The experience of the anxious patient in a student dental clinic

Dental anxiety and fear have been found to play a central role in the avoidance of dental treatment. The prevalence of high dental fear in Australian adults is approximately 16%, which has implications for appointment cancellations, impaired health outcomes and heightened perceptions of oral pain. The current study examined the self-reported responses of new patients seeking treatment at a student dental clinic. The Modified Dental Anxiety Scale (MDAS) was used to measure anxiety levels prior to and post appointment. Data was also collected on the type of procedure undergone, and on clinical factors which influence the levels of apprehension experienced by patients. Clinical factors included time length of appointment, clinical environment, interpersonal skill and clinical ability of the student, supervisor presence, client participation in the procedure (holding suction). Participants totalled 102, 56 male, 43 female. The majority of patients visited the clinic for non-invasive procedures such as first check-up and intra-oral x-rays, scale and clean, and diagnostic pulp testing. Complex treatments were primarily defined as those that required a local anaesthesia injection. The mean MDAS score from the pre-treatment questionnaire was 1.92 (SD=1.15), in comparison to the posttreatment mean score of 1.23 (SD=0.64). Using repeated measures ANOVA, there was a significant effect for time (pre/post treatment), calculated using Wilks' Lambda=.25, F (1,100) = 39.28.17, p < .0005, multivariate partial eta squared = .282. Post survey results showed that the "Interpersonal Skills of the Student" and "Clinical ability of the student" were most often cited as making patients less anxious (50% and 40.2% respectively); with the time length of the appointment being cited by 11.8% of patients as making them more anxious. Females had a higher mean score for MDAS than males and reported significantly higher levels of anxiety for the specific treatment of "Scale and Polish". Bivariate regressions indicated that type of treatment received did not predict post MDAS anxiety. The complexity of treatments received by the participants is a limitation to this study, as third year undergraduate students, who are unable to practise the full scope of dental procedures, primarily treated the participants