Validation and Invariance of the Dental Anxiety Scale in a Brazilian sample

Patient-related predictors of post-operative pain following root canal treatment: A structural model analysis

AIM

The pathways to post-operative pain are complex and encompass factors that extend beyond the treatment protocol employed. This study aimed to identify patient-related predictors of post-operative pain following root canal treatment.

METHODOLOGY

A total of 154 patients received a single-visit root canal treatment for asymptomatic necrotic mandibular molars. Before treatment, dental anxiety, dental fear and sense of coherence (SOC) were measured as predictors for each patient using validated questionnaires. Other measured predictors included gender, age, previous negative experiences at the dental offices and prior root canal treatment. Post-operative pain was assessed using the Numeric Rating Scale at multiple time-points over 30 days. Structural equation analysis was employed to evaluate the direct and indirect effects of patient-related predictors on a theoretical model of post-operative pain. The irrigant solution was also included in the model, as it was the only aspect that varied in the treatment protocol (sodium hypochlorite 2.5% and 8.25%).

RESULTS

Dental anxiety (coefficient 0.028; p < .01), dental fear (coefficient 0.007; p = .02) and irrigant solution (coefficient 0.004; p = .03) exerted a direct effect on post-operative pain. SOC exerted an indirect effect on post-operative (coefficient 0.006; p = .01) through dental anxiety and dental fear. Moreover, previous negative experiences (coefficient 0.048; p = .04) exerted an indirect effect on post-operative pain through dental anxiety.

CONCLUSIONS

Dental anxiety, dental fear, previous negative experiences and SOC are patient-related predictors of post-operative pain following root canal treatment. These factors should be taken into consideration in clinical practice, as patients with these characteristics may be at an increased risk of experiencing post-operative pain.

Single-channel electroencephalography and its associations with anxiety and pain during oral surgery: a preliminary report

Background

This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions.

Methods

The State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed.

Results

The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety.

Conclusions

The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.

Psychological Functioning of Patients Undergoing Oral Surgery Procedures during the Regime Related with SARS-CoV-2 Pandemic

The coronavirus pandemic has become a huge global challenge medically, economically and psychologically. The COVID-19 pandemic shows that the population can experience general psychological distress. The sanitary regime in dental offices and lack of vaccine for coronavirus may have an impact on the level of dental anxiety among patients undergoing oral surgery procedures. A clinical study was conducted between November 2019 and September 2020. A total of 175 patients (n = 175) were enrolled in the research. The aim of the study was to assess the attitude of patients towards the new situation related to the reduced availability of dental offices providing oral surgery procedures. The level of anxiety associated with surgical intervention was measured using a self-made COVID-19 questionnaire and the MDAS scale. The ED-5Q questionnaire and EQ-VAS scale were also used in this research. The study showed that 21.9% of respondents presented with increased anxiety about a dental visit compared with the time before the pandemic. This epidemiological situation has led to an overwhelming increase in moderate dental anxiety (M: 11.4) among patients undergoing oral surgery procedures. The quality of patients’ health (EQ-VAS) related to the impact of the coronavirus pandemic and the quarantine decreased by 10 percentage points. Oral surgeons should be prepared for more anxious patients in dental offices during the pandemic.

Validation of Arabic version of the Modified Dental Anxiety Scale (MDAS) and Kleinknecht's Dental Fear Survey Scale (DFS) and combined self-modified version of this two scales as Dental Fear Anxiety Scale (DFAS) among 12 to 15 year Saudi school students in Riyadh city

Aims

The aim of this study was to test the reliability and validity of the Arabic version of Modified Dental Anxiety Scale (MDAS), Dental Anxiety Scale (DAS), and a combined self-modified version of these scales and Dental Fear and Anxiety Scale (DFAS). We also aimed to assess the impact of dental fear and anxiety among Arabic-speaking 12-15-year-old Saudi students on their quality of life by correlating MDAS, DAS, and DFAS scores with other demographic data.

Materials and Methods

A cross-sectional study was conducted among 500 individuals (250 male and 250 female) in Riyadh city using a questionnaire. An unpaired t-test was used to check the mean difference between anxiety score among males and females, and one-way analysis of variance was used to check the mean difference between percentage anxiety score among different visit groups. Scheffe post hoc test was used to check the pairwise difference between the groups, and Cronbach's alpha was used to measure internal consistency of the questionnaire.

Results

Overall mean percentage DAS score was 51.1640 + 6.87358 and 55.2080 + 8.52805 for male and females, respectively. The overall mean percentage MDAS score was 51.6640 + 10.9478 and 58.3200 + 11.62990 for males and females, respectively. The overall mean total score was found to be 64.4080 + 11.80776 and 100.4680 + 12.34840 for males and females, respectively. All the above results were statistically significant by 5% (P < 0.001). Cronbach's alpha score for MDAS and DAS was found to be 0.843 and it was 0.960 for DFAS. It was found that removal of any item would have decreased the overall consistency, which indicated a high level of internal consistency for our scales.

Conclusion

Saudi Arabian version of Arabic version of MDAS, DAS and DFAS have shown high validity and reliability, and can be used to assess the dental patient's anxiety and fear.

Cross-Cultural adaption, validity and reliability of a Hindi version of the Corah's Dental Anxiety Scale

Background: An appropriate scale to assess the dental anxiety of Hindi speaking population is lacking. This study, therefore, aims to evaluate the psychometric properties of Hindi version of one of the oldest dental anxiety scale, Corah’s Dental Anxiety Scale (CDAS) in Hindi speaking Indian adults.

Methods: A total of 348 subjects from the outpatient department of a dental hospital in India participated in this cross-sectional study. The scale was cross-culturally adapted by forward and backward translation, committee review and pretesting method. The construct validity of the translated scale was explored with exploratory factor analysis. The correlation of the Hindi version of CDAS with visual analogue scale (VAS) was used to measure the convergent validity. Reliability was assessed through calculations of Cronbach’s alpha and intra class correlation 48 forms were completed for test-retest.

Results: Prevalence of dental anxiety in the sample within the age range of 18-80 years was 85.63% [95% CI: 0.815-0.891]. The response rate was 100 %. Kaiser-Meyer-Olkin (KMO) test value was 0.776. After factor analysis, a single factor (dental anxiety) was obtained with 4 items.The single factor model explained 61% variance. Pearson correlation coefficient between CDASand VAS was 0.494. Test-retest showed the Cronbach’s alpha value of 0.814. The test-retest intraclass correlation coefficient of the total CDAS score was 0.881 [95% CI: 0.318-0.554].

Conclusion: Hindi version of CDAS is a valid and reliable scale to assess dental anxiety in Hindi speaking population. Convergent validity is well recognized but discriminant validity is limited and requires further study.

Prevalence of Dental Anxiety among Dental Patients in Saudi Arabia

OBJECTIVE

Anxiety towards dental procedures are common difficulties that may be experienced by dental patients all over the world. This study focused on evaluating the dental anxiety frequency and its relationship with age, gender, educational level, and past dental visits among patients attending the outpatient clinics of College of Dentistry, Al Jouf University, Saudi Arabia.

MATERIAL AND METHODS

A total of 221 patients, aged 21-50 years were selected for the study. A questionnaire comprising the Modified Dental Anxiety Scale (MDAS) was used to measure the level of dental anxiety. Data was analyzed using SPSS version 20.

RESULTS

The mean anxiety score of the 221 patients was 11.39 (SD ± 2.7). Independent t-test showed a significant variation between the age groups with regards to their mean overall anxiety score (P < 0.05), which reduced with increasing age. A significant difference was found by independent t-test in the mean total score between male and female groups and regarding previous dental visit (P < 0.05). Regarding education level, there was no significant difference between the groups (P > 0.05).

CONCLUSION

Younger patients, female, and patients with previous unpleasant dental experience were associated with increased MDAS score.

CLINICAL SIGNIFICANCE

The present study was done for better patient management and proper treatment plan development for dentally anxious patients.