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Objectives: To assess self-reported population oral health conditions amid the COVID-19 pandemic using user reports on Twitter. Method and materials: Oral health-related tweets during the COVID-19 pandemic were collected from 9,104 Twitter users across 26 states (with sufficient samples) in the United States between 12 November 2020 and 14 June 2021. User demographics were inferred by leveraging the visual information from the user profile images. Other characteristics including income, population density, poverty rate, health insurance coverage rate, community water fluoridation rate, and relative change in the number of daily confirmed COVID-19 cases were acquired or inferred based on retrieved information from user profiles. Logistic regression was performed to examine whether discussions vary across user characteristics. Results: Overall, 26.70% of the Twitter users discussed "Wisdom tooth pain/jaw hurt," 23.86% tweeted about "Dental service/cavity," 18.97% discussed "Chipped tooth/tooth break," 16.23% talked about "Dental pain," and the rest tweeted about "Tooth decay/gum bleeding." Women and younger adults (19 to 29 years) were more likely to talk about oral health problems. Health insurance coverage rate was the most significant predictor in logistic regression for topic prediction. Conclusion: Tweets inform social disparities in oral health during the pandemic. For instance, people from counties at a higher risk of COVID-19 talked more about "Tooth decay/gum bleeding" and "Chipped tooth/tooth break." Older adults, who are vulnerable to COVID-19, were more likely to discuss "Dental pain." Topics of interest varied across user characteristics. Through the lens of social media, these findings may provide insights for oral health practitioners and policy makers. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic interrupted dental care for individuals due to dental practice closures beginning in March 2020. The purpose of this study was to investigate the relationships between fear or stress related to COVID-19, dental anxiety and attending dental visits among adults in the United States (US). Methods: A cross-sectional survey research design was used with a non-probability sample of adults residing in the US. Three validated scales, the COVID-19 Stress Scale (CSS), Fear of COVID-19 Scale (FCV-19S) and Modified Dental Anxiety Scale (MDAS), were used for the electronically delivered survey instrument. A crowdsourcing platform was used to recruit participants over the age of 18, residing in the US. Descriptive, correlation, and multiple regression tests were used for data analysis. Results: A total of 308 participants opened the survey with a 97% completion rate (n=299). Time since the last dental visit was positively correlated with all measurement scale scores (p<0.01). Males had statistically significant higher scores on the CSS traumatic stress (p=0.002) and checking (p=0.001) sub-scales. Participants with bachelor and master's degrees had significantly higher scores across FCV-19S and CSS subscales. Conclusion: Individuals with dental anxiety were more likely to exhibit higher levels of fear and anxiety about COVID-19 transmission, resulting in delays in seeking dental care. Dental professionals should address patient concerns about the safety of dental settings and the infection control measures in place to prevent the transmission of COVID-19 in dental settings. Public health entities and professional organizations need to promote messaging about the measures in place to deliver safe oral health care. [ABSTRACT FROM AUTHOR]

Purpose Many adults in the United States struggle with mild, moderate, or severe dental anxiety (DA). Understanding the perspectives of patients with DA may help oral health professionals gain greater insight into their needs and learn how to provide an improved experience for these patients. The purpose of this study was to identify patients' perspectives on factors that impact anxiety in a dental practice setting. Methods A qualitative, descriptive case study design was used to identify patients' perspectives on factors impacting anxiety in a dental practice setting. Potential participants were screened using the Modified Dental Anxiety Scale (MDAS) and needed a moderate DA score to qualify for the study. An interview guide focused on obtaining information about the etiology, contributing factors, management strategies, and participant experiences of DA was used for the semi-structured virtual interviews. Responses were coded using a qualitative research analytic platform (Dedoose; Los Angeles, CA, USA). The co-investigators systematically reviewed the codes using the classic qualitative analysis strategies and journal notes to identify themes and subthemes. Results Twenty-two individuals qualified for participation in this study. Most participants reported having DA beginning in early childhood and throughout their adult life. Seven themes, including Avoidance, Supportive Behaviors, Confidence in Provider, Diversion, Enduring, Adaptations, and Benevolence emerged. Participants reported their primary method for managing DA was to avoid attending their dental appointments. Conclusion Participants in this study expressed various coping mechanisms and management strategies to alleviate the symptoms of DA. Multiple opportunities exist for increasing patient-provider trust and patient comfort to reduce DA, and ultimately improve the oral health status of individuals with DA., (Copyright © 2024 The American Dental Hygienists’ Association.)

Objectives: Dental fear and anxiety are known determinants of delaying or avoiding dental care and vary considerably based on factors such as age and gender. However, little is known about dental fear and anxiety in racial/ethnic minority populations, which bear a disproportionate burden of poor oral health outcomes. Structural and social pathways responsible for producing these disparities are also understudied. Experiences of racism over the lifecourse may contribute to poor oral health outcomes through a pathway of dental fear and anxiety. This paper aimed to evaluate perceived experiences with racism, dental fear and anxiety, and the utilization of dental services, in the Black Women's Health Study (BWHS), a United States-based prospective cohort., Methods: Analysis of prospective data obtained from a geographic subset of participants in the BWHS was conducted. In 2014, BWHS participants residing in Massachusetts responded to a mailed oral health questionnaire that included the Index of Dental Anxiety and Fear (IDAF-4C+) instrument (N = 484; 69% response rate). Previously collected demographic and health information, along with reported experiences of everyday and lifetime racism, obtained from national BWHS questionnaires between 1995 and 2009, were merged with the Massachusetts-based sub-sample. Associations between high dental anxiety (HDA) (mean IDAF-4C+ score ≥2.5 on the dental fear and anxiety module) and oral health outcomes and perceived racism and HDA were explored via prevalence ratios (PR) calculated using log-binomial regression models, including adjustment for potential confounders., Results: Reported exposures to everyday racism occurred weekly on average for the top 25% of the sample, while 13% of participants reported exposure to multiple (n = 3) experiences of unfair treatment due to their race over their lifetime. HDA was prevalent among 17.8% of the sample and was significantly associated with indicators of poor oral health status. High exposures to everyday and lifetime experiences of racism were positively associated with HDA (PR = 1.08; 95% CI: 0.90, 1.58 and PR = 1.72; 95% CI: 1.03, 2.88, respectively)., Conclusions: Significant associations between racism and HDA, and between HDA and poor oral health and reduced utilization of dental care were observed. Dental anxiety may be a pathway through which perceived experiences with racism may impact oral health outcomes., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: The purpose of the study was to assess the knowledge, education, attitudes, confidence, and practice of dental hygienists providing dental care to adult patients with dental anxiety (DA). Methods: A purposive sample of dental hygienists, using a snowball sampling technique, were recruited through social media sites. Inclusion criteria were limited to actively practicing, registered dental hygienists in the United States (U.S.). The validated survey had 29 questions regarding dental hygienists' knowledge, education, attitudes, confidence, and practice in regards to patients with DA. Regression analysis and chi square tests were performed on the data with research outcomes represented through frequency tables and percentiles. Results: A total of 417 participants attempted the survey; 355 participants (n=355) completed the survey yielding a participation rate of 87%. A majority, 73%, of the respondents reported DA as a "somewhat serious" to "extremely serious" issue when treating patients. Forty-eight percent of the respondents indicated that their education had prepared them to address DA but also reported the need for additional education in this area. Dental hygienists indicating higher levels of confidence in addressing DA in their patients also allowed for extra time in their schedules to treat patients with DA. Conclusion: Increased DA education in the undergraduate dental hygiene curriculum as well as post-graduate education opportunities may increase dental hygienists' confidence and capability in the management of DA. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to: (1) evaluate the level of dental fear among transgender individuals and (2) investigate specific predictors of dental fear in individuals who identify as transgender.Method and Results: An anonymous survey among transgender adults was conducted using both a web-based and paper survey. The survey included the Dental Fear Survey (DFS), history of hormonal interventions, perceived gender roles, and demographic information. The bivariate analyses did not show a significant difference in DFS between sex assigned at birth (p = 0.628) or among gender identities (p = 0.109). A regression model analysis for the level of DFS by using participants' demographic information as independent variables indicated the fear and experience of discrimination/maltreatment were significant predictors of dental fear; standardized beta coefficients (p-value) were 0.35 (p = 0.017) and 0.28 (p = 0.041), respectively.Conclusion: The fear and experiences of discrimination/maltreatment were significantly positively associated with their level of dental fear. [ABSTRACT FROM AUTHOR]

This study aimed to determine the associations between acculturation, dental anxiety, and dental utilization among Hispanics/Latinos living in the US. A proxy measure of dental anxiety was available for 7539 adults who had not visited a dentist within the last year. All completed the Short Acculturation Scale for Hispanics (SASH). Bivariate logistic regression and adjusted multivariable logistic regression analysis were conducted. Approximately 22% of the sample was dentally anxious. Dental anxiety was significantly associated with SASH language scale score (OR 1.09, 95%CI 1.02, 1.18, p = 0.04), years in US (OR 1.53, 95%CI 1.23, 1.91, p < 0.0001), and preferred Spanish language (OR 1.30, 95%CI 1.05, 1.63, p = 0.0192); lower acculturation corresponded to higher dental anxiety. Adjusting for sex, age, education, income, insurance, and oral health status, level of acculturation was associated with dental anxiety (AOR 0.87, 95%CI 0.75, 0.91, p = 0.009), but neither were associated with utilization. Acculturation may be an important predictor of dental anxiety for Hispanics/Latinos living in the US., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: To assess self-reported population oral health conditions amid the COVID-19 pandemic using user reports on Twitter., Method and Materials: Oral health-related tweets during the COVID-19 pandemic were collected from 9,104 Twitter users across 26 states (with sufficient samples) in the United States between 12 November 2020 and 14 June 2021. User demographics were inferred by leveraging the visual information from the user profile images. Other characteristics including income, population density, poverty rate, health insurance coverage rate, community water fluoridation rate, and relative change in the number of daily confirmed COVID-19 cases were acquired or inferred based on retrieved information from user profiles. Logistic regression was performed to examine whether discussions vary across user characteristics., Results: Overall, 26.70% of the Twitter users discussed "Wisdom tooth pain/jaw hurt," 23.86% tweeted about "Dental service/cavity," 18.97% discussed "Chipped tooth/tooth break," 16.23% talked about "Dental pain," and the rest tweeted about "Tooth decay/gum bleeding." Women and younger adults (19 to 29 years) were more likely to talk about oral health problems. Health insurance coverage rate was the most significant predictor in logistic regression for topic prediction., Conclusion: Tweets inform social disparities in oral health during the pandemic. For instance, people from counties at a higher risk of COVID-19 talked more about "Tooth decay/gum bleeding" and "Chipped tooth/tooth break." Older adults, who are vulnerable to COVID-19, were more likely to discuss "Dental pain." Topics of interest varied across user characteristics. Through the lens of social media, these findings may provide insights for oral health practitioners and policy makers.

Background: In the early 1990s, much of the periodontal profession perceived an upcoming shift in services performed by periodontists as many patients began to expect sedation for periodontal surgery. As a result, in 1993 the American Academy of Periodontology began encouraging postgraduate periodontal programs to train residents in the use of conscious sedation. The purpose of this study is to investigate trends in the training of intravenous (IV) sedation in residency and its use in periodontal practice. Methods: An 18-question survey was mailed to a sample of 1596 active periodontists throughout the United States and Canada. Thirty-seven percent (596) of the surveys were returned. Twenty-two retired periodontists responded and were excluded from the analysis. The data from the remaining 574 surveys were analyzed with a statistical software package. Results: Approximately half (49.8%) of the survey respondents offer IV sedation in their practices. Among respondents who completed residency prior to 1996, 42.6% offer IV sedation compared with 64.2% of respondents who completed residency in 1996 or later. The number of IV sedations performed in residency was moderately correlated with the number of IV sedations personally performed in periodontal practice (Spearman r = 0.5169, P <0.0001). The largest percentage of periodontists using IV sedation (74.0%) was reported from American Academy of Periodontology District 5 (south central United States), whereas District 7 (New Jersey and New York) reported the lowest usage (15.6%). Conclusions: Approximately half of all periodontists provide IV sedation, with more recent periodontal graduates more likely to personally offer and administer IV sedation services for their patients. Regional differences exist in the use and training of IV sedation. [ABSTRACT FROM AUTHOR]

Dental anxiety and subsequent avoidance of dental care and deterioration of oral health pose a significant problem for the dental profession. In an attempt to elucidate preferences of anxious dental patients, we gathered survey data from 121 persons at a small, private liberal arts college in the mid-Atlantic region of the United States. Half of the respondents experienced dental anxiety, and most of these (66 percent) attributed anxiety to fear of anticipated pain. The majority of anxious patients preferred a dentist to be friendly (93 percent), talkative (82 percent), and to have an office with adorned walls (89 percent) and a slightly cool temperature (63 percent). Patients who identified themselves as anxious also indicated that music in the background (89 percent) and magazines and books in the dental office (75 percent) were helpful. Anxious patients were more likely than nonanxious patients to prefer a male dentist (77 percent versus 52 percent). This finding was especially marked among anxious male respondents, 93 percent of whom preferred a male dentist compared to 73 percent of anxious female respondents. These survey data may assist dental professionals in understanding and combating patients' dental anxiety, in order to increase the frequency of dental visits and to prompt a corresponding restoration or maintenance of oral health. [ABSTRACT FROM AUTHOR]

The Dental Fear Survey (DFS), a paper and pencil instrument for assessing dental fear and avoidance, has been widely used and validated in fear studies in the US. However, before such instruments are used in countries and cultures dissimilar to the one in which it was developed, they should be cross-validated in that culture. The present study is an examination of the DFS response characteristics in a group of 374 Brazilian university students. Factor analysis of the DFS revealed three factors essentially identical to those found among university students in the US and in Singapore, as well as among US adult dental patients. Higher DFS scores were significantly associated longer intervals since last dental visit. These results are taken as evidence that the DFS performs in this Brazilian sample very much as it does in other samples; and is thus, a valid indicator of dental fear at least among Brazilian university students. [ABSTRACT FROM AUTHOR]

Data sources PubMed, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Health Sciences Literature (Lilacs), US National Library of Medicine and Google Scholar. There were no limits on language or publication dates.Study selection Two independent reviewers performed the study selection of randomised controlled trials (RCT) investigating distraction techniques to manage dental anxiety & fear in patients under 18 years old compared to no interventionData extraction and synthesis Data were extracted by two independent reviewers using standardised data tables. Risk of bias was assessed using Cochrane Collaboration's Risk of Bias Tool. Study heterogeneity precluded meta-analysis. Qualitative analyses were performed.Results Twenty-one RCTs were included in this systematic review. Participant ages ranged from 4 to 16 years old. Distraction techniques included use of audio and audio-visual techniques, instrument camouflage, biofeedback therapy, dental operating microscope and toys. Data were collected pre- and post-dental procedures including: dental examination; prophylaxis; local anaesthetic administration; restoration placement; exodontia; and placement of rubber dam. Within studies, between one and six instruments were used to measure children's anxiety and dental fear. Objective measures with pulse oximeters and blood pressure cuffs were used most frequently.Conclusions The studies included in this systematic review suggest that distraction techniques might be useful to control children's anxiety and fear during dental appointments, however, the certainty of evidence is very low. There are no contraindications for the use of distraction techniques during children's and adolescents' dental appointments.

Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials-with 2 meta-analyses finding strong average effect sizes ( d > 1)-CBT has received almost no dissemination beyond the specialty clinics that tested it. The challenge, then, is not how to treat dental fear but how to disseminate and implement such an evidence-based treatment in a way that recognizes the rewards and barriers in the US health care system. This mixed-method study investigated the potential of disseminating CBT through care from a mental health provider from within the dental home, a practice known as evidence-based collaborative care (EBCC). Two preadoption studies were conducted with practicing dentists drawn from a self-organized Practice-Based Research Network in the New York City metropolitan area. The first comprised 3 focus groups ( N = 17), and the second involved the administration of a survey ( N = 46). Focus group participants agreed that CBT for dental fear is worthy of consideration but identified several concerns regarding its appeal, feasibility, and application in community dental practices. Survey participants indicated endorsement of factors promoting the use of EBCC as a mechanism for CBT dissemination, with no factors receiving less than 50% support. Taken together, these findings indicate that EBCC may be a useful framework through which an evidence-based treatment for dental fear treatment can be delivered.

Oral health is a significant issue for women because of its association with overall health and quality of life. There is growing evidence that the casual factors and consequences of oral disease are not only physical, but are also social and psychologic. As the importance and implications of the psychosocial factors become better understood, a more comprehensive model for treatment is developing. Accepting this role can lead dentists to a more multidisciplinary approach to successful treatment for their female patients.