Anxiety in Dental Patients Before and After Tooth Extraction

An interesting article titled “Assessment of general pre and post operative anxiety in patients undergoing tooth extraction a prospective study,” appears in the British Journal of Oral and Maxillofacial Surgery and written by Pia López-Jornet and et al. (vol. 52, pp. 18-23, 2014). The article sought to explore the amount of anxiety and fear before, immediately after, and one week after dental extraction. The researchers included 70 patients in their study.

It is known that fear and anxiety in dentistry is usually associated with poor oral health and poor oral health related quality of life. Some studies have shown that those with lower socioeconomic status and with less education have more anxiety but others have shown those with more education have more anxiety. The researchers believe that oral surgery is stressful for patients and that anxiety fluctuates over time. They feel dental anxiety can be assessed with self-reported scales including the Spielberger’s State-Trait Anxiety Inventor (STAI), the Modified Dental Anxiety Scale (MDAS), and the Dental Fear Survey (DFS).

The patients included in the study were healthy, with no serious medical conditions or blood dyscrasias. Patients who presented with acute infections were excluded, as well as those with psycho-organic or behavioural disorders, or those with language or cognitive problems. The teeth were extracted under normal conditions
(local anaesthesia only, with no premedication or sedation).

There were significant differences in the STAI-Traitscale between before and 7 days after extraction (p = 0.04), and in the MDAS between before and immediately after extraction (p = 0.02),and between immediately after and 7 days after extraction (p = <0.001). The DFS also differed between before and immediately after extraction
(p = 0.002), and between immediately and 7 days after extraction (p <0.001). P values less than 0.05 were taken as significant.

In the article the authors state

“Humphris et al. referred to anxiety as an “aversive psychological construct”, unpleasant to experience and almost always associated with a specific event, which takes time to dissipate. This is supported by our findings as scores improved by the 7-day follow-up. Our patients reported less anxiety a week after the operation in all tests; this may result from rapid recuperation, given that no patients developed any complications.”

The authors point out a few limitations of their study including no control group being used and a short follow-up time after dental extraction.

3 thoughts on “Anxiety in Dental Patients Before and After Tooth Extraction”

  1. You make a lot of valid points here. Many people often experience a wave of anxiety before their visit to the dentist, especially if something like a tooth extraction is scheduled. The studies you discuss here are very insightful and well explained. Awesome post! Thanks so much for sharing!

  2. I just had my remaining 7 upper teeth removed and now I have severe panic attacks almost a week later.

  3. while I was having my tooth pulled the dentist and his assistant were arguing..that did not help my anxiety …and now 3 weeks later ..still feeling drained and anxious….

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