ORCID Profile
0000-0001-7962-7559
Current Organisations
University of Adelaide
,
University of South Australia
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Publisher: Wiley
Date: 06-2004
Publisher: Elsevier BV
Date: 03-2013
Publisher: Wiley
Date: 22-07-2015
DOI: 10.1111/IPD.12126
Abstract: To explore the mechanisms by which some children select disruptive behaviours to cope with stressful dental events. In particular, the relationships between dental fear, expected effectiveness of destructive coping, and intentions of displaying uncooperative behaviours were analysed. Participants were 170 children who filled out a questionnaire survey. Descriptive statistics by gender and group age as well as comparisons of means were calculated. Spearman's rho correlation coefficients and binary logistic regression analysis were used to test hypotheses of the relationships among variables. Both dental fear and the expected effectiveness of destructive coping strategies were significantly associated with children's uncooperative intentions at the dentist. In addition, children who strongly endorsed the effectiveness of destructive coping strategies had a higher probability of uncooperative intentions as dental fear increased. In contrast, this relationship was not statistically significant among children who did not expect negative behaviours to be effective. Children's expectations about the effectiveness of destructive coping behaviours can help explain variations in the use of these strategies in stressful dental situations. Dental fear as well as children's inadequate expectancies about coping alternatives should be explored and targeted to prevent and modify uncooperative behaviour intentions at the dentist.
Publisher: Wiley
Date: 03-2003
DOI: 10.1111/J.1752-7325.2003.TB03469.X
Abstract: Previous studies have attributed the caries-preventive effects of preeruption (PRE) and posteruption (POST) exposure to fluoridated water based on data collected before and after the commencement or discontinuation of water fluoridation. This study aims to determine the relative pre- and posteruption exposure effects of fluoridated water on caries experience of 6-15-year-old Australian children based on in idual residential histories. Parental questionnaires covering residential history of participants were linked to their oral examinations conducted between June 1991 and May 1992 by the School Dental Services of South Australia and Queensland. Percentage of lifetime exposed to optimally fluoridated water PRE and POST was calculated with respect to the eruption age for first permanent molars. Combined pre- and posteruption categories were created to test PRE against POST exposure: PRE & POST = 0, PRE POST, and PRE & POST > or = 90 percent lifetime exposure. These categories were used as indicator variables with PRE and POST = 0 as reference in an analysis of first permanent molar DMFS scores. The linear regression model controlled for important potential confounders. Participation rates were 69.7 percent in South Australia and 55.6 percent in Queensland with 9,690 and 10,195 participants, respectively. Pre- and posteruption exposures were strongly correlated (r =. 74 P POST, PRE = POSTin the range 0-90 percent, and PRE and POST > or = 90 percent showed significantly lower caries levels. The findings indicated that preeruption exposure was required for a caries-preventive effect and that exposure after eruption alone did not lower caries levels significantly. However, the maximum caries-preventive effects of fluoridated water were achieved by high pre- and posteruption exposure.
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/13557850601002197
Abstract: To explore the prevalence and severity of Indigenous and non-Indigenous child dental disease in relation to age, sex, residential location and socio-economic status in three Australian states and territories. Children aged 4-14 years who were enrolled in a school dental or screening service in New South Wales, South Australia and the Northern Territory, Australia, were randomly selected to take part in this cross-sectional study. Bivariate and multivariate analyses were used to assess outcomes. A total of 328,042 children were included, of which 10,517 (3.2%) were Indigenous. Some 67.1% of Indigenous children lived in rural areas and 47.3% lived in areas of high disadvantage. About 37.5% of 4- to 10-year-old Indigenous children had no experience of dental disease in the primary dentition while 70.7% of 6- to 14-year-old Indigenous children had caries-free permanent dentitions. The mean number of decayed, missing and filled primary teeth (dmft) of Indigenous 4- to 10-year-old children was 2.9 (SD 3.4) while the mean DMFT of Indigenous 6- to 14-year-old children was 0.8 (SD 1.6). Across all age-groups, Indigenous children living in the most deprived areas had higher dmft and DMFT levels than their more socially advantaged counterparts, while rural-dwelling Indigenous children had higher levels of dental disease experience than metropolitan-dwelling Indigenous children. After adjusting for potential confounding, Indigenous children aged 4-10 years were over twice as likely to have caries in the deciduous dentition than similarly aged non-Indigenous children (OR: 2.25, CI: 2.14-2.36), and 6- to 14-year-old Indigenous children were over one and a half times more likely to have decay in the permanent dentition (OR: 1.68, CI: 1.60-1.77) than their non-Indigenous counterparts. Indigenous children experienced higher caries prevalence and severity than non-Indigenous children, irrespective of other socio-demographic factors. Factors concerning Indigenous social capital may have influenced our findings.
Publisher: Wiley
Date: 06-07-2006
DOI: 10.1111/J.1600-0528.2006.00277.X
Abstract: To describe oral health inequalities among indigenous and nonindigenous children in the Northern Territory of Australia using an area-based measure of socioeconomic status (SES). Data were obtained from indigenous and nonindigenous 4-13-year-old children enrolled in the Northern Territory School Dental Service in 2002-2003. The Socio-Economic Indices For Areas (SEIFA) were used to determine socioeconomic relationships with dental disease experience. Some 12,584 children were examined, 35.1% of whom were indigenous. Across all age-groups, socially disadvantaged indigenous children experienced higher mean dmft and DMFT levels than their similarly aged, similarly disadvantaged nonindigenous counterparts. Indigenous children aged 5 years had almost four times the dmft of their nonindigenous counterparts in the same disadvantage category (P < 0.05), while indigenous children aged 10 years had almost five times the DMFT of similarly disadvantaged nonindigenous children (P < 0.05). A distinct social gradient was apparent among indigenous and nonindigenous children, respectively, whereby those with the highest dmft/DMFT levels were in the most disadvantaged SES category and those least disadvantaged had the lowest dmft/DMFT levels. In most age-groups, indigenous children who were least disadvantaged had worse oral health than the most disadvantaged nonindigenous children. The findings suggest that indigenous status and SES have strong oral health outcome correlations but are not mutually dependent, that is, indigenous status influences oral health outcomes irrespective of social disadvantage. From a health policy perspective, greater oral health gains may be possible by concentrating public health and clinical effort among all indigenous children irrespective of SES status.
Publisher: Wiley
Date: 11-2010
DOI: 10.1111/J.2041-1626.2010.00023.X
Abstract: To test whether residents of Queensland differ from residents elsewhere in Australia with respect to support for water fluoridation. Questionnaire data were obtained from an Australia-wide s le of 517 adults. The study occurred in 2008, shortly after the state government mandated fluoridation across Queensland. There were no significant differences in fluoridation support or in beliefs regarding the benefits and harms of fluoridation between Queensland and non-Queensland residents. However, respondents from Queensland were more resistant to changing their minds regarding their fluoridation stance, more distrusting of public health officials, and more supportive of decisions to introduce fluoridation being made by the people via a referendum. After controlling for potentially confounding variables, Queenslanders demonstrated significantly more support for water fluoridation than non-Queenslanders. Perceived Queensland characteristics, which political scientists have used to explain aberrant political behavior or public policy, were not relevant to the longstanding pre-2009 disparity in water fluoridation coverage between Queensland and the rest of Australia. The findings of this investigation do not support the assumption that Queenslanders are more opposed to fluoridation than residents elsewhere in Australia.
Publisher: Wiley
Date: 17-09-2014
DOI: 10.1111/ADJ.12211
Abstract: It is recommended that dentists screen for dental anxiety (DA) so that fearful patients may be better managed. The main aim of this study was to determine what dentists are being taught in relation to DA as well as whether and how anxious patients are identified in the clinic. Two hundred and forty-six practising dentists (adjusted response rate = 40.1%), from a random s le of registered Australian dentists, completed a mailed questionnaire. Dentists estimated that high DA affected 23.3% of children and 19.4% of adults seen. Only 3.7% of dentists reported using a published scale for screening DA, with the most common reason being lack of awareness (56.5%). Approximately one-half of responding dentists directly asked their patients about DA and this was more common among younger dentists (χ(2) = 7.75, p = 0.021). There were few differences in DA screening by other practitioner or practice characteristics (p > 0.05). Only one-third of dentists had received undergraduate training related to DA and only 41.7% considered this to be 'good' or better. Almost 37% of respondents expressed an interest in future training opportunities. The use of formal, validated scales for screening DA is minimal. Training in anxiety management appears to be low and is an area that could be expanded upon.
Publisher: Wiley
Date: 06-07-2017
DOI: 10.1111/ADJ.12531
Abstract: The aim of this study was to investigate the association between early-life family income and dental pain experience from childhood to early adulthood. Data came from a 14-year prospective study (1991/1992-2005/2006) carried out in South Australia, which included children and adolescents aged 4-17 years (N = 9875) at baseline. The outcome was dental pain experience obtained at baseline, 14 years later in adulthood and at a middle point of time. The main explanatory variable was early-life family income collected at baseline. The prevalence of dental pain was 22.8% at baseline, 19.3% at 'middle time' and 39.3% at follow up. The proportion of people classified as 'poor' at baseline was 27.7%. Being poor early in life was significantly associated with dental pain at 14-year follow up (odds ratio = 1.45 95% confidence interval = 1.27-1.66). Early-life relative poverty is associated with more frequent dental pain across the 14-year follow up and may be a key exposure variable for later dental conditions.
Publisher: JMIR Publications Inc.
Date: 06-10-2015
DOI: 10.2196/IJMR.4712
Publisher: Wiley
Date: 25-09-2013
DOI: 10.1111/CDOE.12009
Abstract: Recently, cognitive approaches have been successfully applied to the understanding of child dental anxiety. Our study aimed to analyze the interplay between cognitive variables and their associations with dental fear. In particular, we proposed that the observed relationship between dental treatment-related cognitive vulnerability (i.e., uncontrollability, unpredictability, dangerousness, and disgustingness appraisals) and dental fear is moderated by the expectancies of the probability and aversiveness of negative events during dental treatments. A questionnaire survey was conducted with data obtained from 179 participants (8-18 years, 55.9% female) who attended 12 randomly selected educational establishments in Madrid (Spain). Dental fear was associated with an irregular pattern of dental visits. As expected, cognitive vulnerability was strongly linked to dental anxiety. For those children who expected a lower likelihood of negative dental events or appraised them in a less aversive way, the relationship between cognitive vulnerability and fear was attenuated. As dental fear and oral health are connected, the prevention and reduction of dental fear among children and adolescents might be a worthwhile target for public health interventions. Our study sheds some light on how this could be achieved, that is, by modifying the children's vulnerability appraisals as well as their fearful dental expectancies.
Publisher: Elsevier BV
Date: 12-2016
Abstract: This paper describes and compares magnitudes of socioeconomic (SES) inequalities in oral health among Indigenous and non-Indigenous children over a 10-year period. We analysed annual oral health survey data from NSW, NT and SA. Data were extracted for time period 1 (2000-2002, N=215,317) and time period 2 (2007-2010, N=34,495). Oral health outcomes were untreated decayed deciduous teeth (dt) and cumulative dental caries experience (dmft). Postcode-level Socioeconomic Index for Areas was used to assess SES. Age standardisation and complex survey weights were used. Indices of socioeconomic inequality in health (Slope Index of Inequality, Relative Index of Inequality, Absolute and Relative Concentration Index) were used to quantify inequality in dental caries and its changes over time. Oral health outcomes deteriorated in both Indigenous and non-Indigenous populations over time. Indigenous children experienced higher levels of disease at both times. Untreated dt increased in both populations. The cummulative disease (dmft) increased at higher rate among children in low-SES areas in both populations. Over time, there was an increase in socioecononomic inequalities in dmft in all children and in dt in non-Indigenous children. Area-level socioeconomic inequality in child oral health has widened due to deterioration in low-SES children.
Publisher: Wiley
Date: 26-05-2014
DOI: 10.1111/ADJ.12173
Abstract: The reasons why social inequality is associated with oral health outcomes is poorly understood. This study investigated whether stratification by different measures of socio-economic status (SES) helped elucidate these associations. Cross-sectional survey data were used from Australia's 2004-06 National Survey of Adult Oral Health. The outcome variable was poor self-rated oral health. Explanatory variables comprised five domains: demographic, economic, general health behaviour, oral health-related quality of life and perceived need for dental care. These explanatory variables were each stratified by three measures of SES: education, income and occupation. The overall proportion of adults reporting fair or poor oral health was 17.0% (95% CI 16.1, 18.0). Of these, a higher proportion were older, Indigenous, non-Australian born, poorly educated, annual income <$20 000, unemployed, eligible for public dental care, smoked tobacco, avoided food in the last 12 months, experienced discomfort with their dental appearance, experienced toothache or reported a need for dental care. In stratified analyses, a greater number of differences persisted in the oral health impairment and perceived need for dental care domains. Irrespective of the SES measure used, more associations between self-rated oral health and dental-specific factors were observed than associations between self-rated oral health and general factors.
Publisher: Wiley
Date: 29-01-2027
DOI: 10.1111/J.1440-1754.2007.01029.X
Abstract: To compare the dental disease experience of Indigenous and non-Indigenous children in South Australia's mid-north region (regional area) and to assess Indigenous oral health differences at a regional- and state-level. Data were collected from a School Dental Service based in an Aboriginal-owned medical health service and standard school dental clinics in the regional area from March 2001 to March 2006. State-level data were obtained over a 12-month period in 2003. Caries prevalence (per cent dmft or DMFT >0) and severity (mean dmft or DMFT, SiC and SiC10) measures were used to assess dental disease experience. In the regional area, Indigenous children aged 0, mean dmft, SiC primary and SiC(10) primary, respectively, of their non-Indigenous counterparts, while Indigenous children aged 6+ years had 1.3, 1.7, 1.7 and 1.6 times the percent DMFT > 0, mean DMFT, SiC permanent and SiC10 permanent, respectively, of non-Indigenous children. Indigenous children in the regional area had significantly higher caries prevalence and severity than Indigenous children at a state-level. Indigenous children in South Australia's mid-north region are dentally disadvantaged in comparison with their non-Indigenous counterparts and with the general South Australian Indigenous child population.
Publisher: Wiley
Date: 23-04-2015
DOI: 10.1111/CDOE.12166
Abstract: This study aimed to analyze the role that psychosocial elements may play concerning dental attendance and oral health in children. In particular, we explored the associations among dental fear-related cognitive vulnerability perceptions, dental prevention beliefs, the pattern of dental visits, and the number of decayed teeth. A cross-sectional design was used to collect data from 250 Spanish schoolchildren who completed a questionnaire. Oral health status was evaluated by pediatric dentists. Statistical analyses were mainly based on binary logistic regression and multiple linear regression, which allowed us to test possible associations among variables as well as interaction and mediation effects. Children with more vulnerability-related cognitions (Adj. OR = 0.74 P < 0.05) and more unfavorable dental prevention beliefs (Adj. OR = 1.47 P < 0.01) were less likely to attend the dentist regularly. Moreover, the interaction between dental prevention beliefs and cognitive vulnerability perceptions was associated with more decayed teeth (β = -0.13 P < 0.05). The irregular pattern of dental visit, associated with fearful and unfavorable dental prevention cognitions, accounted for 20% of the effects of these variables on dental caries. The combination of greater cognitive vulnerability-related perceptions and low awareness of the benefits of dental prevention increased the risk of dental caries. Children with this profile also tended to demonstrate a more inadequate pattern of dental attendance. Preventive oral health programs would benefit from considering the role of children's cognitions on their oral health habits and dental health.
Publisher: SAGE Publications
Date: 13-03-2020
Abstract: Greater school absenteeism is associated with numerous negative educational outcomes. We used a retrospective cohort design with linked administrative data on 296,422 children to examine the relationship between school absenteeism and child protection system (CPS) involvement. Children with substantiated maltreatment had 4.1 times more unexplained and problem absences than children with no CPS involvement. In multivariate analyses, children with substantiated maltreatment had significantly greater “chronic” truancy ( OR = 3.41) and less “acceptable” levels of absences ( OR = 0.74) compared to children with no CPS involvement. Greater absenteeism was seen for children with substantiated neglect and who had their first CPS notification earlier in life. Being in out-of-home care for 3+ years was a protective factor for children who had a CPS notification before age 5. Additional adversities had a strong additive effect with CPS involvement on absenteeism and chronic truancy. This study demonstrates the potential scope for reducing problem absenteeism and helps inform the public debate regarding how the type and timing of CPS involvement might ameliorate or exacerbate harm for children.
Publisher: Wiley
Date: 25-09-2013
DOI: 10.1111/CDOE.12005
Abstract: A vicious cycle is believed to operate in the maintenance of dental fear, whereby greater dental fear leads to the delay or avoidance of dental visiting, deteriorated oral health and problem-oriented treatment, which then serves to reinforce the fear. The current study sought to uncover the existence of this vicious cycle pattern and to investigate the role of both dental fear and avoidance in terms of their hypothesized effect on treatment needs and visiting for problems. Study participants were 1036 (response rate = 71.6%) dentate Australians (aged 15+) from all Australian states and territories. Dental fear was associated with avoidance, treatment need and problem-oriented visiting. For people with moderate to high dental fear, 38.5% fit the hypothesized vicious cycle pattern of avoiding dental visiting because of fear, having treatment need and visiting for a problem. This compared with only 0.9% of people with no dental fear. Avoiding going to the dentist was an important predictor of treatment need and problem-oriented visiting independent of dental fear. Dental fear was a statistically significant predictor of treatment need and problem-oriented visiting and also acted as an effect modifier on avoidance because of fear. The results support the premises underlying the vicious cycle model of dental fear maintenance. Dental fear appears to act as a determinant of avoiding or delaying dental visit, which has flow-on effects in terms of greater treatment need and problem-oriented visiting.
Publisher: Wiley
Date: 05-07-2011
DOI: 10.1111/J.1600-0722.2011.00839.X
Abstract: While somatization has been investigated as an important variable in relation to excessive health-service utilization, its role in relation to dental visiting and dental fear has received limited attention. It was hypothesized that an excessive focus on physical symptoms might lead somatizers to experience dental treatment as more traumatic, resulting in greater dental fear. The aims of this study were to determine whether somatization was associated with dental fear, reduced dental visiting, and symptomatic visiting. Questionnaire data were collected from 5,806 dentate Finnish adults, with somatization measured using 12 items from the Symptom Check List (SCL-90). Dental fear was measured using a single-item question and dental visiting was assessed by questions relating to time since last dental visit and the usual reason for dental visiting. Multinomial logistic regression analyses indicated that somatization has a statistically significant positive association with both dental fear and symptomatic dental visiting after controlling for age, gender, and education. However, the association between dental-visiting frequency and somatization was not statistically significant. The results were consistent with the hypothesized role of somatization in the development of dental fear. Further investigation of how somatization is related to dental fear and dental-service utilization appears warranted.
Publisher: Wiley
Date: 03-2006
DOI: 10.1111/J.1834-7819.2006.TB00405.X
Abstract: This study aimed to describe both the prevalence of dental fear in Australia and to explore the relationship between dental fear and a number of demographic, socio-economic, oral health, insurance and service usage variables. A telephone interview survey of a random s le of 7312 Australian residents, aged five years and over, from all states and territories. The prevalence of high dental fear in the entire s le was 16.1 per cent. A higher percentage of females than males reported high fear (HF). Adults aged 40-64 years old had the highest prevalence of high dental fear with those adults aged 80+ years old having the least. There were also differences between low fear (LF) and HF groups in relation to socioeconomic status (SES), with people from higher SES groups generally having less fear. People with HF were more likely to be dentate, have more missing teeth, be covered by dental insurance and have a longer time since their last visit to a dentist. This study found a high prevalence of dental fear within a contemporary Australian population with numerous differences between in iduals with HF and LF in terms of socioeconomic, socio-demographic and self-reported oral health status characteristics.
Publisher: Elsevier BV
Date: 06-2009
DOI: 10.1111/J.1753-6405.2009.00376.X
Abstract: To map the geographic distribution of fluoride in water supplies and child dental caries in remote Indigenous communities of the Northern Territory (NT). To examine the association between fluoride levels, household and community factors, access to services and child dental caries in these communities and to model the impact on the caries experience of children of introducing water fluoridation. Fluoride testing was conducted in 80 locations across the NT in 2001. Measures of mean caries experience for six-year-olds and 12-year-olds and community and housing-related infrastructure were obtained from records of the NT School Dental Service. Associations between community fluoride levels, community level variables and childhood caries experience and potential impact of water fluoridation were assessed using linear regression modeling. Mean caries experience for six- and 12-year-olds tended to be higher in northern and eastern areas of the NT, corresponding to the distribution of low levels of natural fluoride. Several-fold more children in remote NT communities are exposed to the risks of inadequate fluoride than are exposed to excessive fluoride. Mean reticulated fluoride level was the only variable significantly associated (p<0.05) with caries experience in both age groups. The potential reduction of caries through introducing water fluoridation is expected to be about 28% for children living in communities with the lowest levels of fluoride (<0.3 mg/L). Introduction of fluoridation of water supplies into communities with inadequate natural fluoride is a vital measure for improving the dental health of children living in remote NT communities.
Publisher: Wiley
Date: 31-05-2017
DOI: 10.1111/ADJ.12509
Abstract: While Australians are searching the internet for third molar (TM) information, the usefulness of online sources may be questioned due to quality variation. This study explored: (i) internet use, online information-seeking behaviour among TM patients attending public dental services and (ii) whether patients' TM knowledge scores are associated with the level of internet use and eHealth Literacy Scale (eHEALS) scores. Baseline survey data from the 'Engaging Patients in Decision-Making' study were used. Variables included: sociodemographics, internet access status, online information-seeking behaviour, eHEALS, the Control Preferences Scale (CPS) and TM knowledge. Participants (N = 165) were mainly female (73.8%), aged 19-25 years (42.4%) and had 'secondary school or less' education (58.4%). A majority (N = 79, 52.7%) had sought online dental information which was associated with active decisional control preference (odds ratio = 3.1, P = 0.034) and higher educational attainment (odds ratio = 2.7, P = 0.040). TM knowledge scores were not associated with either the level of internet use (F 'The internet-prepared patient' phenomena exists among public TM patients and was explained by preference for involvement in decision-making. However, internet use was not associated with better TM knowledge. Providing TM patients with internet guidance may be an opportunity to improve TM knowledge.
Publisher: American Psychological Association (APA)
Date: 2010
DOI: 10.1037/A0018678
Abstract: The measurement of dental fear is important due to its high prevalence and appreciable in idual, clinical, and public health consequences. However, existing measures of dental anxiety and fear (DAF) have theoretical or practical limitations. This study describes the development and subsequent assessment of the reliability and validity of test scores of a new DAF scale for adults. The Index of Dental Anxiety and Fear (IDAF-4C+) contains 3 modules that measure DAF, dental phobia, and feared dental stimuli. The final 8-item DAF module (IDAF-4C) assesses emotional, behavioral, physiological, and cognitive components of the anxiety and fear response. The proposed scale dimensionality received support from exploratory factor analysis. IDAF-4C items showed good internal consistency (Cronbach's alpha = .94) and test-retest reliability at 4 months (r = .82), and the scale was strongly associated with other dental fear scales as well as with dental visiting patterns, avoidance of the dentist, and dental phobia diagnosis. The convergent and predictive validity of the IDAF-4C compared positively to Corah's (1969 Corah, Gale, & Illig, 1978) Dental Anxiety Scale and a single-item measure of dental fear, and the scale predicted future dental visiting and visit perceptions. Both phobia and stimulus modules showed strong and statistically significant associations with DAF ratings. In all, sufficient evidence is provided to demonstrate that the new scale would be a useful tool to assess DAF in an adult population. The IDAF-4C+ is based on strong theoretical underpinnings, yet the scale is practical enough for application across a variety of potential uses.
Publisher: Wiley
Date: 22-12-2011
DOI: 10.1111/J.1834-7819.2010.01279.X
Abstract: The Index of Dental Anxiety and Fear (IDAF-4C) is a theoretically derived test developed to allow clinicians and researchers to measure a person's level of dental fear. Population norms have not previously been made available for the IDAF-4C. The aim of this study was to provide Australian norms for the IDAF-4C using percentile ranks and to examine associations between scores and in idual-level characteristics, dental avoidance and fear of pain. A stratified random s le of 1511 Australian adults yielded complete questionnaire data for 1063 in iduals (70.4%). Percentile ranks were calculated for IDAF-4C full scale scores stratified by age and gender. IDAF-4C mean scores varied significantly by age, gender, income, and speaking a language other than English at home. Tables to convert raw scores to percentiles showed that full scale scores varied by age and gender. Scores on the IDAF-4C had strong and significant associations with avoidance of the dentist due to fear, average dental visiting frequency and anxiety about pain when going to the dentist. Population norms allow clinicians or researchers to compare results for an in idual or subgroup to the Australian population. It is recommended that a dental fear scale be used to screen all dental patients for dental fear to enable a more tailored and effective dental treatment experience.
Publisher: Wiley
Date: 09-2006
Publisher: Wiley
Date: 24-07-2017
DOI: 10.1111/ADJ.12541
Abstract: The Index of Dental Anxiety and Fear (IDAF-4C) was introduced to overcome the theoretical and practical shortcomings of previously developed dental fear measures. This new scale has not been tested on population s les other than in its country of origin, Australia. The aim of this study was to validate the IDAF-4C in a different cultural setting and to determine the prevalence and sociodemographic associations of dental anxiety. A cross sectional study of a representative New Zealand adult population s le was undertaken. The questionnaire was mailed to 523 randomly-selected participants. Data were collected on sociodemographic characteristics, oral and general health care, and dental anxiety using both the IDAF-4C and the Dental Anxiety Scale (DAS). The response rate was 51.8%. The factor structure of the IDAF-4C was confirmed. The prevalence estimates for high dental anxiety and fear were 18.6% using the DAS and 13.0% using the IDAF-4C. Mean scores for the IDAF-4C and DAS were higher among episodic dental visitors and those without a recent dental visit. The performance of the IDAF-4C in this New Zealand community s le supports its use for dental anxiety measurement.
Publisher: Springer Science and Business Media LLC
Date: 24-01-2008
Publisher: Wiley
Date: 12-2010
DOI: 10.1111/J.1834-7819.2010.01256.X
Abstract: For the general dental practitioner, fearful patients are harder and more stressful to treat and are most likely to attend irregularly. This study presents updated and refined dental fear and phobia prevalence estimates in Australia as well as information on the nature of dental fear and phobia. A total of 1084 Australian adults (response rate = 71.7%) completed a mailed questionnaire. The survey contained four measures of dental fear and phobia, as well as questions regarding potentially anxiety-eliciting dental stimuli and past aversive dental experiences. The prevalence of high dental fear ranged from 7.8% to 18.8%, and more incapacitating dental phobia from 0.9% to 5.4%, depending upon the scale, cut-point and specific criteria used. Dental phobia was significantly associated with blood-injection-injury (BII) concerns. The cost of dental treatment was endorsed as the most anxiety-eliciting dental situation (64.5%), followed by fear of needles/injections (46.0%) and painful or uncomfortable procedures (42.9%). Anxiety-eliciting stimuli and the type of aversive dental experiences varied significantly by gender, age, income, education, language spoken at home and dental visiting frequency. High dental fear and dental phobia are common in Australia although prevalence estimates are highly dependent on both the scale and cut-points used.
Publisher: Elsevier BV
Date: 10-2005
DOI: 10.1111/J.1467-842X.2005.TB00230.X
Abstract: To evaluate whether access to fluoridated public water in New South Wales (NSW) is related to both a reduction in caries experience within NSW regions and to better dental health for disadvantaged children. Cross-sectional population data on children attending the School Dental Service in NSW in 2000 were used to calculate and compare the number of decayed, missing and filled teeth (dmft/ DMFT) across areas of differing availability of fluoridated water within NSW Area Health Service (AHS) regions. Analyses were also undertaken looking at differences in caries between optimally fluoridated and non-fluoridated communities across strata of socio-economic disadvantage and by Indigenous status. A total s le of 248,944 children aged 3-15 years was obtained. Caries experience in the deciduous dentition of 5-6 year-olds and the permanent dentition of 11-12 year-olds was significantly lower for children in fluoridated areas than nonfluoridated areas in six of the eight AHSs and six of the 10 AHSs respectively where comparisons could be made. Children living in fluoridated areas had lower caries experience than children living in nonfluoridated areas, regardless of socio-economic disadvantage. Both Indigenous and non-Indigenous children had reduced caries experience in fluoridated compared with non-fluoridated areas. Water fluoridation was found to be related to significantly reduced caries experience in the majority of AHSs where comparisons could be made, and to benefit all socio-economic strata of the community. Water fluoridation should be extended to those areas of NSW that are yet to benefit from this successful caries preventive public health initiative.
Publisher: Wiley
Date: 2008
DOI: 10.1002/AJP.20511
Abstract: We describe two cases of infanticide, two suspected infanticides, and a forced copulation by familiar resident males in two populations of wild spider monkeys (Ateles belzebuth chamek and A. geoffroyi yucatanensis). These are the first known infanticides and forced copulation in spider monkeys. Data were gathered from four neighboring communities of spider monkeys in Manu National Park at the Cocha Cashu Biological Station, Peru and two communities in the Otoch Ma'ax Yetel Kooh Reserve at Punta Laguna, Mexico, during intensive field studies of over 2,000 hr each. These are rare behaviors, but results suggest that mating history and sexual coercion are important in spider monkey social relationships.
Publisher: Wiley
Date: 19-04-2013
DOI: 10.1111/EOS.12041
Abstract: Negative experiences, cognitions, and family variables are involved in the etiology of child dental fear, but previous research has frequently considered them separately. This study uses the Cognitive Vulnerability Model to explore the influence of negative dental experiences and family members on children's dental anxiety. The participants were 185 children who completed a questionnaire comprising measures of dental fear and cognitive vulnerability-related perceptions. Measures were obtained for 88 of the participants' fathers and for 97 of the participants' mothers. Cognitive vulnerability perceptions had the strongest association with children's dental fear (β = 0.40), explaining 14-21% of the variance in dental fear scores beyond that explained by other variables. Furthermore, vulnerability perceptions mediated the relationship between negative dental experiences and dental fear. Children's dental fear and cognitive vulnerability perceptions were significantly associated with those of their fathers (r = 0.23 and r = 0.40, respectively) and mothers (r = 0.28 and r = 0.35, respectively). Moreover, fathers' (β = 0.24) and mothers' (β = 0.31) levels of cognitive vulnerability significantly predicted the children's levels of dental fear. The Cognitive Vulnerability Model offers a framework to understand child dental fear. Furthermore, this cognitive approach may help explain why some children develop dental fear problems after suffering a negative dental experience and how dental anxiety is passed on from parents to children.
Publisher: Wiley
Date: 23-01-2012
DOI: 10.1111/J.1600-0722.2011.00924.X
Abstract: Although previous research has successfully tested the usefulness of cognitive and non-cognitive factors to predict dental anxiety, they have rarely been jointly analysed. This study therefore aimed to compare the relative predictive power of a set of cognitive and non-cognitive factors in accounting for dental anxiety scores. A s le of 167 Spanish undergraduate students (81.4% women mean age 21.2 yr) completed a questionnaire comprising measures of dental anxiety, non-cognitive antecedents of dental anxiety (i.e. past aversive dental experiences, exposure to dentally fearful relatives, and trait-based negative mood), and cognitive variables (i.e. dental-related cognitive vulnerability, probability/aversiveness expectancies, and dental cognitions and beliefs). In multiple linear regression analyses, cognitions were found to significantly increase the proportion of variance accounted for in dental fear scores (ΔR(2) = 0.15, maximum ΔR(2) = 0.35). Cognitive factors were found to be the best in idual predictors of dental fear (β-values ranging from 0.23-0.66). Furthermore, scores for past aversive treatment experiences and negative mood were not significant predictors of scores for dental anxiety when cognitive variables were included in the models. The analysis of cognitive mechanisms involved in dental anxiety is revealed as a potentially important point in better understanding this problem.
Publisher: Wiley
Date: 20-07-2008
DOI: 10.1111/J.1600-0528.2007.00379.X
Abstract: People with dental fear often suffer from other psychological disorders, as well as from a number of other specific fears. Fear of going to the dentist may be associated not only with general fearfulness, but also with underlying personality dispositions. This exploratory study, therefore, investigated the associations between dental fear and 67 other specific fears, general fearfulness, disgust sensitivity and harm sensitivity. Participants were 88 Australian adults who were administered the Fear Survey Schedule III (FSS-III), the Harm Sensitivity Index and the Disgust Sensitivity Index. Principle axis factor analysis with Promax rotation was used to examine how dental fear related to other specific fears as measured with the FSS-III. Dental fear was significantly correlated with most of the other specific fears, with factor analysis indicating that it tended to load more with fears related to lack of control rather than with what have often been classed as 'medical' fears. Significant associations were found between dental fear and the personality dispositions of general fearfulness, harm sensitivity and disgust sensitivity, although these associations were not linear. Findings reveal extensive co-occurrence of other specific fears with dental fear, while the associations of dental fear with personality traits suggest enduring aspects to dental fear which may translate into difficulties in fear alleviation. Dental fear was more related to a erse range of fears relating to a loss of control than to medical-specific fears.
Publisher: Wiley
Date: 21-05-2008
DOI: 10.1111/J.1834-7819.2008.00025.X
Abstract: The establishment of the evaluation programme of the Australian School Dental Scheme has led to continuous surveillance of child oral health extending from 1977 to the present day. The aims of this study were to examine the state of child oral health in Australia in 2002 and to explore longer term trends across the quarter of a century of recorded surveillance activity. Caries data were obtained for children who were enrolled in the School Dental Services of each state and territory for the years 1977-2002. Data collection derived from routine examinations within the School Dental Service with oral examinations carried out by dentists and dental therapists. There were considerable declines in caries experience between 1977 and the mid to late 1990s, with mean decayed, missing and filled deciduous teeth (dmft) for 6-year-old children decreasing from over 3 in 1977 to approximately 1.6 in 1996, and permanent 12-year-old decayed, missing and filled teeth (DMFT) decreasing from 4.8 in 1977 to 0.89 in 1998. However, since the mid to late 1990s, deciduous 6-year-old dmft has increased by 24 per cent and 12-year-old DMFT has increased by almost 15 per cent. Reductions in caries experience of those children with the most disease have also ceased, and between 1999 and 2002 an increase in the Significant Caries Index occurred. Improvements in the oral health of Australian children halted during the mid 1990s, after which caries experience has increased. It is important that we understand the changes taking place and their causes, so that action can be taken to halt any further possible declines in child oral health.
Publisher: Wiley
Date: 15-05-2009
DOI: 10.1111/J.1600-0528.2009.00468.X
Abstract: This study aimed to investigate the association between dental fear and both dental caries and periodontal indicators. A three-stage stratified clustered s le of the Australian adult population completed a computer-assisted telephone interview followed by a clinical examination. Oral health measures were the DMFT index and its components, periodontitis and gingivitis. A total of 5364 adults aged 18-91 years were dentally examined. Higher dental fear was significantly associated with more decayed teeth (DT), missing teeth (MT) and DMFT. There was an inverted 'U' association between dental fear and the number of filled teeth (FT). Periodontitis and gingivitis were not associated with dental fear. The association between dental fear and DMFT was significant for adults aged 18-29 and 30-44 years, but not in older ages. Dental fear was significantly associated with more DT, MT, and DMFT but with fewer FT after controlling for age, sex, income, employment status, tertiary education, dental insurance status and oral hygiene. This study helps reconcile some of the conflicting results of previous studies and establishes that dental fear is associated with more decayed and missing teeth but fewer FT. That people with higher dental fear have significantly more caries experience underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.
Publisher: S. Karger AG
Date: 2010
DOI: 10.1159/000316665
Abstract: There are a limited number of longitudinal investigations that examine the progression of dental disease in an indigenous population. Dental examinations of a cohort of indigenous Australians born in Darwin (Australia) between 1987 and 1990 were conducted at ages 6–8 and 11–13 years as part of the Child Dental Health Survey, and 18–20 years as part of the longstanding prospective Aboriginal Birth Cohort (ABC) study. Data was available at all ages for 145 participants. The percent DMFT increased from 17.2 to 44.1 to 81.4%, representing a linear trajectory, whereas mean DMFT increased from 0.3 to 1.0 to 5.6, representing an exponential trajectory. Both trends were significant. At age 18–20 years, the percent DMFT among ABC study participants was 1.2 times that of their counterparts at a national level. The differences were more marked when dental caries severity was considered, with mean DMFT among 18- to 20-year-old ABC study participants being 1.7 times that of similarly aged adults at a national level. Most of this disparity was constituted by the decayed component, with ABC study participants having eight times the mean DT of their national-level counterparts. The findings indicate that Aboriginal young adults in this birth cohort experience a disproportionate amount of dental disease relative to their non-indigenous counterparts, and that this pattern is consistent across the life course.
Publisher: Cold Spring Harbor Laboratory
Date: 02-12-2020
DOI: 10.1101/2020.11.30.20241216
Abstract: To systematically review the literature on the prevalence of dental fear in adults to estimate a worldwide pooled prevalence and to investigate factors related to the heterogeneity of estimates. Inclusion criteria were population-based studies reporting the prevalence or data that allowed the calculation of prevalence of dental fear in adults and/or elders. Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library (BVS) and Web of Science) were searched. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed to investigate variability between studies. The search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. A total of 72,577 in iduals 18 years of age or older composed the s le of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 13.8%, 11.2% and 2.6%, respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instrument used to measure dental fear also affected the prevalence of the outcome. Dental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women.
Publisher: Wiley
Date: 06-2006
DOI: 10.1111/J.1752-7325.2006.TB02567.X
Abstract: To examine the role of location in Indigenous and non-indigenous child oral health in three Australian states and territories. The association of Indigenous status and residential location with caries prevalence, severity and unmet treatment need was examined. Data were collected as part of a national monitoring survey of 4-14-year-old children enrolled in school dental services in New South Wales, South Australia and the Northern Territory, Australia. Of the 326,099 children examined, 10,473 (3.2%) were Indigenous. Fewer 4-10-year-old rural Indigenous children were caries-free in the deciduous dentition than their non-indigenous counterparts and rural Indigenous children had almost twice the mean number of decayed, missing and filled teeth (dmft) of rural non-indigenous children. The % d/dmft was higher among rural Indigenous children than rural nonIndigenous children. Fewer 6-14-year-old rural Indigenous children were caries-free in the permanent dentition than their non-indigenous counterparts and rural Indigenous children had almost twice the mean DMFT of rural non-Indigenous children. The % D/DMFT was higher in rural Indigenous than rural non-indigenous children. Living in a rural location was the strongest indicator of caries prevalence, severity and unmet treatment need in the deciduous dentition of Indigenous 4-10-year-olds while being socially disadvantaged was the strongest indicator of poor oral health outcomes among older Indigenous and all non-Indigenous children. Living in a rural location exhibited the strongest association with poor oral health outcomes for young Indigenous children but was also associated with poorer oral health among older Indigenous and non-Indigenous children.
Publisher: Wiley
Date: 03-2007
DOI: 10.1111/J.1752-7325.2007.00026.X
Abstract: This study aims to examine the relationship between child caries prevalence and six discrete area-based measures of socioeconomic status (SES). Comparisons were also made of the discrete SES measures and the Socio-Economic Index for Areas (SEIFA) composite index in explaining child caries experience. Oral health data were electronically captured for 58,463 4- to 16-year-old children enrolled in the School Dental Service of South Australia in 2001. Socioeconomic measures for the same year were extracted from Basic Community Profiles for postcodes available from the Australian Bureau of Statistics. There were generally consistent linear relationships between caries prevalence and SES with children having poorer oral health residing in areas of greater socioeconomic disadvantage. This was evident across all SES measures, although some variations were shown for some measures. Children from more socioeconomically disadvantaged areas had higher odds of having either one or more decayed, missing, or filled teeth or four or more decayed, missing, or filled teeth. Most discrete SES measures explained a significant amount of the variance in oral disease beyond that accounted for by the composite SEIFA index. Pervasive social inequality in child oral health exists in Australia. Specific area-based measures of SES are valuable in documenting these inequalities and may be more meaningful than composite area-based indices of SES.
Publisher: Elsevier BV
Date: 10-2006
DOI: 10.1016/J.CPR.2006.03.007
Abstract: This paper attempts to fill the partial theoretical vacuum surrounding the understanding of fear acquisition. A review of recent and contemporary theories of the etiology of fear is presented, serving as a justification for further theorizing and allowing for greater understanding of those aspects of fear that remain to be adequately explained. A new model of the etiology of specific fears is subsequently put forward and the various aspects and implications of this model are discussed. How an in idual perceives a stimulus is proposed as being critical in determining fear in relation to the stimulus. In particular, perceptions of the stimulus as uncontrollable, unpredictable, dangerous and disgusting create a schema of vulnerability. The Cognitive Vulnerability Model integrates much of the extensive body of research on fears and specific phobias into a unifying theory of the etiology of fear. The model offers parsimonious explanations for the various characteristics of specific fears and phobias.
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/J.JANXDIS.2006.10.005
Abstract: The present study reports on an attempt to experimentally manipulate perceptions of uncontrollability, unpredictability and dangerousness related to an imaginal encounter with a spider in order to determine whether there is an effect on self-rated predicted spider fear. Experimental manipulations involved differing information in relation to both the spider and the imaginal task. The control, predictability and dangerousness manipulations all had significant main effects on task-related spider fear (TRSF). Measures of the perception of the spiders as uncontrollable, unpredictable and dangerous were also significantly associated with TRSF and accounted for 42% of the variance in predicted fear beyond that accounted for by the experimental manipulations. Results are discussed in terms of their implications for better understanding the etiology and maintenance of fear. The overall findings are consistent with the cognitive vulnerability model, with cognitive perceptions of an object or situation seen as causal determinants of the fear associated with the stimulus.
Publisher: Wiley
Date: 03-2009
DOI: 10.1111/J.1752-7325.2008.00110.X
Abstract: This study aimed to document the changing distribution of and inequalities in dental caries in Australian children across the 25-year period from 1977 to 2002. Oral health data were obtained from Australia's national Child Dental Health Survey Measures of caries distribution included the Significant Caries Index and the proportions of children with high caries experience [decayed, missing and filled teeth (DMFT) > or =4], while inequality was assessed by using Gini coefficients calculated from Lorenz curves. Changes in caries distribution were compared with changes in child dmft/DMFT. While appreciable reductions occurred in child caries experience, in terms of both mean dmft/DMFT and for those children with the poorest oral health, inequalities in the distribution of caries experience increased across the 25-year period. Inequalities in the distribution of decayed and filled teeth differed for the deciduous and permanent dentition and, in the permanent dentition, became increasingly similar in the 1990s. Increasing inequalities in child dental caries in Australia must be interpreted in the context of declines in both mean caries experience and in the caries experience of those children with the poorest oral health. The Gini coefficient documents that the majority of the caries experience is increasingly being confined to a smaller percentage of the child population however, this is a consequence of population-wide child oral health improvements.
Publisher: Wiley
Date: 07-06-2017
DOI: 10.1111/ADJ.12514
Abstract: This study aimed to adapt a measure of trust in physicians to trust in dentists and to assess the reliability and validity of the measure. Questionnaire data were collected from a simple random s le of 596 Australian adults. The 11-item General Trust in Physicians Scale was modified to apply to dentists. The Dentist Trust Scale (DTS) had good internal consistency (α = 0.92) and exploratory factor analysis revealed a single-factor solution. Lower DTS scores were associated with less trust in the dentist last visited, having previously changed dentists due to unhappiness with the care received, currently having dental pain, usual visiting frequency, dental avoidance, and with past experiences of discomfort, gagging, fainting, embarrassment and personal problems with the dentist. The majority of people appear to exhibit trust in dentists. The DTS shows promising reliability and validity evidence.
Publisher: Wiley
Date: 12-2013
DOI: 10.1111/ADJ.12118
Abstract: People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners. This paper presents a review of a number of non-pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery in order to assist anxious in iduals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized. The importance of firstly identifying dental fear and then understanding its aetiology, nature and associated components is stressed. Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety. It is concluded that successfully managing dentally fearful in iduals is achievable for clinicians but requires a greater level of understanding, good communication and a phased treatment approach. There is an acceptable evidence base for several non-pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.
Publisher: Elsevier BV
Date: 09-2020
Publisher: Elsevier BV
Date: 11-1996
DOI: 10.1016/S0005-7967(96)00045-9
Abstract: It was proposed that cognitive vulnerability representations relating to the perceived uncontrollability, unpredictability, dangerousness and disgustingness of spiders are important factors in the fear of spiders. One-hundred and ninety-two first-year psychology students completed a questionnaire measuring the four vulnerability variables, spider fear and learning history. It was found that fear of spiders was highly correlated with each of the four vulnerability variables. In addition, greater fear of spiders was found for females in comparison with males and this was associated with differential perceptions of spiders as uncontrollable, unpredictable, dangerous and disgusting. Finally, the vulnerability variables accounted for significantly more variance in fear scores than the experience of a number of classical conditioning, vicarious and informational learning events. It is argued that there is value in considering a person's perception of the uncontrollability, unpredictability, dangerousness and disgustingness of spiders in order to better understand in idual differences in spider fear.
Publisher: Wiley
Date: 11-05-2010
DOI: 10.1111/J.1600-0722.2010.00740.X
Abstract: Traumatic dental experiences are associated with dental anxiety and fear. However, many people with no dental fear have had negative dental experiences, and some people with considerable fear fail to recall any traumatic incidents. This study aimed to determine whether dental fear was better explained by experiences or by cognitive perceptions of going to the dentist as being uncontrollable, unpredictable, dangerous, and disgusting. A random s le of 1,084 Australian adults (response rate = 71.7%) completed a mailed questionnaire with measures of dental fear, perceptions of going to the dentist, and dental experiences. Perceptions of uncontrollability, unpredictability, dangerousness, and disgustingness had strong bivariate associations with scores on the Index of Dental Anxiety and Fear (IDAF-4C). Vulnerability-related perceptions accounted for 46.3% of the variance in IDAF-4C scores beyond that accounted for by demographic variables and five possible dental experiences comprising intense pain, considerable discomfort, gagging, fainting, and having a personal problem with the dentist. In contrast, dental experiences accounted for < 1% of the variance in IDAF-4C scores beyond that accounted for by the four cognitive perceptions. Perceptions of uncontrollability, unpredictability, dangerousness, and disgustingness were superior predictors of dental fear compared with negative dental experiences.
Publisher: Elsevier BV
Date: 2008
DOI: 10.1016/J.JANXDIS.2007.03.003
Abstract: The effect of manipulating perceptions of the uncontrollability, unpredictability and dangerousness of a spider was assessed using both an imaginal and in vivo task involving an encounter with a spider. Participants were randomly assigned to one of eight conditions formed by the crossing of factors. Experimental manipulations of uncontrollability, unpredictability and dangerousness all had a significant effect on Task Related Spider Fear in the in vivo exposure task. Results indicated a greater effect on task related fear for in vivo exposure (R(2)=.258) compared to imaginal exposure (R(2)=.053). Perceptions of spiders as uncontrollable, unpredictable and dangerous accounted for much of the variance in spider fear beyond that accounted for by the experimental manipulations. The idea that perceptions of spiders as uncontrollable, unpredictable and dangerous are causally related to spider fear was supported with in vivo exposure being a stronger modality for fear modification than imaginal exposure.
Publisher: Wiley
Date: 08-05-2012
Publisher: Wiley
Date: 06-07-2011
DOI: 10.1111/J.1600-0528.2011.00628.X
Abstract: To assess the level of agreement and concordance of three different dental anxiety and fear scales and determine whether using commensurate cut-points reduces discrepancies in the estimated prevalence of high dental fear. A representative s le of the Australian adult population completed a computer-assisted telephone interview (CATI) with additional data obtained on a random s le of 25% of those completing the CATI. Participants completed three measures of dental anxiety and fear: the Dental Anxiety Scale, the Index of Dental Anxiety and Fear, and a single-item question. Cut-points were determined to equivalize the range of possible score responses defining a case of high dental fear for each scale. A total of 1084 people completed the CATI and returned a questionnaire (response rate = 71.4%). Prevalence estimates ranged from 7.3% to 28.4% depending upon both the scale and cut-point used. The overall percent agreement between the scales was high, but the overlap between the scales in those people determined to have high dental fear was considerably lower. Using different cut-points to define a case significantly altered the sensitivity and specificity of the scale in predicting dental avoidance, problem-oriented visiting and fear of lack of control. Equivalizing scale cut-points does reduce variation in prevalence estimates of high dental fear across scales, but variation remains because of differences in the nature of, and content covered by, each scale. Dichotomizing scores on continuous scales to obtain prevalence estimates of high dental fear should be appropriately justified, correctly interpreted and supplemented by results describing the distribution of scores.
Publisher: Wiley
Date: 05-04-2013
DOI: 10.1111/EOS.12036
Abstract: Dental fear is related to poorer oral health outcomes, and this might be explained by the less frequent dental visiting of many fearful people. The objectives of this study were to investigate differences between dentally fearful people who regularly attend the dentist and fearful people who infrequently visit the dentist. A random s le of 1,082 Australians ≥ 15 yr of age completed a mailed questionnaire (response rate = 71.6%), and 191 dentate, high-fear adults (≥ 18 yr of age) were selected for further analysis. Dental avoidance was recorded if a person was currently avoiding or delaying dental care and if he/she had not been to a dentist in the previous 2 yr. Among the selected dentally fearful adults, dental avoidance was predicted by smoking status, toothbrushing frequency, coping strategy use, perceptions of dental visits as uncontrollable and unpredictable, and by anxiety relating to numbness, not knowing what the dentist is going to do, and cost. In a multivariate logistic regression model, smoking, toothbrushing, coping, and anxiety about numbness and cost remained as statistically significant predictors, with the model accounting for 30% of the variance. While several variables were associated with dental avoidance among fearful adults, the nature and causal directions of these associations remain to be established.
Publisher: Frontiers Media SA
Date: 2014
Publisher: Wiley
Date: 02-11-2015
DOI: 10.1111/EOS.12229
Abstract: Dental anxiety (DA) is a common condition, with significant medical, psychological, and social consequences. High-quality psychometric tools for the assessment of dental anxiety are necessary for clinical and research purposes. The aim of this study was to adapt the Index of Dental Anxiety and Fear (IDAF-4C(+) ) to the Swedish language and to explore the psychometric properties of the translated version. The study included a clinical s le (n = 414 17-91 yr of age) and a non-clinical s le (n = 51 19-47 yr of age). The scales used were the IDAF-4C(+) , the Single-Question Assessment of Dental Anxiety (SQDA), the Dental Fear Survey (DFS), and the Internal Health Locus of Control (IHLOC). The Swedish IDAF anxiety module showed a clear, one-dimensional structure, good internal consistency (Cronbach's alpha = 0.95), and adequate validity, as evidenced by strong correlations with the other DA measures (SQDA and DFS) and weak correlations with the IHLOC. In addition, the IDAF phobia module and the IDAF stimulus module were strongly correlated with the other DA measures. To conclude, the study shows promising findings for the reliability and validity of the Swedish translation of the IDAF-4C(+) , as a useful measure of dental anxiety in research and clinical practice.
Publisher: Wiley
Date: 2010
DOI: 10.1111/J.1752-7325.2009.00144.X
Abstract: A considerable body of evidence confirms that water fluoridation effectively reduces the community incidence of dental caries with minimal side effects. However, proposals to introduce this widely endorsed public-health measure are often perceived as controversial, and public opinion frequently plays a role in the outcome. Despite this, the public's perception of risk associated with water fluoridation has not been well researched and remains poorly understood. Our objectives were to determine whether risk perceptions reflecting various "outrage" factors are associated with water fluoridation support and opposition. We conducted a cross-sectional questionnaire survey of a national s le of 517 Australian adults (response rate = 34.7 percent) aged 18-92 years. Approximately 70.5 percent of respondents supported water fluoridation, with 15.1 percent opposed and 14.3 percent neutral. Sixteen of the 20 assessed outrage factors were significantly associated with water fluoridation stance in the predicted direction, with greater outrage being related to increased water fluoridation opposition. An overall outrage index computed from the 16 significant outrage factors accounted for a statistically significant 58 percent of the variance in water fluoridation stance beyond the effects of age, gender, socioeconomic status, and age and presence of children. Outrage factors are important aspects of the public's perception of risk in relation to water fluoridation. Given that water fluoridation appears to be a low-risk, high-outrage controversy, efforts to mitigate the level of public outrage, rather than continuing to deny possible hazards, may offer a worthwhile strategy in gaining public acceptance for the extension of water fluoridation.
Publisher: American Public Health Association
Date: 03-2013
Abstract: Objectives. We examined demographic and socioeconomic differences in the consumption of sugar-sweetened beverages (SSBs), its association with dental caries in children, and whether exposure to water fluoridation modifies this association. Methods. In a cross-sectional study, we used a stratified, clustered s ling design to obtain information on 16 508 children aged 5 to 16 years enrolled in Australian school dental services in 2002 to 2005. Dental staff assessed dental caries, and parents completed a questionnaire about their child’s residential history, sources of drinking water, toothbrushing frequency, socioeconomic status (SES), and SSB consumption. Results. Children who brushed their teeth less often and were older, male, of low SES, from rural or remote areas consumed significantly more SSBs. Caries was significantly associated with greater SSB consumption after controlling for potential confounders. Finally, greater exposure to fluoridated water significantly reduced the association between children’s SSB consumption and dental caries. Conclusions. Consumption of SSBs should be considered a major risk factor for dental caries. However, increased exposure to fluoridated public water helped ameliorate the association between SSB consumption and dental decay. These results reconfirm the benefits of community water fluoridation for oral health.
Publisher: Springer Science and Business Media LLC
Date: 12-2007
Publisher: Elsevier BV
Date: 2013
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1111/IDJ.12119
Publisher: Wiley
Date: 06-07-2004
Publisher: Elsevier BV
Date: 12-2006
Publisher: American Psychological Association (APA)
Date: 2015
DOI: 10.1037/HEA0000186
Abstract: It has been proposed that avoidance of dental visits might be the main determinant of poor oral health outcomes in people with high dental anxiety (HDA). This study aimed to determine the predictors of dental avoidance among people with HDA and also whether these predictors differed from those found in people with lower dental anxiety (LDA). Study participants (n = 596 response rate = 41.1%) comprised a random cross-sectional s le of the Australian adult population who completed a mailed self-complete questionnaire containing items relating to the use and accessibility of dental services, trust in dental professionals, dental anxiety, dental experiences, self-perceived oral health, vulnerability-related perceptions of visiting the dentist, and psychological health. Multiple imputation was used to replace missing values and statistically significant variables in bivariate analyses were entered into a multivariable logistic generalized linear model. More than two-thirds of participants with HDA were currently avoiding or delaying a dental visit. Among people with HDA, dental avoidance was independently and significantly predicted by difficulty paying a $300 dental bill, having no or only little trust in the last-visited dentist, perceived treatment need and dental anxiety. Among people with LDA, only perceived treatment need and dental anxiety predicted avoidance. In addition to their high anxiety, a number of additional barriers to dental visiting were found for people with HDA. These barriers, especially cost and communication issues with dentists, need to be addressed to assist people with HDA obtain necessary, regular dental care.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2008
DOI: 10.1007/S00127-008-0454-6
Abstract: Dental phobia is associated with poorer dental attendance so epidemiological surveys requiring participants to undertake a dental examination may result in an under-representation of participants with high dental fear. We compared the dental fear distribution of participants and non-participants in an oral examination component of a national epidemiological survey of oral health. Of 12,606 in-scope dentate people aged 15+ who completed a structured computer-assisted telephone interview (CATI) survey, 5,505 (43.7%) participated in the oral examination. Dental fear was assessed with a single-item measure in the CATI. There was a significant difference between the percentages of participants and non-participants who rated themselves as "extremely" afraid, although the absolute difference (1.9%) was small. The association between extreme dental fear and participation was significant (OR = 0.66, 95% CI = 0.56-0.77) in multivariate analyses after controlling for possible confounders. Females with extreme dental fear were also significantly less likely to undertake an oral examination. Even though people with dental fear and phobia may delay or avoid dental visits, they do not appear to be appreciably under-represented in oral epidemiological surveys.
Publisher: Springer Science and Business Media LLC
Date: 12-2007
Publisher: Elsevier BV
Date: 08-2013
DOI: 10.1111/IDJ.12032
Publisher: Wiley
Date: 09-2005
Publisher: Wiley
Date: 20-01-2012
DOI: 10.1111/J.1600-0722.2011.00921.X
Abstract: Cognitive elements play a key role in dental anxiety. Nevertheless, relatively little is known about how dental treatments and frequency of visits to the dentist are related to dental fear and its cognitive antecedents. This study aimed to explore the relationships between dental visits, past treatment experiences, expectations on the aversiveness robability of negative dental events, and dental fear in children. The participants were 147 children (60% female mean age = 12.0 yr) who completed a questionnaire comprising measures of dental treatment-related experience (attendance, fillings, and extractions), perceived aversiveness and probability of dental events, and dental anxiety. Bivariate correlations and multiple linear regression analyses were used to analyze the data. A higher frequency of dental visits was associated with less dental fear and a decreased belief in the probability of negative events occurring during treatment. The type of treatments received was not directly linked to dental fear. However, having received fillings was significantly associated with the perceived probability of negative dental events, whereas extractions were positively associated with these expectations but negatively associated with the perceived aversiveness of possible dental events. Regular dental visits, as well as dental treatments, can influence, in different ways, cognitive elements associated with dental anxiety in children.
Publisher: Springer Science and Business Media LLC
Date: 14-01-2007
Publisher: Wiley
Date: 13-09-2014
DOI: 10.1111/J.1752-7325.2012.00368.X
Abstract: Dental satisfaction is associated with continuity of dental care, compliance with dentist advice, and positive health outcomes. It is expected that people with higher dental fear might have less dental satisfaction because of more negative dental experiences. The objective of this study was to examine satisfaction and reasons for satisfaction with dental practitioners in Switzerland and variations by dental fear. A national s le of 1,129 Swiss residents aged 15-74 (mean = 43.2 years) completed a personal interview at their home with questions assessing dental fear, dental service use, general satisfaction with their dentist, and reasons for satisfaction or dissatisfaction. Overall, 47.9 percent of participants responded that they were satisfied with their dentist and 47.6 percent that they were very satisfied. Satisfaction differed significantly by gender, language spoken, region of residence, and educational attainment. Greater dental fear was significantly associated with greater dissatisfaction with the dentist. The percentage of people who were very satisfied with the dentist ranged from 56.0 percent among people with no fear to 30.5 percent for participants with "quite a lot" of fear but was higher (44.4 percent) for people who stated that they were "very much" afraid of the dentist. The most common reasons attributed for satisfaction with dentists were interpersonal characteristics of the dentist and staff. People with "quite a lot" of fear were found to endorse these sentiments least. Although higher dental fear was associated with more dissatisfaction with the dentist, the level of satisfaction among fearful in iduals in Switzerland is still high.
Publisher: Wiley
Date: 21-05-2009
No related grants have been discovered for Jason Armfield.