ترس از دندانپزشکی با و بدون ترس از تزریق خون: مفاهیم برای سلامت دندان و عملکرد بالینی

The relation between dental, blood and injection fear and oral health was examined in 936 New Zealand 18-year-olds. Of the approximately ten percent (n=96) of the sample who reported a dental fear, 1 in 10 also reported a fear of blood and 53% a co-morbid fear of injections. Study members with dental fear alone or co-morbid dental and blood or injection fear had significantly worse oral health (i.e. greater caries experience) than a no-fear comparison group or individuals with blood-injection fear only. Further, individuals with dental and blood or injection fear had a significantly higher level of recent tooth decay than individuals with dental fear alone. Time since last dental treatment also tended to be highest in this group. Implications for dental health and practice were discussed.

Despite continued interest in the relation between dental fear and blood-injury-injection (BII) fears, their combined impact on dental health is not well understood. Past research has examined overlap among these fears in an attempt to explain fear of the dentist (e.g. Fiset et al., 1989). That is, does dental anxiety result from specific learning experiences (e.g. dental trauma) or is it part of a more generalized anxiety syndrome (e.g. Fiset et al., 1989; Roy-Byrne et al., 1994; Weiner and Sheehan, 1990)? More recently, the nature and extent of this co-morbidity has been examined in the hope of improving clinical practice. Locker et al. (1997) hypothesized that patients with dental anxiety and blood-injury (BI) fears may be more difficult to treat than those with dental fear alone due to the potential for more extreme fear reactions in those with multiple fears. This was expected due to the characteristic fainting response seen in most individuals with BII fears ( Kleinknecht et al., 1990).