Factors Influencing Dental Anxiety in Adults Presenting to the Outpatient Department of Saidu College of Dentistry, Swat
DOI:
https://doi.org/10.52206/jsmc.2025.15.4.1138Abstract
Background: Dental anxiety is a widespread concern that negatively impacts oral health and quality of life. Patients experiencing dental anxiety often delay or avoid treatment, which can lead to worsening oral conditions and compromised general well-being.
Objective: This study aimed to identify the prevalence and key factors associated with dental anxiety among adults attending the outpatient department of Saidu College of Dentistry, Swat.
Methodology: A descriptive cross-sectional study was conducted from December 2023 to May 2024. A total of 384 adults aged 18–65 years were recruited through consecutive non-probability sampling. Data were collected using a structured, validated questionnaire with a Cronbach’s alpha of 0.89. The tool assessed demographics, nervousness regarding dental visits, anxiety linked to dental instruments and drill sounds, past experiences, social influences, and concerns about pain, outcomes, and costs. Descriptive statistics were calculated, and associations between gender and anxiety-related factors were analyzed using chi-square or Fisher’s exact test, with p ≤ 0.05 considered significant.
Results: Of the 384 participants, 52.9% were females and 47.1% males. The largest age group was 18–30 years (40%). Fear of dental pain (69%) and nervousness about dental visits (64%) were the most frequently reported sources of anxiety. Delay in dental visits due to anxiety was reported by 60% of participants, while 58% identified drill sounds and 57% identified dental instruments as triggers. Gender differences were significant, with males more likely to report nervousness about visiting the dentist, whereas females showed higher anxiety regarding instruments, drill sounds, and delayed treatment (p < 0.001).
Conclusion: Dental anxiety was highly prevalent, primarily driven by fear of pain, nervousness about visits, and sensory stimuli such as instruments and drill sounds. Gender-based differences highlighted the need for tailored interventions, with strategies focusing on reducing sensory triggers for females and addressing nervous anticipation in males.
Keywords: Dental anxiety, Dental fear, Gender differences, Nervousness, Sensory triggers.
References
Alowid AM, Hebbal M, Aldegheishem A, Nadakkavukaran Santhosh V, Surath Kumar R, Alfayyadh AM, et al. A cross-sectional study on levels of dental anxiety, its influencing factors, and the preferred management techniques among patients in Riyadh, Saudi Arabia. PLoS One. 2024 Sep 6;19(9):e0309248. https://doi.org/10.1371/journal.pone.0309248.
Arif K, Alam B, Khan MI, Khare A, Malhotra S, Singh B. To assess the prevalence of dental anxiety among patients visiting a teaching dental hospital in Lucknow, India, and their self-perceived treatment needs. J Oral Biol Craniofac Res. 2022 Nov 1;12(6):798-801. https://doi.org/10.1016/j.jobcr.2022.09.007
Sukumaran I, Taylor S, Thomson WM. The prevalence and impact of dental anxiety among adult New Zealanders. Int Dent J. 2021 Apr 1;71(2):122-6. https://doi.org/10.1111/idj.12613
Scandurra C, Gasparro R, Dolce P, Bochicchio V, Muzii B, Sammartino G, et al. The role of cognitive and non-cognitive factors in dental anxiety: A mediation model. Eur J Oral Sci. 2021 Aug;129(4):e12793. https://doi.org/10.1111/eos.12793
Kassem El Hajj H, Fares Y, Abou-Abbas L. Assessment of dental anxiety and dental phobia among adults in Lebanon. BMC Oral Health. 2021 Dec;21:1-0. https://doi.org/10.1186/s12903-021-01409-2
Muduroglu R, Ionescu AC, Del Fabbro M, Scolavino S, Brambilla E. Distribution of adhesive layer in class II composite resin restorations before/after interproximal matrix application. J Dent. 2020 Dec 1;103:103494. https://doi.org/10.1016/j.jdent.2020.103494
Ghaffar RS, Sheikh M, Kidwai M, Sanaullah A, Salman M, Ilyas A, et al. Impact of high-speed handpiece noise-induced dental anxiety on heart rate: analyzing experienced and non-experienced patients-a comparative study. BMC Oral Health. 2024 Feb 23;24(1):265. https://doi.org/10.1186/s12903-024-04017-y
Muneer MU, Ismail F, Munir N, Shakoor A, Das G, Ahmed AR, et al. Dental anxiety and influencing factors in adults. Healthcare (Basel). 2022 Nov 23;10(12):2352. https://doi.org/10.3390/healthcare10122352
Sinha E, Rekha R, Nagashree SR. Anxiety of dental treatment among patients visiting primary health centers. J Indian Assoc Public Health Dent. 2019 Jul 1;17(3):235-45. https://doi.org/10.4103/jiaphd.jiaphd_178_18
S?lcudean A, Tru?culescu LM, Popovici RA, ?erb N, Pa?ca C, Bodo CR, et al. Dental anxiety – a psychosocial cause affecting the quality of life: a systematic review. Rom J Oral Rehabil. 2024;16(4).31. https://doi.org/10.62610/RJOR.2024.4.16.46
Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization, and dental fear. BMC Oral Health. 2007 Dec;7:1-5. https://doi.org/10.1186/1472-6831-7-1
Karim ZA, Ali MF, Askary G, Askary H, Siddiqui UN. Factors influencing level of anxiety and pain in patients receiving endodontic treatment. Natl J Health Sci. 2023 Dec 28;8(4):152-7. https://doi.org/10.21089/njhs.84.0152
Dhanapriyanka M, Jayasekara P, Rumy AS, Athambawa N, Haseena AL, Salman KR, et al. Prevalence and associated factors of dental anxiety among adults attending public outpatient dental clinic in the Eastern Province, Sri Lanka. BMC Oral Health. 2024 Dec 24;24(1):1549. https://doi.org/10.1186/s12903-024-05288-1
Winkler CH, Bjelopavlovic M, Lehmann KM, Petrowski K, Irmscher L, Berth H. Impact of dental anxiety on dental care routine and oral-health-related quality of life in a German adult population: A cross-sectional study. J Clin Med. 2023 Aug 14;12(16):5291. https://doi.org/10.3390/jcm12165291.
Tahmassebi JF, Malik M, Berg N, Pavitt S, Gray-Burrows K, O’Grady A. Using process drama to explore the causes of dental anxiety in primary-school children. Eur Arch Paediatr Dent. 2021 Oct;22(5):869-77. https://doi.org/10.1007/s40368-021-00623-4
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