Dental Anxiety

牙科焦虑
  • 文章类型: Journal Article
    目的:本研究的目的是验证改良牙科焦虑量表(MDAS)和牙科恐惧量表(DFS)在三个不同时间的心理测量特性:紧接着,在观看了四个层次的样本中的下第三磨牙的手术摘除视频的七天后:焦虑症,调整障碍,混合性焦虑抑郁障碍,在马拉加的一家精神病诊所,年龄在18-70岁之间没有精神障碍。方法:VirgenMacarena-VirgendelRocío医院的研究伦理委员会批准了该研究。在接受精神科医生的采访后,随后完成了汉密尔顿焦虑和抑郁等级量表,参与者被分为4个阶层(每个阶层60人)。然后分析了受教育程度的影响。结果:量表表现出良好的心理测量学特性,对于较低的教育水平和混合性焦虑抑郁障碍,MDAS和DFS评分较高。结论:显示较高水平的牙科焦虑和牙科恐惧的患者将是受教育程度较低的患者,以及那些患有混合焦虑抑郁障碍的人。
    Objective: The goal of this study is to validate the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Scale (DFS) at three different times: seven days before, immediately after, and seven days after watching a video of surgical extraction of a lower third molar in a sample with four strata: anxiety disorder, adjustment disorder, mixed anxiety-depressive disorder, and no mental disorder ages 18-70 in a psychiatric clinic in Malaga. Methods: The Research Ethics Committee of the Virgen Macarena-Virgen del Rocío Hospitals approved the study. After being interviewed by a psychiatrist and subsequently completing the Hamilton Rating Scales for Anxiety and Depression, the participants were divided into 4 strata (60 persons in each). The influence of education level was then analyzed. Results: The scales demonstrated good psychometric properties, with higher MDAS and DFS scores for lower levels of education and mixed anxiety-depressive disorder. Conclusions: Patients who show higher levels of dental anxiety and dental fear will be those with lower education levels, as well as those who suffer from mixed anxiety-depressive disorder.
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  • 文章类型: Journal Article
    牙科焦虑是普通人群中的普遍现象,在有学习障碍的人群中可能更为普遍。人们对认知行为疗法(CBT)方法的使用越来越感兴趣,包括牙科焦虑管理。然而,关于CBT方法在学习障碍患者牙科焦虑管理中的应用,人们知之甚少。本文概述了在英国特殊护理牙科服务中治疗的学习障碍患者实施基于CBT的牙科焦虑途径的详细信息。该途径以牙科团队(牙科护士和牙医)的技能利用为模型,以提供谈话会话的组合,脱敏和积极肯定在五个不同阶段。实施此途径后,服务用户的早期反馈表明,成功接受了牙科护理,减少了镇静助剂的使用。
    Dental anxiety is a common phenomenon in the general population and may be more prevalent in people with learning disabilities. There is growing interest in the use of cognitive behaviour therapy (CBT) approaches, including within dental anxiety management. However, relatively little is known regarding the application of CBT approaches in dental anxiety management for patients with learning disabilities. This paper outlines details of the implementation of a CBT-based dental anxiety pathway for patients with learning disabilities treated in a special care dental service in England. The pathway is modelled on the utilisation of skills from the dental team (dental nurses and dentists) to deliver a combination of talking sessions, desensitisation and positive affirmation in five distinct stages. Early feedback from service users following implementation of this pathway indicates successful acceptance of dental care with a decreased use of sedative adjuncts.
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  • 文章类型: Journal Article
    目的:本研究旨在评估临床摘除固定局部义齿(FPDs)对口腔健康相关生活质量(OHRQoL)和个体焦虑值的影响,并确定高焦虑水平的临床因素。
    方法:总共,300名参与者被纳入这项研究。临床切除FPDs的六种不同原因(口腔检查,义齿更新,牙髓治疗,拔牙,牙周治疗,和复合充填修复)被定义。英国口腔健康相关生活质量测量(OHRQoL-UK),改良牙科焦虑量表(MDAS),和Spielberger状态-特质焦虑库存状态(STAI-S)和特征(STAI-T)被回答。使用单向方差分析(ANOVA)比较原因组。进行二元logistic回归分析以评估高焦虑的危险因素。
    结果:原因组OHRQoL-UK评分无显著差异(P=.279),但是MDAS有显著差异,STAI-S,原因组之间的STAI-T得分(分别为P=.004,P<.001,P=.018)。牙髓治疗,拔牙,性别被确定为危险因素,考虑到焦虑的程度。
    结论:女性患特质焦虑的可能性是男性的2.2倍。尽管临床切除FPDs对OHRQoL的影响在各组之间相似,结论是,无论FPD使用时间如何,牙髓治疗和临床切除FPD的拔牙原因可能是高度焦虑的危险因素。
    OBJECTIVE: This study aimed to evaluate the effect of the clinical removal of fixed partial dentures (FPDs) on oral health-related quality of life (OHRQoL) and the anxiety values of individuals and to determine the clinical factors of high anxiety levels.
    METHODS: In total, 300 participants were included in this study. Six different reasons for the clinical removal of FPDs (oral examination, denture renewal, endodontic treatment, tooth extraction, periodontal treatment, and composite filling restoration) were defined. The United Kingdom Oral Health-Related Quality-of-Life Measure (OHRQoL-UK), the Modified Dental Anxiety Scale (MDAS), and the Spielberger State-Trait Anxiety Inventory- State (STAI-S) and Trait (STAI-T) were answered. The reason groups were compared using one-way analyses of variance (ANOVA). Binary logistic regression analyses were performed to evaluate the risk factors for high anxiety.
    RESULTS: There was no significant difference in OHRQoL-UK scores (P=.279) among the reason groups, but there were significant differences in MDAS, STAI-S, and STAI-T scores (P=.004, P<.001, P=.018 respectively) among the reason groups. Endodontic treatment, tooth extraction, and gender were determined to be risk factors, considering the anxiety scales.
    CONCLUSIONS: Females are 2.2 times more likely to have trait anxiety than men. Although the effect of the reason for the clinical removal of FPDs on OHRQoL was similar among the groups, it is concluded that endodontic treatment and tooth extraction reasons for the clinical removal of FPDs could be risk factors for high anxiety regardless of FPD usage time.
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  • 文章类型: Journal Article
    背景:药理学方法,特别是镇静剂,在牙科预约期间管理儿童的行为方面越来越受欢迎。
    目的:本研究的目的是比较1m/kg鼻内右美托咪定,0.3mg/kg鼻内咪达唑仑,和一氧化二氮在评估镇静水平时,孩子的行为,开始镇静,生理体征,和不利影响。
    方法:在这项交叉试验中,15名6-8岁儿童随机接受鼻内雾化右美托咪定,鼻内雾化咪达唑仑,和吸入一氧化二氮在三个不同的访问。服用镇静剂后,在每次预约期间进行一次牙髓切除术,并记录结果.每次访问之间的清除期为1周。
    结果:所有三种镇静剂在控制总体行为方面同样有效。右美托咪定的镇静水平评分(激动;评分9)低于其他组。镇静的开始有统计学上的显著差异,右美托咪定的最长起效时间为36.2±9.47分钟。鼻内咪达唑仑给药后主要观察到咳嗽和打喷嚏。在局部麻醉给药和治疗后,鼻内咪达唑仑组的氧饱和度水平在统计学上较低。
    结论:0.3mg/kg的咪达唑仑鼻内镇静与一氧化二氮镇静同样有效,可以控制儿童牙科患者的行为并提供足够的镇静。然而,1m/kg右美托咪定不能提供相同的镇静水平,并且起效时间明显更长。0.3mg/kg鼻内咪达唑仑是焦虑儿童一氧化二氮镇静的有效替代药物。
    BACKGROUND: Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments.
    OBJECTIVE: The aim of this study was to compare 1 m/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects.
    METHODS: In this cross-over trial, 15 children aged 6-8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week.
    RESULTS: All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post-treatment.
    CONCLUSIONS: 0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 m/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children.
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  • 文章类型: Journal Article
    背景:龋齿是一种多因素疾病,表现为原发性和永久性牙列。凹坑和裂缝密封剂已成为解决儿童深凹坑和裂缝的最有效的非侵入性治疗方法。本研究的目的是评估使用橡胶坝和MiniDam施用窝沟密封剂时儿童的行为。
    方法:将52名9-12岁的儿童随机分为两组:I组,橡胶坝和第二组,MiniDam.将儿童随机分为两组,第1组(橡胶坝隔离)有26名成员,第2组(MiniDam隔离)有26名成员。使用改良的Venham量表和心率评估儿童的焦虑。使用Memojis疼痛量表评估儿童的疼痛强度。收集的数据采用SPSS软件进行统计和分析。显著性水平建立在0.05。
    结果:组间心率比较显示两组在不同时间间隔的差异有统计学意义(P值0.05),也就是说,在放置大坝之前,有了大坝,在治疗期间。两组患者术前、术后疼痛、焦虑评分差异均有统计学意义(P<0.05)。
    结论:由于其独特的品质,MiniDam的使用可以为坑/裂缝密封剂程序提供更好的选择,包括放置的简单性,改进行为管理,儿童的椅子时间更少。
    BACKGROUND: Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive treatment for addressing teeth with deep pits and fissures in children. The purpose of the present study was to evaluate the behavior of the child when administering the pit and fissure sealant using the rubber dam and MiniDam.
    METHODS: Fifty-two children in the age range of 9-12 years were randomly allocated into two groups: Group I, rubber dam and Group II, MiniDam. The children were randomly assigned into two groups with 26 members in Group 1 (rubber dam isolation) and 26 members in Group 2 (MiniDam isolation). Children\'s anxiety was assessed using the modified Venham scale and heart rate. The children\'s pain intensity was assessed using Memojis Pain Scale. The data collected were tabulated and statistically analyzed using SPSS software. The level of significance was established at 0.05.
    RESULTS: Intergroup comparison of heart rates showed a statistically significant difference for both the groups at various intervals (P value 0.05), that is, before placing the dam, with the dam, and during treatment. Pain and anxiety scores showed a statistically significant difference in both the groups before and after the procedure (P < 0.05).
    CONCLUSIONS: The use of MiniDam can offer a better option for the pit/fissure sealant procedure due to its unique qualities, including simplicity of placement, improved behavior management, and less chair time in children.
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  • 文章类型: Journal Article
    目标:美洲印第安人和阿拉斯加本地人(AI/AN)表示对医疗保健系统不信任。这项研究探讨了AI/AN成人中高水平的牙科不信任或高水平的牙科护理相关恐惧和焦虑(“牙科焦虑”)与口腔健康结果之间的关联。
    方法:2022年美国口腔健康公平状况调查包括改良牙科焦虑量表,并询问受访者在多大程度上同意该声明,“在我最后一次口腔健康访问中,我信任我看到的口腔健康提供者,”并询问了自我评估的口腔健康和牙科之家的存在。
    结果:报告牙齿信任度低(n=110)或牙齿焦虑高(MDAS≥19;n=113)的AI/AN个体(N=564)报告的总体和口腔健康状况明显恶化,并且拥有牙科之家的可能性显着降低(每种分析均使用p<0.05)。
    结论:牙科不信任和牙科焦虑可以显着影响AI/AN社区的口腔健康和牙科利用,并且是改善AI/AN口腔健康的重要干预目标。
    OBJECTIVE: American Indian and Alaska native (AI/AN) individuals report distrust of the healthcare system. This study explored associations between having either high levels of dental distrust or high levels of dental care-related fear and anxiety (\"dental anxiety\") and oral health outcomes in AI/AN adults.
    METHODS: The 2022 State of Oral Health Equity in America survey included the Modified Dental Anxiety Scale and asked to what extent respondents agreed with the statement, \"At my last oral health visit, I trusted the oral health provider I saw\", and asked about self-rated oral health and presence of a dental home.
    RESULTS: AI/AN individuals (N = 564) who reported low dental trust (n = 110) or with high dental anxiety (MDAS≥19; n = 113) reported significantly worse overall and oral health and were significantly less likely to have a dental home (p < 0.05 used for each analysis).
    CONCLUSIONS: Dental distrust and dental anxiety can significantly impact oral health and dental utilization in AI/AN communities and are important intervention targets to improve AI/AN oral health.
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  • 文章类型: Journal Article
    目的:在系统评价和荟萃分析中探讨6至12岁儿童的牙科恐惧与龋齿之间的关系。
    方法:根据医学主题词(MeSH)或非MeSH选择系统评价搜索词。在Scopus进行了一项以英文发表的研究的电子搜索,该研究评估了牙科恐惧(儿童恐惧调查时间表-牙科子量表)与龋齿(DMFT或dmft指数)之间的关系,WebofScience,PubMed,Embase,截至2022年3月的Cochrane和Proquest数据库。在最初检索的5759篇文章中,16人符合纳入研究的条件,其中5例纳入定量分析。根据纽卡斯尔-渥太华量表评估研究质量。Begg检验用于评估发表偏倚。
    结果:根据荟萃分析,结果显示,在低和高恐惧评分组中,DMFT评分的平均值没有统计学上的显著差异,平均差为1.28(95%置信区间-0.132至2.693)(P=0.076)。在低恐惧得分和高恐惧得分组的平均dmft得分上发现有统计学上的显著差异,平均差0.227(95%置信区间0.058至0.395)(P=0.008)。高恐惧评分组的平均dmft明显更高。
    结论:牙科恐惧与乳牙龋齿有显著关系,但不是恒牙。
    OBJECTIVE: To investigate the relationship between dental fear and dental caries in children aged 6 to 12 years in a systematic review and meta-analysis.
    METHODS: Systematic review search terms were selected according to medical subject headings (MeSH) or non-MeSH. An electronic search of studies published in English assessing the relationship between dental fear (children\'s fear survey schedule-dental subscale) and dental caries (DMFT or dmft index) was carried out of the Scopus, Web of Science, PubMed, Embase, Cochrane and Proquest databases up to March 2022. Of 5,759 articles retrieved initially, 16 were eligible for inclusion in the study, and 5 of these were included in the quantitative analysis. The quality of studies was evaluated based on the Newcastle-Ottawa scale. Begg tests were employed to assess the publication bias.
    RESULTS: According to the meta-analysis, the results revealed no statistically significant difference in mean of DMFT score in low and high fear score groups, with a mean difference of 1.28 (95% confidence interval -0.132 to 2.693) (P = 0.076). A statistically significant difference was found in the mean dmft score for the low and high fear score groups, with a mean difference of 0.227 (95% confidence interval 0.058 to 0.395) (P = 0.008). The mean dmft was significantly higher in the high fear score group.
    CONCLUSIONS: Dental fear has a significant relationship with caries in primary teeth, but not in permanent teeth.
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  • 文章类型: Journal Article
    这篇综述评估了干预成人状态焦虑(牙科治疗期间的恐惧和情绪困扰)的随机对照试验(RCT),慢性牙科(特质焦虑)或牙科恐惧症(不成比例的高特质焦虑;符合特定恐惧症的诊断标准)。系统检索了7个在线数据库。173项RCT符合纳入标准,其中67人符合14项汇总分析的资格。为了减轻口腔手术期间的状态焦虑,中度确定性证据支持使用催眠(SMD=-0.31,95CI[-0.56,-0.05]),低确定性证据支持使用苯二氮卓类药物(SMD=-0.43,[-0.74,-0.12])。关于心理治疗,减少状态焦虑的证据尚无定论,并且不支持虚拟现实暴露疗法(VRET),虚拟现实分心,音乐,芳香疗法,视频信息和针灸。为了减少特质焦虑,中度确定性证据支持使用认知行为疗法(CBT;SMD=-0.65,[-1.06,-0.24])。关于牙科恐惧症,具有低到中等确定性的证据支持采用心理治疗(SMD=-0.48,[-0.72,-0.24]),特别是CBT(SMD=-0.43,[-0.68,-0.17]),但不是VRET。这些结果表明牙齿焦虑是可控制和可治疗的。临床医生应确保干预措施符合他们在治疗期间管理急性情绪的目的,或缓解慢性焦虑和回避倾向。现有的研究差距强调了未来试验最小化偏倚和遵循CONSORT报告指南的必要性。
    This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.
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  • 文章类型: Journal Article
    背景:母亲通常在抚养孩子和发展与健康相关的行为中起主要作用。本研究旨在评估母亲和儿童牙齿焦虑与口腔卫生状况之间的关系。
    方法:该研究包括305名儿童,4-12岁,第一次来看牙医的人和他们的母亲。所有人口统计学和口腔卫生信息均通过问卷收集。使用改良牙科焦虑量表(MDAS)和Venham图片测试(VPT)评估母亲和儿童的牙科焦虑,分别。对母亲和孩子进行了口腔检查,和他们的PI,GI,并记录DMFT评分。
    结果:尽管MDAS和VPT之间的相关性在8-12岁的儿童中呈正相关且强,但在4-7岁的儿童中呈正相关,但较弱。检测到母亲的PI之间存在显著关系,GI,DMFT,和孩子的VPT分数。根据母亲的牙齿焦虑,PI无统计学差异,GI,以及4至7岁儿童的dmft值。在8-12岁的儿童中,发现母亲的牙科焦虑与儿童的DMFT之间存在中等正统计学意义的关系。
    结论:儿童牙科焦虑受母亲牙科焦虑的显著影响,母亲经历的治疗后并发症,以及母亲的口腔健康状况。
    背景:临床试验ID:NCT05563532;注册日期:17.09.2022。
    BACKGROUND: Mothers usually have the primary role in raising children and developing health-related behaviors. This study aims to evaluate the relationship between dental anxiety and oral hygiene status of mothers and children\'s dental anxiety and gingival health.
    METHODS: The study included 305 children, aged 4-12 years, who came to the dentist for the first time and their mothers. All the demographic and oral hygiene information were collected through a questionnaire. The dental anxiety of the mothers and children was assessed using the Modified Dental Anxiety Scale (MDAS) and Venham Picture Test (VPT), respectively. The oral examination of the mother and children was performed, and their PI, GI, and DMFT scores were recorded.
    RESULTS: While the correlation between MDAS and VPT was positive and strong in children aged 8-12, it was positive but weak in the 4-7 age group. A significant relationship was detected between the mother\'s PI, GI, DMFT, and the child\'s VPT score. According to the mothers\' dental anxiety, there were no statistically significant differences in PI, GI, and dmft values in children aged between 4 to 7. A moderately positive and statistically significant relationship between maternal dental anxiety and children\'s DMFT was identified in children aged 8-12.
    CONCLUSIONS: Children\'s dental anxiety was significantly influenced by maternal dental anxiety, post-treatment complications experienced by the mother, and the oral health status of the mother.
    BACKGROUND: Clinical Trials-ID: NCT05563532; Registration Date: 17.09.2022.
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