Understanding and assessing dental anxiety and fear in Malaysia / Rashidah Esa
Dental anxiety refers to a vague, unpleasant feeling that something undesirable awaits whereas dental fear is a normal response to a threat or danger. Anticipation of a dental visit can induce dental anxiety whereas the most fear-provoking situations were the sight of injection needles and the...
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| Format: | Thesis |
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2021
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| Online Access: | http://studentsrepo.um.edu.my/13256/ http://studentsrepo.um.edu.my/13256/4/rashidah.pdf |
| Summary: | Dental anxiety refers to a vague, unpleasant feeling that something undesirable awaits
whereas dental fear is a normal response to a threat or danger. Anticipation of a dental
visit can induce dental anxiety whereas the most fear-provoking situations were the sight
of injection needles and the drilling procedures. Nevertheless, the terms are often used
interchangeably. Dental anxiety and fear (DAF) are perpetual problems worldwide and
their assessment is important to assist dentists in the management of highly anxious
patients. In Malaysia, more studies are needed to add to the growing body of DAF
research. The aim of this thesis was to explore different aspects of DAF and their
associated factors among adolescents, ante natal mothers, preschool children and their
mothers. A series of study was conducted to achieve the aim. In the ante natal study, 407
mothers from Negeri Sembilan participated. The adolescent study comprised of 503, 16-
year-old schoolchildren from Penang. In both these studies, the questionnaire consisted
of participants� demographic profile and the Kleinknecht�s DFS. Two separate studies
were conducted to assess the psychometric properties (validity and reliability) of the
Malay-Early Childhood Oral Health Impact Scale (Malay-ECOHIS) and the Malay
Modified Child Dental Anxiety Scale (Malay-MCDASf).In the mother-child dyad study,
842 complete data were obtained from 24 kindergartens in two districts in Selangor.
Mothers answered the questionnaire on socio-economic status, the Malay-Modified
Dental Anxiety Scale (Malay-MDAS), and the Malay-ECOHIS to assess maternal
perception of impact on child�s oral health-related quality of life (COHRQoL). Child's
dental anxiety was assessed using the Malay-MCDASf. The clinical examination
consisted of the DMFT/dmft as the outcome measure of dental caries disease and
treatment experience.
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The overall prevalence of dental fear among ante natal mothers was 94.1%. However,
67.6% had low fear, whilst 26.5% were moderately fearful. Among 16-year-old
adolescents, 46.7% were moderately fearful and the mean DFS score was 40.8. None of
the ante natal mothers and adolescents reported high fear. The prevalence of high dental
anxiety in the sample of mother-child dyads were 8.7% and 53.9% respectively.
Significant relationship between dental anxiety and dental decay experience in
adolescents, antenatal mothers and mother-child dyads were established. Dentally
anxious participants had more dental decay and higher overall DMFT/dmft. Adolescents
from rural areas reported having significantly higher fear. Maternal dental anxiety and
child dental caries showed significant impact on COHRQoL, child impacts section (CIS)
and family impacts sections (FIS). Demographic factors such as education, income,
urban/rural location, and public/private kindergarten acted as moderators that modify the
strengths of the maternal dental anxiety-COHRQoL relationship. However, child dental
anxiety does not have any significant direct impact on COHRQoL, CIS, FIS, or child
dental caries.
In summary, DAF is quite common among all the studied populations. The prevalence
of child dental anxiety was high. Treating DAF at an early age can produce positive
outcomes and improve the quality of life. There is a need to establish the norms cut-off
points for the different DAF indices. Future research requires development of more
complex models to further understand the dynamics of DAF and their associated factors.
Keywords: dental anxiety, dental fear, dental caries, psychometric, quality of life
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