Differences in ethnic beliefs about the perceived need for local anesthesia for tooth drilling and childbirth labor were surveyed among Anglo-Americans, Mandarin Chinese, and Scandinavians (89 dentists and 251 patients) matched for age, gender, and occupation. Subjects matched survey questionnaire items selected from previously reported interview results to estimate (a) their beliefs about the possible use of anesthetic for tooth drilling and labor pain compared with other possible remedies and (b) the choice of pain descriptors associated with the use of nonuse of anesthetic, including descriptions of injection pain. Multidimensional scaling, Gamma, and Chi-square statistics as well as odds ratios and Spearman's correlations were employed in the analysis. Seventy-seven percent of American informants reported the use of anesthetics as possible remedies for drilling and 51% reported the use of anesthetics for labor pain compared with 34% that reported the use of anesthetics among Chinese for drilling and 5% for labor pain and 70% among Scandinavians for drilling and 35% for labor pain. Most Americans and Swedes described tooth-drilling sensations as sharp, most Chinese used descriptors such as sharp and "sourish" (suan), and most Danes used words like shooting (jagende). By rank, Americans described labor pain as cramping, sharp, and excruciating, Chinese used words like sharp, intermittent, and horrible, Danes used words like shooting, tiring, and sharp, and Swedes used words like tiring, "good," yet horrible. Preferred pain descriptors for drilling, birth, and injection pains varied significantly by ethnicity. Results corroborated conclusions of a qualitative study about pain beliefs in relation to perceived needs for anesthetic in tooth drilling. Samples used to obtain the results were estimated to approach qualitative representativity for these urban ethnic groups.
Little attention has been given to the issue of the age of onset of dental anxiety, even though it may have a bearing on the origins of this type of fear. This study aimed to identify the age of onset of dental anxiety and to identify differences by age of onset with respect to potential etiological factors, such as negative dental experiences, family history of dental anxiety, and general psychological states. Data were collected by means of two mail surveys of a random sample of the adult population. Of 1420 subjects returning questionnaires, 16.4% were dentally anxious. Half, 50.9%, reported onset in childhood, 22.0% in adolescence, and 27.1% in adulthood. Logistic regression analyses indicated that negative dental experiences were predictive of dental fear regardless of age of onset. A family history of dental anxiety was predictive of child onset only. Adolescent-onset subjects were characterized by trait anxiety and adult-onset subjects by multiple severe fears and symptoms indicative of psychiatric problems. The three groups were similar in terms of their physiological, cognitive, and behavioral responses to dental treatment. However, adolescent- and adult-onset subjects were more hostile toward and less trusting of dentists. These results indicate that child-onset subjects were more likely to fall into the exogenous etiological category suggested by Weiner and Sheehan (1990), while adult-onset subjects were more likely to fall into the endogenous category.
Using an expectancy value approach, personal and normative beliefs about the outcome of using dental floss and drinking non-sugared mineral water were studied in a sample of 970 15-year-old adolescents in the county of Hordaland in Norway. The data stem from a survey performed in October 1992. A detailed analysis of these beliefs provides information about which of them should be targeted in a persuasive communication directed at changing behavior. The adolescents evaluated six outcomes of each behavior in terms of how much they wanted or feared them, and rated the probability of each outcomes happening. The adolescents also rated the probability that four significant referents would approve the performance of each behavior and how much they valued the approval of each referent. Subjects with relatively strong and relatively weak intentions to use dental floss and to drink non-sugared mineral water (intenders and non-intenders) were compared with respect to their scores on each measure. A one-way analysis of variance showed consistent differences between intenders and non-intenders. Intenders were more likely to believe that the specified behaviors would result in positive outcomes and they evaluated these outcomes as more desirable than non-intenders. Intenders believed their referens, in particular dentists and parents, to be more concerned about whether or not to perform the specified behaviors than non-intenders. The most promising candidates for persuasive communication among behavioral beliefs with respect to the specified behaviors appeared to be reduced tooth decay and several non, health beliefs in terms of immediate social and sensory concerns.
The aim of this article was to report on the attitudes, opinions and confidences of final year dental students in three European schools towards the restoration of posterior teeth and in particular towards the use of amalgam and resin composite. One hundred and twenty-eight pre-piloted questionnaires were distributed to final year dental students in Cardiff, Dublin and Malmö. The questionnaire sought information relating to various opinions and attitudes towards the use of amalgam and resin composite in posterior teeth. Information was returned anonymously. Ninety-one completed questionnaires were returned (response rate=71%; Cardiff: n =40, Dublin: n=24, Malmö: n=27). Ninety-three per cent of Malmö students (n=24), 67% of Dublin students (n=16) and 60% of Cardiff students (n=24) reported that they feel confident when placing posterior resin composites. One hundred per cent of Malmö students (n=27), 75% of Cardiff students (n=30) and 33% of Dublin students (n=8) would prefer to have a resin composite rather than amalgam, placed in one of their own posterior teeth. Eighty-five per cent of Malmö students (n=23), 30% of Cardiff students (n=12) and 25% of Dublin students (n=6) perceive amalgam as being harmful to the environment. For the restoration of a posterior tooth in a pregnant female, 44% of students (n=40) would place a resin composite restoration, and 7% (n=6) would place an amalgam restoration, while 32% (n=29) would place a temporary restoration. Students at Malmö report that they place more posterior resin composites and have greater confidence at placing posterior resin composites than students at Cardiff or Dublin. There was confusion relating to the choice of restorative materials for pregnant females. Large variations in restorative strategies among graduates must be considered as dental professionals can practice in all countries within the European Union.
During the last 3 decades, large resources have been allocated through the organized dental care system for the improvement of dental health among children and teenagers in Sweden. The aim of this study was to describe attitudes related to dental health and dental care among 20 to 25-year-old Swedes. A random sample of 650 individuals was drawn from the database of the National Social Insurance Board of Sweden. A postal questionnaire comprising 70 questions was delivered to the subjects and the response rate was 78%. A high proportion of the respondents considered themselves to have a high need for dental care. They had a strong conception of being able to influence their own dental health. Quite a few were concerned about their dental health. A high proportion indicated that they were satisfied with their dental function, but fewer individuals were satisfied with the appearance of their teeth. The respondents also reported good reception by their dentists, although opinions differed between the sexes. Women reported a significantly higher degree of discomfort and unease than men. Most respondents had adopted good oral hygiene habits but dental floss was rarely used. The majority of subjects indicated that they attended dental examinations on an annual basis. There is a need for further investigation into patients' attitudes to dental health and dental care. It is important to understand the significance patients attach to different concepts in the dental treatment. This would enhance our understanding of how the concept of felt need is expressed and transformed into demand for care.