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      Factors influencing anxiety levels in children undergoing dental treatment in an undergraduate clinic

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          Abstract

          Introduction:

          Dental anxiety is a kind of fear exerted due to threatening stimuli. Assessing a child's dental anxiety level is very important to perform a particular treatment. The aim of this study is to examine the various factors that determine the anxiety levels in children and evaluate their anxiety levels.

          Materials and Methods:

          A total of 50 children participated in the survey conducted. Each participant had fulfilled the inclusion and exclusion criteria to answer the questionnaire. It included questions regarding their habits, fears, and dental visit experience. Evaluation of their anxiety levels was done using the facial image scale (FIS) and the modified dental anxiety scale and was correlated with various factors using the Statistical Package for Social Science Software.

          Results:

          Female children are more anxious than male children toward dental treatment. About 38% were anxious and 16% refused while undergoing radiographic examination and showed significant anxiety levels ( P = 0.012). About 16% of the population were highly uncooperative and were necessary to implement behavioral shaping techniques on them. It influences the FIS anxiety score before initiation of the treatment ( P = 0.003). About 48% of children had maintained a good rapport with the dentist and showed strong significance with the child's anxiety ( P = 0.025).

          Conclusion:

          Gender and behavior of the child while diagnosis and radiographic examination, implementation of behavioral shaping techniques, and rapport developed between child and dentist are all influencing factors of dental anxiety. The number of visits to the dental clinic, socioeconomic status, kind of amount of consumption of sugars, and type of treatment being done do not contribute to a child's anxiety level.

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          Most cited references24

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          The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age

          Background The Modified Dental Anxiety Scale (MDAS) is a brief, self-complete questionnaire consisting of five questions and summed together to produce a total score ranging from 5 to 25. It has reasonable psychometric properties, low instrumental effects and can be integrated into everyday dental practice as a clinical aid and screen for dental anxiety. The objectives were to (i) produce confirmatory evidence of reliability and validity for the MDAS, (ii) provide up-to-date UK representative norms for the general public to enable clinicians to compare their patients' scores, (iii) to determine the nature of the relationship between dental anxiety and age. Methods Telephone survey of a representative quota sample of 1000 UK adults (>18 years of age) conducted between 7–21 April, 2008. Results Attrition of potential participants was high in the recruitment process, although bias was minimal. Estimated proportion of participants with high dental anxiety (cut-off score = 19) was 11.6%. Dental anxiety was four times greater in the youngest age group (18–39 yrs) compared to older participants (60+ yrs), controlling for sex, social class and self-reported dental visiting behaviour confirming previous developed-world reports. Conclusion The scale's psychometrics is supportive for the routine assessment of patient dental anxiety to compare against a number of major demographic groups categorised by age and sex. Dental anxiety was high in younger compared to older people.
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            Validation of a Facial Image Scale to assess child dental anxiety.

            To examine the validity of a scale that uses faces as an indicator of children's dental anxiety. Department of Child Dental Health waiting room, Newcastle Dental Hospital. 100 children (aged 3-18 years) completed the Facial Image Scale (FIS) and the Venham Picture Test (VPT) in the dental hospital waiting room. A strong correlation (0.7) was found between the two scales, indicating good validity for the FIS. Findings also showed that a small, but significant, number of children are anxious in the dental context. The findings suggest that the FIS is a valid means of assessing child dental anxiety status in a clinical context.
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              The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial.

              To review the effect of lavender scent on anticipatory anxiety in dental participants. In a cluster randomized-controlled trial, patients' (N = 340) anxiety was assessed while waiting for a scheduled dental appointment, either under the odor of lavender or with no odor. Current anxiety, assessed by the brief State Trait Anxiety Indicator (STAI-6), and generalized dental anxiety, assessed by the Modified Dental Anxiety Scale (MDAS) were examined. Analyses of variance (anovas) showed that although both groups showed similar, moderate levels of generalized dental anxiety (MDAS F((1,338)) = 2.17, P > 0.05) the lavender group reported significantly lower current anxiety (STAI: F((1,338)) = 74.69, P < 0.001) than the control group. Although anxiety about future dental visits seems to be unaffected, lavender scent reduces state anxiety in dental patients.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Wolters Kluwer - Medknow (India )
                2249-4863
                2278-7135
                June 2019
                : 8
                : 6
                : 2036-2041
                Affiliations
                [1 ] Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. Deepa Gurunathan, Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, Poonamallee High Road, Chennai - 600 077, Tamil Nadu, India. E-mail: drgdeepa@ 123456yahoo.co.in
                Article
                JFMPC-8-2036
                10.4103/jfmpc.jfmpc_229_19
                6618196
                31334176
                aab7591d-8b5e-4791-ad82-c1eed3b1fe5a
                Copyright: © 2019 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 17 March 2019
                : 19 March 2019
                : 03 April 2019
                Categories
                Original Article

                behavioral shaping techniques,dental anxiety,facial image scale,modified dental anxiety scale,threatening stimuli

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