Armfield Jason M, Ketting Manon
Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide.
Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam.
Health Psychol. 2015 Sep;34(9):929-40. doi: 10.1037/hea0000186. Epub 2014 Dec 22.
It has been proposed that avoidance of dental visits might be the main determinant of poor oral health outcomes in people with high dental anxiety (HDA). This study aimed to determine the predictors of dental avoidance among people with HDA and also whether these predictors differed from those found in people with lower dental anxiety (LDA).
Study participants (n = 596; response rate = 41.1%) comprised a random cross-sectional sample of the Australian adult population who completed a mailed self-complete questionnaire containing items relating to the use and accessibility of dental services, trust in dental professionals, dental anxiety, dental experiences, self-perceived oral health, vulnerability-related perceptions of visiting the dentist, and psychological health. Multiple imputation was used to replace missing values and statistically significant variables in bivariate analyses were entered into a multivariable logistic generalized linear model.
More than two-thirds of participants with HDA were currently avoiding or delaying a dental visit. Among people with HDA, dental avoidance was independently and significantly predicted by difficulty paying a $300 dental bill, having no or only little trust in the last-visited dentist, perceived treatment need and dental anxiety. Among people with LDA, only perceived treatment need and dental anxiety predicted avoidance.
In addition to their high anxiety, a number of additional barriers to dental visiting were found for people with HDA. These barriers, especially cost and communication issues with dentists, need to be addressed to assist people with HDA obtain necessary, regular dental care.
有人提出，避免看牙可能是导致牙科焦虑症患者口腔健康状况不佳的主要决定因素。本研究旨在确定牙科焦虑症患者中避免看牙的预测因素，以及这些预测因素是否与牙科焦虑程度较低的患者不同。
研究参与者（n = 596；回复率 = 41.1%）是从澳大利亚成年人口中随机抽取的横断面样本，他们完成了一份邮寄的自填问卷，问卷内容涉及牙科服务的使用和可及性、对牙科专业人员的信任、牙科焦虑、看牙经历、自我感知的口腔健康、与看牙相关的脆弱感以及心理健康。采用多重填补法替代缺失值，并将双变量分析中有统计学意义的变量纳入多变量逻辑广义线性模型。
超过三分之二的牙科焦虑症患者目前正在避免或推迟看牙。在牙科焦虑症患者中，支付300美元牙科账单困难、对上次就诊的牙医没有或仅有很少信任、感知到的治疗需求以及牙科焦虑是独立且显著的避免看牙的预测因素。在牙科焦虑程度较低的患者中，只有感知到的治疗需求和牙科焦虑可预测避免看牙。
除了高度焦虑外，还发现牙科焦虑症患者存在一些额外的看牙障碍。这些障碍，尤其是费用问题以及与牙医的沟通问题，需要得到解决，以帮助牙科焦虑症患者获得必要的定期牙科护理。
