Rami Kankaanpää1,2,3, Juha Auvinen4,5,6, Kari Rantavuori7, Jari Jokelainen4,5,6, Jaro Karppinen4,6,8, Satu Lahti1,9. 1. Department of Community Dentistry, University of Turku, Turku, Finland. 2. Oral and Maxillofacial Deceases, Tampere University Hospital, Tampere, Finland. 3. Oral Health Services, City of Tampere, Tampere, Finland. 4. Center for Life Course Health Research, University of Oulu, Oulu, Finland. 5. Unit of Primary Care, Oulu University Hospital, Oulu, Finland. 6. Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland. 7. Department of Oral Development and Orthodontics, University of Turku, Turku, Finland. 8. Finnish Institute of Occupational Health, Oulu, Finland. 9. Turku Clinical Research Centre, Turku University Hospital, Turku, Finland.
Abstract
INTRODUCTION: Dental fear is a prevalent problem leading to severe deterioration of oral health and health-related quality of life. Despite the knowledge that dental fear is closely linked to painful experience, the association between pain sensitivity and dental fear remains unclear. This study was designed to evaluate this association with validated measures of dental fear and pressure pain sensitivity in a cohort population. METHODS: The study population consisted of a subpopulation of the Northern Finland Birth Cohort 1966. At the age of 46 years, 1736 participants completed the valid and reliable Modified Dental Anxiety Scale (MDAS) and participated in a clinical examination, where their nonorofacial pressure pain sensitivity was evaluated by validated pressure pain threshold (PPT) and tolerance (PPTo) measurements. Gender-specific Tobit regressions were performed to analyse this association adjusted for smoking and depressive and anxiety symptoms. RESULTS: Women with moderate dental fear had 5% (31.3 kPa; P < 0.05), and women with high dental fear had 7% (42.9 kPa; n.s.) lower pressure pain threshold than women with low dental fear. Women with moderate dental fear had 4% (35.4 kPa; P < 0.05) and women with high dental fear had 9% (82.7 kPa; P < 0.01) lower pressure pain tolerance than women with low dental fear. Men with moderate and high dental fear had 3% lower pressure pain tolerance (35.4 kPa; P < 0.05 and 29.6 kPa; n.s., respectively) than men with low dental fear, whereas the associations with pain threshold were not statistically significant. Among women, both anticipatory and treatment-related dental fears were associated with pain threshold and pain tolerance. Among men, pain threshold was associated with treatment-related dental fear only and the associations with pain tolerance were not statistically significant. CONCLUSIONS: Nonorofacial pressure pain threshold and tolerance appeared to be lower in participants with dental fear, which emphasizes the role of pain sensitivity in dental fear.
INTRODUCTION: Dental fear is a prevalent problem leading to severe deterioration of oral health and health-related quality of life. Despite the knowledge that dental fear is closely linked to painful experience, the association between pain sensitivity and dental fear remains unclear. This study was designed to evaluate this association with validated measures of dental fear and pressure pain sensitivity in a cohort population. METHODS: The study population consisted of a subpopulation of the Northern Finland Birth Cohort 1966. At the age of 46 years, 1736 participants completed the valid and reliable Modified Dental Anxiety Scale (MDAS) and participated in a clinical examination, where their nonorofacial pressure pain sensitivity was evaluated by validated pressure pain threshold (PPT) and tolerance (PPTo) measurements. Gender-specific Tobit regressions were performed to analyse this association adjusted for smoking and depressive and anxiety symptoms. RESULTS:Women with moderate dental fear had 5% (31.3 kPa; P < 0.05), and women with high dental fear had 7% (42.9 kPa; n.s.) lower pressure pain threshold than women with low dental fear. Women with moderate dental fear had 4% (35.4 kPa; P < 0.05) and women with high dental fear had 9% (82.7 kPa; P < 0.01) lower pressure pain tolerance than women with low dental fear. Men with moderate and high dental fear had 3% lower pressure pain tolerance (35.4 kPa; P < 0.05 and 29.6 kPa; n.s., respectively) than men with low dental fear, whereas the associations with pain threshold were not statistically significant. Among women, both anticipatory and treatment-related dental fears were associated with pain threshold and pain tolerance. Among men, pain threshold was associated with treatment-related dental fear only and the associations with pain tolerance were not statistically significant. CONCLUSIONS: Nonorofacial pressure pain threshold and tolerance appeared to be lower in participants with dental fear, which emphasizes the role of pain sensitivity in dental fear.
Authors: Mohammad Wazzan; Mohammed Estaitia; Sima Habrawi; Dina Mansour; Zain Jalal; Hadir Ahmed; Hayder A Hasan; Sausan Al Kawas Journal: Acta Biomed Date: 2022-01-19