Dental anxiety and alexithymia: Gender differences

Abstract

Objective. Alexithymia refers to a personality construct that is characterized by impoverishment of imagination, poor capacity for symbolic thought, and inability to experience and describe feelings. Our aim was to investigate the association of alexithymia and dental anxiety in patients attending dental practice. A further aim was to discover whether gender differences exist in this association when adjusting for the effect of age. Material and Methods. The data were collected among adult (18+ years) patients attending the public dental health centers in Pori, Finland. Patients received a questionnaire assessing dental anxiety (Modified Dental Anxiety Scale, MDAS), alexithymia (20-item Toronto Alexithymia Scale, TAS-20), and demographic profile. Total score and scores for three TAS factors: 1) “difficulty identifying with feelings”, 2) “difficulty describing feelings”, and 3) “externally orientated thinking”, were computed. Results. Of 823 patients, 81% correctly completed the questionnaires. Nine percent belonged to the high anxiety (MDAS score 19 or higher) group and 7% reported alexithymia (total score 61 or higher). The prevalence of alexithymia was 15.5% among those reporting high dental anxiety compared with 5.9% among those reporting low dental anxiety (p=0.005). Those with high dental anxiety scored higher in TAS factor 1 than those with lower dental anxiety. No statistically significant bivariate associations with other TAS factors were found. When adjusting for the effect of age and gender, the association between TAS factors and dichotomized MDAS was significant in all TAS scores except TAS factor 3. Conclusions. In a sample representing Finnish adult dental patients, alexithymia was associated with dental anxiety.