Journal of dentistry · 2026
DENTAL ANXIETY AND FEAR: A POTENTIAL BARRIER TO PERIODONTAL HEALTH.
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Lai Clement Wei Ming, Jie Jacob Chew Ren, Seah Francine, Lee Michelle H, Fu Jia-Hui, Yip Julie K, Tan Kai Soo, Toh Sue-Anne, Preshaw Philip M, Goh Charlene E
Аннотация
OBJECTIVES: To examine the association of dental anxiety and fear (DFA) with periodontal disease and dental healthcare utilisation among adults in a multiethnic Asian population.
METHODS: Cross-sectional data were analysed from a community-based study of 238 adults who completed the Index of Dental Anxiety and Fear core (IDAF-4C) and stimulus module questionnaires, and underwent full-mouth oral examinations. High DFA was defined as a mean IDAF-4C score ≥2.5. Multivariable regressions examined the associations between high DFA, and measures of periodontal health and dental healthcare utilisation.
RESULTS: Overall, 18% of participants had high DFA. Compared with participants with low anxiety, those with high DFA had a higher occurrence of irregular dental attendance (PR: 1.83, 95% CI: 1.16, 2.89), and higher prevalence of moderate/severe periodontitis (PR: 1.23, 95% CI: 1.03, 1.46), and greater bleeding on probing (%BOP) (mean difference: 11.90%, 95% CI: 3.77, 20.02), even after adjusting for potential confounders. Treatment costs and fear of painful or uncomfortable procedures were the most prominent anxiety-provoking stimuli.
CONCLUSIONS: High dental anxiety was common and associated with poorer periodontal health and irregular dental attendance in this multiethnic Asian population. These findings suggest that DFA may be a potentially modifiable barrier to timely periodontal care. Future prospective and interventional research could evaluate the value of routine DFA assessment and develop and test targeted interventions addressing the procedural and structural drivers of DFA.
CLINICAL SIGNIFICANCE STATEMENT: Dental anxiety is prevalent. Identifying patients who require tailored communication, upfront discussion of treatment costs, and targeted pain-control strategies may support dental attendance and earlier periodontal management.
METHODS: Cross-sectional data were analysed from a community-based study of 238 adults who completed the Index of Dental Anxiety and Fear core (IDAF-4C) and stimulus module questionnaires, and underwent full-mouth oral examinations. High DFA was defined as a mean IDAF-4C score ≥2.5. Multivariable regressions examined the associations between high DFA, and measures of periodontal health and dental healthcare utilisation.
RESULTS: Overall, 18% of participants had high DFA. Compared with participants with low anxiety, those with high DFA had a higher occurrence of irregular dental attendance (PR: 1.83, 95% CI: 1.16, 2.89), and higher prevalence of moderate/severe periodontitis (PR: 1.23, 95% CI: 1.03, 1.46), and greater bleeding on probing (%BOP) (mean difference: 11.90%, 95% CI: 3.77, 20.02), even after adjusting for potential confounders. Treatment costs and fear of painful or uncomfortable procedures were the most prominent anxiety-provoking stimuli.
CONCLUSIONS: High dental anxiety was common and associated with poorer periodontal health and irregular dental attendance in this multiethnic Asian population. These findings suggest that DFA may be a potentially modifiable barrier to timely periodontal care. Future prospective and interventional research could evaluate the value of routine DFA assessment and develop and test targeted interventions addressing the procedural and structural drivers of DFA.
CLINICAL SIGNIFICANCE STATEMENT: Dental anxiety is prevalent. Identifying patients who require tailored communication, upfront discussion of treatment costs, and targeted pain-control strategies may support dental attendance and earlier periodontal management.