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Aim: To assess the prevalence of dental avoidance due to dental fear and economic burden and its distribution by utilization of dental care and socio‐behavioural characteristics. Method: A sample of 9052 Norwegian adults aged 25–35 years was invited to participate, and 2551 completed electronic questionnaires regarding lifetime prevalence of dental avoidance due to fear and last year prevalence of dental avoidance due to economic burden. Results: Cancelled‐ and avoided ordering appointments due to fear amounted to 14.7% and 30.5%, respectively. Avoidance of dental visits due to cost was 37.7%. Frequency of cancelled appointments due to fear was 30% and 16.6% among participants attending dental care several times annually and seldom, respectively. Multiple logistic regression revealed that avoiding dental visits due to cost was less likely among participants with higher household income (OR 0.4, 95% CI 0.3–0.5) and more likely among participants with dental care need (OR 1.8, 95% CI 1.2–2.7). Cancelled and avoided appointments due to fear was most likely among those with need for dental care and lower education. Early unpleasant experience with dental care remained a covariate of avoidance behaviour due to fear. Conclusion: 14.7%, 30.5%, and 37.7% confirmed cancelled appointments due to fear, avoided ordering appointments due to fear, and avoided visiting the dentist due to cost. Avoiding dental care due to fear and economic burden was more and less common among participants with respectively, frequent and seldom use of dental care. Dental avoidance behaviours were highest among socially disadvantaged groups, indicating a hole in the welfare state model that needs political consideration. [ABSTRACT FROM AUTHOR]

Objective: To evaluate quality-of-life (QoL), before and after cognitive behavioral therapy (CBT) in patients diagnosed with intra-oral injection phobia according to DSM-IV and to compare with the general population. This study also aimed to evaluate if QoL was associated with self-reported injection anxiety, dental anxiety, time since last dental treatment and oral health., Materials and Methods: Subjects were 55 patients (mean age 35.5 ± 12.2, 78.2% women) who participated in a treatment study in which 89% managed an intra-oral injection at 1 year follow-up. The patients completed a set of questionnaires including Quality of Life Inventory (QOLI), Injection Phobia Scale-Anxiety, Dental Anxiety Scale and a single-item question assessing self-perceived oral health. Objective measures of oral health and treatment needs were based on clinical examination. QOLI-scores from a non-clinical sample were used for comparison., Results: Before treatment the general and health specific QoL were lower among intra-oral injection phobics than in the non-clinical sample. At 1 year follow-up the QoL in general had improved significantly and was similar to that of the non-clinical sample. Poor self-reported oral health and long-term avoidance of dental treatment were associated with lower general and health-specific QoL. Self-reported injection anxiety and dental anxiety were not associated with QoL., Conclusions: Patients with intra-oral injection phobia report lower QoL compared with a general population. Phobia treatment seems to increase QoL to normative levels. Self-perceived poor oral health is associated with reduced QoL in these patients.

Objective: To describe oral health and oral treatment needs in a group of dental phobic patients (DSM-IV) and to explore possible relationships between these factors and changes in self-reported dental anxiety before and after phobia treatment., Material and Methods: Forty patients (25 women) fulfilling the DSM-IV criteria for specific phobia were included in the study. Mean age of the group was 34.9 years (range 19-60) and mean dental avoidance was 11.2 years (range 3-30 years). They were treated with cognitive behavioral therapy (CBT) during either one session (3 h) or five sessions (1 h each). Oral health was evaluated by orthopantomogram and clinical examination. The outcome of the CBT was measured by the change in dental anxiety scores (DAS, DFS) and in positive and negative thoughts during a standardized dental behavior test from pretreatment to 1-year follow-up., Results: Mean (SD) DMFT was 16.5 (5.8), range 3-26; DT was 6.6 (4.2). Mean number of teeth with dental treatment need (restorative, periodontal, extractions, etc.) was 9.6 (6.9), range 1-28. There were statistically significant correlations between number of decayed teeth and decrease in negative thoughts (r=-0.39, p=0.048) and maximum anxiety (r=-0.65, p=0.001). The total number of teeth with treatment need correlated with an increase in positive thoughts (r=0.60, p=0.001) and decrease in maximum anxiety (r=0.50, p=0.015)., Conclusions: There are large variations in oral health and treatment needs among patients fulfilling the DSM-IV criteria for dental phobia. Patients with the best dental health and lowest treatment needs experience the largest increase in positive cognitions during exposure to dental treatment at 1-year follow-up.