Exploring high dental anxiety subtypes using cluster analysis approach: a cross-sectional study.

Area of Science:

• Psychology
• Dentistry
• Public Health

Background:

• Dental anxiety (DA) stems from external experiences and internal vulnerabilities.
• Factors combining to cause high DA in adults remain unclear.
• Identifying DA subtypes can inform targeted interventions.

Purpose of the Study:

• To identify empirical subtypes of high dental anxiety.
• To compare these subtypes based on oral health, care-seeking, and treatment preferences.
• To understand the interplay of exogenous and endogenous factors in DA.

Main Methods:

• Cross-sectional online survey of 399 Japanese adults with high DA.
• Two-step cluster analysis using exogenous (e.g., distressing experiences) and endogenous (e.g., fear of pain) variables.
• Comparison of clusters using chi-square and Mann-Whitney U tests for demographics, oral health, and treatment preferences.

Main Results:

• Two DA subtypes emerged: Cluster 1 (Trauma & Catastrophizing) and Cluster 2 (Latent-Trait Driven).
• Cluster 1 reported distressing dental events and higher pain catastrophizing.
• Cluster 2 had fewer dental visits and less interest in treatment, with no reported trauma.

Conclusions:

• Two distinct DA phenotypes were identified: 'Trauma & Catastrophizing' and 'Latent-Trait Driven'.
• Tailored strategies, including trauma-informed exposure and sensory-adapted engagement, may improve oral healthcare uptake.
• Future research should incorporate broader endogenous indicators to refine subtype classifications.