Fear of dental treatment and its possible effects on oral health

Working with 59 ambulant patients (average age 42 +/- 16 years), male and female, at the Dental Clinic of the University of Mainz, questions concerning fear of treatment were raised, and the answers compared with clinical findings on the status of oral health and with habits of oral hygiene. Pulse and blood pressure were also measured before and after treatment. 65% of the patients reported some level of fear of dental treatment. Younger patients had significantly more fear of treatment than older patients (p <0.05, Fisher-test). Patients reported the noise and vibration of the drill (56%), the sight of the injection needle (47%) and sitting at the treatment chair (42%) as especially fear provoking. As subjective elements of their fear, the patients reported muscle tension (64%), higher heart-beat (59%), accelerated breathing (37%), sweating (32%), and stomach cramps (28%). Among fearful patients, greater changes in pulse rate (>10 beats/min) and changes in blood pressure were measured. Oral health correlated with levels of fear only for younger patients. Although the frequency of caries (DMF/T) and the degree of treatment need (CPITN) showed a significant correlation (p >0.005) with subjective fear of treatment among patients under 35 years of age, the correlation weakens with increasing age of the patients studied. The present findings strongly suggest the need for more prophylactic measures, and dental education, in kindergartens and elementary schools. By such means, a considerable improvement in levels of oral hygiene might be achieved, together with lower levels of fear of dental treatment.