Dental anxiety is a well-defined disorder, with a prevalence between 4 and 23.4%. It tends to manifest in the preoperative phase, leading to the postponement of treatment plans, with particular regard to surgery, where the phenomenon can affect up to 60-80% of cases.
Consider a classic intervention such as third molar surgery: the factors determining preoperative anxiety are basically lack of information regarding the procedure and the operating environment.
A useful approach, to be implemented in the preliminary phase, is to determine the levels of dental anxiety among patients who have undergone surgical treatment. This can be done through the application of specific scales, which can be conducted through questionnaires, administered verbally or in writing. These questionnaires aim to quantify aspects that relate to the subjective perception of the patient and, in the current state of the art, are, also for simplicity, the most reliable option for this purpose. Anxiety, for example, can be placed in a continuum that goes from “non anxiety” to “severe anxiety”.
The interesting study by Sancak and Akal, recently published in the Journal of Oral and Maxillofacial Surgery, proposed to evaluate the influence of information, as well as previous surgical experience, on dental anxiety in view of an avulsion operation of the third molar.
The survey, conducted at the Department of Oral and Maxillofacial Surgery of the Faculty of Dentistry of the University of Ankara, Turkey, involved a total of 66 patients who underwent third molar surgery under local anesthesia.
Patients were randomly assigned to one of the following groups:
– Group 1: patients who were given only basic information verbally.
– Group 2: patients who have been given detailed information in writing about the period of preoperative interest and also about the intra- and post-operative phases.
To these should be added a group 3, consisting of patients with previous experience in third molar surgery who, in turn, received only basic verbal information.
The following questionnaires were submitted to all patients in the pre- and post-operative phase:
– Spielberger State Anxiety Inventory (STAI-S): generic, consisting of 20 items, distinguishes between low, moderate and high anxiety.
– Dental Fear Scale (DFS): also includes 20 items, evaluates the levels of fear (from 1 to 5) in terms of avoidance by the dentist, somatic symptoms of fear.
– Fear of various practice-related demands.
– Modified Dental Anxiety Scale (MDAS): short questionnaire with a total score ranging from a minimum of five to a maximum of 25.
– Visual Analog Scale (VAS): 100 mm line in which the patient indicates their perception in a continuum from “no anxiety” to “maximum imaginable anxiety.”
With regard to the VAS and MDAS surveys, the study found significantly lower scores, in the transition from pre to post-operative, in patients informed in writing. The study, therefore, showed that all patients, even those with previous experience, can benefit from the assessment of their state of anxiety and from being informed in detail about the intervention. In this respect, the written form is the preferred way forward.