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Park, Lee, Ju, Choi, Oh, and Lee: Relationship of dental anxiety with oral health behavior and dental caries experience in adolescents
Original Article

J Korean Acad Oral Health 2015;39(1):17-24.

Published online: 12 March 2015

DOI: https://doi.org/10.11149/jkaoh.2015.39.1.17

Relationship of dental anxiety with oral health behavior and dental caries experience in adolescents

Sun-Hwa Park, Na-Gyung Lee, Hyun-Jeong Ju, Boo-Young Choi, Hyo-Won Oh, Heung-Soo Lee

Department of Preventive and Public Health Dentistry, College of dentistry, Wonkwang University, Iksan, Korea

Corresponding Author: Heung-Soo Lee Department of Preventive and Public Health Dentisty, Wonkwang University College of Dentistry, 460 Iksan-daero, Iksan 570-749, Korea Tel: +82-63-850-6851 Fax: +82-63-850-6851 E-mail: smagn@wonkwang.ac.kr

Received 13 October 2014       Revised 13 November 2014       Accepted 13 November 2014

Copyright © 2015 Journal of Korean Academy of Oral Health

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to examine the relationship of dental anxiety with oral health behavior and dental caries experience among adolescents.

Methods

The subjects were 469 teenagers (238 middle school students and 231 high school students) in 15 different schools located in 7 regions of Bucheon in Gyeonggi Province, Daejeon, and others. A survey and interviews were conducted to evaluate subjects’ oral health behavior and dental anxiety. Dental anxiety was additionally assessed by Corah’s Dental Anxiety Scale. The caries experience of subjects was examined.

Results

There were no regional differences in dental anxiety. Girls felt more dental anxiety than boys did. Adolescents who did not receive treatment even when they needed it felt more dental anxiety than those who did receive treatment. There were also statistically significant differences in dental anxiety according to the type of treatment received. Adolescents who received extraction treatment or underwent oral surgery experienced more dental anxiety than those who received orthodontic or aesthetic treatment. Those who had a toothache or who experienced gingival bleeding felt more dental anxiety than those who did not have those conditions. Subjects with poor perceived oral health also had more dental anxiety. The number of decayed teeth and filled teeth was significantly correlated with dental anxiety.

Conclusions

In adolescents, dental anxiety is related to their oral health behavior, the type of conditions they present with, the treatment received, and dental caries experience. Therefore, the kind of systematic programs that could relieve adolescents of dental anxiety should be prepared.

Keywords: Behavior, Dental anxiety, DMF index, Students

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Table 1.
Oral health behaviors of subjects
N %
Dental treatment demand for the past one year Yes 233 49.7
No 236 50.3
Unmet need of dental treatment Yes 121 25.8
No 348 74.2
Unmet reason of unmet need of dental treatment Etc (except fear) 89 74.2
Fear 31 25.8
Type of received dental treatment Routine check-ups 37 7.9
Preventive care 7 1.5
Caries treatment 143 30.5
Periodontal treatment 5 1.1
3rd molar treatment 3 0.6
Tooth removal/oral surgery 3 0.6
Prothetics/trauma 10 2.1
Orthodontics/esthetic 14 3.0
Etc 12 2.6
Usage of oral hygiene auxiliaries Use 166 35.4
No use 303 64.6
Frequency of snack intake per day No intake 63 13.4
Once and over 394 84.0
Don't know 12 2.6
Frequency of cariogenic beverages intake per day No intake 189 40.3
Once and over 268 57.1
Don't know 12 2.6
Tooth brushing frequency 2.83* 0.83†

*Mean,

† Standard deviation.

Tabie 2.
Self-reported oral health status of subjects
N %
Experience of toothache for the past one year Yes 179 38.2
No 290 61.8
Experience of gingival bleeding for the past one year Yes 177 37.7
No 292 62.3
Experience with maxillofacial injury Yes 75 16.0
No 394 84.0
Perceived oral health status Very good 18 3.8
Good 79 16.8
Fair 249 53.1
Poor 112 23.9
Very poor 11 2.3
Table 3.
Dental anxiety score by subject characteristics
M±SD t or F P
Region Metropolis 10.25±3.56 1.364 0.257
Cities 10.49±3.49
Rural area 9.81±3.92
Level of education ≤Middle school 9.75±3.40 ―3.142 0.002
≥High school 10.79±3.76
Sex Male 9.12±3.04 ―7.201 <0.001
Female 11.40±3.79

*M±SD: Mean±Standard deviation, P-value determined by t-test and ANOVA.

Table 4.
Dental anxiety score by dental service utilization
M±SD t or F P
Dental treatment demand for the past one year Yes 10.17±3.39 ―0.551 0.582
No 10.36±3.84
Unmet need of dental treatment Yes 11.61±3.96 ―4.508 <0.001
No 9.80±3.37
Unmet reason of unmet need of dental treatment Etc (except fear) 10.16±3.11 ―7.795 <0.001
Fear 15.45±3.66
Type of received dental treatment Routine check-ups 9.32±3.13 2.265 0.024
Prevention care 8.86±3.02
Caries treatment 10.69±3.46
Peridontal treatment 10.00±3.00
3rd molar treatment 10.00±6.61
Tooth removal/oral surgery 14.00±2.00
Prothetics/trauma 10.20±3.16
Orthodontics/esthetic 7.86±3.03
Etc 9.58±2.91

*M±SD: Mean±Standard deviation, P-value determined by t-test and ANOVA.

Table 5.
Dental anxiety score by oral health behaviors of subjects
M ± SD t or F P
Before breakfast Brushing 10.56±3.56 1.404 0.161
No brushing 10.08±3.65
After breakfast Brushing 10.00±3.62 ―2.202 0.028
No brushing 10.79±3.56
After lunch Brushing 10.46±3.75 1.035 0.301
No brushing 10.11±3.51
After dinner Brushing 10.11±3.62 ―1.548 0.122
No brushing 10.69±3.59
Before sleep Brushing 10.54±3.57 1.951 0.052
No brushing 9.88±3.67
Usage of oral hygiene auxiliaries Use 10.19±3.43 ―.317 0.751
No use 10.30±3.72
Frequency of snack intake per day No intake 9.56±3.56 1.406 0.246
Once and over 10.37±3.62
Don't know 10.50±3.87
Frequency of cariogenic beverages intake per day No intake 10.11±3.58 0.387 0.679
Once and over 10.35±3.61
Don't know 10.83±4.47
Experience of toothache for the past one year Yes 10.91±4.07 ―2.886 0.004
No 9.87±3.26
Experience of gingival bleeding for the past one year Yes 10.75±3.61 ―2.280 0.023
No 9.97±3.60
Experience with maxillofacial injury Yes 10.36±3.82 0.249 0.803
No 10.25±3.58

*M±SD: Mean±Standard deviation, P-value determined by t-test and ANOVA.

Table 6.
Correlations between dental anxiety and dental caries experience (DMF)
D M F DMF
Dental anxiety 0.112* ―0.026 0.102* 0.043

*P<0.05 (Pearson correlation coefficients).

Table 7.
Multiple regression analysis about factors related dental anxiety
B SE T P
Sex ―0.117 0.045 ―0.122 ―2.623 0.009
Percieved oral health status 0.089 0.028 0.149 3.201 0.001
R2=0.041 AdjustedR2=0.036 F =9.484 P<0.001
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