Identificação precoce da ansiedade em função do tratamento odontológico é uma ferramenta que pode auxiliar o profissional no atendimento e contribuir para pesquisas, especialmente com crianças. Este estudo teve como objetivo testar a confiabilidade e validade da versão brasileira do Childrens Fear Survey Schedule- Dental Subscale (CFSS-DS). A amostra foi composta por 136 crianças, que são atendidas sob livre-demanda na clínica de Odontopediatria da Faculdade de Odontologia de Bauru, Bauru - SP, Brasil. Todas recrutadas aleatoriamente. A versão em português brasileiro do CFSS-DS foi respondida por crianças previamente ao atendimento odontológico. A escala foi testada quanto à consistência interna e confiabilidade teste-reteste. Para testar a validade do critério, o comportamento das crianças foi avaliado utilizando a escala de Frankl durante o atendimento odontológico, e os resultados foram comparados com os escores de CFSS-DS das crianças. A análise fatorial também foi utilizada. Os resultados evidenciaram que a versão brasileira do CFSS-DS mostrou alta confiabilidade, quanto à confiabilidade testereteste (ICC = 0,76, p <0,001) e consistência interna ( de Cronbach = 0,90). Demonstrou boa validade de critério, as crianças com comportamento negativo apresentaram pontuação no CFSS-DS significativamente maiores (t = 16,64, p <0,001). A análise fatorial identificou os seguintes fatores: \"medo de procedimentos habituais e anestesia\", \"medo de estranhos\" e \"medo de aspectos médicos gerais\". Após análise dos resultados pode-se inferir que a versão brasileira do CFSS-DS é uma medida confiável e válida para aferir ansiedade em função do tratamento odontológico em crianças brasileiras de língua portuguesa. Dentistas e pesquisadores de Odontopediatria podem usar esta versão validada do CFSS-DS para identificar o medo do tratamento odontológico em crianças brasileiras. / Early recognition of anxiety caused by dental treatment is a tool that could help the dentist during the treatment as well as contribute to research, especially when dealing with children. The purpose of this study was to test the reliability and validity of the Brazilian version of the Childrens Fear Survey Schedule-Dental Subscale (CFSSDS). The sample was composed by 136 random children that attended the Pediatric Dentistry Clinic in the Bauru School of Dentistry, Bauru SP, Brazil. The children answered the CFSS-DS Brazilian-Portuguese version previously to dental treatment. The Scale was tested according to its internal consistency, and test-retest reliability. Frankl Scale was used to evaluate the childrens behavior during dental treatment in order to test the criteria validity. Results were compared to CFSS-DS score. Factorial analysis was used as well. According to the results, CFSS-DS Brazilian version presented high reliability, both in test-retest reliability (ICC = 0,76, p <0,001) and internal consistency ( de Cronbach = 0,90). Good criteria validity was also demonstrated, children with negative behavior presented significantly higher CFSSDS score (t = 16,64, p <0,001). Factorial analysis identified the following factors: fear of habitual procedures and anesthesia, fear of strangers and fear of general medical aspects. After results analysis, we can conclude that the CFSS-DS Brazilian- Portuguese version is a valid and reliable tool that can be used to measure anxiety caused by dental treatment in Brazilian children. Pediatric Dentists and researchers can use this validated CFSS-DS version to identify dental treatment fear in Brazilian Children.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Apesar dos avanÃos da ciÃncia, o medo e ansiedade, por razÃes odontolÃgicas, ainda acometem uma grande quantidade de pessoas, comprometendo a procura por tratamento e resultando, ocasionalmente, em baixos nÃveis de saÃde oral. A aparÃncia fÃsica dos instrumentos parece ser um dos principais causadores de medo e ansiedade no meio odontolÃgico, e a seringa anestÃsica à o instrumental que mais desencadeia estes sentimentos. Assim, diminuir a ansiedade e o medo do tratamento odontolÃgico deveria ser uma das prioridades do cirurgiÃo-dentista. Para tanto, a presente dissertaÃÃo teve por objetivo comparar as reaÃÃes apresentadas por crianÃas que foram anestesiadas com um dispositivo em formato lÃdico e com uma seringa tradicional, com a finalidade de analisar se uma mudanÃa no desenho externo da seringa anestÃsica seria capaz de influenciar os nÃveis de ansiedade, medo e dor dos pacientes. Sessenta e quatro crianÃas, com idade ente 4-10 anos, foram distribuÃdas aleatoriamente em dois grupos, de acordo com o dispositivo a ser utilizado na primeira sessÃo anestÃsica. G1 (Convencional) e G2 (Design modificado). Os participantes submeteram-se a duas sessÃes anestÃsicas, e cada paciente foi anestesiado com ambos dispositivos. Um Ãnico pesquisador, odontopediatra, realizou os procedimentos anestÃsicos que foram filmados e consistiram de anestesias terminais infiltrativas, na regiÃo posterior da maxila. Devido ao carÃter multidimensional do medo, ansiedade e dor, uma combinaÃÃo de testes foi utilizada para avaliÃ-los, como: O teste de medo da crianÃa (Child Fear Survey Schedule â Dental Subscale - CFSS-DS), escala de ansiedade facial (Facial Anxiety Scale- FAS), frequÃncia cardÃaca, escala som, olhos e movimento (Sound, Eyes and Motor-SEM), escala visual analÃga â Visual Analogue Scale (VAS) e escala Frankl. As escalas foram aplicadas em momentos predeterminados, como: sala de espera (SE), cadeira odontolÃgica (CO), inÃcio da anestesia (IA) e final da anestesia (FA). ApÃs a segunda sessÃo anestÃsica, as crianÃas escolheram o dispositivo que mais as agradou. Os resultados mostraram que 78% da amostra foi classificada como pouco ansiosa (CFSS-DS). Nenhuma diferenÃa estatisticamente significante pÃde ser observada nas diferentes escalas, ao comparar o dispositivo tradicional com o modificado. A seringa com mudanÃa no design foi a preferida por 57,8% das crianÃas. As crianÃas ansiosas relataram mais dor que as nÃo ansiosas (p=0,001) e o estado emocional variou nas diferentes situaÃÃes: SE, CO, IA e FA. (p<0,05). Assim, concluiu-se que a aparÃncia da seringa à importante, mas nÃo à fundamental no controle da ansiedade, medo e dor de crianÃas submetidas à anestesia odontolÃgica. / Despite advances in Odontology, fear and anxiety regarding dentistry still affect a large number of people who, because of their fears, fail to seek treatment; this can result in low levels of oral health. The physical appearance of the instruments used by dentists seems to be a major cause of such fear and anxiety with regard to dentistry. The anesthetic syringe is the instrument that causes the strongest feelings of fear. So, the prevention of dental anxiety and patients fear should be one of the dentistâs highest priorities, this study aims to compare the reactions shown when children were anesthetized with a modified device and when they were anesthetized with a traditional syringe, and examine the results to see if a change in the external design of the anesthetic syringe can influence the levels of anxiety, fear and pain of patients. Sixty-four children aged 4-10 years were randomly assigned into two groups according to the device to be used in the first session of anesthesia. G1 (Traditional Syringe) and G2 (Modified syringe). Participants underwent two sessions and each patient was anesthetized with both devices. A single researcher performed anesthetic procedures, which were videotaped and the procedure consisted of infiltrative anesthesia in the posterior area of the maxilla. Due to the multidimensional nature of fear, anxiety and pain, a combination of tests was used to access them: Child Fear Survey Schedule - Dental Subscale - CFSS-DS, Facial Anxiety Scale-FAS, heart rate, the SEM scale Sound, Eyes and Motor, the Visual Analogue Scale (VAS) and the Frankl scale. These tests were applied in predefined situations as the waiting room (WR), the dental chair (DC), during the onset of anesthesia (OA) and end of anesthesia (EA). After the second session of anesthesia, children chose the device that they preferred. The results showed that most 78% children were classified as having a low level of anxiety (CFSS-DS). No significant difference was observed when comparing the traditional and modified devices. The syringe with a change in design was preferred by (57.8%) of the children. The anxious children reported more pain than non-anxious (p = 0.001) and their emotional state varied in different situations: WR, DC, OA and EA. (P <0.05). Thus, it was concluded that the appearance of the syringe is important, but not essential in order to control the anxiety, fear and pain which children suffer when undergoing dental anesthesia.

Identificação precoce da ansiedade em função do tratamento odontológico é uma ferramenta que pode auxiliar o profissional no atendimento e contribuir para pesquisas, especialmente com crianças. Este estudo teve como objetivo testar a confiabilidade e validade da versão brasileira do Childrens Fear Survey Schedule- Dental Subscale (CFSS-DS). A amostra foi composta por 136 crianças, que são atendidas sob livre-demanda na clínica de Odontopediatria da Faculdade de Odontologia de Bauru, Bauru - SP, Brasil. Todas recrutadas aleatoriamente. A versão em português brasileiro do CFSS-DS foi respondida por crianças previamente ao atendimento odontológico. A escala foi testada quanto à consistência interna e confiabilidade teste-reteste. Para testar a validade do critério, o comportamento das crianças foi avaliado utilizando a escala de Frankl durante o atendimento odontológico, e os resultados foram comparados com os escores de CFSS-DS das crianças. A análise fatorial também foi utilizada. Os resultados evidenciaram que a versão brasileira do CFSS-DS mostrou alta confiabilidade, quanto à confiabilidade testereteste (ICC = 0,76, p <0,001) e consistência interna ( de Cronbach = 0,90). Demonstrou boa validade de critério, as crianças com comportamento negativo apresentaram pontuação no CFSS-DS significativamente maiores (t = 16,64, p <0,001). A análise fatorial identificou os seguintes fatores: \"medo de procedimentos habituais e anestesia\", \"medo de estranhos\" e \"medo de aspectos médicos gerais\". Após análise dos resultados pode-se inferir que a versão brasileira do CFSS-DS é uma medida confiável e válida para aferir ansiedade em função do tratamento odontológico em crianças brasileiras de língua portuguesa. Dentistas e pesquisadores de Odontopediatria podem usar esta versão validada do CFSS-DS para identificar o medo do tratamento odontológico em crianças brasileiras. / Early recognition of anxiety caused by dental treatment is a tool that could help the dentist during the treatment as well as contribute to research, especially when dealing with children. The purpose of this study was to test the reliability and validity of the Brazilian version of the Childrens Fear Survey Schedule-Dental Subscale (CFSSDS). The sample was composed by 136 random children that attended the Pediatric Dentistry Clinic in the Bauru School of Dentistry, Bauru SP, Brazil. The children answered the CFSS-DS Brazilian-Portuguese version previously to dental treatment. The Scale was tested according to its internal consistency, and test-retest reliability. Frankl Scale was used to evaluate the childrens behavior during dental treatment in order to test the criteria validity. Results were compared to CFSS-DS score. Factorial analysis was used as well. According to the results, CFSS-DS Brazilian version presented high reliability, both in test-retest reliability (ICC = 0,76, p <0,001) and internal consistency ( de Cronbach = 0,90). Good criteria validity was also demonstrated, children with negative behavior presented significantly higher CFSSDS score (t = 16,64, p <0,001). Factorial analysis identified the following factors: fear of habitual procedures and anesthesia, fear of strangers and fear of general medical aspects. After results analysis, we can conclude that the CFSS-DS Brazilian- Portuguese version is a valid and reliable tool that can be used to measure anxiety caused by dental treatment in Brazilian children. Pediatric Dentists and researchers can use this validated CFSS-DS version to identify dental treatment fear in Brazilian Children.

Background Anxiety experienced by individuals visiting the dental office to receive treatment is prevalent in the population. The clinical manifestation of these anxieties is considerable; it is estimated that approximately between 14 and 30 million people in the United States do not seek routine dental care due to dental anxiety. Dentists and other scientists have explored many techniques and procedures in attempts to ameliorate these anxieties and improve patient care. Biofeedback is a process that involves measuring a person's specific bodily functions such as blood pressure, heart rate, skin temperature, muscle tension, or breathing rate, and conveying the information to the patient in real-time. This raises the patient's awareness and therefore the possibility of conscious control of those functions. Evidence has shown biofeedback to be a useful modality of treatment for numerous conditions associated with anxiety. Anxiety has been shown to up-regulate the sympathetic nervous system. When the sympathetic nervous system is up-regulated, the pain threshold is decreased, and physiologic parameters of anxiety are manifested in the patient. This physiological phenomenon is well understood and demonstrates that, with anxiety, the individual will have a decreased pain threshold (i.e., greater response to noxious or painful stimuli). The purpose of the current pilot study is to investigate the use of a novel biofeedback system (RESPeRATE™) to reduce patients' pre-operative general anxiety levels and subsequently the pain associated with dental injections. Methods Eighty-one subjects participated in this randomized controlled study. Forty subjects were in the experimental group and forty-one subjects were in the control group. All subjects were asked to fill out a pre-injection survey (Dental Injection Sensitivity Survey - DISS), measuring baseline anxiety levels. Subjects in the experimental group used a biofeedback technique, while subjects in the control group were not exposed to any biofeedback. All participants then received an inferior alveolar local anesthetic injection. Subjects in both groups were then given a post-injection survey (measuring anxiety levels), and filled out a Visual Analog Scale (VAS). The VAS was designed to measure the subjects' perception of pain of the injection, the overall injection experience, and anticipatory anxiety for future injections. Results The results of the study demonstrated that there was no significant difference between the treatment group and the control group with respect to any of the pre/post-operative anxiety measures as recorded by the DISS. This study did demonstrate that with the use of the RESPeRATE™ device there was a significant difference in the overall injection experience between the experimental group and the control group (p=0.013), as measured by the VAS. A trend towards improved responses for the experimental group was noted with respect to both level of discomfort and ratings of future nervousness; these results did not reach a statically significance of p<.05. Conclusions Future studies and power calculation will be more specific towards the RESPeRATE™ in a dental setting, and lead to more accurate approximations on the number of subjects needed to determine whether the difference was due to chance or due to the treatment modality. It appears that this novel pilot study was underpowered. It would also be feasible to apply the technology to other areas in dentistry where anxiety and sympathetic up-regulation are etiologic components. Areas of future studies may include temporomandibular joint dysfunction, orofacial pain, periodontal disease, and wound healing.

Thèse (Ph. D.)--Université Laval, 1996. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--Allegheny University of the Health Sciences, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thèse (Ph. D.)--Université Laval, 1996. / Includes bibliographical references.

Thesis (Ph. D.)--Allegheny University of the Health Sciences, 1997. / Includes bibliographical references.

Syfte: Litteraturstudien hade två syften. Det första syftet var att undersöka hur vanligt det är att tandvårdsrädsla är en orsak till att vuxna inte går till tandvården och det andra om oregelbundna tandvårdsbesökare är mer tandvårdsrädda. Material och metod: En systematisk litteratursökning utfördes i databasen PubMed. Inklusionskriterierna var att studierna ska ha utförts på personer > 15 år och artiklar vara skrivna på engelska. Exklusionskriteriet var reviewartiklar. Efter att ha läst titel och sammanfattning på de funna artiklarna hämtades fulltext på de artiklar som stämde med inklusions- och exklusionskriterierna. Dessa artiklar relevansgraderades sedan och artiklar med hög relevans inkluderades i resultattabellerna och kvalitetsbedömdes. Artiklar med låg relevans exkluderades. Resultat: Tjugofem artiklar hade hög relevans och användes i resultattabellerna. Av dessa artiklar användes 10 stycken i syfte 1 och 15 artiklar i syfte 2. Av dessa artiklar fick två bedömningen medelhög kvalitet och 23 artiklar fick hög kvalitet. Konklusion: Resultatet visar att tandvårdsrädsla är en av de stora anledningarna till att vuxna inte går till tandvården. Andra faktorer påverkar också som tidsbrist, kostnad och att patienterna inte känner behov av att gå så länge de inte har några problem med tänderna. Resultatet visar även att oregelbundna tandvårdsbesökare är mer tandvårdsrädda. / Objective: The literature study had two aims. The first was to investigate how common it is that dental anxiety is a reason why adults do not go to the dentistry and the second if irregular dental attenders have a higher level of dental anxiety. Material and methods: A systematic literature search of the database PubMed was carried out. The inclusion criteria were that studies should have been conducted in individuals > 15 years old and articles should be written in English. The exclusion criterion was reviews. After reading the title and abstract of the found articles, articles that matched the inclusion and exclusion criteria were retrieved in full text. These were graded on relevance and articles of high relevance were included in the result tables and quality were then assessed. Articles with low relevance were excluded. Results: Twenty-five articles had high relevance and were used in the result tables. Of these, 10 articles were used for the first aim, 15 articles for the second aim. Of these, two articles were assessed as showing medium-high quality, 23 articles were of high quality. Conclusion: The results show that dental anxiety is one of the major reasons that adults do not go to the dentist. Other factors also influence like the lack of time, cost and that the patients do not feel the need to go as long as they do not have any problems with their teeth. The result also show that irregular dental attenders have a higher level of dental anxiety.

Introduction: Dental anxiety, fear, and phobia are common factors that prevent individuals from seeking dental care by delaying dental care or terminating the visit entirely, which may cause a decline in oral health-related quality of life. Dental anxiety often has a correlation with other psychological constructs. There is a significant prevalence of dental anxiety among various ethnic groups, which highlights the importance of understanding and addressing these issues to improve oral health outcomes and access to care.Aim: To examine the associations between psychological constructs, dental anxiety, and phobia, as well as the associations between key demographics and dental anxiety and phobia among patients seeking dental care at TUKSoD. Methods: Baseline data from 499 patients who participated in a randomized clinical trial that evaluated the efficacy of an online intervention in managing dental anxiety (National Institute of Health U01DE027328) was used. Subjects completed a semi-structured interview according to the Diagnostic Schedule Manual-IV (DSM-IV) criteria and self-reported measures on dental anxiety (Modified Dental Anxiety Scale (MDAS)), fear or avoidance of dental care, sensitivity to pain (PSI), ability to tolerate distress (DTS), blood-injection-injury (BII) phobia, and other psychological factors. Bivariate analysis was done using paired sample t-tests and analysis of variance to evaluate differences in mean scores for MDAS by sex, race, gender, and ethnicity. Multivariable Regression Models were used to explore the association between MDAS, selected demographic variables and psychological constructs while controlling for potential confounders, likewise for clinical severity rating (CSR). These analyses were performed using R 4.3.2 and statistical significance was set at two-sided p-value < 0.05. Results: Mean age of subjects was 48.9±14.7 years old, most were female (71.6%), non-Hispanic (88.6%) with an income lower than $30,000 (40.0%) and most had completed a high school diploma /GED (26%). The majority (63.3%) reported high dental anxiety (MDAS≥19) and 64.57 % met criteria for specific phobia (CSR≥4), with mean scores of 19.53 ± 3.62 and 4.49 ± 1.69 respectively. Mean scores for FQBII, PSI, DTS, and ASI were 15.51 ± 10.15, 68.02±22.9, 44.73±13.2, and 31.0 ± 16.87 respectively. Significant differences in Clinical Severity Rating were observed by age (p< 0.01), sex (p = 0.02), and race (p<0.01), while the psychological constructs FQBII, DTS and PSI varied significantly across age, race, and ethnicity (p<0.05). The Hispanic group had clinical severity ratings that were approximately 10.1% higher than the non-Hispanic group. This was not statistically significant (p=0.07). Conclusion: Dental anxiety scores were higher among African American low-income women compared to Caucasians. Age, sex, income, and race demonstrated to have a strong association with Dental anxiety. Having high pain sensitivity and fear of blood/injections seem to increase dental anxiety. Key words: Dental anxiety, Dental phobia / Oral Biology