Dental students' and patients' perceived importance and knowledge of dental anxiety

Exploring dental students' attitudes toward patient-centered management of dental fear

PURPOSE/OBJECTIVES

A patient-centered care (PCC) paradigm undergirds modern dental education. PCC is particularly relevant in the management of patient dental fear. The aims of this study were three-fold: (a) to examine the preliminary psychometric properties of an author-designed survey administered to explore dental fear knowledge and perceptions, (b) to assess how 4th-year dental students regard dental fear, (c) and to investigate the relationship between students' knowledge and perceptions of dental fear and their clinical behavior.

METHODS

In 2022, 4th-year dental students (N = 453) participated in a cross-sectional study. Participants completed a 16-item survey that assessed (a) knowledge and perceptions about dental fear, (b) common biases in patient fear assessment, and (c) patient management behaviors when fear is encountered. Exploratory factor analysis, descriptive statistics, and logistic regressions were run to address the study's aims.

RESULTS

Exploratory factor analysis revealed three factors, with the two strongest factors pertaining to beliefs about the importance of dental fear (α = 0.87) and self-efficacy in managing fear (α = 0.74). Participants indicated that it is important to assess for dental fear and rated their self-efficacy in ability managing it as high. Ratings on both factors slightly increased the odds of engaging in routine patient screening for dental fear. Students also displayed assessment biases commonly seen among practicing dentists.

CONCLUSION(S)

Results indicate educational gaps within the current behavioral-science training for dental students. Changes to improve advanced dental students' appreciation of their patients' dental fear are warranted.

Changes in symptoms of anxiety, depression, and PTSD in an RCT-study of dentist-administered treatment of dental anxiety

BACKGROUND

Educating dentists in treatment methods for dental anxiety would increase the patients' access to treatments that are important to their oral health. However, to avoid adverse effects on comorbid symptoms, involvement by a psychologist has been considered necessary. The objective of the present paper was to evaluate whether a dentist could implement systematized treatments for dental anxiety without an increase in comorbid symptoms of anxiety, depression or PTSD.

METHODS

A two-arm parallel randomised controlled trial was set in a general dental practice. Eighty-two patients with self-reported dental anxiety either completed treatment with dentist-administered cognitive behavioural therapy (D-CBT, n = 36), or received dental treatment while sedated with midazolam combined with the systemized communication technique "The Four Habits Model" (Four Habits/midazolam, n = 41). Dental anxiety and comorbid symptoms were measured pre-treatment (n = 96), post-treatment (n = 77) and one-year after treatment (n = 52).

RESULTS

An Intention-To-Treat analysis indicated reduced dental anxiety scores by the Modified Dental Anxiety Scale (median MDAS: 5.0 (-1,16)). The median scores on the Hospital Index of Anxiety and Depression (HADS-A/D) and the PTSD checklist for DSM-IV (PCL) were reduced as follows: HADS-A: 1 (-11, 11)/HADS-D: 0 (-7, 10)/PCL: 1 (-17,37). No between-group differences were found.

CONCLUSIONS

The study findings support that a general dental practitioner may treat dental anxiety with Four Habits/Midazolam or D-CBT without causing adverse effects on symptoms of anxiety, depression or PTSD. Establishing a best practice for treatment of patients with dental anxiety in general dental practice should be a shared ambition for clinicians, researchers, and educators.

TRIAL REGISTRATION

The trial was approved by REC (Norwegian regional committee for medical and health research ethics) with ID number 2017/97 in March 2017, and it is registered in clinicaltrials.gov 26/09/2017 with identifier: NCT03293342.

Evaluation of dental students’ responses to roleplay videos in a professionalism course

Objective

This study aimed to evaluate dental students’ perceptions of roleplay videos used in a professionalism course that was conducted over three years.

Methods

All third-year dental students (N = 310) who participated in a professionalism course over three years (2016/17–2018/19) were included in this cross-sectional study. Miller's framework for clinical competence was used for the student-generated videos, which included 1) knowledge, 2) observation, 3) simulation, and 4) experience. Every year, at the end of the course, the students provided their responses to the roleplay videos using a 25-item self-administered questionnaire. The questionnaire was divided into four sections: 1) student preparations for video production, 2) skills developed through video production, 3) benefits of watching the videos, and 4) general aspects of the activity.

Results

Most students agreed that video production led to them working as a team (76%) and understanding professional communication with colleagues (70%) and patients (66%). An improvement in problem-solving skills (67%) and project management skills (65%) was recognised by a majority of the students. Nearly three quarters of the students acknowledged that watching videos improved their professional behaviour towards the patients. Female students and those with high grades showed greater mean scores for most items (22 and 11 out of 25 items, respectively) with significant differences (p < 0.05).

Conclusion

In our study, the impact of roleplay videos was recognised by a majority of the students. Female students and those with high grades highly rated learning through this method of teaching. Video assignments should be a part of professionalism courses in dentistry to improve students’ communication skills and professional behaviours with colleagues and patients.