| Author | Study Population | Aim of the Study | Methods, Used Tests | Comorbid Phobias | Comorbid Psychiatric Symptoms | Comments |
|---|---|---|---|---|---|---|
| Aartman [30] et al. 1997 | Patients of Dental fear clinic, n=321. Study group was compared to a normative sample of the Dutch general population, n=1009. | To assess psychological characteristics of highly anxious patients | ● SLC-90 | Patients scored significantly higher in subscale “agoraphobia” than normative population (P<0.001, d=0.55 in men, P<0.001, d=0.53 in women) | Patients scored higher - anxiety (P=0.000, d=0.83 in men, P=0.000, d=0.84 in women) - depression (P=0.000, d=0.54 and P=0.000, d=0.72) - somatization (P=0.001, d=0.38, P=0.000, d=0.47) - cognitive-performance difficulty (P=0.005, d=0.33 and P=0.000, d=0.41) - interpersonal sensitivity and paranoid ideation (P=0.001, d=0.42, P=0.000, d=0.50) |
Control group was not matched to study population. Dental anxiety patients scored higher in all subscales than Dutch normative population. |
| DeJongh [32] et al. 1998 | ● Sample A: 41 adult patients of dental fear clinic in Netherlands ● Sample B: 22 adult patients comparable to sample A ● Sample C: 173 patients (aged 11-84yrs, mean 33.6) of department of dental surgery |
To determine the relationship between characteristics of dental fear and BII (blood-injection-injury) fears To explore the degree of overlap between dental phobia and BII phobia on the basis of DSM-IV criteria |
● Sample A: - DAS - the Blood-injury Scale of the FQ-BI - SLC-90-R - a 22-item questionnaire constructed for the purpose of the present study - DQ ● Sample B: - DAS - Phobia Checklist ● Sample C: - Phobia Checklist49 - Questionnaires about fainting |
● Dental anxiety (DAS) was significantly correlated to general trait anxiety (SLC-anxiety) (r=0.55, p<0.001) but not to BII-fear (r=16). ● 56.7% of the patients with dental phobia had at least one additional BII subtype-specific phobia (only 7.9% of non-dental phobic patients had additional phobia). ● They also had a significantly higher proportion of any BII phobias than non-dental phobics (p<0.0001): - blood 10% vs. 2.4 - injection 45.5 vs. 5.5 - injury 23.3 vs. 3.0 |
The authors concluded that, despite the co-occurrence of dental phobia and blood-injection-injury phobia, dental anxiety should be considered a specific, independent phobia within DSM-IV. | |
| Halonen [34] et al. 2014 | Young adult university students, Finland, n=880. Participants scoring ≥19 (out of max. 25 pts) were classified as dentally anxious, 12-18 pts mildly anxious and ≤11 pts not anxious | To assess the correlation between dental anxiety, general clinical anxiety and depression. | ●MDAS ●BAI ●BDI |
Dental anxiety was significantly correlated with general anxiety (p<0.001) and depression (p<0.001) in females. DA was significantly correlated to general anxiety in men (p<0.016). |
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| Hägglin [33] et al. 2001 | A random female population in Gothenburg, Sweden, n=310. A longitudinal study from 1968 to 1992. Participants were grouped into low, high or extreme dental fear subgroups by the Phobia questionnaire. | To examine levels in dental anxiety in relation to other fears/phobias longitudinally | ● The phobia self-referred questionnaire (number of phobias) ● Psychiatric interview (major depression DSM-III, psychiatric impairment) ● Self-reported anxiety level |
● High dental fear at baseline was associated with a higher number of other phobias (mean 1.3 vs. 4.7, P<0.001) |
High dental fear at baseline was associated with more psychiatric impairment (10.7% vs. 18.3%, P=0.003),
social disability (1.7% vs. 10.8%, P<0.001) and anxiety (21.5% vs. 30%, P=0.007). Depression was higher in chronic group (i.e. highly dentally anxious at 1968 and 1992) than incident/never groups at baseline (30.8% vs. 0.0% / 6.1%, P<0.01). |
Drop-outs had higher dental fear level. A tendency to maintain fear over time was predicted by psychiatric impairment and the personality factor neuroticism at baseline. Remission was predicted by personality factor extraversion. During the follow-up, dental anxiety increased / decreased in concert with the number of other fears. |
| Locker [11] et al. 1997 | Randomly selected adult population in Etobicoke, Canada, n=1420. Subjects scoring ≥13 on the DAS or ≥8 on the Gatchel Fear Scale or reported being very afraid of the dental treatment were considered to be dentally anxious. |
To study 1) the overlap between dental anxiety and BI (blood and injury) fears 2) the psychological characteristics of dentally anxious patients with and without BI fears 3) the contribution to BI fears make to dental anxiety |
● DAS ● The Gatchel Fear Scale48 ● MQ (blood and injury fears) ● FSS-II (also other tests) |
● Correlations between scores on MQ (measuring BI fears) and measures of dental anxiety were significant, but low (from 0.23 to 0.29, p<0.001 in all cases). ● Patients with dental anxiety had a mean MQ score of 4.87 (SD=3.23), and non-anxious patients a mean MQ score of 3.49 (SD=2.79; P<0.001). ● 16.1% of the patients with dental anxiety had BI fears. |
BI phobics and dentally anxious patients without BI fears appeared to be rather similar in psychological characteristics. Agoraphobic symptoms, MQ score and number of psychiatric symptoms (and two other factors) had significant independent effects on DAS scores (F=80.15; P<0.001). |
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| Locker [2, 3] et al. 2001a, b | A birth cohort study, Dunedin, New Zealand. a) Assessment was undertaken at the age of 18 years, n=805. Subjects scoring ≥13 on the DAS (max. 20 pts.) were considered dentally anxious. Psychological health in the previous 12 months was measured using DIS. b) Longitudinal study, patients were examined at ages of 18 and 26 yrs, n=784. Incident cases were participants with DAS scores ≤12 at age 18 but a score of ≥13 at age 26. Dental visit and treatment experiences were examined. |
a) Compare the prevalence of psychological disorders among dentally anxious and non-anxious groups b) Assess risk factors for the development of dental anxiety. |
● DAS ● DIS |
● Non-anxious vs. Moderately anxious vs. Severely anxious groups: - goraphobia 4.4 vs. 4.8 vs.13.9% - Social phobia 12.1 vs. 15.9 vs. 30.6% - Simple phobia 6.4 vs. 9.5 vs. 19.4% ● The difference was not significant concerning fear of blood, heights, storms, enclosed spaces, being in water, animals and insects. ● In a longitudinal study, incident cases had significantly higher scores than non-incident cases for simple phobia (p<0.001) |
● Non-anxious vs. Moderately anxious vs. Severely anxious groups: Conduct disorder 6.9% vs. 14.3% vs. 19.4% ● One or more anxiety disorders: 21.6% vs. 27.0% vs. 52.8%. ● One or more anxiety OR one or more mood disorders: 30.3% vs. 39.7% vs. 58.3%. ● One or more anxiety and one or more mood disorders: 7.9% vs. 12.7% vs. 19.4%. In a longitudinal study, incident cases had significantly higher scores for major depressive episode ((P<0.05), generalized anxiety (P<0.01) and substance dependence (P<0.05). |
The prevalence of comorbid phobias was largely accounted for by highly dentally anxious patients. |
| Moore et al.1991, Moore [31] et al. 1995 | Dental Phobia Research and Treatment Center patients, Denmark, n=155. Additional subsample of patients with DAS score ≥15 was selected, n=80. Reference group of routine dental patients, same institution, n=148. | To explore the manifestations and acquisition of dental fear and to clarify diagnostic categories | ● DAS ● STAI ● Modified FSS-II Geer Fear Scale59 ● DBS ● Semi-structured interviews were conducted for a subsample of 80 patients |
The mean scores between test and reference group differed significantly between DAS and STAI-state (P<0.001) and between DAS and GFS (P<0.001) |