Moore R, Brødsgaard I, Mao T K, Kwan H W, Shiau Y Y, Knudsen R
Department of Oral Medicine, University of Washington, Seattle, USA.
Community Dent Oral Epidemiol. 1996 Aug;24(4):292-5. doi: 10.1111/j.1600-0528.1996.tb00862.x.
Fear of injections and reports of negative dentist behavior and associations with dental anxiety and avoidance of treatment were explored among 951 adults from dental school clinics in Iowa City, Iowa and Taipei, Taiwan. Use and fear of anesthetic injections and negative dentist behavior were assessed by written questionnaire to test associations with demographics, overall dental anxiety (Dental Anxiety Scale or "DAS") and utilization behaviors. Frequency and logistic regression analyses showed that use of dental anesthetics for routine treatment was much greater overall among caucasian Americans than Taiwanese, as was fear of injections. Taiwanese and Americans with high dental anxiety (DAS 12) had similar high fear of injections, but inspite of similar fears about dental drilling, high anxiety Taiwanese reported using much less local anesthesia for routine treatments than did high anxiety Americans. Report of condescending remarks to patients ("put downs") by dentists was mainly an American phenomenon associated with high dental anxiety. Avoidance of appointment making was high for persons afraid of injections and for Americans reporting negative dentist behavior. Avoidance was highest in subjects with high dental anxiety. That predominant characteristics or etiologies of dental anxiety can differ by cultural differences in dental health care systems, dentist beliefs and/or expectations of patients within those systems was discussed in relation to the literature.
在来自爱荷华州爱荷华市和台湾台北牙科学校诊所的951名成年人中，研究了对注射的恐惧以及关于牙医负面行为的报告，以及这些与牙科焦虑和治疗回避之间的关联。通过书面问卷评估麻醉注射的使用和恐惧以及牙医的负面行为，以测试与人口统计学、总体牙科焦虑（牙科焦虑量表或“DAS”）和使用行为之间的关联。频率和逻辑回归分析表明，美国白种人在常规治疗中使用牙科麻醉剂的总体比例远高于台湾人，对注射的恐惧也是如此。牙科焦虑程度高（DAS≥12）的台湾人和美国人对注射的恐惧程度相似，但尽管对牙钻操作的恐惧相似，但牙科焦虑程度高的台湾人在常规治疗中报告使用的局部麻醉剂比牙科焦虑程度高的美国人少得多。牙医对患者发表贬低性言论（“贬低”）的报告主要是一种与牙科焦虑程度高相关的美国现象。对于害怕注射的人和报告牙医有负面行为的美国人来说，避免预约的情况很普遍。在牙科焦虑程度高的受试者中，回避情况最为严重。结合文献讨论了牙科焦虑的主要特征或病因可能因牙科医疗保健系统的文化差异、牙医的信念和/或这些系统中对患者的期望而有所不同。
