DMFT) and the number of filled sound teeth (FS-T) were statistically significantly linked to the social/behavioural gradient (DMFT: χ 2 (9) = 20.17 p = 0.02, Z = 0.02 p = 0.99; FS-T: χ 2 (9) = 25.68 p < 0.01, Z = -4.31 p < 0.01). DMFT was statistically significantly associated with gender and with social and behavioural variables. FS-T was higher in women (p = 0.03) and was linked to smoking ( p < 0.01). Conclusions The proposed social/behavioural gradient demonstrated how subjects reporting the worst circumstances on the questionnaire exhibited the worst dental health. The use of the gradient demonstrates that health promotion and prevention cannot be compartmentalized.
Full Text Available Introduction: Dental care utilization is limited, and teeth are often left untreated or extracted in India. Several barriers exist for the utilization of dental services. The present study was undertaken to assess the oral healthcare needs, utilization pattern of oral healthcare services, and barriers to utilization of oral healthcare services among the outpatients of Peripheral Medical Centre, Poonjeri, Mamallapuram, India. Materials and Methods: Simple random sampling was conducted among outpatients and their attenders reporting to the health centre; demographic profile of the patients were recorded followed by interviewer-administered questionnaire for recording the self-perceived dental needs and barriers in utilizing dental care services followed by Type II clinical examination to assess normative dental treatment needs. Results: N =282 study participants participated in the present study; majority of the study participants were from upper lower class and lower middle class. Among the study subjects n = 124 (44% have not accessed any dentist, n = 112 (39.7% had visited dentist for toothache. Common reason cited as Self – perceived barriers for dental care are n = 184 (65.2% – 'Unaware of the dental problems' and n = 118 (41.8% 'Fear of dental treatment'. Logistic regression showed that significant difference was seen in gender, socioeconomic status, and barriers to dental care (P < 0.05 in influencing the utilization pattern of dental care. Conclusion: Perceived and normative dental needs were high among the study population due to problem-oriented care, and it is influenced by various barriers such as unawareness of dental problems, fear, cost, accessibility, and time.
Nascimento, Alex Rodrigues do; Andrade, Fabíola Bof de; César, Cibele Comini
This study sought to describe the agreement between self-perception and clinical evaluation of dental treatment needs in adults and analyze associated factors. The sample comprised adult individuals who took part in SBBrazil 2010 and SBMinas Gerais 2012. The study's outcome was agreement between self-perception and clinical evaluation of dental treatment needs. We used multiple Poisson regression in order to determine the factors associated with the outcome. Agreement between self-perception and clinical evaluation was 78.8% in Brazil and 73.8% in Minas Gerais. Clinical and self-reported oral health conditions that affect function and quality of life were associated with a higher agreement, while a recent visit to the dentist was associated with a lower agreement. Identifying associated factors may enable the development of questionnaires that favor correct self-perception regarding treatment needs.
Full Text Available Background Chimpanzee dental pulp stem/stromal cells (ChDPSCs are very similar to human bone marrow derived mesenchymal stem/stromal cells (hBMSCs as demonstrated by the expression pattern of cell surface markers and their multipotent differentiation capability. Results ChDPSCs were isolated from an incisor and a canine of a forty-seven year old female chimpanzee. A homogenous population of ChDPSCs was established in early culture at a high proliferation rate and verified by the expression pattern of thirteen cell surface markers. The ChDPSCs are multipotent and were capable of differentiating into osteogenic, adipogenic and chondrogenic lineages under appropriate in vitro culture conditions. ChDPSCs also express stem cell (Sox-2, Nanog, Rex-1, Oct-4 and osteogenic (Osteonectin, osteocalcin, osteopontin markers, which is comparable to reported results of rhesus monkey BMSCs (rBMSCs, hBMSCs and hDPSCs. Although ChDPSCs vigorously proliferated during the initial phase and gradually decreased in subsequent passages, the telomere length indicated that telomerase activity was not significantly reduced. Conclusion These results demonstrate that ChDPSCs can be efficiently isolated from post-mortem teeth of adult chimpanzees and are multipotent. Due to the almost identical genome composition of humans and chimpanzees, there is an emergent need for defining the new role of chimpanzee modeling in comparative medicine. Teeth are easy to recover at necropsy and easy to preserve prior to the retrieval of dental pulp for stem/stromal cells isolation. Therefore, the establishment of ChDPSCs would preserve and maximize the applications of such a unique and invaluable animal model, and could advance the understanding of cellular functions and differentiation control of adult stem cells in higher primates.
Pereira, Rodrigo Dos Santos; Gomes-Ferreira, Pedro Henrique Silva; Bonardi, João Paulo; Silva, Jonathan Ribeiro da; Latini, Gustavo Lima; Hochuli-Vieira, Eduardo
Infections of the maxillofacial complex caused by caries disease are common in dental practice. The professionals have to have technical knowledge to treat it at the onset of the condition and avoid the spread to deep anatomical spaces of face and neck, which can implicate in a risk of patients' life.In Brazil, current dental professionals usually denied oral surgical treatments in patients with some clinical conditions, not because of fear to resolve it but for lack of knowledge to treat it. An example of these conditionals is pregnancy. It is well known that during the pregnancy period, the patient can be treated in the correct period of gestation. Early diagnosis is crucial for effective therapy in serious infections. The treatment has to be crucial during pregnancy because of the potentially fatal situation that the disease can create to the pregnant woman and the fetus.The aim of this article is to demonstrate a case of dental caries in a pregnant patient, which was evaluated by other professionals and had the treatment denied, evolving to a serious maxillofacial infection.
Helöe, L A
The major issues and challenges confronting the dental professions in the United States and Norway were studied through speeches of and interviews with the presidents of the American Dental Association (ADA) and the Norwegian Dental Association (NDA) in the period 1980-86. The issues most frequently dealt with related to public authorities, particularly legislation and government involvement in dental practice. Anxiety concerning "busyness," the future dental market, and a drop in the quality of applicants to dental schools were also major subjects. The spokespersons of both associations were engaged in increasing the demand for dental services by marketing, but they were ambivalent regarding advertising, especially individual advertising. Both were concerned with protecting dentistry's autonomy. While the Norwegian presidents apparently feared the medical profession's influence upon dentistry, the Americans were concerned with the hygienists and denturists, and with the insurance companies which they suspected of intruding into the dentist-patient relationship. The presidents' statements, which frequently varied, were apparently influenced by the current domestic political climate, the basic socio-political principles of the two countries, and the different socio-demographic make-up of their memberships.
Bayat, Fariborz; Vehkalahti, Miira M; Murtomaa, Heikki; Tala, Heikki
To investigate patients' reasons for selecting a dental clinic given their choice of free or highly-subsidized dental services. The study was based on cross-sectional data obtained through phone interviews with adults in Tehran, Iran. The present study included those entitled to free or highly-subsidized dental services (n = 726). The data covered the patients' awareness of subsidized dental services and type of dental clinic for their most recent visit and their reasons for selecting that clinic. Awareness of subsidized dental services was dichotomized as being either aware or unaware of such subsidy. The type of clinic was dichotomized as providing either free or highly-subsidized (FHS) or fully out-of-pocket paid (FOP) services. Free format answers about the subjects' reasons for selecting a particular clinic were later sub-grouped as: convenient access, good technical aspects, good interpersonal aspects, low or reasonable fees, recommendation by a friend, and no reason. Socio-demographic status was based on background. Data analysis included the chi-square test and logistic regression model. Of the subjects (n = 726), 60% were women and 58% were under 35 years of age. The subjects' mean age was 33.5 years with no difference by gender (P = 0.24) and the majority had public insurance (91%). Of all the subjects, 60% selected FOP. Good interpersonal aspects were the strongest reason for selecting FOP (OR = 4.6), follow by good technical aspects (OR = 2.3). Those subjects who were unaware of their benefit had 4.6 times the odds of selecting FOP. Despite the opportunity to use highly-subsidized dental services, good interpersonal and good technical aspects lead patients to select private dentists and to pay fully out of pocket.
Junghans-Rutelonis, Ashley N; Tackett, Alayna P; Suorsa, Kristina I; Chaney, John M; Mullins, Larry L
The present study examined the impact of asthma-specific thought intrusion (TI) and thought suppression (TS) on two cognitive-affective variables (self-focused attention and fear of negative evaluation) among adolescents and young adults (AYAs) diagnosed with childhood-onset asthma. Participants were 290 AYAs who completed assessment questionnaires and participated in a written exercise electronically. Asthma-TI and TS were reported by participants following participation in a writing assignment. Asthma-TI was associated with increased private, public, and social anxiety self-focused attention, and greater fear of negative evaluation. Interestingly, asthma-TS was not associated with these same outcome variables. Findings suggest illness-specific cognitions are associated with cognitive-affective variables and it may be important to assess for illness-specific intrusive thoughts following asthma-focused medical appointments. Additionally, findings suggest the importance of assessing asthma-TI and TS separately in order to better understand thoughts about health and psychological functioning.
Kumari, Punita; Kauser, Hina; Wadhwa, Meetu; Roy, Koustav; Alam, Shahnawaz; Sahu, Surajit; Kishore, Krishna; Ray, Koushik; Panjwani, Usha
Fear memory is essential for survival, and its dysregulation leads to disorders. High altitude hypobaric hypoxia (HH) is known to induce cognitive decline. However, its effect on fear memory is still an enigma. We aimed to investigate the temporal effect of HH on fear conditioning and the underlying mechanism. Adult male Sprague-Dawley rats were trained for fear conditioning and exposed to simulated HH equivalent to 25,000 ft for different durations (1, 3, 7, 14 and 21 days). Subsequently, rats were tested for cued and contextual fear conditioning. Neuronal morphology, apoptosis and DNA fragmentation were studied in the medial prefrontal cortex (mPFC), hippocampus and basolateral amygdala (BLA). We observed significant deficit in cued and contextual fear acquisition (at 1, 3 and 7 days) and consolidation (cued at 1 and 3 days and contextual fear at 1, 3 and 7 days) under HH. HH exposure with retraining showed the earlier restoration of contextual fear memory. Further, we found a gradual increase in the number of pyknotic and apoptotic neurons together with the increase in DNA fragmentation in mPFC, hippocampus, and BLA up to 7 days of HH exposure. The present study concludes that HH exposure equivalent to 25000 ft induced cued and contextual fear memory deficit (acquisition and consolidation) which is found to be correlated with the neurodegenerative changes in the limbic brain regions. Copyright © 2018. Published by Elsevier B.V.
Klein, Anke M; Kleinherenbrink, Annelies V; Simons, Carlijn; de Gier, Erwin; Klein, Steven; Allart, Esther; Bögels, Susan M; Becker, Eni S; Rinck, Mike
Several information-processing models highlight the independent roles of controlled and automatic processes in explaining fearful behavior. Therefore, we investigated whether direct measures of controlled processes and indirect measures of automatic processes predict unique variance components of children's spider fear-related behavior. Seventy-seven children between 8 and 13 years performed an Affective Priming Task (APT) measuring associative bias, a pictorial version of the Emotional Stroop Task (EST) measuring attentional bias, filled out the Spider Anxiety and Disgust Screening for Children (SADS-C) in order to assess self-perceived fear, and took part in a Behavioral Assessment Test (BAT) to measure avoidance of spiders. The SADS-C, EST, and APT did not correlate with each other. Spider fear-related behavior was best explained by SADS-C, APT, and EST together; they explained 51% of the variance in BAT behavior. No children with clinical levels of spider phobia were tested. The direct and the different indirect measures did no correlate with each other. These results indicate that both direct and indirect measures are useful for predicting unique variance components of fear-related behavior in children. The lack of relations between direct and indirect measures may explain why some earlier studies did not find stronger color-naming interference or stronger fear associations in children with high levels of self-reported fear. It also suggests that children with high levels of spider-fearful behavior have different fear-related associations and display higher interference by spider stimuli than children with non-fearful behavior. Copyright © 2012 Elsevier Ltd. All rights reserved.
Broadwater, Margaret A.
Some evidence suggests that adolescents are more vulnerable than adults to alcohol-induced cognitive deficits and that these deficits may persist into adulthood. Five experiments were conducted to assess long-term consequences of ethanol exposure on tone and context Pavlovian fear conditioning in male Sprague-Dawley rats. Experiment 1 examined age-related differences in sensitivity to ethanol-induced disruptions of fear conditioning to a pre-conditioning ethanol challenge. Experiments 2 examined fear conditioning 22 days after early-mid adolescent (P28-48) or adult (P70-90) exposure to 4 g/kg i.g. ethanol or water given every other day (total of 11 exposures). In Experiment 3, mid-late adolescents (P35-55) were exposed in the same manner to assess whether timing of ethanol exposure within the adolescent period would differentially affect later fear conditioning. Experiment 4 assessed the influence of prior adolescent or adult ethanol exposure on the disrupting effects of a pre-conditioning ethanol challenge. In Experiment 5, neurogenesis (doublecortin---DCX) and cholinergic (choline acetyltransferase---ChAT) markers were measured to assess potential long-term ethanol-induced changes in neural mechanisms important for learning and memory. Results indicated that the long-lasting behavioral effects of ethanol exposure varied depending on exposure age, with early-mid adolescent exposed animals showing attenuated context fear retention (a relatively hippocampal-dependent task), whereas mid-late adolescent and adult exposed animals showed slower context extinction (thought to be reliant on the mPFC). Early-mid adolescent ethanol-exposed animals also had significantly less DCX and ChAT expression than their water-exposed counterparts, possibly contributing to deficits in context fear. Tone fear was not influenced by prior ethanol exposure at any age. In terms of age differences in ethanol sensitivity, adolescents were less sensitive than adults to ethanol
Makino, Keitaro; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao; Shimada, Hiroyuki
Fear of falling (FOF) is associated with spatial and temporal gait parameters in older adults. FOF is prevalent among older adults, both those with and without fall history. It is still unclear whether the relationships between FOF and gait parameters are affected by fall history. The aim of the present study was to compare gait parameters by the presence of FOF and fall history. A total of 3575 older adults (mean age 71.7 years, 49.7% female) met the inclusion criteria for the present study. We assessed the presence of fall history and FOF by face-to-face interview, and gait parameters (gait speed, stride length, step rate, double support time and variation of stride length) at a comfortable speed using a computerized electronic walkway. Prevalences of fall history and FOF were as follows: non-fallers without FOF 52.6% (n = 1881); fallers without FOF 6.3% (n = 227); non-fallers with FOF 34.4% (n = 1229); and fallers with FOF 6.7% (n = 238). Analysis of covariance showed significant differences among the four groups in all gait variables even after adjusting for age, sex and number of medications used. It should be noted that non-fallers with FOF showed significantly slower gait speed, shorter stride length and longer double support time than did non-fallers without FOF (P fall history. The assessment of FOF might be helpful for better understanding of age-related changes in gait control. Geriatr Gerontol Int 2017; 17: 2455-2459. © 2017 Japan Geriatrics Society.
Majstorovic, M; Veerkamp, J S; Skrinjaric, I
The aim of the study was to evaluate reliability and validity of different questionnaires and predict related causes, as concomitant factors in assessing different aspects of children's dental anxiety. Children were interviewed on dental anxiety, dispositional risk factors and satisfaction with the dentist after dental treatment had been accomplished. Parents were interviewed on dental anxiety as well. The study population included 165 children (91 boys) aged 5 to 15 years, referred to a university dental clinic by general dental practitioners because of a history of fear and uncooperative behaviour during previous dental visits. Children were treated by two dentists, both experienced in treating fearful children. Statistical analysis was performed in Statistics for Windows, Release 5.5 and Release 7.5. Pearson's correlation coefficients were calculated for validity and Cronbach alpha for reliability of the measures. Spearman Brown prophecy formula was used for correction of the alpha scores. Results The children's total average CFSS-DS score was 27.02, with no significant difference with respect to gender. The highest Cronbach alpha scores regarding reliability were obtained for the S-DAI, the CFSS-DS and the PDAS. Pearson's correlations regarding validity presented significant correlations between the CMFQ, the CDAS and the S-DAI, between the OAS, the CDAS and the S-DAI, as well as between the OAS and the DVSS-SV. Previous negative medical experience had significant influence on children's dental anxiety, supporting Rachman's conditioning theory. Anxious children were more likely to show behaviour problems (aggression) and more introvert in expressing their judgement regarding the dentist. Both the S-DAI and the CFSS-DS, which were standardized in the Croatian population sample, showed the highest reliability in assessment of children's dental anxiety.
Dincheva, Iva; Lynch, Niccola B; Lee, Francis S
Brain-derived neurotrophic factor (BDNF) is a growth factor that is dynamically expressed in the brain across postnatal development, regulating neuronal differentiation and synaptic plasticity. The neurotrophic hypothesis of psychiatric mood disorders postulates that in the adult brain, decreased BDNF levels leads to altered neural plasticity, contributing to disease. Although BDNF has been established as a key factor regulating the critical period plasticity in the developing visual system, it has recently been shown to also play a role in fear circuitry maturation, which has implications for the emergence of fear-related mood disorders. This review provides a detailed overview of developmental changes in expression of BDNF isoforms, as well as their receptors across postnatal life. In addition, recent developmental studies utilizing a genetic BDNF single nucleotide polymorphism (Val66Met) knock-in mouse highlight the impact of BDNF on fear learning during a sensitive period spanning the transition into adolescent time frame. We hypothesize that BDNF in the developing brain regulates fear circuit plasticity during a sensitive period in early adolescence, and alterations in BDNF expression (genetic or environmental) have a persistent impact on fear behavior and fear-related disorders. © 2016 Wiley Periodicals, Inc.
Friedman, Jay W; Nash, David A; Mathu-Muju, Kavita R
The Virtual Dental Home is a concept of the Pacific Center for Special Care of the Arthur A. Dugoni School of Dentistry in San Francisco. It is designed to improve access to dental care for underserved populations, specifically children and institutionalized adults. This article describes the development and implementation of the Virtual Dental Home, subsequently critiquing the concept. The criteria for a dental home are not met by the program. It is the equivalent of a traditional public oral health prevention and screening program, with the additional dimension of allowing dental hygienists and assistants to place interim glass ionomer restorations in dental cavities. The critique questions the need to insert a "cloud" dentist into the process. The routine utilization of radiographs is also challenged. The VDH not only lacks the attributes of a dental home, it has not been shown to be as efficient and effective as traditional programs staffed by dental hygienists and dental therapists. The article concludes by describing how programs utilizing dental therapists could address the deficiencies of the Virtual Dental Home, effectively improving access to oral health care for underserved populations. © 2017 American Association of Public Health Dentistry.
Kritman, Milly; Lahoud, Nisrine; Maroun, Mouna
A growing body of evidence suggests that the hypothalamic neuropeptide oxytocin (OT), aside from its central role in the regulation of social behavior, reduces fear and anxiety. The functional and opposing interactions of the medial prefrontal cortex (mPFC) and the amygdala in regulation of fear provide a unique experimental setting to examine the effects of OT on fear and extinction. Recent evidence suggests that in the adult animal OT can play a dual role in the regulation of fear leading to contrasting effects on fear depending on the manipulated brain region and the time of manipulations. The OT system is one of the systems that undergoes major changes throughout development, however, its role in regulating fear in young animals has not been widely explored. We recently showed that the mechanisms of extinction, and specifically engagement of the mPFC in extinction, are not identical in adult and juvenile animals. Thus, the purpose of this study was to elucidate the effects of OT on fear and extinction in juvenile animals. To that end, we determine extinction, by measuring freezing at different time points, following microinjection of the OT agonist, TGOT, into the mPFC, the basolateral and the central nuclei of the amygdala (BLA and CeA, respectively). The results show that whereas TGOT microinjections into the IL-mPFC did not affect extinction, microinjections into the amygdala were mainly associated with enhanced fear and impaired extinction. These results further emphasize the differences between adult and juvenile brains. Copyright © 2017. Published by Elsevier Inc.
Ko, Brittany L; Unkel, John H
Moyamoya disease (MMD) is a rare cerebrovascular disorder involving progressive constriction of the internal carotid artery and its branches. The disease has a particularly aggressive course in very young patients, and early surgical intervention is often necessary to prevent permanent neurological damage. MMD patients have an increased risk of stroke development, which may be provoked by pain or anxiety. Currently, no reports of pediatric patients with MMD exist in the dental literature. The purpose of this paper was to discuss the dental management of a two-year-old with moyamoya disease who presented with early childhood caries and dental fear, offering recommendations for dental providers with emphasis on stroke prevention, collaboration with the medical team, anesthesia considerations for patients with increased stroke risk, and the challenges to maintain the oral health of a patient undergoing complex medical treatment.
Diangelis, Anthony J; Andreasen, Jens O; Ebeleseder, Kurt A
Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines sh...... goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented....
Full Text Available Avoidance is considered as a central hallmark of all anxiety disorders. The acquisition and expression of avoidance which leads to the maintenance and exacerbation of pathological fear is closely linked to Pavlovian and operant conditioning processes. Changes in conditionability might represent a key feature of all anxiety disorders but the exact nature of these alterations might vary across different disorders. To date, no information is available on specific changes in conditionability for disorder-irrelevant stimuli in specific phobia (SP. The first aim of this study was to investigate changes in fear acquisition and extinction in spider-fearful individuals as compared to non-fearful participants by using the de novo fear conditioning paradigm. Secondly, we aimed to determine whether differences in the magnitude of context-dependent fear retrieval exist between spider-fearful and non-fearful individuals. Our findings point to an enhanced fear discrimination in spider-fearful individuals as compared to non-fearful individuals at both the physiological and subjective level. The enhanced fear discrimination in spider-fearful individuals was neither mediated by increased state anxiety, depression, nor stress tension. Spider-fearful individuals displayed no changes in extinction learning and/or fear retrieval. Surprisingly, we found no evidence for context-dependent modulation of fear retrieval in either group. Here we provide first evidence that spider-fearful individuals show an enhanced discriminative fear learning of phobia-irrelevant (de novo stimuli. Our findings provide novel insights into the role of fear acquisition and expression for the development and maintenance of maladaptive responses in the course of SP.
Bárez-López, Soledad; Montero-Pedrazuela, Ana; Bosch-García, Daniel; Venero, César; Guadaño-Ferraz, Ana
A euthyroid state in the brain is crucial for its adequate development and function. Impairments in thyroid hormones (THs; T3 or 3,5,3'-triiodothyronine and T4 or thyroxine) levels and availability in brain can lead to neurological alterations and to psychiatric disorders, particularly mood disorders. The thyroid gland synthetizes mainly T4, which is secreted to circulating blood, however, most actions of THs are mediated by T3, the transcriptionally active form. In the brain, intracellular concentrations of T3 are modulated by the activity of type 2 (D2) and type 3 (D3) deiodinases. In the present work, we evaluated learning and memory capabilities and anxiety-like behavior at adult stages in mice lacking D2 (D2KO) and we analyzed the impact of D2-deficiency on TH content and on the expression of T3-dependent genes in the amygdala and the hippocampus. We found that D2KO mice do not present impairments in spatial learning and memory, but they display emotional alterations with increased anxiety-like behavior as well as enhanced auditory-cued fear memory and spontaneous recovery of fear memory following extinction. D2KO mice also presented reduced T3 content in the hippocampus and decreased expression of the T3-dependent gene Dio3 in the amygdala suggesting a hypothyroid status in this structure. We propose that the emotional dysfunctions found in D2KO mice can arise from the reduced T3 content in their brain, which consequently leads to alterations in gene expression with functional consequences. We found a downregulation in the gene encoding for the calcium-binding protein calretinin (Calb2) in the amygdala of D2KO mice that could affect the GABAergic transmission. The current findings in D2KO mice can provide insight into emotional disorders present in humans with DIO2 polymorphisms. Copyright © 2017 Elsevier Ltd. All rights reserved.
Oberoi, Sukhvinder Singh; Marya, Charu Mohan; Sharma, Nilima; Mohanty, Vikrant; Marwah, Mohita; Oberoi, Avneet
Oral health care of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS) is a growing area of concern. Information on HIV- and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS. The purpose of this study was to assess the knowledge and attitude of Indian clinical dental students towards the treatment of patients with HIV/AIDS and perceived sources of information regarding HIV-related issues. Data were collected from clinical dental students (third year, fourth year and internship) from three dental institutions in Delhi National Capital Region (NCR). The questions assessed the knowledge and attitude towards treatment of patients with HIV and the perceived source of information related to HIV. The willingness to treat HIV-positive patients among dental students was 67.0%, and 74.20% were confident of treating a patient with HIV/AIDS. The potential problems in rendering treatment to these patients were effect on the attitude of other patients (49.90%) and staff fears (52.50%). The correct knowledge regarding the infection-control practice (barrier technique) was found among only 15.50% of respondents. The respondents had sufficient knowledge regarding the oral manifestations of HIV/AIDS. There was no correlation between the knowledge and attitude score, demonstrating a gap between knowledge and attitude among dental students regarding treatment of HIV-infected patients. Appropriate knowledge has to be delivered through the dental education curriculum, which can instil confidence in students about their ability to manage HIV-positive patients. © 2014 FDI World Dental Federation.
Moaddab, Mahsa; Dabrowska, Joanna
Oxytocin (OT) is a hypothalamic neuropeptide that modulates fear and anxiety-like behaviors. Dorsolateral bed nucleus of the stria terminalis (BNST dl ) plays a critical role in the regulation of fear and anxiety, and expresses high levels of OT receptor (OTR). However, the role of OTR neurotransmission within the BNST dl in mediating these behaviors is unknown. Here, we used adult male Sprague-Dawley rats to investigate the role of OTR neurotransmission in the BNST dl in the modulation of the acoustic startle response, as well as in the acquisition and consolidation of conditioned fear using fear potentiated startle (FPS) paradigm. Bilateral intra-BNST dl administration of OT (100 ng) did not affect the acquisition of conditioned fear response. However, intra-BNST dl administration of specific OTR antagonist (OTA), (d(CH 2 ) 5 1 , Tyr(Me) 2 , Thr 4 , Orn 8 , des-Gly-NH 2 9 )-vasotocin, (200 ng), prior to the fear conditioning session, impaired the acquisition of cued fear, without affecting a non-cued fear component of FPS. Neither OTA, nor OT affected baseline startle or shock reactivity during fear conditioning. Therefore, the observed impairment of cued fear after OTA infusion resulted from the specific effect on the formation of cued fear. In contrast to the acquisition, neither OTA nor OT affected the consolidation of FPS, when administered after the completion of fear conditioning session. Taken together, these results reveal the important role of OTR neurotransmission in the BNST dl in the formation of conditioned fear to a discrete cue. This study also highlights the role of the BNST dl in learning to discriminate between threatening and safe stimuli. Copyright © 2017 Elsevier Ltd. All rights reserved.
Srivastava, Preety; Chen, Gang; Harris, Anthony
This study uses data from the 2004-2006 Australian National Survey of Adult Oral Health and a simultaneous equation framework to investigate the interrelationships between dental health, private dental insurance and the use of dental services. The results show that insurance participation is influenced by social and demographic factors, health and health behaviours. In turn, these factors affect the use of dental services, both directly and through insurance participation. Our findings confirm that affordability is a major barrier to visiting the dentist for oral health maintenance and treatment. Our results suggest that having supplementary insurance is associated with some 56 percentage points higher probability of seeing the dentist in the general population. For those who did not have private insurance cover, we predict that conditional on them facing the same insurance conditions, on average, having insurance would increase their visits to the dentist by 43 percentage points. The uninsured in the survey have lower income, worse oral health and lower rates of preventive and treatment visits. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Babar, Muneer G; Hasan, Syed S; Ooi, Yong J; Ahmed, Syed I; Wong, Pei S; Ahmad, Siti F; Mnm-Rosdy, Nik M; Malik, Normaliza A
The study objectives were to identify the stress levels and to explore the impact of students' year of study and gender on the perceived sources of stress among Malaysian dental students. This was a cross-sectional study involving dental students from year one to year five from private and public universities in Malaysia. The study was formally approved by the Research and Ethics Committee, International Medical University Malaysia. Dental Environment Stress (DES) questionnaire was used for data collection and the gathered data were analyzed using SPSS® version 18. The Kruskal-Wallis and the Mann-Whitney U tests were used to compare stress items across various academic years and universities. A total of five hundred and twenty nine (529) students participated in this study. Fear of failing the course at the end of year exams (mean stress level=5.57); concerns regarding completion of clinical work (mean=5.30); and examination results and grades (mean=5.27) were found as top stressors among dental students. Female students had higher stress scores than males with respect to personal issues, academic performance, educational environment and learning of clinical skills. Students from public universities had higher stress scores than their counterparts from private universities. The Malaysian dental students reported higher levels of stress. Present study identified stressors affecting dental students' academic life, and highlights the importance of stress management programs and other measures to minimize the impact of stress on both academic and personal lives of the students.
Kristina L Wanyonyi
Full Text Available This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England.Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008-2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients' individual characteristics (demography, smoking, payment status and contextual experience (deprivation based on area of residence, with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments.Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (<18 years and older adults (≥65 years received preventive care in the form of 'instruction and advice', compared with 46% of working age adults (18-64 years; p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001: 'partial dentures' (7%; 'scale and polish' (3.7%; 'tooth extraction' (3%; p = 0.001, and 'instruction and advice' (3%; p = 0.001. Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive 'instruction and advice' than non-smokers (OR 4.124; 95% CI: 3.088-5.508; p = 0.01. A further new finding from the multilevel models was a significant difference in treatment related to area
Moore, Rod; Brødsgaard, Inger; Rosenberg, Nicole
Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20-65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of
Birn, Rasmus M; Patriat, Rémi; Phillips, Mary L; Germain, Anne; Herringa, Ryan J
Adult posttraumatic stress disorder (PTSD) has been characterized by altered fear-network connectivity. Childhood trauma is a major risk factor for adult PTSD, yet its contribution to fear-network connectivity in PTSD remains unexplored. We examined, within a single model, the contribution of childhood maltreatment, combat exposure, and combat-related posttraumatic stress symptoms (PTSS) to resting-state connectivity (rs-FC) of the amygdala and hippocampus in military veterans. Medication-free male veterans (n = 27, average 26.6 years) with a range of PTSS completed resting-state fMRI. Measures including the Clinician-Administered PTSD Scale (CAPS), Childhood Trauma Questionnaire (CTQ), and Combat Exposure Scale (CES) were used to predict rs-FC using multilinear regression. Fear-network seeds included the amygdala and hippocampus. Amygdala: CTQ predicted lower connectivity to ventromedial prefrontal cortex (vmPFC), but greater anticorrelation with dorsal/lateral PFC. CAPS positively predicted connectivity to insula, and loss of anticorrelation with dorsomedial/dorsolateral (dm/dl)PFC. Hippocampus: CTQ predicted lower connectivity to vmPFC, but greater anticorrelation with dm/dlPFC. CES predicted greater anticorrelation, whereas CAPS predicted less anticorrelation with dmPFC. Childhood trauma, combat exposure, and PTSS differentially predict fear-network rs-FC. Childhood maltreatment may weaken ventral prefrontal-subcortical circuitry important in automatic fear regulation, but, in a compensatory manner, may also strengthen dorsal prefrontal-subcortical pathways involved in more effortful emotion regulation. PTSD symptoms, in turn, appear to emerge with the loss of connectivity in the latter pathway. These findings suggest potential mechanisms by which developmental trauma exposure leads to adult PTSD, and which brain mechanisms are associated with the emergence of PTSD symptoms. © 2014 Wiley Periodicals, Inc.
Khan, Munizeh; Fida, Mubassar
To assess the psychosocial impact of dental aesthetics using the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ) and self-rated Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Cross-sectional study. Dental Section, the Aga Khan University Hospital, Karachi, from August to September 2006. Adults with no prior orthodontic treatment were asked to complete a modified version of the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ). A total of four variables including 'Dental Self-confidence', 'Social impact', 'Psychological impact' and 'Perceived orthodontic treatment need' were assessed by a series of statements, whereas dental aesthetics were assessed by the respondents using the IOTN Aesthetic Component (self-rated IOTN-AC). Kruskal-Walli's test was applied to determine significance. The respondents were 120 adults (70 females and 50 males; mean age 25.8 years), all four of the above-mentioned variables measuring psychosocial impact showed positive and significant correlations with the perceived severity of malocclusion as depicted by the Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN), with p-value of less than 0.01 for all variables. The results indicate the strong psychosocial impact of altered dental aesthetics on the emotional state of an individual. The association between self-rated IOTN-AC grading with psychosocial well-being stands established, indicating that the perceived aesthetics of malocclusion may be as significant a factor in determining treatment need as the degree of malocclusion.
Young, Earle R.
Sedation can help to overcome the fear that prevents many Canadians from accepting dental treatment. This article discusses the indications and contraindications for oral, intramuscular, and inhalation sedation as used by the general dental practitioner for both adult and child patients, with a note on the growing number of specialist dental anesthetists who provide intravenous out-patient sedation. Local anesthesia is discussed with reference to allergic reactions, malignant hyperthermia, an...
Todor T. Uzunov
Full Text Available Purpose: The aim of the study is to determine the extent of the use of photography by dentists for the needs of everyday practice. Material and methods: The survey was conducted among 254 dentists practicing in Sofia, 64 (25.2% - men and 190 (74.8% - women. The average age of respondents is 43.21 years. Questionnaire was developed, consisting of 9 questions, divided into two parts. The first part covers questions about the nature of the dental practice of respondent doctor. The second part includes questions about the use of photography for the purpose of daily practice. Results: A statistical data processing is made. The average values of the responses received by groups of questions are analyzed. The factors that affect the use of dental photography were defined. The results show that from all of the surveyed persons, 82 (32.28% people use photography for dental practice and 172 (67.72% dentists do not to apply this method in their daily work. It was found that the reasons for not using the photography by dentists are: fear of cross-infection - 4 persons (1.57%; lack of need to use photography - 14 persons (5.51%; lack of interest - 18 persons (7.09%; cost of clinical time - 24 persons (9.45%; additional training - 58 (22.83%; expensive investment - 98 persons (38.58%. Conclusion: The extent and reasons for use of photography for the dental practice were found. The factors that are relevant to the use of dental photography by dentists were investigated.
Samsudin, A.R.; Meor Kamal, M. Z.; Afifi Abu Bakar
The aim of this study is to look at the efficacy of radiosterilised demineralised freeze dried bovine bone xenograft as a dental haemostatic agent in tooth socket wound following tooth extraction. Six adult Merino sheep underwent extraction of two central incisor teeth under general anaesthesia. In one tooth extraction socket (socket side A) a standard gelatin dental haemostatic agent was inserted while a radiosterilised cancellous bovine bone cube was inserted into the second tooth extraction socket (socket side B). The time taken for the bleeding from the both socket to stop was noted and the sheep were kept asleep under general anesthesia till complete hemostasis was achieved. The feeding habits and wound healing were observed till the tenth postoperative day. Results showed that in socket A, complete hemostasis was achieved in a mean time of 135 seconds (range 110 seconds to 145 seconds) and in socket B, complete hemostasis was achieved in a mean time of 97 seconds (range 8 8 seconds to 112 seconds). Observation regarding feeding habits demonstrate that all the sheep showed preference to chew food on the side of socket 'side B' till the fifth postoperative day and by the seventh day, all sheep chew on both sides of the jaw. The standard gelatin dental hemostatic agent was found to be dislodged from all socket side B on the first postoperative day while the bovine bone cube remained in socked side A till the seventh postoperative day. In conclusion, radiosterilised cancellous bovine bone cube may be applied as an effective dental hemostatic agent following tooth extraction
García-Cortés, José Obed; Mejia-Cruz, Jorge Adrián; Medina-Cerda, Eduardo; Orozco-De la Torre, Guillermo; Medina-Solís, Carlo Carlo; Márquez-Rodríguez, Sonia; Navarrete-Hernández, José de Jesús; Islas-Granillo, Horacio
To determine the experience, prevalence and severity of dental caries as well as to establish the treatment needs and restorative care in adolescents and young adults. This cross-sectional study included 638 subjects 16-25 years old candidates to enter to state public university of San Luis Potosí, México. For caries detection was used the DMFT index (sum of decayed teeth + missing teeth + filled teeth in the permanent dentition). With DMFT index data were calculated the experience, the prevalence and the severity of caries. Also are reported the significant caries index (SiC), the treatment needs index (TNI) and the care index (CI). Statistical analysis was performed using nonparametric tests. The mean DMFT index was 4.24 ± 3.85, prevalence 76.5% and severity of 52.3% for DMFT > 3 and 26.2% for DMFT > 6. The SiC index was 8.7. The TNI was 43.0% and 52.8% CI. No variation was observed (p > 0.05) on the experience, prevalence and severity of caries by age. The component "filled teeth" showed differences by age (p caries experience and severity than men (p dental caries in this sample of adolescents and young adults. We found almost 40% of untreated caries lesions. We found some differences by sex.
Chi, Donald L; Lenaker, Dane; Mancl, Lloyd; Dunbar, Matthew; Babb, Michael
Dental Health Aide Therapists (DHATs) have been part of the dental workforce in Alaska's Yukon-Kuskokwim (YK) Delta since 2006. They are trained to provide preventive and restorative care such as filling and extractions. In this study, we evaluated community-level dental outcomes associated with DHATs. This was a secondary data analysis of Alaska Medicaid and electronic health record data for individuals in Alaska's YK Delta (2006-2015). The independent variable was the number of DHAT treatment days in each community. Child outcomes were preventive care, extractions, and general anesthesia. Adult outcomes were preventive care and extractions. We estimated Spearman partial correlation coefficients to test our hypotheses that increased DHAT treatment days would be associated with larger proportions utilizing preventive care and smaller proportions receiving extractions at the community-level. DHAT treatment days were positively associated with preventive care utilization and negatively associated with extractions for children and adults (P justice. © 2018 American Association of Public Health Dentistry.
Latusz, Joachim; Radaszkiewicz, Aleksandra; Bator, Ewelina; Wędzony, Krzysztof; Maćkowiak, Marzena
Epidemiological data have indicated that memory impairment is observed during adolescence in groups at high risk for schizophrenia and might precede the appearance of schizophrenia symptoms in adulthood. In the present study, we used a neurodevelopmental model of schizophrenia based on the postnatal blockade of N-methyl-d-aspartate (NMDA) receptors in rats to investigate fear memory in adolescence and adulthood. The rats were treated with increasing doses of CGP 37849 (CGP), a competitive antagonist of the NMDA receptor (1.25mg/kg on days 1, 3, 6, 9; 2.5mg/kg on days 12, 15, 18 and 5mg/kg on day 21). Fear memory was analysed in delay and trace fear conditioning. Sensorimotor gating deficit, which is another cognitive symptom of schizophrenia, was also determined in adolescent and adult CGP-treated rats. Postnatal CGP administration disrupted cue- and context-dependent fear memory in adolescent rats in both delay and trace conditioning. In contrast, CGP administration evoked impairment only in cue-dependent fear memory in rats exposed to trace but not delay fear conditioning. The postnatal blockade of NMDA receptors induced sensorimotor gating deficits in adult rats but not in adolescent rats. The postnatal blockade of NMDA receptors induced fear memory impairment in adolescent rats before the onset of neurobehavioral deficits associated with schizophrenia. Copyright © 2016. Published by Elsevier Urban & Partner Sp. z o.o.
In recent years, questions have been raised regarding the dimensionality of existing measures of fear of fear. This is an important issue that needs to be addressed if the dimensions(s) of any scale purporting to assess fear of fear are to guide theory and research. One of the most widely used
E. N. Mitin
Full Text Available Psychological comfort on the dental admission is important for the implementation of preventive measures. Considerable attention is now being given to the relationship doctor-dentist with patients, establish positive communication, without which it is impossible to implement preventive measures. Particularly urgent is the problem of creating a trusting relationship between doctor and patient in childhood. With three years there has been persistent memory on the pain, the child’s organs and systems are in a state of unstable equilibrium, so the feeling of fear and pain have a particularly pronounced effect on the psyche of a young patient. The dominant value in the motivation for subsequent visits to the doctor is the emotional coloring of the first visits to the dental clinic.
De Oliveira, Patricia Alves Drummond; Paiva, Saul Martins; De Abreu, Mauro Henrique Nogueira Guimarães; Auad, Sheyla Márcia
The purpose of this study was to investigate the impact of gastroesophageal reflux disease (GERD) on dental erosion (DE) in children and analyze the association between dental erosion and diet, oral hygiene, and sociodemographic characteristics. This case-control study encompassed 43 two- to 14-year-olds diagnosed positive for GERD by the 24-hour pH monitoring, paired by age group with 136 healthy controls, in Belo Horizonte, Minas Gerais, Brazil. DE was assessed by one calibrated examiner using the O'Sullivan index. A questionnaire was self-administered by parents collecting information regarding sociodemographics, oral hygiene, and dietary habits. Dental erosion experience was compared between the groups, and a stratified analysis was performed (PDental erosion was diagnosed in 10.6 percent (N equals 19) of all the children; 25.6 percent (N equals 11) of GERD children and 5.9 percent (N equals eight) of children without GERD, P=0.001). Dental erosion was not associated with dietary consumption or sociodemographic characteristics in both groups (P≥0.05). Children who used adult toothpaste had a 5.79 higher chance of having dental erosion in the group with GERD. Children diagnosed with gastroesophageal reflux disease were at an increased risk of having dental erosion when compared to healthy subjects; among the GERD children, dental erosion was associated with the use of adult toothpaste.
Full Text Available Three days of fear conditioning that combines tactile stimulation of a row of facial vibrissae (conditioned stimulus, CS with a tail shock (unconditioned stimulus, UCS expands the representation of "trained" vibrissae, which can be demonstrated by labeling with 2-deoxyglucose in layer IV of the barrel cortex. We have also shown that functional reorganization of the primary somatosensory cortex (S1 increases GABAergic markers in the hollows of "trained" barrels of the adult mouse. This study investigated how whisker-shock conditioning (CS+UCS affected the expression of puncta of a high-affinity GABA plasma membrane transporter GAT-1 in the barrel cortex of mice 24 h after associative learning paradigm. We found that whisker-shock conditioning (CS+UCS led to increase expression of neuronal and astroglial GAT-1 puncta in the "trained" row compared to controls: Pseudoconditioned, CS-only, UCS-only and Naïve animals. These findings suggest that fear conditioning specifically induces activation of systems regulating cellular levels of the inhibitory neurotransmitter GABA.
Background Dental general anaesthesia (DGA) is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS) and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age (periodontics, surgical procedures and miscellaneous. The reasons for DGA and the treatments provided varied according to age, immigration, previous sedation and DGA and medical background. The logistic regression model showed that previous sedation (OR 2.3; 95%CI 1.3-4.1; p=0.005) and extreme non-cooperation (OR 1.7; 95%CI 0.9-3.2; p=0.103) were most indicative of preventive measures given. Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA. PMID:23102205
Marsh, Abigail A; Cardinale, Elise M
Psychopathy is a disorder characterized by reduced empathy, shallow affect and behaviors that cause victims distress, like threats, bullying and violence. Neuroimaging research in both institutionalized and community samples implicates amygdala dysfunction in the etiology of psychopathic traits. Reduced amygdala responsiveness may disrupt processing of fear-relevant stimuli like fearful facial expressions. The present study links amygdala dysfunction in response to fear-relevant stimuli to the willingness of individuals with psychopathic traits to cause fear in other people. Thirty-three healthy adult participants varying in psychopathic traits underwent whole-brain fMRI scanning while they viewed statements that selectively evoke anger, disgust, fear, happiness or sadness. During scanning, participants judged whether it is morally acceptable to make each statement to another person. Psychopathy was associated with reduced activity in right amygdala during judgments of fear-evoking statements and with more lenient moral judgments about causing fear. No group differences in amygdala function or moral judgments emerged for other emotion categories. Psychopathy was also associated with increased activity in middle frontal gyrus (BA 10) during the task. These results implicate amygdala dysfunction in impaired judgments about causing distress in psychopathy and suggest that atypical amygdala responses to fear in psychopathy extend across multiple classes of stimuli.
Park, Y; Paik, N-J; Kim, K W; Jang, H-C; Lim, J-Y
Fall is a common cause of disability and death in old adults, and much research has been focused on identifying risk factors and developing preventive measures. Yet the majority of preceding research has been focused on physical performance. This study aims to evaluate the association between fall and depressive symptoms in community-dwelling elderly. Cross-sectional data of 431 men and 546 women was collected from old Korean adults living in Seongnam, Korea. Geriatric fall assessment was conducted by self-report questionnaires. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale. Results indicated that depressive symptoms were associated with both fall and fear of falling in old adults. A clear gender difference was newly discovered, as depression played a stronger role in women. These results imply that clinicians should consider the negative affect of geriatric patients when assessing fall risk. Also, measures against depression might be effective in reducing falls.
Kuriyama, Kenichi; Honma, Motoyasu; Yoshiike, Takuya; Kim, Yoshiharu
Sleep deprivation immediately following an aversive event reduces fear by preventing memory consolidation during homeostatic sleep. This suggests that acute insomnia might act prophylactically against the development of posttraumatic stress disorder (PTSD) even though it is also a possible risk factor for PTSD. We examined total sleep deprivation and memory suppression to evaluate the effects of these interventions on subsequent aversive memory formation and fear conditioning. Active suppression of aversive memory impaired retention of event memory. However, although the remembered fear was more reduced in sleep-deprived than sleep-control subjects, suppressed fear increased, and seemed to abandon the sleep-dependent plasticity of fear. Active memory suppression, which provides a psychological model for Freud's ego defense mechanism, enhances fear and casts doubt on the potential of acute insomnia as a prophylactic measure against PTSD. Our findings bring into question the role of sleep in aversive-memory consolidation in clinical PTSD pathophysiology.
Krikken, J B; van Wijk, A J; ten Cate, J M; Veerkamp, J S J
Treating children can be difficult for both dentist and child. In some cases treatment fails and those children are referred to a specialist paediatric dentist. Different factors can be put forward for referral of children, such as factors relating to the child, dentist and parent. Possible child-related factors can be dental anxiety and the child's temperament. A possible parental factor is the parental rearing style. The objective of this study was to assess the possible associations between dental anxiety, parental rearing style and referral status of children. Parents of 120 non-referred and 335 referred paediatric dental patients were asked to fill out the Child Rearing Practices Report (CRPR) and the Child Fear Survey Schedule Dental Subscale (CFSS-DS) on behalf of their children. The questionnaires were filled out by 115 (96%) parents of primary schoolchildren and by 331 (99%) parents of referred children. Referred children were younger than non-referred children, t(442) = 6.9, p authoritarian parenting style were more anxious than the other non-referred children. In the present study, referral status and dental anxiety of 4-12 year old children were not associated with parental rearing style.
Oosterwijk, S.; Topper, M.; Rotteveel, M.; Fischer, A.H.
In the present study, the authors tested whether conceptual fear knowledge can (a) evoke bodily reactions and (b) enhance subsequent bodily reactions to fearful stimuli. Participants unscrambled neutral or fear sentences and subsequently viewed fearful and neutral pictures in combination with
Full Text Available Abstract: This article aimed to describe the levels of user satisfaction in different age groups and to study the association between user satisfaction and different types of dental services in a representative sample of Brazilians. This study is based on the Brazilian Oral Health Survey, which evaluated the dental health of adolescents, adults and older adults in 177 Brazilian cities. The outcome variable was user satisfaction, related to the last dental visit, evaluated in a five-level Likert-type scale. The main exposure variable was the type of dental service (public service, private service, health plan or insurance. The independent variables were DMFT (decay, missing and filled teeth; pain intensity in the past six months; reason for the last dental visit; perceived need for treatment; frequency of use of dental services; sex; equivalent income; and educational level. An ordered logistic regression analysis was performed separately for each age group. Few participants evaluated the services as bad or very bad (4.3% of adolescents, 6.1% of adults and 4.1% of older adults. In the crude model, the use of public services was associated with lower satisfaction than the use of private services and health plans between all groups. However, after adjusting by covariates, this association remained only in adolescents, who showed lower satisfaction with the public service compared to the private service and health plans. In general, Brazilians are satisfied with dental services, but, among adolescents, the use of public services was associated with lower satisfaction. Public services may be focused on issues related to children, adults and older adults, and not to the adolescent audience, which has specific demands.
Goh, Hui-Ting; Nadarajah, Mohanasuntharaam; Hamzah, Norhamizan Binti; Varadan, Parimalaganthi; Tan, Maw Pin
Falls are common after stroke, with potentially serious consequences. Few investigations have included age-matched control participants to directly compare fall characteristics between older adults with and without stroke. Further, fear of falling, a significant psychological consequence of falls, has only been examined to a limited degree as a risk factor for future falls in a stroke population. To compare the fall history between older adults with and without a previous stroke and to identify the determinants of falls and fear of falling in older stroke survivors. Case-control observational study. Primary teaching hospital. Seventy-five patients with stroke (mean age ± standard deviation, 66 ± 7 years) and 50 age-matched control participants with no previous stroke were tested. Fall history, fear of falling, and physical, cognitive, and psychological function were assessed. A χ 2 test was performed to compare characteristics between groups, and logistic regression was performed to determine the risk factors for falls and fear of falling. Fall events in the past 12 months, Fall Efficacy Scale-International, Berg Balance Scale, Functional Ambulation Category, Fatigue Severity Scale, Montreal Cognitive Assessment, and Patient Healthy Questionnaire-9 were measured for all participants. Fugl-Meyer Motor Assessment was used to quantify severity of stroke motor impairments. Twenty-three patients and 13 control participants reported at least one fall in the past 12 months (P = .58). Nine participants with stroke had recurrent falls (≥2 falls) compared with none of the control participants (P falling than did nonstroke control participants (P falls in the nonstroke group, whereas falls in the stroke group were not significantly associated with any measured outcomes. Fear of falling in the stroke group was associated with functional ambulation level and balance. Functional ambulation level alone explained 22% of variance in fear of falling in the stroke group
Jiang, Tingting; Lee, Sang-Mi; Hou, Yanan; Chang, Xin; Hwang, Hyeon-Shik
Objective To investigate the dimensional accuracy of digital dental models obtained from the dental cone-beam computed tomography (CBCT) scan of alginate impressions according to the time elapse when the impressions are stored under ambient conditions. Methods Alginate impressions were obtained from 20 adults using 3 different alginate materials, 2 traditional alginate materials (Alginoplast and Cavex Impressional) and 1 extended-pour alginate material (Cavex ColorChange). The impressions wer...
Giachero, Marcelo; Bustos, Silvia G.; Calfa, Gaston; Molina, Victor A.
The present study investigates the fear memory resulting from the interaction of a stressful experience and the retrieval of an established fear memory trace. Such a combination enhanced both fear expression and fear retention in adult Wistar rats. Likewise, midazolam intra-basolateral amygdala (BLA) infusion prior to stress attenuated the…
Wanyonyi, Kristina L; Radford, David R; Gallagher, Jennifer E
This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008-2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients' individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (care in the form of 'instruction and advice', compared with 46% of working age adults (18-64 years); p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001): 'partial dentures' (7%); 'scale and polish' (3.7%); 'tooth extraction' (3%; p = 0.001), and 'instruction and advice' (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive 'instruction and advice' than non-smokers (OR 4.124; 95% CI: 3.088-5.508; p = 0.01). A further new finding from the multilevel models was a significant difference in treatment related to area of residence; adults from the most deprived quintile were more likely
R Frederick Lambert
Full Text Available The purpose of this study is to understand engagement with and availability of dental services among people living with HIV in a low-income community of South Africa.In depth qualitative interviewing was used to collect data, which was analyzed using an inductive content analytical approach. The study was conducted in Gugulethu, a township community located outside of Cape Town, South Africa. Local public sector health services provided free of charge are the main source of primary health and dental care for this population. Participants included South African adults (age 18-35 recently diagnosed with HIV who had a CD4 count >350 cells/mm3.Many participants had little to no experience with dental care, did not know which health care providers are appropriate to address oral health concerns, were not aware of available dental services, utilized home remedies to treat oral health problems, harbored many misperceptions of dental care, avoided dental services due to fear, and experienced poverty as a barrier to dental services.Our findings suggest that integration of oral healthcare into medical care may increase patient knowledge about oral health and access to care. Leveraging the relatively robust HIV infrastructure to address oral disease may also be an effective approach to reaching these participants and those living in resource poor communities generally.
Lau, Ying; Chow, Aloysius; Chan, Sally; Wang, Wenru
The present study aimed to investigate the attitudes of Chinese older adults toward seeking help from healthcare professionals, and its impact on their self-care ability and medication adherence. A cross-sectional study using a questionnaire survey was carried out. A convenience sample of 301 older adults was recruited from six health centers in Macao, People's Republic of China. The Chinese versions of Fear of Intimacy with Helping Professionals (C-FIHP), Exercise of Self-care Agency (C-ESCA) and Morisky 4-Item Self-Report Measure of Medication-Taking Behavior (C-MMAS) were used to measure the study variables. Chinese older adults who were married and had comorbidity with arthritis showed significantly negative attitudes toward seeking help form healthcare professional than those who were not married (P Chinese older adults' fear of intimacy with helping professionals impacts their perceived self-care ability and medication adherence. The three predictive factors identified in the present study might provide useful pointers for healthcare professionals to customize an effective approach to encourage and engage older adults. This might improve the self-care ability and medication adherence of older adults, which will result in a better quality of life and psychosocial well-being. © 2013 Japan Geriatrics Society.
Takeshita, Toru; Yasui, Masaki; Shibata, Yukie; Furuta, Michiko; Saeki, Yoji; Eshima, Nobuoki; Yamashita, Yoshihisa
Dental plaque is a dynamic microbial biofilm ecosystem that comprises hundreds of species including difficult-to-cultivate bacteria. We observed the assembly of a plaque bacterial community through 16S rRNA gene analysis. Plaque samples that accumulated on a hydroxyapatite disk for 1, 2, 3, 4, 5, and 7 days with saliva on day 0 were collected from 19 young adults using a removable resin splint. Quantitative PCR analysis showed that the total bacterial amount gradually increased and reached a plateau on day 4. Barcoded pyrosequencing analysis revealed that the microbial richness and diversity particularly increased between days 5 and 7. A principal coordinate analysis plot based on unweighted UniFrac showed the community assembly in a time-related manner, which became increasingly similar to the salivary microbiota. Facultative anaerobic bacteria such as Streptococcus, Neisseria, Abiotrophia, Gemella, and Rothia were predominant in the plaque bacterial community in the earlier days, whereas obligate anaerobes, such as Porphyromonas, Fusobacterium, Prevotella, and Capnocytophaga showed increased dominance on later days. UniFrac analysis also demonstrated that dental caries experience had a significant effect on the assembly process. Our results reveal the development pattern of the plaque bacterial community as well as the inter-individual differences associated with dental caries experience.
Gabriela Fleury SEIXAS
Full Text Available Anti-dentin autoantibodies are associated with inflammatory root resorption in permanent teeth and are modulated by dental trauma and orthodontic force. However, it is not known whether deciduous tooth trauma can stimulate the development of a humoral immune response against dentin. The aim of this study was to evaluate the levels of salivary SIgA reactivity against human dentin extract in young adults with a history of trauma in the primary dentition. A sample of 78 patients, aged 18 to 25, who had completed an early childhood (0 to 5 years old caries prevention program years earlier at the Universidade Estadual de LondrinaPediatric Clinic, underwent radiographic examination and salivary sampling. Anti-dentin SIgA levels were analyzed by immunoenzymatic assay and Western blotting. Although dental trauma to deciduous teeth had occurred in 34 (43.6% of the patients, no differences in SIgA levels were detected between individuals who had experienced trauma and those who had not (p > 0.05. Multivariate regression analysis showed no association between dental trauma and SIgA levels (p > 0.05. Patients with a history of deciduous trauma presented low levels of anti-dentin antibodies, associated with orthodontic root resorption (p
Full Text Available Dental anxiety and fear can be a significant barrier to dental care, with symptoms ranging from feelings of unease to avoidance of care. The management of anxious patients is essential to improve their oral health. Triggers include sights, sounds, sensations, and smells of the equipment used in restorative procedures, and management should focus on controlling these factors. Recommendations for controlling these triggers include distraction and pharmacological interventions. In medicine, distractions include animal-assisted therapy, which proves an effective means of reducing anxiety levels. Studies have shown that interactions with live animals reduce self-reported anxiety more than distractions by either humans or magazines. The media also addresses the valuable role of emotional support by animals in boosting health and enhancing lives. In the past year, numerous news stories have reported regarding the use of certified therapy by dogs to comfort anxious patients in dental practices across the United States. Dogs serve to distract patients, drawing their focus away from dentistry, and generate a positive energy that enliven both the staff and the patients. The positive impact that therapy dogs have had on patients′ dental experiences cannot be overstated. The incorporation of pet anti-anxiety therapy is a safe, effective, and inexpensive approach to easing dental anxiety and has profound potential for improving oral health.
Baker, Kathryn D.; McNally, Gavan P.; Richardson, Rick
Adolescent rats exhibit impaired extinction retention compared to pre-adolescent and adult rats. A single nonreinforced exposure to the conditioned stimulus (CS; a retrieval trial) given shortly before extinction has been shown in some circumstances to reduce the recovery of fear after extinction in adult animals. This study investigated whether a…
Boscato, Noeli; Schuch, Helena S; Grasel, Claudia E; Goettems, Marilia L
To assess differences in the oral diseases/conditions between adults and older adults. A cross-sectional study was carried out with all adults and older adults in Luzerna, South Brazil (n = 569). Clinical data included use of and need for dental prostheses; number of decayed, missing and filled teeth; and temporomandibular disorder. Differences between adults and older adults were evaluated using χ(2) -tests. Associations between independent variables and the use of and need for dental prostheses were determined using Poisson regression analyses (P older adults. After adjustments, lower social class (P = 0.001) and unmarried status (P = 0.05) were associated with greater need for prosthetic rehabilitation. Women (P = 0.02), older individuals (P adults and older adults was observed. The frequency of use of and need for dental prostheses was higher for older adults, although they had reported lower frequency of temporomandibular disorder. Women, married and individuals of higher socioeconomic status showed better oral health conditions. Geriatr Gerontol Int 2016; 16: 1014-1020. © 2015 Japan Geriatrics Society.
Raner, Elisabeth; Lindqvist, Lina; Johansson, Sofia; Hassan, Haidar; Carlén, Anette; Suksu-art, Narong; Dahlén, Gunnar
This study compares pH and microbiological profile of dental plaque in children and adults of a low caries population. Thirty-nine children, 12-14 years of age and 45 adults between 20 and 39 years of age in 5 Karen villages of the Tak province, Northern Thailand were examined for plaque, calculus, caries (DMFT) and pH measurements in resting plaque and after a sucrose rinse. Information on dietary and oral hygiene habits was obtained through interviews using a fixed questionnaire. Microbiological profile of plaque samples was analyzed with DNA-DNA checkerboard technique. Mean DMFT was 0.77 ± 1.56 and 87% of the adults and 67% of the children were caries free (p plaque samples showed high levels of low acidogenic and anaerobic species, which dominated over strong acid producers such as streptococci. The study indicates that the Karen children and adults has a plaque physiology and microbiology predominating by low acidogenic anaerobes, which in addition to the low sucrose intake explains the low caries prevalence in this population. Copyright © 2014 Elsevier Ltd. All rights reserved.
Molarius, Anu; Engström, Sevek; Flink, Håkan; Simonsson, Bo; Tegelberg, Åke
BACKGROUND: The aims of this study were to determine self-rated oral health and dental attendance habits among Swedish adults, with special reference to the role of social inequalities, after the Swedish dental care reform in 2008. METHODS: The study is based on a survey questionnaire, sent to 12,235 residents of a Swedish county, in 2012. The age group was 16-84 years: 5,999 (49%) responded. Using chi-square statistics, differences in prevalence of self-rated oral health and regular dental a...
Aro, A R; Jallinoja, P T; Henriksson, M M
Suicide victims with fear of acquired immunodeficiency syndrome (AIDS) or other somatic illness were compared for psychosocial and health-related characteristics, triggers and content of fear. Fear of AIDS cases (n = 28), 2% of the 1-year Finnish suicide population (n = 1397), were younger...... and fewer had serious somatic disease (32% vs 64%) compared with cases of fear of other somatic illness. Both groups had more depression, especially major depression (54% and 61% vs 26%), more psychotic disorders (50% and 32% vs 24%) and health care contacts during their final week (61% and 64% vs 36%) than...... other suicides. Suicidal fear of AIDS calls for evaluation of sexual and other risk behaviour, but fear of AIDS was largely generated by the extensive media coverage. Fear of other somatic illness was more diverse in origin and related to illness experiences. Suicidal fear of illness calls...
Stránská, Petra; Velemínský, P.; Poláček, Lumír
Roč. 60, č. 1 (2015), s. 62-76 ISSN 0003-9969 R&D Projects: GA ČR GB14-36938G Institutional support: RVO:67985912 ; RVO:68081758 Keywords : bioarchaeology * early medieval population * Great Moravia * non-adult individuals * dental caries * socio-economic status Subject RIV: AC - Archeology, Anthropology, Ethnology Impact factor: 1.733, year: 2015
Kim, Hyang-Sook; Sheffield, Donna; Almutairi, Talal
Background: Fear appeals are commonly used in health communication to reduce risk. It is not clear, however, whether familiarity with a health topic can lessen the threat intended. The use of unregulated dietary supplements among young adults is one such area that needs study. Purpose: The study examined the effect of fear appeals on…
Riggs, Samantha; Cook, Carrie L
The shadow hypothesis regarding the impact of fear of sexual assault on fear of violent crime suggests that female fear of crime is characterized by concern about sexual assault as a contemporaneous victimization event during a violent crime event. Recent research has found that other types of crime, namely physical assault, may also be feared as a contemporaneous offense. We know of no research that has examined the unique impact of fear of murder versus fear of sexual assault on fear of violent crime. There is also a lack of research that explores how these two types of fear uniquely affect men and women. In addition to gender, we examine factors that have been suggested in previous research to correlate with fear of crime: race, victimization, vicarious victimization, and perceived risk. Through survey methodology, this research examines the unique relationship between both fear of murder and fear of sexual assault and fear of three types of violent crime for men and women. Results suggest differences in how fear of murder and fear of sexual assault are related to fear of other types of violence for men and women. Specifically, fear of murder is important in estimating male fear of robbery and aggravated assault. However, fear of sexual assault is almost as important as fear of murder for men in estimating fear of home invasion. Similarly, for women, fear of sexual assault and fear of murder both are significant factors associated with fear of violent crime, and differences between the levels of significance are marginal. This study is a first to examine whether murder may also be feared as a contemporaneous offense. The results are informative in identifying what drives fear of crime, particularly violent crime, for both men and women. Avenues for future research are discussed. © The Author(s) 2014.
Sebastiani, Francesco R; Dym, Harry; Wolf, Joshua
This article highlights the commonly used medications used in dentistry and oral surgery. General dentists and specialists must be knowledgeable about the pharmacology of the drugs currently available along with their risks and benefits. Enteral sedation is a useful adjunct for the treatment of anxious adult and pediatric patients. When enteral sedation is used within the standards of care, the interests of the public and the dental profession are served through a cost-effective, effective service that can be widely available. Oral sedation enables dentists to provide dental care to millions of individuals who otherwise would have unmet dental needs. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Methods Subjects (Ss were consecutive specialist clinic patients, 16 men, 14 women, 20–65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Results Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9 with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment
Hauer, Klaus A; Kempen, Gertrudis I J M; Schwenk, Michael; Yardley, Lucy; Beyer, Nina; Todd, Chris; Oster, Peter; Zijlstra, G A Rixt
Measures of fear of falling have not yet been validated in patients with dementia, leaving a methodological gap that limits research in a population at high risk of falling and fall-related consequences. The objectives of this study are to determine: (1) the validity of the 7-item Short Falls Efficacy Scale International (Short FES-I) in geriatric patients with and without cognitive impairment, and (2) the sensitivity to change of the 10-item Falls Efficacy Scale (FES), the 16-item FES-I and the 7-item Short FES-I in geriatric patients with dementia. Cross-sectional data of community-dwelling older adults and geriatric rehabilitation patients (n = 284) collected during face-to-face interviews were used to determine construct and discriminant validity by testing for differences within variables related to fear of falling. Sensitivity to change was studied in an intervention study including patients with mild to moderate dementia (n = 130) as determined by standard response means (SRMs). The Short FES-I showed excellent construct and discriminant validity in the total group and subsamples according to cognitive status. Sensitivity to change was adequate to good in the FES (range SRM: 0.18-0.77) and FES-I (range SRM: 0.21-0.74), with the Short FES-I showing the highest peak sensitivity to change (range SRM: 0.18-0.91). The Short FES-I is a valid measure to assess fear of falling in frail older adults with and without cognitive impairment, yet it may show floor effects in higher functioning older people. All scales, including the Short FES-I, were sensitive to detecting intervention-induced changes in concerns about falling in geriatric patients with dementia. Copyright © 2010 S. Karger AG, Basel.
Julie eBoulanger Bertolus
Full Text Available Interval timing refers to the ability to perceive, estimate and discriminate durations in the range of seconds to minutes. Very little is currently known about the ontogeny of interval timing throughout development. On the other hand, even though the neural circuit sustaining interval timing is a matter of debate, the striatum has been suggested to be an important component of the system and its maturation occurs around the third post-natal week in rats. The global aim of the present study was to investigate interval timing abilities at an age for which striatum is not yet mature. We used odor fear conditioning, as it can be applied to very young animals. In odor fear conditioning, an odor is presented to the animal and a mild footshock is delivered after a fixed interval. Adult rats have been shown to learn the temporal relationships between the odor and the shock after a few associations. The first aim of the present study was to assess the activity of the striatum during odor fear conditioning using 2-Deoxyglucose autoradiography during development in rats. The data showed that although fear learning was displayed at all tested ages, activation of the striatum was observed in adults but not in juvenile animals. Next, we assessed the presence of evidence of interval timing in ages before and after the inclusion of the striatum into the fear conditioning circuit. We used an experimental setup allowing the simultaneous recording of freezing and respiration that have been demonstrated to be sensitive to interval timing in adult rats. This enabled the detection of duration-related temporal patterns for freezing and/or respiration curves in infants as young as 12 days post-natal during odor-fear conditioning. This suggests that infants are able to encode time durations as well as and as quickly as adults while their striatum is not yet functional. Alternative networks possibly sustaining interval timing in infant rats are discussed.
Zhang, Bo; Tan, Xiaodan; Zhang, Kunlun
We aimed to investigate whether the cadmium concentrations differ in human dental calculus obtained from the residents with no smoking living in the contaminated area and those with no smoking living in noncontaminated area. In total, there were 260 samples of dental calculus from the adults (n = 50) with no smoking living in contaminated area, the adults (n = 60) with no smoking living in mountainous area, and the adults (n = 150) with no smoking living in low altitude area in Hunan province of China. All samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS) for cadmium levels. The cadmium levels in dental calculus were significantly higher in the adults with no smoking living in contaminated area than those living in mountainous area and in low altitude area (p dental calculus were also higher in the adults with no smoking living in low altitude area than those living in mountainous region (p dental calculus may be a useful noninvasive method for analysis of environmental exposure to cadmium in the human oral cavity. The low altitude region may have an area contaminated with cadmium in Hunan province of China.
AlShahrani, Mohammed Thamer; Haralur, Satheesh B; Alqarni, Mohammed
Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition.
Mohammed Thamer AlShahrani
Full Text Available Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition.
Gross-Panico, Michelle L; Freeman, Wilbur K
Minority children and children from lower income families are more likely to experience the burden of oral disease. Since oral disease reduces quality of life, it is a priority to utilize preventive dental services. The research questions ask if affiliated practice increases utilization of preventive dental services by underserved children from birth to 18 years of age, and what the barriers to receiving preventive dental services are and their level of importance. A survey was administered to parents/guardians of patients from birth to 18 years of age who received preventive dental services from Catholic Healthcare West East Valley Children's Dental Clinic, an affiliated practice dental clinic in Chandler, Arizona. Thirty-four surveys were completed: 21 completed in English and 13 completed in Spanish. The data was analyzed to provide descriptive statistics and non-parametrically analyzed using the Friedman's, Kendall's W and Wilcoxon Signed Ranks Tests. The cost of preventive dental services is more important to this population than both convenience of appointment time and distance traveled. As the cost increases for preventive dental services, this population will utilize preventive dental services less frequently. The study indicated that the increase of self-reported utilization of preventive dental services by underserved children, ranging in age from birth to 18 years old, in Arizona affiliated practice dental clinics, was primarily impacted by perceived reduced costs of receiving care. Funding efforts, reimbursement mechanisms and legislative policies should support this dental care delivery model to provide care to underserved children, adults and seniors throughout the U.S.
Calvasina, Paola; Muntaner, Carles; Quiñonez, Carlos
This study examines predictors of transnational dental care utilization, or the use of dental care across national borders, over a 4-year period among immigrants to Canada. Data from the Longitudinal Survey of Immigrants to Canada (LSIC, 2001-2005) were used. Sampling and bootstrap weights were applied to make the data nationally representative. Bivariate and multiple logistic regression analyses were applied to identify factors associated with immigrants' transnational dental care utilization. Approximately 13% of immigrants received dental care outside Canada over a period of 4 years. Immigrants lacking dental insurance (OR = 2.05; 95% CI: 1.55-2.70), those reporting dental problems (OR = 1.45; 95% CI: 1.12-1.88), who were female (OR = 1.59; 95% CI: 1.22-2.08), aged ≥ 50 years (OR = 2.30; 95% CI: 1.45-3.64), and who were always unemployed (OR = 1.70; 95% CI: 1.20-2.39) were more likely to report transnational dental care utilization. History of social assistance was inversely correlated with the use of dental services outside Canada (OR = 0.48; 95% CI: 0.30-0.83). It is estimated that roughly 11 500 immigrants have used dental care outside Canada over a 4-year period. Although transnational dental care utilization may serve as an individual solution for immigrants' initial barriers to accessing dental care, it demonstrates weaknesses to in-country efforts at providing publicly funded dental care to socially marginalized groups. Policy reforms should be enacted to expand dental care coverage among adult immigrants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available Attentional control (AC and fear extinction learning are known to be involved in pathological anxiety. In this study we explored whether individual differences in non-emotional AC were associated with individual differences in the magnitude and gradient of fear extinction (learning and recall. In 50 individuals with fear of spiders, we collected measures of non-emotional AC by means of self-report and by assessing the functioning of the major attention networks (executive control, orienting, and alerting. The participants then underwent a paradigm assessing fear extinction learning and extinction recall. The two components of the orienting network functioning (costs and benefits were significantly associated with fear extinction gradient over and above the effects of trait anxiety. Specifically, participants with enhanced orienting costs (i.e., difficulties in disengaging attention from cues not relevant for the task showed faster extinction learning, while those with enhanced orienting benefits (i.e., attention facilitated by valid cues exhibited faster extinction recall as measured by fear-potentiated startle and Unconditioned Stimulus expectancies, respectively. Our findings suggest that, in non-emotional conditions, the orienting component of attention may be predictive of fear extinction. They also show that the use of fear extinction gradients and the exploration of individual differences in non-emotional AC (using performance-based measures of attentional network functioning can provide a better understanding of individual differences in fear learning. Our findings also may help to understand differences in exposure therapy outcomes.
Meyerhoefer, Chad D; Zuvekas, Samuel H; Manski, Richard
Chronic tooth decay is the most common chronic condition in the United States among children ages 5-17 and also affects a large percentage of adults. Oral health conditions are preventable, but less than half of the US population uses dental services annually. We seek to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. Using data from the 2001-2006 Medical Expenditure Panel Survey and an American Dental Association survey of dental procedure prices, we jointly estimate the probability of using preventive and both basic and major restorative services through a correlated random effects specification that controls for endogeneity. We found that dental coverage increased the probability of preventive care use by 19% and the use of restorative services 11% to 16%. Both conditional and unconditional on dental coverage, the use of dental services was not sensitive to out-of-pocket costs. We conclude that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants. Copyright © 2013 John Wiley & Sons, Ltd.
Nabi, Robin L; Myrick, Jessica Gall
Fear appeal research has focused, understandably, on fear as the primary emotion motivating attitude and behavior change. However, while the threat component of fear appeals associates with fear responses, a fear appeals' efficacy component likely associates with a different emotional experience: hope. Drawing from appraisal theories of emotion in particular, this article theorizes about the role of hope in fear appeals, testing hypotheses with two existing data sets collected within the context of sun safety messages. In both studies, significant interactions between hope and self-efficacy emerged to predict behavioral intentions. Notable main effects for hope also emerged, though with less consistency. Further, these effects persisted despite controlling for the four cognitions typically considered central to fear appeal effectiveness. These results, consistent across two samples, support the claim that feelings of hope in response to fear appeals contribute to their persuasive success. Implications for developing a recursive model of fear appeal processing are discussed.
Dunne, Güler; Reynolds, Gemma; Askew, Chris
Superior learning for fear-relevant stimuli is typically indicated in the laboratory by faster acquisition of fear responses, greater learned fear, and enhanced resistance to extinction. Three experiments investigated the speed, magnitude, and robustness of UK children's (6-10 years; N = 290; 122 boys, 168 girls) vicariously learned fear responses for three types of stimuli. In two experiments, children were presented with pictures of novel animals (Australian marsupials) and flowers (fear-irrelevant stimuli) alone (control) or together with faces expressing fear or happiness. To determine learning speed the number of stimulus-face pairings seen by children was varied (1, 10, or 30 trials). Robustness of learning was examined via repeated extinction procedures over 3 weeks. A third experiment compared the magnitude and robustness of vicarious fear learning for snakes and marsupials. Significant increases in fear responses were found for snakes, marsupials and flowers. There was no indication that vicarious learning for marsupials was faster than for flowers. Moreover, vicariously learned fear was neither greater nor more robust for snakes compared to marsupials, or for marsupials compared to flowers. These findings suggest that for this age group stimulus fear relevance may have little influence on vicarious fear learning. Copyright © 2017 Elsevier Ltd. All rights reserved.
Zimmerman, Mark; Dalrymple, Kristy; Chelminski, Iwona; Young, Diane; Galione, Janine N
In DSM-IV, the diagnosis of social anxiety disorder (SAD) and specific phobia in adults requires that the person recognize that his or her fear of the phobic situation is excessive or unreasonable (criterion C). The DSM-5 Anxiety Disorders Work Group has proposed replacing this criterion because some patients with clinically significant phobic fears do not recognize the irrationality of their fears. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project we determined the number of individuals who were not diagnosed with SAD and specific phobia because they did not recognize the excessiveness or irrationality of their fear. We interviewed 3,000 psychiatric outpatients and 1,800 candidates for bariatric surgery with a modified version of the Structured Clinical Interview for DSM-IV. In the SAD and specific phobia modules we suspended the skip-out that curtails the modules if criterion C is not met. Patients who met all DSM-IV criteria for SAD or specific phobia except criterion C were considered to have "modified" SAD or specific phobia. The lifetime rates of DSM-IV SAD and specific phobia were 30.5 and 11.8% in psychiatric patients and 11.7 and 10.2% in bariatric surgery candidates, respectively. Less than 1% of the patients in both samples were diagnosed with modified SAD or specific phobia. Few patients were excluded from a phobia diagnosis because of criterion C. We suggest that in DSM-5 this criterion be eliminated from the SAD and specific phobia criteria sets. © 2010 Wiley-Liss, Inc.
Alzahem, Abdullah M; Van der Molen, Henk T; Alaujan, Arwa H; De Boer, Benjamin J
This study compared the effectiveness of stress management programs in dental education by systematic review of the literature. The number of studies concerning stress management programs for dental students is limited compared with studies discussing sources of stress. Several types of programs for stress management have been reported, and differ in their duration, content, and outcomes. Two main strategies have been used to help stressed students, ie, decreasing the number of stressors and increasing the ability to cope with stress. The first strategy includes several components, such as reducing fear of failure and workload pressure due to examinations and requirements. The second strategy includes coping techniques, such as deep breathing exercises. Although positive effects have been reported for most of the programs, these have mainly been evaluated using subjective self-report measures. There is a need for more research to identify the most effective stress management program. PMID:24904226
Judith R. Homberg
Full Text Available Conditioned fear plays a key role in anxiety disorders as well as depression and other neuropsychiatric conditions. Understanding how neuromodulators drive the associated learning and memory processes, including memory consolidation, retrieval/expression, and extinction (recall, is essential in the understanding of (individual differences in vulnerability to these disorders and their treatment. The human and rodent studies I review here together reveal, amongst others, that acute selective serotonin reuptake inhibitor (SSRI treatment facilitates fear conditioning, reduces contextual fear, and increases cued fear, chronic SSRI treatment reduces both contextual and cued fear, 5-HT1A receptors inhibit the acquisition and expression of contextual fear, 5-HT2A receptors facilitates the consolidation of cued and contextual fear, inactivation of 5-HT2C receptors facilitate the retrieval of cued fear memory, the 5-HT3 receptor mediates contextual fear, genetically induced increases in serotonin levels are associated with increased fear conditioning, impaired cued fear extinction, or impaired extinction recall, and that genetically induced 5-HT depletion increases fear conditioning and contextual fear. Several explanations are presented to reconcile seemingly paradoxical relationships between serotonin levels and conditioned fear.
de Haas, Elske N.; Kops, Marjolein S.; Bolhuis, J. Elizabeth; Groothuis, Ton G. G.; Ellen, Esther D.; Rodenburg, T. Bas
Fearfulness of an individual can affect its sensitivity to stress, while at the same time the social situation in which an animal lives can affect its fear level. It is however unknown what the long-term effects of high fearfulness on sensitivity to stress are, on individual or group level in laying
Full Text Available It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.
Chippendale, Tracy; Lee, Chang Dae
Using a theoretical model that combines an ecological perspective and Bandura's theory of self-efficacy as a guide, we sought to compare experiences and characteristics of community dwelling older adults with and without concern about falling outdoors. A survey of randomly selected community dwelling older adults across NYC (N = 120) was conducted using the outdoor falls questionnaire. Descriptive quantitative analyses of participant characteristics were conducted for all participants and for those with and without concern about falling outside. Conventional content analysis using two coders was employed to examine outdoor fall experiences for each group. A mixed methods matrix was used to integrate qualitative and quantitative findings. Some participant characteristics were more common among those with a concern about falling outside such as decreased functional status, female gender, and number of prior outdoor falls. As per descriptions of outdoor fall experiences, participants with concern were more likely to report a fall while climbing stairs or stepping up a curb, describe an intrinsic factor as a cause of their fall, use an injury prevention strategy during the fall, sustain a moderate to severe injury, seek medical attention, have had an ambulance called, require help to get up, and describe implementation of a behavioral change after the fall. Differences exist in participant characteristics and outdoor fall experiences of those with and without concern about falling outside. The proposed model can be used to understand fear of falling outdoors and can help to inform the target population and content of intervention programs.
Burgette, J M; Lee, J Y; Baker, A D; Vann, W F
The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). As part of the Carolina Oral Health Literacy Project, clients in the Women, Infants, and Children's Special Supplemental Nutrition Program completed a structured 30-min in-person interview conducted by 2 trained interviewers at 9 sites in 7 counties in North Carolina. Data were collected on clients' OHL, sociodemographics, dental utilization, self-efficacy, and dental knowledge. The outcome, OHL, was measured with a dental word recognition test (30-item Rapid Estimate of Adult Literacy in Dentistry). Descriptive and multiple linear regression methods were used to examine the distribution of OHL and its association with covariates. After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL (P > 0.05). Under the conditions of this study, dental utilization was not a significant predictor of OHL. © International & American Associations for Dental Research 2015.
Full Text Available Dental caries has a polymicrobial etiology within the complex oral microbial ecosystem. However, the overall diversity and structure of supragingival plaque microbiota in adult dental health and caries are not well understood. Here, 160 supragingival plaque samples from patients with dental health and different severities of dental caries were collected for bacterial genomic DNA extraction, pyrosequencing by amplification of the 16S rDNA V1–V3 hypervariable regions, and bioinformatic analysis. High-quality sequences (2,261,700 clustered into 10,365 operational taxonomic units (OTUs; 97% identity, representing 453 independent species belonging to 122 genera, 66 families, 34 orders, 21 classes, and 12 phyla. All groups shared 7522 OTUs, indicating the presence of a core plaque microbiome. Smooth rarefaction curves were suggestive of plaque microbial diversity. α diversity analysis showed that healthy plaque microbial diversity exceeded that of dental caries, with the diversity decreasing gradually with the severity of caries. The dominant phyla of plaque microbiota included Bacteroidetes, Actinobacteria, Proteobacteria, Firmicutes, Fusobacteria, and TM7. The dominant genera included Capnocytophaga, Prevotella, Actinomyces, Corynebacterium, Neisseria, Streptococcus, Rothia, and Leptotrichia. β diversity analysis showed that the plaque microbial community structure was similar in all groups and that group members were relatively constant, only showing differences in abundance. Analysis of composition differences identified 10 health-related and 21 caries-related genera. Key genera (27 that potentially contributed to plaque microbiota distributions between groups were identified. Finally, co-occurrence network analysis and function prediction were performed. Treatment strategies directed toward modulating microbial interactions and their functional output should be further developed.
Carolina Kruleske da Silva
Full Text Available Fear of falling, self-perception of health, and participation in physical activity programs have been associated with several variables related to health and performance in older adults. The purpose of this study was to evaluate self-perception of health and fear of falling in older adult participants and non-participants of physical activity programs, and to verify the relationship between these variables. A total of 40 healthy but sedentary older adults, and 45 physically active older adults were assessed through the Falls Efficacy Scale International-Brazil (FES-I and a questionnaire that measured their self-perception of health. The older adults that did not participate in regular physical activity programs presented higher scores of fear of falling, which, in turn, is associated with an increase of risk for falls. Moreover, older adults, participants in regular physical activity programs exhibited a more positive health perception than did the non-participants. Also, non-participants of physical activity programs perceived their health status as being poor or very poor as well as expressing great concern about falling compared to those who considered their health as excellent, good or regular. The results of this study have important implications for making clinical decisions in prevention or rehabilitation of older people, and they justify recommendations to the public health system.
Tjørnelund, Karen B.; Jonsson, Lena M.; Kortegaard, Hanne Ellen
Dental ailments, mandibular swelling, and dentoalveolar abscesses are common in tapirs, but knowledge about prevalence or etiology of these lesions in the Tapiridae family in general, and in lowland tapirs ( Tapirus terrestris ) in particular, is scarce. A recent study identified resorptive lesions...... of unknown etiology as a common problem in the Malayan tapir ( Tapirus indicus ). In order to investigate the type and prevalence of dental lesions occurring in lowland tapirs, and to compare these with findings with the Malayan tapir, skulls and teeth from 46 deceased lowland tapirs were visually...... with associated periapical reaction (15%) and periapical reactions of various degrees without associated detectable dental pathology (13%). All these lesions likely originated from dental trauma. As in Malayan tapirs, juveniles had significantly fewer lesions than adults. This study shows that dental lesions...
Ornstein, Katherine A; DeCherrie, Linda; Gluzman, Rima; Scott, Elizabeth S; Kansal, Jyoti; Shah, Tushin; Katz, Ralph; Soriano, Theresa A
To assess the oral health status, use of dental care, and dental needs of homebound elderly adults and to determine whether medical diagnoses or demographic factors influenced perceived oral health. Cross-sectional analysis. Participants' homes in New York City. Homebound elderly adults (N = 125). A trained dental research team conducted a comprehensive clinical examination in participants' homes and completed a dental use and needs survey and the Geriatric Oral Health Assessment Index. Participants who reported a high level of unmet oral health needs were more likely to be nonwhite, although this effect was not significant in multivariate analysis. Individual medical diagnoses and the presence of multiple comorbidities were not associated with unmet oral health needs. The oral health status of homebound elderly adults was poor regardless of their medical diagnoses. High unmet oral health needs combined with strong desire to receive dental care suggests there is a need to improve access to dental care for this growing population. In addition to improving awareness of geriatricians and primary care providers who care for homebound individuals, the medical community must partner with the dental community to develop home-based programs for older adults. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.
Baratta, Michael V; Kodandaramaiah, Suhasa B; Monahan, Patrick E; Yao, Junmei; Weber, Michael D; Lin, Pei-Ann; Gisabella, Barbara; Petrossian, Natalie; Amat, Jose; Kim, Kyungman; Yang, Aimei; Forest, Craig R; Boyden, Edward S; Goosens, Ki A
Prior exposure to stress is a risk factor for developing posttraumatic stress disorder (PTSD) in response to trauma, yet the mechanisms by which this occurs are unclear. Using a rodent model of stress-based susceptibility to PTSD, we investigated the role of serotonin in this phenomenon. Adult mice were exposed to repeated immobilization stress or handling, and the role of serotonin in subsequent fear learning was assessed using pharmacologic manipulation and western blot detection of serotonin receptors, measurements of serotonin, high-speed optogenetic silencing, and behavior. Both dorsal raphe serotonergic activity during aversive reinforcement and amygdala serotonin 2C receptor (5-HT2CR) activity during memory consolidation were necessary for stress enhancement of fear memory, but neither process affected fear memory in unstressed mice. Additionally, prior stress increased amygdala sensitivity to serotonin by promoting surface expression of 5-HT2CR without affecting tissue levels of serotonin in the amygdala. We also showed that the serotonin that drives stress enhancement of associative cued fear memory can arise from paired or unpaired footshock, an effect not predicted by theoretical models of associative learning. Stress bolsters the consequences of aversive reinforcement, not by simply enhancing the neurobiological signals used to encode fear in unstressed animals, but rather by engaging distinct mechanistic pathways. These results reveal that predictions from classical associative learning models do not always hold for stressed animals and suggest that 5-HT2CR blockade may represent a promising therapeutic target for psychiatric disorders characterized by excessive fear responses such as that observed in PTSD. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
Arnaudova, Inna; Krypotos, Angelos-Miltiadis; Effting, Marieke; Kindt, Merel; Beckers, Tom
Individual differences in fear generalisation have been proposed to play a role in the aetiology and/or maintenance of anxiety disorders, but few data are available to directly support that claim. The research that is available has focused mostly on generalisation of peripheral and central physiological fear responses. Far less is known about the generalisation of avoidance, the behavioural component of fear. In two experiments, we evaluated how neuroticism, a known vulnerability factor for anxiety, modulates an array of fear responses, including avoidance tendencies, towards generalisation stimuli (GS). Participants underwent differential fear conditioning, in which one conditioned stimulus (CS+) was repeatedly paired with an aversive outcome (shock; unconditioned stimulus, US), whereas another was not (CS-). Fear generalisation was observed across measures in Experiment 1 (US expectancy and evaluative ratings) and Experiment 2 (US expectancy, evaluative ratings, skin conductance, startle responses, safety behaviours), with overall highest responding to the CS+, lowest to the CS- and intermediate responding to the GSs. Neuroticism had very little impact on fear generalisation (but did affect GS recognition rates in Experiment 1), in line with the idea that fear generalisation is largely an adaptive process.
Hammer, Jennifer L; Marsh, Abigail A
Despite communicating a "negative" emotion, fearful facial expressions predominantly elicit behavioral approach from perceivers. It has been hypothesized that this seemingly paradoxical effect may occur due to fearful expressions' resemblance to vulnerable, infantile faces. However, this hypothesis has not yet been tested. We used a combined approach-avoidance/implicit association test (IAT) to test this hypothesis. Participants completed an approach-avoidance lever task during which they responded to fearful and angry facial expressions as well as neutral infant and adult faces presented in an IAT format. Results demonstrated an implicit association between fearful facial expressions and infant faces and showed that both fearful expressions and infant faces primarily elicit behavioral approach. The dominance of approach responses to both fearful expressions and infant faces decreased as a function of psychopathic personality traits. Results suggest that the prosocial responses to fearful expressions observed in most individuals may stem from their associations with infantile faces. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Manski, Richard J.; Moeller, John F.; Chen, Haiyan; Schimmel, Jody; St Clair, Patricia A.; Pepper, John V.
Objective The purpose of this article is to examine the relationship between changes in household finances (wealth and income) and changes in dental utilization at the onset of the recent recession in a population of older Americans. Methods Data from the Health and Retirement Study (HRS) were analyzed for U.S. individuals aged 51 years and older during the 2006 and 2008 waves of the HRS. We estimated logistic models of (1) starting and (2) stopping dental use between 2006 and 2008 survey periods as a function of changes in household wealth and income, controlling for other potentially confounding covariates. Results We found that only when household wealth falls by 50 percent or more were older adults less likely to seek dental care. Changes in household income and other changes in household wealth were not associated with changes in dental utilization among this population. Conclusions Older Americans’ dental care utilization appeared to be fairly resilient to changes in household finances; only when wealth fell by 50 percent or more did individuals decrease dental use. This finding might extend to other health care services that are preventive, routine, and relatively inexpensive. PMID:22994647
Chu, Carol; Buchman-Schmitt, Jennifer M; Moberg, Fallon; Joiner, Thomas E
Fear of negative evaluation has been documented as a mechanism that explains variations in feelings of belongingness. According to the interpersonal theory of suicide (Joiner, 2005), feelings of thwarted belongingness, that one does not belong, can significantly increase desire and risk for suicide. We proposed that differences in thwarted belongingness may explain variations in suicidal ideation and behavior as a function of levels of fear of negative evaluation. This hypothesis was tested by examining self-reported fears of negative evaluation, thwarted belongingness, and suicidal ideation in 107 young adults, many who were explicitly targeted for recruitment due to a history of suicidal ideation and behavior (13.1% had thoughts about suicide without a previous attempt; 15.9% reported at least one previous attempt [max = 5 attempts]). Mediation analyses were conducted with suicidal ideation entered as the outcome variable. Results indicated that greater fears of negative evaluation were significantly and positively associated with levels of suicidal ideation. Differences in thwarted belongingness fully accounted for the relationship between fears of negative evaluation and suicidal ideation. We conclude with clinical implications and future directions.
Dunsmoor, Joseph E.; Mitroff, Stephen R.; LaBar, Kevin S.
The present study investigated the extent to which fear generalization in humans is determined by the amount of fear intensity in nonconditioned stimuli relative to a perceptually similar conditioned stimulus. Stimuli consisted of graded emotionally expressive faces of the same identity morphed between neutral and fearful endpoints. Two…
Chikkala, Jayanth; Chandrabhatla, Srinivas Kumar; Vanga, Narasimha Rao V
It is essential to understand the factors influencing the level of anxiety to dental treatment among different children as it can influence seeking dental care. Here, we assessed the impact of parental loss on dental anxiety among 6-13-year-old children. A total of 444 children within the age group 6-13 years were selected. Group 1 consisted of orphan children living in government-run orphanages, Group 2 consisted of orphan children taken care by a person with a motherly relationship, Group 3 consisted of abandoned children living in private organization and Group 4 consisted of children living with their parents. Dental anxiety was measured using children's fear survey schedule-dental subscale and modified faces version of modified child dental anxiety scale. The highest number of anxious children were observed in Group 4 and the difference in the anxiety levels among the four groups was found to be highly statistically significant. Children living in government-run orphanages had least dental anxiety. All the orphans may not have the same anxiety levels and the environment of upbringing the orphans plays a significant role in the development of the anxiety.
Full Text Available The article conceptualizes the term Pedagogy of Fear as the master narrative of educational systems around the world. Pedagogy of Fear stunts the active and vital educational growth of the young person, making him/her passive and dependent upon external disciplinary sources. It is motivated by fear that prevents young studentsas well as teachersfrom dealing with the great existential questions that relate to the essence of human beings. One of the techniques of the Pedagogy of Fear is the internalization of the view that without evaluation and assessment we cannot know a childs level or worthand therefore are unable to help him/her if he is slow in learning. In contrast, Philosophy for/with Children offers a space for addressing existential questions, some of which deal with urgent social issues. The willingness to make philosophy inquiry an alternative already from an early age seeks to allow the child to challenge him/herself with new and fresh questions. Philosophy for/with Children does not regard children as a space of lack (experience, knowledge, values, etc. The new and fresh philosophical perspective of children demands the presence of a willingness to engage in dialogue and rejection of the fear of the innocent and deep questions of philosophy. Shaking free of the Pedagogy of Fear and restoring honor to childrens questions demands a fundamental conceptual change within education. The replacement of existential certainty as it is depicted by adults in the existing education system with an existential question is a heavy intellectual task that in most cases is viewed as subversiveprimarily on the part of the adult. It demands a return to starting points and a willingness to allow children a free and safe educational space in which to ground preliminary and fertile questions about themselves, their lives, their environment, and, most of all, the changing world they discover with the form of originality that is right for them.
Full Text Available Abstract Calcium-calmodulin dependent protein kinase IV (CaMKIV is a protein kinase that activates the transcription factor CREB. Our previous work demonstrated that mice lacking CaMKIV had a defect in fear memory while behavioral responses to noxious stimuli were unchanged. Here, we measured ultrasonic vocalizations (USVs before and after fear conditioning and in response to a noxious injection of capsaicin to measure behavioral responses to emotional stimuli. Consistent with previous findings, behavioral nociceptive responses to capsaicin were undistinguishable between wild-type and CaMKIV-/- mice. Wild-type animals showed a selective increase in 50 kHz USVs in response to capsaicin while such an increase was absent in CaMKIV-/- mice. The foot shock given during fear conditioning caused an increase in 30 kHz USVs in both wild-type and CaMKIV-/- mice. When returned to the context one hour later, USVs from the wild-type were significantly decreased. Additionally, the onset of a tone, which had previously been paired with the foot shock, caused a significant decrease in USVs during auditory conditioning. CaMKIV-/- mice showed significantly less reduction in USVs when placed in the same context three days after receiving the shock, consistent with the decrease in freezing reported previously. Our results provide a new approach for investigating the molecular mechanism for emotional vocalization in mice and suggest that CaMKIV dependent signaling pathways play an important role in the emotional response to pain and fear.
Wilson, Kimberley; Kortes-Miller, Katherine; Stinchcombe, Arne
Canada is experiencing population aging, and given the heterogeneity of older adults, there is increasing diversity in late life. The purpose of this study was to help fill the research gaps on LGBT aging and end-of-life. Through focus groups, we sought to better understand the lived experience of older LGBT individuals and to examine their concerns associated with end-of-life. Our analysis highlights the idea that identifying as LGBT matters when it comes to aging and end-of-life care. In particular, gender identity and sexual orientation matter when it comes to social connections, in the expectations individuals have for their own care, and in the unique fear related to staying out of the closet and maintaining identity throughout aging and end-of-life. This study underscores the need to consider gender identity and sexual orientation at end-of-life. In particular, recognition of intersectionality and social locations is crucial to facilitating positive aging experiences and end-of-life care.
VanCleave, Andrea M; Jones, James E; McGlothlin, James D; Saxen, Mark A; Sanders, Brian J; Walker, LaQuia A
Surgical fires are well-characterized, readily preventable, potentially devastating operating room catastrophes that continue to occur from 20 to 100 times per year or, by one estimate, up to 600 times per year in US operating rooms, sometimes with fatal results. The most significant risk factors for surgical fires involve (a) the use of an ignition source, such as laser or electrocautery equipment, in or around an oxygen-enriched environment in the head, neck, and upper torso area and (b) the concurrent delivery of supplemental oxygen, especially via nasal cannula. Nonetheless, while these 2 conditions occur very commonly in dental surgery, especially in pediatric dental surgery where sedation and anesthesia are regularly indicated, there is a general absence of documented dental surgical fires in the literature. Barring the possibility of underreporting for fear of litigation, this may suggest that there is another mechanism or mechanisms present in dental or pediatric dental surgery that mitigates this worst-case risk of surgical fires. Some possible explanations for this include: greater fire safety awareness by dental practitioners, incidental ventilation of oxygen-enriched environments in patient oral cavities due to breathing, or suction used by dental practitioners during procedures. This review of the literature provides a background to suggest that the practice of using intraoral suction in conjunction with the use of supplemental oxygen during dental procedures may alter the conditions needed for the initiation of intraoral fires. To date, there appear to be no published studies describing the ability of intraoral suctioning devices to alter the ambient oxygen concentration in an intraoral environment. In vivo models that would allow examination of intraoral suction on the ambient oxygen concentration in a simulated intraoral environment may then provide a valuable foundation for evaluating the safety of current clinical dental surgical practices
Nov 1, 2013 ... Hardwick K. Dental service use among adults with human immunodeficiency virus infection. Med Care. 1997;35(1):77–85. 18. Shiboski CH, Palacio H, Neuhaus JM,. Greenblatt RM. Dental care access and use among HIV-infected women. Am J Public. Health. 1999;89(6):834–839. 19. Marcus M, Freed JR, ...
Dental caries is a disease process, one that will not be eliminated by tooth repair alone. Caries is the most prevalent disease of children and the primary reason for most restorative dental visits in both adults and children. A risk-based approach to managing caries targets those in greatest jeopardy for contracting the disease and provides…
Lauridsen, Eva; Hermann, Nuno Vibe; Gerds, Thomas Alexander
and fracture types among children, adolescents, and adults, and to analyze the distribution and prevalence of combination injuries. MATERIAL AND METHOD: The study group included 4754 patients (3186 men and 1568 women) with 10 166 traumatized permanent incisors treated at Copenhagen University Hospital......BACKGROUND: Traumatic dental injuries (TDI) comprise six types of luxation and seven types of tooth fractures. The risk of pulp necrosis is increased in teeth with combination injuries where fractures and luxations occur concomitantly. AIM: To report and compare the distributions of luxations......, Rigshospitalet. Differences in the distributions of trauma types among age groups (children 20 years) and distributions of concomitant crown fractures for each luxation type were analyzed with the Chi-square test. RESULTS: A total of 7464 teeth (73.4%) had suffered...
Pervez, Anushey; Kinney, Janet S; Gwozdek, Anne; Farrell, Christine M; Inglehart, Marita R
In 2005, Public Act No. 161 (PA 161) was passed in Michigan, allowing dental hygienists to practice in approved public dental prevention programs to provide services for underserved populations while utilizing a collaborative agreement with a supervising dentist. The aims of this study were to assess how well dental and dental hygiene students and faculty members and practicing dental hygienists have been educated about PA 161, what attitudes and knowledge about the act they have, and how interested they are in additional education about it. University of Michigan dental and dental hygiene students and faculty members, students in other Michigan dental hygiene programs, and dental hygienists in the state were surveyed. Respondents (response rate) were 160 dental students (50%), 63 dental hygiene students (82%), 30 dental faculty members (26%), and 12 dental hygiene faculty members (52%) at the University of Michigan; 143 dental hygiene students in other programs (20%); and 95 members of the Michigan Dental Hygienists' Association (10%). The results showed that the dental students were less educated about PA 161 than the dental hygiene students, and the dental faculty members were less informed than the dental hygiene faculty members and dental hygienists. Responding dental hygiene faculty members and dental hygienists had more positive attitudes about PA 161 than did the students and dental faculty members. Most of the dental hygiene faculty members and dental hygienists knew a person providing services in a PA 161 program. Most dental hygiene students, faculty members, and dental hygienists wanted more education about PA 161. Overall, the better educated about the program the respondents were, the more positive their attitudes, and the more interested they were in learning more.
Kwok, Boon Chong; Pua, Yong Hao
the study compares the effects of a Nintendo Wii exercise programme and a standard Gym-based exercise intervention on fear of falling, knee strength, physical function and falls rate in older adults. eighty community-dwelling adults aged 60 years and above with short physical performance battery score of 5-9 points and modified falls efficacy scale (MFES) score of ≤9 points participated in the parallel-group randomised trial. Each intervention arm involved an hour of intervention per week, totalling 12 sessions over 12 weeks. Besides 1-year fall incidence, the participants were evaluated on MFES, knee extensor strength (KES), timed-up-and-go test, gait speed, 6-minute walk test and narrow corridor walk test at weeks 13 and 24. at week 13, between interventions, the effect of MFES changes did not reach statistical significance (difference = -0.07 point, 95% CI -0.56 to 0.42, P = 0.78); at week 24, the Wii group showed statistically significant effects over the Gym group (difference = 0.8 point, 95% CI 0.27 to 1.29, P falling when compared to a standard Gym-based exercise intervention; however, post-intervention there was an apparent reduction in fear of falling in the group allocated to Wii training, despite knee strength apparently improving more in those allocated to the Gym. It is possible that long-term gains after using the Wii might be due to a carry-over effect. Australian New Zealand Clinical Trials Registry, ACTRN12610000576022. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Ghaderi, Faezeh; Fijan, Soleiman; Hamedani, Shahram
Prediction of child cooperation level in dental setting is an important issue for a dentist to select the proper behavior management method. Many psychological studies have emphasized the effect of birth order on patient behavior and personality; however, only a few researches evaluated the effect of birth order on child's behavior in dental setting. This study was designed to evaluate the influence of children ordinal position on their behavior in dental setting. A total of 158 children with at least one primary mandibular molar needing class I restoration were selected. Children were classified based on the ordinal position; first, middle, or last child as well as single child. A blinded examiner recorded the pain perception of children during injection based on Visual Analogue Scale (VAS) and Sound, Eye and Movement (SEM) scale. To assess the child's anxiety, the questionnaire known as "Dental Subscale of the Children's Fear Survey Schedule" (CFSS-DS) was employed. The results showed that single children were significantly less cooperative and more anxious than the other children (p<0.001). The middle children were significantly more cooperative in comparison with the other child's position (p< 0.001). Single child may behave less cooperatively in dental setting. The order of child birth must also be considered in prediction of child's behavior for behavioral management.
Teachman, Bethany A; Stefanucci, Jeanine K; Clerkin, Elise M; Cody, Meghan W; Proffitt, Dennis R
Emotion and psychopathology researchers have described the fear response as consisting of four main components--subjective affect, physiology, cognition, and behavior. The current study provides evidence for an additional component in the domain of height fear (perception) and shows that it is distinct from measures of cognitive processing. Individuals High (N = 35) and Low (N = 36) in acrophobic symptoms looked over a two-story balcony ledge and estimated its vertical extent using a direct height estimation task (visual matching), and an indirect task (size estimation); the latter task seems to exhibit little influence from cognitive factors. In addition, implicit and explicit measures of cognitive processing were obtained. Results indicated that, as expected, the High Fear group showed greater relative, implicit height fear associations and explicit threat cognitions. Of primary interest, the High (compared to Low) Fear group estimated the vertical extent to be higher, and judged target sizes to be greater, even when controlling for the cognitive bias measures. These results suggest that emotional factors such as fear are related to perception. (Copyright) 2008 APA.
Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder.
van Dijke, Annemiek; Hopman, Juliette A B; Ford, Julian D
Objective : Complex posttraumatic stress disorder (CPTSD) as defined by the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) formulation is associated with childhood relational trauma and involves relational impairment, affect dysregulation, and identity alterations. However, the distinct contributions of relational impairment (operationalized in the form fears of closeness or abandonment), affect dysregulation (operationalized in the form of overregulation and under-regulation of affect), and identity alterations (operationalized in the form of positive or negative psychoform or somatoform dissociation) to the relationship between childhood trauma and CPTSD/DESNOS have not been systematically tested. Method and Results : In a clinical sample of adults diagnosed with severe and chronic psychiatric and personality disorders ( n = 472; M = 34.7 years, SD = 10.1), structural equation modelling with bootstrap 95% confidence intervals demonstrated that the association between childhood trauma and CPTSD/DESNOS symptoms in adulthood was partially mediated by under-regulation of affect, negative psychoform dissociation, and adult relational fears of closeness and of abandonment. These results also were independent of the effects of borderline personality disorder (BPD) symptoms. Conclusions : Some, but not all, hypothesized components of the DESNOS formulation of CPTSD statistically mediate the relationship between childhood trauma and adult CPTSD/DESNOS. These relationships appear specific to CPTSD/DESNOS and not to the effects of another potential sequelae of childhood trauma BPD. Replication with prospective longitudinal studies is needed.
Boateng, Francis D
While much is known about fear of crime in the West, little is known about how fearfulness of crime develops in non-Western societies, especially among university students. Representing the first attempt to empirically compare levels of fear of crime between Ghanaian and U.S. college students, this article examined students' levels of fear of crime on campus, and tested the applicability of two evolving models of fear of crime-the vulnerability and reassurance models-using comparative data. The general finding is that Ghanaian and U.S. college students differ in terms of their rates of fearfulness on campus. This significant difference adds to the already existing differences between the two countries.
Reynolds, Gemma; Field, Andy P; Askew, Chris
Vicarious learning has become an established indirect pathway to fear acquisition. It is generally accepted that associative learning processes underlie vicarious learning; however, whether this association is a form of conditioned stimulus-unconditioned stimulus (CS-US) learning or stimulus-response (CS-CR) learning remains unclear. Traditionally, these types of learning can be dissociated in a US revaluation procedure. The current study explored the effects of post-vicarious learning US revaluation on acquired fear responses. Ninety-four children (46 males and 48 females) aged 6 to 10 years first viewed either a fear vicarious learning video or a neutral vicarious learning video followed by random allocation to one of three US revaluation conditions: inflation; deflation; or control. Inflation group children were presented with still images of the adults in the video and told that the accompanying sound and image of a very fast heart rate monitor belonged to the adult. The deflation group were shown the same images but with the sound and image of a normal heart rate. The control group received no US revaluation. Results indicated that inflating how scared the models appeared to be did not result in significant increases in children's fear beliefs, avoidance preferences, avoidance behavior or heart rate for animals above increases caused by vicarious learning. In contrast, US devaluation resulted in significant decreases in fear beliefs and avoidance preferences. Thus, the findings provide evidence that CS-US associations underpin vicarious learning and suggest that US devaluation may be a successful method for preventing children from developing fear beliefs following a traumatic vicarious learning episode with a stimulus.
Winer, J N; Arzi, B; Leale, D M; Kass, P H; Verstraete, F J M
Museum specimens (maxillae and/or mandibles) from 317 polar bears (Ursus maritimus) were examined macroscopically according to predefined criteria and 249 specimens were included in this study. The specimens were acquired between 1906 and 2011. There were 126 specimens (50.6%) from male animals, 93 (37.3%) from female animals and 30 (12.1%) from animals of unknown sex. The ages of the animals ranged from neonate to adult, with 125 adults (50.2%) and 124 young adults (49.8%) included and neonates/juveniles excluded from the study. The number of teeth available for examination was 7,638 (73.5%); 12.3% of teeth were absent artefactually, 0.8% were deemed absent due to acquired tooth loss and 13.4% were absent congenitally. With respect to tooth morphology, 20 teeth (0.26% of available teeth) in 18 specimens (7.2% of available specimens) were small vestigial structures with crowns that were flush with the level of surrounding alveolar bone. One supernumerary tooth and one tooth with enamel hypoplasia were encountered. Persistent deciduous teeth and teeth with an aberrant number of roots were not found. Relatively few teeth (3.7%) displayed attrition/abrasion, 90% of which were the maxillary and mandibular incisor teeth, in 41 polar bears (16.5%). Nearly twice as many adult specimens exhibited attrition/abrasion as those from young adults; significantly more males were affected than females. Dental fractures were noted in 52 polar bears, affecting 20.9% of specimens and 1.3% of the total number of teeth present. More adult polar bears had dental fractures than young adults. There were 21 specimens (8.4%) that displayed overt periapical disease, affecting a total of 24 dental alveoli (0.23%). Some degree of periodontitis was seen in 199 specimens (79.9%); however, only 12.6% of dental alveoli had bony changes indicative of periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 23 specimens (9.2%). TMJ-OA was significantly
Laporte, Paola P; Pan, Pedro M; Hoffmann, Mauricio S; Wakschlag, Lauren S; Rohde, Luis A; Miguel, Euripedes C; Pine, Daniel S; Manfro, Gisele G; Salum, Giovanni A
To distinguish normative fears from problematic fears and phobias. We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.
Shane, Dan M; Wehby, George L
Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.
Spencer, Andrea E; Marin, Marie-France; Milad, Mohammed R; Spencer, Thomas J; Bogucki, Olivia E; Pope, Amanda L; Plasencia, Natalie; Hughes, Brittany; Pace-Schott, Edward F; Fitzgerald, Maura; Uchida, Mai; Biederman, Joseph
We examined whether non-traumatized subjects with Attention Deficit Hyperactivity Disorder (ADHD) have dysfunctional activation in brain structures mediating fear extinction, possibly explaining the statistical association between ADHD and other disorders characterized by aberrant fear processing such as PTSD. Medication naïve, non-traumatized young adult subjects with (N=27) and without (N=20) ADHD underwent a 2-day fear conditioning and extinction protocol in a 3T functional magnetic resonance imaging (fMRI) scanner. Skin conductance response (SCR) was recorded as a measure of conditioned response. Compared to healthy controls, ADHD subjects had significantly greater insular cortex activation during early extinction, lesser dorsal anterior cingulate cortex (dACC) activation during late extinction, lesser ventromedial prefrontal cortex (vmPFC) activation during late extinction learning and extinction recall, and greater hippocampal activation during extinction recall. Hippocampal and vmPFC deficits were similar to those documented in PTSD subjects compared to traumatized controls without PTSD. Non-traumatized, medication naive adults with ADHD had abnormalities in fear circuits during extinction learning and extinction recall, and some findings were consistent with those previously documented in subjects with PTSD compared to traumatized controls without PTSD. These findings could explain the significant association between ADHD and PTSD as well as impaired emotion regulation in ADHD. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Davoudi, Amin; Rismanchian, Mansour; Akhavan, Ali; Nosouhian, Saeid; Bajoghli, Farshad; Haghighat, Abbas; Arbabzadeh, Farahnaz; Samimi, Pouran; Fiez, Atiyeh; Shadmehr, Elham; Tabari, Kasra; Jahadi, Sanaz
Dental anxiety and fear of needle injection is one of the most common problems encountered by dental practitioners, especially in the pediatric patient. In consequences, it might affect the patient's quality of life. Several methods are suggested to lower the discomfort of local anesthesia injection during dental procedures. Desensitization of injection site is one of the recommended strategies. Among chemical anesthetic topical agents that are effective but might have allergic side effects, using some nonpharmacological and safe techniques might be useful. This study aimed to overview the efficacy of using cooling techniques, mostly by ice or popsicles, warming or pH buffering of drug, and using modern devices to diminish the discomfort of local anesthesia injection during dental procedures. PMID:26957683
Despina E. Ganella
Full Text Available While deficits in fear extinction recall have been suggested to underlie vulnerability to anxiety disorders in adolescents, the neurobiology of these deficits remain underexplored. Here we investigate the functional connectivity (FC of the ventromedial prefrontal cortex (vmPFC and dorsolateral PFC (dlPFC underlying extinction recall in healthy adolescents, and assess associations between FC and state/trait anxiety. Adolescents (17 and adults (14, for comparison completed a fear-learning paradigm involving extinction and extinction recall during a functional magnetic resonance imaging session, in which skin conductance response (SCR was recorded. Psychophysiological interaction analyses revealed that during extinction recall there was significant negative connectivity between the vmPFC and amygdala in adults, but not adolescents. vmPFC-amygdala connectivity was positively correlated with SCR. Adolescents showed significant negative FC between the dlPFC and the left and right hippocampus, and the amygdala, which was positively correlated with state anxiety. Recall was also associated with negative connectivity between the dlPFC and thalamus, posterior cingulate cortex, fusiform gyrus, and pallidum in adolescents. These results demonstrate that fear extinction recall in healthy adolescents is associated with FC between prefrontal and limbic brain regions, and suggest that alterations in connectivity may be associated with vulnerability to anxiety in adolescence.
Prokop, Pavol; Usak, Muhammet; Erdogan, Mehmet; Fancovicova, Jana; Bahar, Mehmet
Human perceives invertebrates less positively than vertebrates because they are small and behaviourally and morphologically unfamiliar. This cross-cultural research focused on Slovakian (n=150) and Turkish (n=164) students' fear, disgust and perceived danger regarding 25 invertebrates [including 5 disease relevant adult insects, 5 ectoparasites, 5…
Majstorovic, M; Morse, D E; Do, D; Lim, L l; Herman, N G; Moursi, A M
We evaluated the relationship between child dental anxiety and selected child and parental characteristics. Children and their parents were interviewed at the New York University, College of Dentistry, Pediatric Dentistry Clinic. The Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) evaluated child self-reported anxiety; the Modified Dental Anxiety Scale (MDAS) measured self-reported parental anxiety when the parent received dental treatment. Ninety-three children and their parents completed the questionnaires. Mean CFSS-DS scores were higher for girls than boys (32.5 vs. 26.3, p=0.003) and for children whose accompanying parents had MDAS scores of 11+ vs. ≥ 11 (32.8 vs. 26.6, p=0.001). There was little difference in mean CFSS-DS scores among those aged 6-10 yrs. vs. 11-14 yrs. (30.1 vs. 29.3). Significant correlations were found between CFSS-DS and both gender (Spearman's rho, rs=0.31) and MDAS scores (rs=0.33), but not between CFSS-DS and child age (rs=-0.05). Controlling simultaneously for gender, MDAS score and child age, a high CFSS-DS score (38+ vs. ≥ 38) was positively associated with girls (ORadj=3.76, 95% CI: 1.13-12.54) and an MDAS score of ≤ 15 vs. ≥ 11 (ORadj=2.50, 0.73-8.54), but weakly and inversely associated with age (ORadj=0.80, 0.25-2.52). Child gender and parental anxiety are indicators of child dental anxiety.
Giachero, Marcelo; Calfa, Gaston D; Molina, Victor A
The present research investigated the resulting contextual fear memory and structural plasticity changes in the dorsal hippocampus (DH) following stress and fear conditioning. This combination enhanced fear retention and increased the number of total and mature dendritic spines in DH. Intra-basolateral amygdala (BLA) infusion of midazolam prior to stress prevented both the enhancement of fear retention and an increase in the density of total and mature dendritic spines in DH. These findings emphasize the role of the stress-induced attenuation of GABAergic neurotransmission in BLA in the promoting influence of stress on fear memory and on synaptic remodeling in DH. In conclusion, the structural remodeling in DH accompanied the facilitated fear memory following a combination of fear conditioning and stressful stimulation.
Amílcar González Sánchez
Full Text Available Se realizó un estudio epidemiológico transversal o de prevalencia con el objetivo de describir la morbilidad por caries dental y factores de riesgo seleccionados en adultos jóvenes en el periodo de enero de 2006 a diciembre de 2006, en el municipio "Libertador" del Distrito Capital. El universo de estudio estuvo conformado 245 trabajadores sociales venezolanos "luchadores sociales", que laboraron en la Misión Energía. Se confeccionó un formulario en el cual se recogió toda la información necesaria, se utilizó para ellos los métodos empíricos de la observación e interrogatorio al paciente, se determinó la morbilidad de la caries dental así como la asociación entre estas y factores de riesgos modificables y se calcularon los indicadores de riesgo e impacto potencial. El 90,6 % de los examinados presentaron caries dental, la edad más afectada fue la de 30 años y más con un 94,4 % y el sexo masculino con un 91,2 %, aunque no se determinaron diferencias significativas en cuanto a ellas (p> 0,05. Se determinó asociación significativa en orden de importancia entre las caries y la experiencia anterior de la enfermedad (razón de prevalencia (RP= 2,63; fracción etiológica en los expuestos (EEe= 62,0 y fracción etiológica en la población (FEp= 55,1; ingestión de dieta cariogénica (RP= 2,33; FEe= 57,1 y FEp= 49,9; higiene bucal no adecuada (RP= 1,63, FEe= 38,6 y FEp= 31,55; nivel de conocimiento no adecuado sobre salud bucal (RP= 1,30, FEe= 23,1 y FEp= 16,4 y la no visita sistemática a la consulta estomatológica (RP= 1,27; FEe= 21,3 y FEp= 15,5. Se recomienda diseñar y aplicar estrategias de intervención educativas con participación comunitaria, con el objetivo de modificar los conocimientos, actitudes y prácticas para la prevención de la Caries dental.A cross-sectional epidemiologic or of prevalence study was conducted to describe the morbidity by dental caries and risk factors selected in young adults from January, 2006
García-Aracil, Noelia; Ramos-Pichardo, Juan Diego; Castejón-de la Encina, María Elena; José-Alcaide, Lourdes; Juliá-Sanchís, Rocío; Sanjuan-Quiles, Ángela
To assess the effectiveness of a physical method of managing pain and fear in children and anxiety in the accompanying adult during venous puncture in the emergency department. Quasi-experimental study of 3 groups: one group used a combination of directed distraction by means of a vibration device with ice pack, a second group received only distraction, and no strategy was used in the third. Pain and adult anxiety were similar in the 2 groups in which a pain management strategy was applied. Pain and adult anxiety were greater when no strategy was adopted. We detected no differences in the level of the children's fear. Directed distraction can be useful for managing pain in children and it reduces the anxiety experienced by accompanying adults. The use of a vibration device with ice does not add benefits. Fear is not reduced by any of these measures.
Ledesma-Montes, C; Garcés-Ortíz, M; Salcido-García, J-F; Hernández-Flores, F
The aim of this study was to know the distribution of dental developmental alterations in the population requesting stomatological attention at the Admission and Diagnosis Clinic of our institution in Mexico City. We reviewed the archives and selected those files with developmental dental alterations. Analyzed data were diagnoses, age, gender, location and number of involved teeth. Of the 3.522 patients reviewed, 179 (5.1%) harbored 394 developmental dental alterations. Of them, 45.2% were males and 54.8% were females with a mean age of 16.7 years. The most common were supernumeraries, dental agenesia and dilaceration. Adults were 30.7% of the patients with dental developmental alterations. In them, the most common lesions were agenesia and supernumeraries. Mesiodens was the most frequently found supernumerary teeth (14.7%). Our finding that 30.7% of the affected patients were adults is an undescribed and unusually high proportion of patients that have implications on planning and prognosis of their stomatological treatment.
Thomson, W. M.; Broadbent, J. M.; Locker, D.; Poulton, R.
Objective To examine predictors of dental anxiety trajectories in a longitudinal study of New Zealanders. Methods Prospective study of a complete birth cohort born in 1972/73 in Dunedin, New Zealand, with dental anxiety scale (DAS) scores and dental utilization determined at ages 15, 18, 26 and 32 years. Personality traits were assessed at a superfactor and (more fine-grained) subscale level via the Multidimensional Personality Questionnaire at age 18 years. Group-based trajectory analysis was used to identify dental anxiety trajectories. Results DAS scores from at least three assessments were available for 828 participants. Six dental anxiety trajectories were observed: stable nonanxious low (39.6%); stable nonanxious medium (37.9%); recovery (1.6%); adult-onset anxious (7.7%); stable anxious (7.2%) and adolescent-onset anxious (5.9%). Multivariate analysis showed that males and those with higher DMFS at age 15 years were more likely to be in the stable nonanxious low trajectory group. Membership of the stable nonanxious medium group was predicted by the dental caries experience at age 15 years. Participants who had lost one or more teeth between ages 26 and 32 years had almost twice the relative risk for membership of the adult-onset anxious group. Personality traits predicted group membership. Specifically, high scorers (via median split) on the ‘stress reaction’ subscale had over twice the risk of being in the stable anxious group; low scorers on the traditionalism subscale were more likely to be members of the recovery trajectory group; and high scorers on the ‘social closeness’ subscale had half the risk of being in the stable anxious group. Dental caries experience at age 5 years was also a predictor for the stable anxious group. Membership of the late-adolescent-onset anxious group was predicted by higher dental caries experience by age 15 years, but none of the other predictors was significant. Conclusion Six discrete trajectories of dental anxiety
Nasehi, Mohammad; Farrahizadeh, Maryam; Ebrahimi-Ghiri, Mohaddeseh; Zarrindast, Mohammad-Reza
Behavioral studies have suggested a key role for the cannabinoid system in the modulation of conditioned fear memory. Likewise, much of the literature has revealed that the serotonergic system affects Pavlovian fear conditioning and extinction. A high level of functional overlap between the serotonin and cannabinoid systems has also been reported. To clarify the interaction between the hippocampal serotonin (5-HT4) receptor and the cannabinoid CB1 receptor in the acquisition of fear memory, the effects of 5-HT4 agents, arachidonylcyclopropylamide (ACPA; CB1 receptor agonist), and the combined use of these drugs on fear learning were studied in a fear conditioning task in adult male NMRI mice. Pre-training intraperitoneal administration of ACPA (0.1 mg/kg) decreased the percentage of freezing time in both context- and tone-dependent fear conditions, suggesting impairment of the acquisition of fear memory. Pre-training, intra-hippocampal (CA1) microinjection of RS67333, a 5-HT4 receptor agonist, at doses of 0.1 and 0.2 or 0.2 µg/mouse impaired contextual and tone fear memory, respectively. A subthreshold dose of RS67333 (0.005 µg/mouse) did not alter the ACPA response in either condition. Moreover, intra-CA1 microinjection of RS23597 as a 5-HT4 receptor antagonist did not alter context-dependent fear memory acquisition, but it did impair tone-dependent fear memory acquisition. However, a subthreshold dose of the RS23597 (0.01 µg/mouse) potentiated ACPA-induced fear memory impairment in both conditions. Therefore, we suggest that the blockade of hippocampal 5-HT4 serotonergic system modulates cannabinoid signaling induced by the activation of CB1 receptors in conditioned fear. © The Author(s) 2016.
Paola P. Laporte
Full Text Available Objective: To distinguish normative fears from problematic fears and phobias. Methods: We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA/item response theory (IRT and nonparametric receiver operating characteristic (ROC curve. Results: According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. Conclusion: These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.
Full Text Available Corticotropin releasing factor (CRF dysregulation is implicated in mood and anxiety disorders such as posttraumatic stress disorder (PTSD. CRF is expressed in areas engaged in fear and anxiety processing including the central amygdala (CeA. Complicating our ability to study the contribution of CRF-containing neurons to fear and anxiety behavior is the wide variety of cell types in which CRF is expressed. To manipulate specific subpopulations of CRF containing neurons, our lab has developed a mouse with a Cre recombinase gene driven by a CRF promoter (CRFp3.0Cre (Martin et al., 2010. In these studies, mice that have the gene that encodes NR1 (Grin1 flanked by loxP sites (floxed were crossed with our previously developed CRFp3.0Cre mouse to selectively disrupt Grin1 within CRF containing neurons (Cre+/fGrin1+. We find that disruption of Grin1 in CRF neurons did not affect baseline levels of anxiety, locomotion, pain sensitivity or exploration of a novel object. However, baseline expression of Grin1 was decreased in Cre+/fGrin1+ mice as measured by RTPCR. Cre+/fGrin1+ mice showed enhanced auditory fear acquisition and retention without showing any significant effect on fear extinction. We measured Gria1, the gene that encodes AMPAR1 and the CREB activator Creb1 in the amygdala of Cre+/fGrin1+ mice after fear conditioning. Both Gria1 and Creb1 were enhanced in the amygdala after training. To determine if the Grin1-expressing CRF neurons within the CeA are responsible for the enhancement of fear memory in adults, we infused a lentivirus with Cre driven by a CRF promoter (LV pCRF-Cre/fGrin1+ into the CeA of floxed Grin1 mice. Cre driven deletion of Grin1 specifically within CRF expressing cells in the CeA also resulted in enhanced fear memory acquisition and retention. Altogether, these findings suggest that selective disruption of Grin1 within CeA CRF neurons strongly enhances fear memory.