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      Why Are People Afraid of the Dentist? Observations and Explanations

      a , a , * , b
      Medical Principles and Practice
      S. Karger AG
      Dental anxiety, Dental phobia, Aetiology

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          The aim of this review was to explore the peer-reviewed literature to answer the question: ‘Why are people afraid of the dentist?’


          Relevant literature was identified by searching the following on-line databases: PubMed, PsycInfo, the Cochrane Library and Google Scholar. Publications were extracted if they explored the causes and consequences of dental fear, dental anxiety or dental phobia.


          The research evidence suggests that the causes of dental fear, dental anxiety or dental phobia are related to exogenous factors such as direct learning from traumatic experiences, vicarious learning through significant others and the media, and endogenous factors such as inheritance and personality traits. Each individual aetiological factor is supported by the evidence provided.


          The evidence suggests that the aetiology of dental fear, anxiety or phobia is complex and multifactorial. The findings show that there are clear practical implications indicated by the existing research in this area: a better understanding of dental fear, anxiety and phobia may prevent treatment avoidance.

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          Most cited references50

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          The Modified Dental Anxiety Scale: validation and United Kingdom norms.

          The Corah Dental Anxiety Scale (CDAS) has been used extensively in epidemiology and clinical research. It is brief and is claimed to have good psychometric properties. However, it does not include any reference to local anaesthetic injections, a major focus of anxiety for many. Also, the multiple choice answers for three of the four questions are not clearly in order of severity of anxiety as the CDAS intends. The answers differ among the questions thus making them difficult to compare. They include descriptions of physiological reactions and anxiety, confusing two loosely related components of the experience. The Modified Dental Anxiety Scale (MDAS) described, added a question on anxiety about oral injections. New multiple choice answers, in clear order of anxiety and the same for each question, were provided. Twenty five dental personnel all confirmed independently the order of the multiple choice answers for the MDAS. They disagreed among themselves however, about the appropriate sequence for the answers denoting intermediate anxiety in the CDAS. Therefore the CDAS, unlike the MDAS, can provide meaningful measures only of extremely high or extremely low dental anxiety. Of 1392 subjects tested, 13 per cent expressed extreme anxiety about injections on the MDAS but were only 'fairly' or less anxious about drilling. Thus, the CDAS, unlike the MDAS, must overlook subjects very afraid of injections only. Data confirm the high reliability and validity of the MDAS and provide norms for phobic and nonphobic subjects.
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            Development of a dental anxiety scale.

            N Corah (2015)
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              A cognitive approach to panic.


                Author and article information

                Med Princ Pract
                Med Princ Pract
                Medical Principles and Practice
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch )
                July 2014
                20 December 2013
                20 December 2013
                : 23
                : 4
                : 295-301
                [1] aDental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
                [2] bHealth Psychology, School of Medicine, University of St Andrews, St Andrews, UK
                Author notes
                *Prof. Ruth Freeman, Dental Health Services Research Unit, 9th Floor, School of Dentistry, University of Dundee, Park Place, Dundee DD1 4HN (UK), E-Mail r.e.freeman@ 123456dundee.ac.uk
                Copyright © 2013 by S. Karger AG, Basel

                This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.

                : 23 June 2013
                : 17 November 2013
                Page count
                Figures: 1, Tables: 1, References: 54, Pages: 7

                dental anxiety,dental phobia,aetiology
                dental anxiety, dental phobia, aetiology


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