The association between dental anxiety, general clinical anxiety and depression among Finnish university students.

BACKGROUND Few studies have examined the association between dental fear, anxiety and depressive disorders. The aim of this study was to evaluate the association between dental anxiety, general clinical anxiety and depression among Finnish university students. METHODS During autumn 2007, a Modified Dental Anxiety Scale (MDAS) questionnaire was emailed to 1,551 new students at four Finnish universities willing to participate in this study. The following year, the same study group was asked to repeat the MDAS questionnaire, along with two additional tests: Beck's Anxiety Inventory (BAI), a test to assess the level of general clinical anxiety, and Beck's Depression Inventory (BDI), a test measuring depression. Levels of clinical anxiety and depression were compared with the subgroups related to levels of dental anxiety. The anticipatory and treatment aspects of dental anxiety were derived from the MDAS questionnaire. RESULTS The mean age of the respondents was 25 years. Of the respondents, 99 (11.3%) were classified as dentally anxious patients. Among females, the higher dental anxiety was statistically significantly associated with higher levels of clinical anxiety (p<0.000) and depression (p<0.000), while in males, dental anxiety was only associated with clinical anxiety (p=0.016). For the factors of dental anxiety, only anticipatory dental anxiety was related with clinical anxiety (p=0.004) or depression (p=0.034) in males. In females, anticipatory and treatment dental anxiety were associated with clinical anxiety and depression (all with p<0.001). CONCLUSIONS In severe forms of dental fear, a dentist should recommend that patients seek help from mental health professionals, who are trained to recognize the psychiatric disorders that may be underlying in cases of dental fear.