Dental professional recognition of dental anxiety from a patient perspective: a grounded theory study

Authors

  • Markus Höglund Center for Orofacial Medicine, Public Dental Service Östergötland, Linköping, Sweden; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden https://orcid.org/0000-0001-7655-6521
  • Inger Wårdh Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Academic Center of Geriatric Dentistry, Stockholm, Sweden; Department of Health Sciences, University of Karlstad, Karlstad, Sweden https://orcid.org/0000-0003-0939-802X
  • Shervin Shahnavaz Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden https://orcid.org/0000-0002-7296-4920
  • Carina Berteröf Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden https://orcid.org/0000-0003-1588-135X

DOI:

https://doi.org/10.2340/aos.v83.42447

Keywords:

Dental anxiety, dental staff, identification, patients perspective, qualitative study

Abstract

Objective: To explore patients’ experiences of dental staff recognising their dental anxiety.

Material and Methods: Semi-structured interviews were conducted with 10 adults who identified themselves as dentally anxious. The sampling of study participants was purposive, and the audio-recorded interviews were transcribed verbatim. Classical grounded theory and constant comparative analysis were used to analyse the interview data inductively. Theoretical saturation was reached after eight interviews.

Results: Hope for ‘Fingerspitzengefühl’ from the dental staff emerged as the core category, which means having an intuitive instinct about a situation and knowing how to react to it. It also is tact or sensitivity that comes with experience. The foundation for this core was four categories: Dental anxiety causes involuntary signals, Strategies to minimise contact, Seen and respected by the staff, and Recognisable strategies. The interviewees hoped that the dental staff would notice their dental anxiety and understand their feelings of shame, and take relevant actions to alleviate their anxiety.

Conclusions: Dentally anxious patients often struggle to express their anxiety but hope to find a dentist with Fingerspitzengefühl. The result cannot be generalised but transferred to a similar population.

Downloads

Download data is not yet available.

References

Silveira ER, Cademartori MG, Schuch HS, Armfield JA, Demarco FF. Estimated prevalence of dental fear in adults: a systematic review and meta-analysis. J Dentistry. 2021;108:103632. https://doi.org/​10.1016/j.jdent.2021.103632 DOI: https://doi.org/10.1016/j.jdent.2021.103632

Cohen SM, Fiske J, Newton JT. The impact of dental anxiety on daily living. Br Dent J. 2000;189(7):385–90. https://doi.org/10.1038/sj.bdj.4800777 DOI: https://doi.org/10.1038/sj.bdj.4800777a

Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Aust Dent J. 2013;58(4):390–407. https://doi.org/10.1111/adj.12118 DOI: https://doi.org/10.1111/adj.12118

Höglund M, Bågesund M, Shahnavaz S, Wårdh I. Evaluation of the ability of dental clinicians to rate dental anxiety. Eur J Oral Sci. 2019;127(5):455–61. https://doi.org/10.1111/eos.12648 DOI: https://doi.org/10.1111/eos.12648

Kankaala T, Rajavaara P, Kestilä M, Väisänen M, Vähänikkilä H, Laitala ML, et al. Methods helping dentists to detect dental fear. Int Dent J. 2023;73(2):228–34. https://doi.org/10.1016/j.identj.2022.06.018 DOI: https://doi.org/10.1016/j.identj.2022.06.018

AlMuhaish L, AlArfaj A, AlGhannam M, AlMutiri H, Abuhassan S, Asiri A, et al. Dental anxiety screening and management practices in dental practice in Eastern Province, Saudi Arabia. Patient Prefer Adher. 2022;16:3429–39. https://doi.org/10.2147/PPA.S393399 DOI: https://doi.org/10.2147/PPA.S393399

Steenen SA, Zeegers MAJ, van Wijk AJ, Al-Zubaidi S, Jethu-Ramkrishan M, Loddin A, et al. Dentist empathic accuracy is associated with patient-reported reassurance. Int Dent J. 2023;73(1):101–7. https://doi.org/10.1016/j.identj.2022.06.009 DOI: https://doi.org/10.1016/j.identj.2022.06.009

Höglund M, Wårdh I, Shahnavaz S, Berterö C. Dental clinicians recognizing signs of dental anxiety: a grounded theory study. Acta Odontol Scand. 2023;81(5):340–8. https://doi.org/10.1080/00016357.2022.2154263 DOI: https://doi.org/10.1080/00016357.2022.2154263

Glaser BG. Theoretical sensitivity: advances in the methodology of grounded theory. 1978, p. 164. Sociology Press, Mill Valley, California https://doi.org/1884156010

Glaser BG, Strauss AL. The siscovery of grounded theory: strategies for qualitative research. New York, NY: Aldine de Gruyter; 1967.

Hill CE, Thompson BJ, Hess SA, Knox S, Williams EN, Ladany N. Consensual qualitative research: an update. J Counsel Psychol. 2005;52(2):196–205. https://doi.org/10.1037/0022-0167.52.2.196 DOI: https://doi.org/10.1037/0022-0167.52.2.196

World Medical Association. World Medical Association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4. https://doi.org/10.1001/jama.​2013.281053 DOI: https://doi.org/10.1001/jama.2013.281053

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57. https://doi.org/10.1093/intqhc/mzm042 DOI: https://doi.org/10.1093/intqhc/mzm042

Humphris GM, Morrison T, Lindsay SJ. The modified dental anxiety scale: validation and United Kingdom norms. Community Dent Health. 1995;12(3):143–50.

Fingerspitzengefühl [cited 2024-04-29]. Available from: https://www.dw.com/en/fingerspitzengefühl/a-16426633

Moore R, Brødsgaard I, Rosenberg N. The contribution of embarrassment to phobic dental anxiety: a qualitative research study. BMC Psychiatry. 2004;4:10. https://doi.org/10.1186/1471-244X-4-10 DOI: https://doi.org/10.1186/1471-244X-4-10

Jaakkola S, Rautava P, Saarinen M, Lahti S, Mattila ML, Suominen S, et al. Dental fear and sense of coherence among 18-yr-old adolescents in Finland. Eur J Oral Sci. 2013;121(3pt2):247–51. https://doi.org/10.1111/eos.12006 DOI: https://doi.org/10.1111/eos.12006

Hayes SC, Hofmann SG. ‘Third-wave’ cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry. World Psychiatry. 2021;20(3):363–75. https://doi.org/10.1002/wps.20884 DOI: https://doi.org/10.1002/wps.20884

Wampold BE. How important are the common factors in psychotherapy? An update. World Psychiatry. 2015;14(3):270–7. https://doi.org/10.1002/wps.20238 DOI: https://doi.org/10.1002/wps.20238

Berggren U. Dental fear and avoidance: a study of etiology, consequences and treatment. University of Gothenburg, Gothenburg; 1984. DOI: https://doi.org/10.14219/jada.archive.1984.0328

Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007;7:1. https://doi.org/10.1186/1472-6831-7-1 DOI: https://doi.org/10.1186/1472-6831-7-1

Wang MC, Vinall-Collier K, Csikar J, Douglas G. A qualitative study of patients’ views of techniques to reduce dental anxiety. J Dent. 2017;66:45–51. https://doi.org/10.1016/j.jdent.2017.08.012 DOI: https://doi.org/10.1016/j.jdent.2017.08.012

Yuan S, Freeman R, Hill K, Newton T, Humphris G. Communication, trust and dental anxiety: a person-centred approach for dental attendance behaviours. Dent J. 2020;8(4):118. https://doi.org/10.3390/dj8040118 DOI: https://doi.org/10.3390/dj8040118

Bernson JM, Hallberg LRM, Elfström ML, Hakeberg M. ‘Making dental care possible: a mutual affair’: a grounded theory relating to adult patients with dental fear and regular dental treatment. Eur J Oral Sci. 2011;119(5):373–80. https://doi.org/10.1111/j.1600-0722.​2011.00845.x DOI: https://doi.org/10.1111/j.1600-0722.2011.00845.x

Kulich KR, Berggren U, Hallberg LRM. Model of the dentist-patient consultation in a clinic specializing in the treatment of dental phobic patients: a qualitative study. Acta Odontol Scand. 2000;58(2):63–71. https://doi.org/10.1080/000163500429307 DOI: https://doi.org/10.1080/000163500429307

Additional Files

Published

2024-12-18