Detecting and treating fearful dental patients in primary health care – a practice-based study
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Leena Palotie- sali, 101A, Aapistie 5A, 90230 Oulu
Topic of the dissertation
Detecting and treating fearful dental patients in primary health care – a practice-based study
Doctoral candidate
DDS Taina Kankaala
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, University of Oulu Graduate School, Research Unit of Population Health
Subject of study
Dentistry
Opponent
Professor Heikki Murtomaa, University of Helsinki
Custos
Professor Vuokko Anttonen, University of Oulu
Detecting and treating fearful dental patients in primary health care – a practice-based study
This thesis investigates the detection of dental fear and register-based outcomes of the treatment of fearful patients in primary dental health care. Patients’ preferences regarding the use of dental care were also evaluated.
The study involved three populations in the City of Oulu, Finland. The cross-sectional survey (A) comprised 273 patients in urgent dental care. The questionnaires used were the Modified Dental Anxiety Scale (MDAS) and colour codes for dental fear (CCF). Participants also answered open-ended questions on their facilitators in dental health care, and the impact of Covid-19 on dental fear and attendance. The record-based follow-up study population (B) comprised referral patients in the Clinic for Fearful Dental Patients (CFDP) in 2000–2006. Short- and long-term outcomes were investigated after treatment in the CFDP; the short-term follow-up of mean 2.3 years involved 163 patients. This was regarded as successful when dental care was performed without any notices of dental fear. The long-term outcomes of the same patients consisted of the number of examinations, missed appointments and visits to urgent care in 2006–2016 (n = 152). Patients (n = 12) treated in the CFDP 2017 with dog-assisted support (DAS), along with the personnel involved, served as the third survey population (C).
Severe dental fear measured by CCF correlated well with high MDAS scores. Dentists did not recognise the most fearful individuals. Fearful participants reported personnel- and treatment-related factors as facilitators for dental care. Those with severe fear reported more frequently than others that Covid-19 had a negative impact on dental fear and attendance.
The success rate for short-term outcomes was 69%. Success was associated with being 12 years of age or younger, not having special needs, and the absence of dental general anaesthesia. Fear treatment at age 2–10 years of age and a successful short-term outcome were associated with an optimum number of examinations later, but not with reduction on either number of missed appointments or urgent care visits. Unsuccessful short-term outcomes were associated with a low number of examinations and frequent need for urgent dental care. Patients reported decreased dental fear scores if they found effect of DAS to be calming (p = 0.017). If personnel reported that DAS made working easier, the work also took less time (p = 0.008).
The colour code for dental fear (CCF) of patients appears valid for screening dental fear. Chair-side treatment of fearful patients is beneficial and should be done as early as possible.
The study involved three populations in the City of Oulu, Finland. The cross-sectional survey (A) comprised 273 patients in urgent dental care. The questionnaires used were the Modified Dental Anxiety Scale (MDAS) and colour codes for dental fear (CCF). Participants also answered open-ended questions on their facilitators in dental health care, and the impact of Covid-19 on dental fear and attendance. The record-based follow-up study population (B) comprised referral patients in the Clinic for Fearful Dental Patients (CFDP) in 2000–2006. Short- and long-term outcomes were investigated after treatment in the CFDP; the short-term follow-up of mean 2.3 years involved 163 patients. This was regarded as successful when dental care was performed without any notices of dental fear. The long-term outcomes of the same patients consisted of the number of examinations, missed appointments and visits to urgent care in 2006–2016 (n = 152). Patients (n = 12) treated in the CFDP 2017 with dog-assisted support (DAS), along with the personnel involved, served as the third survey population (C).
Severe dental fear measured by CCF correlated well with high MDAS scores. Dentists did not recognise the most fearful individuals. Fearful participants reported personnel- and treatment-related factors as facilitators for dental care. Those with severe fear reported more frequently than others that Covid-19 had a negative impact on dental fear and attendance.
The success rate for short-term outcomes was 69%. Success was associated with being 12 years of age or younger, not having special needs, and the absence of dental general anaesthesia. Fear treatment at age 2–10 years of age and a successful short-term outcome were associated with an optimum number of examinations later, but not with reduction on either number of missed appointments or urgent care visits. Unsuccessful short-term outcomes were associated with a low number of examinations and frequent need for urgent dental care. Patients reported decreased dental fear scores if they found effect of DAS to be calming (p = 0.017). If personnel reported that DAS made working easier, the work also took less time (p = 0.008).
The colour code for dental fear (CCF) of patients appears valid for screening dental fear. Chair-side treatment of fearful patients is beneficial and should be done as early as possible.
Last updated: 30.1.2025