Behavior-associated self-report items in patient charts as predictors of dental appointment avoidance

Dentally anxious patients with long-term avoidance behavior may experience treatment complications and induce stress in the dentist. Since dental anxiety scales are seldom used clinically, it is valuable to investigate the strength of behavior-associated items in the current patient chart in predicting canceled or missed appointments. Charts from a sample of patients (N=357) who visited the UCLA Dental Center January 2006 to June 2006 were examined for self-reports of depression, moodiness, nervousness, and anxiety. Multivariate regression indicated that reported feelings of depression, moodiness, and prior appointment avoidance due to fear were strong predictors for canceled or missed appointments. Reported anxiety or nervousness did not predict missed appointments. Although studies have shown that anxious patients who have completed behavioral-cognitive therapy were more likely to maintain regular dental care, the lack of prediction from anxiety or nervousness implies that dental anxiety may not play a direct role in patient compliance with attending dental appointments. By examining the relation of additional temperaments to appointment avoidance, a self-report questionnaire can be developed to identify patients with emotional distress and tailor interventions to decrease missed appointments.