Comparison of dental anxiety among students of different academic backgrounds

INTRODUCTION

Anxiety, as per definition, is a feeling of worry or fear, especially about the future. Experiences vary from person to person. The definition of anxiety, the feeling of anxiety is different for everyone.

Dental fear is a response to a known danger, although they are frequently used interchangeably, dental anxiety, fear, and phobia all refer to different conditions.^[1-3] Most of the people have some degree of dental anxiety, which is very common. Dental anxiety has many different root causes, making it a complicated condition. This fear is especially frequent for people who are going to undergo a certain dental procedure that they have never undergone. A person with a dental phobia will avoid going to the dentist at all costs until the issue is resolved physically or psychologically.^[2]

A person’s quality of life, looks, and self-esteem are significantly impacted by their oral health.^[2] A sizable majority of people of all ages and social groups experience dental anxiety. The daily provision of normal dental care continues to be a critical concern for the dental professional and the patient. Since dental anxiety is associated with having to undergo invasive treatment procedures, a decrease in dental anxiety levels had been anticipated. A reliable indicator of the condition that can be applied in clinical and research contexts is one tool for describing, recognizing, and minimizing dental anxiety. Clinicians must identify the condition and consider ways to treat it. Researchers need to pay close attention to measurement concerns while analyzing trends and drawing comparisons.

Numerous evaluation techniques have been employed. One of them is the Modified Dental Anxiety Scale (MDAS). This was modified from the original Corah’s Dental Anxiety Scale. This MDAS is a five-question, self-complete questionnaire that contains the lowest score of 5 indicating not anxious and ranges to 25 indicating extremely anxious after being added together. The MDAS has the advantages of being brief, quick to complete, and a basic, affordable tool for population-based research. It has been translated into other languages and is determined to be trustworthy and cross-culturally valid. The present study measured the prevalence of dental anxiety among medical students including dental and medical in comparison with engineering students. Hence, feedback from students of VSPM Dental College, NKP Salve Institute of Medical Sciences, and engineering colleges will be recorded. The responses were collected through Google Form which included the MDAS.

MATERIALS AND METHODS

A cross-sectional type of study was carried out among the undergraduates of dental, medical, and engineering fields. A prevalidated self-administered questionnaire containing 13 questions related to dental anxiety was distributed.

The MDAS is a brief, well-validated five-item questionnaire with five-point Likert scale responses to each question, ranging from “not anxious” to “extremely anxious.”^[2] The questionnaire consists of basic questions related to the number of visits to a dentist, reasons for being anxious, state and nature of anxiety, and so on. The questionnaire also had the following question regarding anxiety related to dental extractions like How anxious would you feel, if you were about to have your tooth/teeth extracted? Likert scale was used to record responses and patients were asked to choose answers from or “not anxious, slightly anxious, fairly anxious, very anxious, or extremely anxious.”^[2]

A self-administrated questionnaire was distributed among the participants anonymously. All willing and present participants were included in the study.

Convenience sampling was done and 150 undergraduates were enlisted. The MDAS administered to the patients was used to gauge their level of anxiety. P < 0.05 was considered as the statistically significance level. The data were then collected and inserted in an Excel sheet. IBM SPSS Statistics for Windows software was used to do the Chi-square test.

RESULTS

A total of 150 responses were collected. The undergraduates in dental, medical, and engineering fields were included in the study. Out of 150 responses received , 43.3% (65) belonged to dental students, 39.3% (59) belonged to medical students, and 17.3% (26) were engineering students, as described in Figure 1. The fear related to health can be evidently seen more in engineering students. This is because they are less subjected to health-care practice. While dental and medical students are dealing with and exposed more to patients, they are less likely to have high scale fear. This brings us to the result of the questionnaire.

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Figure 1:

Academic background of the participants.

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Tables 1 and 2 summarize the responses from all participants. Results on assessment of anxiety regarding going to a dentist for a checkup revealed that 44% (66) participants have visited regularly, whereas only 27.3% (41) have visited only once. Results on assessment of anxiety regarding going to a dentist revealed that 32% (48) of participants visited due to tooth pain, whereas 26% (39) went for a regular checkup and 18.7% (28) due to cosmetic reasons.

A question regarding the state of mind before a dental visit revealed maximum participants 46% (69) had a neutral feeling. On the contrary minimum number of participants, 2.7% (4) felt cheerful and happy about the visit; further, 29.3% (44) participants were calm and relaxed, whereas 22% (33) participants felt anxious but were cheerful about the same.

For a question regarding anxiety during the waiting period in a dental office, the results revealed that maximum participants of 68% (102) experienced slight anxiousness, as against the minimum of 9.3% (14) participants who were not anxious. In addition, 22.7% (34) of participants were fairly anxious about the situation.

When asked to grade the level of anxiety, 60% (90) participants experienced mild anxiety, whereas 24.7% (37) participants had a moderate feeling about it, whereas 6.7% (10) participants were very anxious.

When questioned about the reason for fear of dental treatment, out of the several procedures, fear of pain was the main cause for 58% (87) participants, whereas fear of injection remains a cause for 18.7% (28) participants. On the contrary, minimum respondents had a fear about the sound of the drill.

When questioned about how anxious a person feels if he/she is about to have a tooth drilled, about 36% (54) participants were fairly anxious while a minimum of 4% (6) participants experienced extreme anxiousness; further, 28% (42) participants were slightly anxious, 17.3% (26) participants were not anxious while 14.7% (22) participants were very anxious about the entire procedure.

When questioned about how anxious would you feel if you were about to get your teeth scaled and polished, 50.7% (76) participants being the maximum felt that they were not anxious while a minimum of 2.7% (4) participants were very anxious about it; further, 32% (48) participants were slightly anxious while 14% (21) participants felt fairly anxious with a lowest being. About 7% (1) participants felt extremely anxious. When questioned about how would you feel if they were about to have a local anesthetic injection in their gums, 33.3% (50) participants were slightly anxious while a minimum of 5.3% (8) participants were extremely anxious while 26% (39) participants were fairly anxious, and 23.3% (35) participants were not at all anxious, while 12% (18) participants were very anxious about the entire procedure.

When questioned about how did fear start, 34.7% (52) participants answered that they had heard it from others, 33.3% (50) participants had a bad experience, for about 25.3% (38) participants did not know the reason behind it, whereas 6.7% (10) participants answered it was due to unempathetic dentist.

When questioned if they experienced any physical manifestation due to fear during the dental procedure that 22% (33) participants experienced sweating, almost equal n 16.7% of participants experienced palpitations and light-headedness. Nonrespondents were 44.7% (67). When questioned about when did you feel the peak of anxiety, 64% (96) participants had a fear when a tooth is being extracted, whereas 32.7% (49) participants felt anxious during root canal treatment, 2% (3) participants felt anxious about the dental filling, and 1.3% (2) participants got anxious about scaling.

When asked which method they would prefer to control anxiety, 47.3% (71) participants suggested counseling by doctors, while a minimum of 11.3% (17) participants suggested that conscious sedation should be preferred, whereas 26% (39) participants suggested medications and alternative relaxation should be preferred and about 15.3% (23) participants suggested that taking medication can be of great help.

As P-values from the independent t-tests were more than the standard P-value, concluding the data are statistically nonsignificant.

DISCUSSION

The research was conducted to compare dental anxiety among students of different academic backgrounds. A distressing emotion aroused by impending danger is what we call fear. Dental care is often avoided as a result of dental phobia and anxiety.^[2]

Dental anxiety is a condition linked to worrying about getting preventative care and having dental operations done at the clinic. We can say it is an uncertain emotional condition that we face even before the commencement of the treatment. Moreover, it is a frequently encountered issue. The feeling of anxiety can be due to previous bad experiences. Before starting the dental treatment, evaluating the patient’s level of anxiety may provide crucial insight into the likely patient’s attitude and behavior.^[1] This can be of great help to manage anxiety. Knowledge does not consistently influence behavior but when it does it affects behavior. Dental anxiety is less among dental students rather than among medical or engineering students. If little knowledge about oral care is added to the curriculum itself, it might be helpful for dealing with anxiety.^[2] Findings can be supported by the background information and knowledge dental students acquire during their education, which would help them feel less anxious if they were aware of some of the specifics of each procedure.^[1] The importance of dental health education can be of great use. Dental education, regular appointments, strong patient–dentist relationships, and efficient communication with the patient’s dentist can all reduce dental anxiety.^[1,2] Eliminating the fear of anxiety is very important and beneficial overall as it elicits physical, cognitive, emotional, and behavioral responses. Furthermore, while dealing with a patient who has anxiety a gentle approach should be taken into consideration. If the patient was already told and explained about the procedure, it can be helpful to, for instance, “tell- show-do” and modeling.^[3] The advantage of dealing with teenagers is that they are moldable and they can be taught a certain thing by explaining properly. At last, it is the duty of a dentist to provide excellent dental care.^[1] If we look at the results, participants were getting anxious just at the thought of pain or getting an injection, which is moreover common in every situation anybody would be in. Following a thorough evaluation, therapy should be tailored to each individual depending on the dentist’s training, experience, level of anxiety, patient intelligence, age, cooperation, and clinical circumstances. In addition, the quality of prior dental experiences — whether positive or negative --had an impact on the amount of anxiety.^[2-5] Therefore, by offering frequent dental education and developing campaigns that raise awareness and understanding about oral health, it may be possible to eliminate anxiety.

CONCLUSION

The result of current research indicates that dental anxiety is quite prevalent among undergraduates. Fear of pain is the main reason behind anxiety. Besides all the anxiety-provoking procedures, it was observed that the extraction of a tooth and root canal caused more anxiety. Therefore, all efforts should be undertaken to allay the fear by appropriate techniques of patient counseling to make sure that the patient understands the necessity of the procedure and cooperate s.