Situational Control: Differences Between Experiences & Desires Of Adolescent Dental Patients

Enhancing control is fundamental to enhancing comfort and preventing the development of fears in young dental patients. Previous work (Behaviour Res Ther 1992;30:367–373) demonstrated that adolescent dental patients who lacked control were less likely to be willing to return for care. Objectives: In this study we investigated the experiences of 760 Australian adolescents (mean age 13) who were being seen for dental care, and asked the youths to rate various modes of enhanced control for use at the next dental visit. Methods: The subjects completed the Child Dental Control Assessment (CDCA), Children’s Dental Fear Survey Schedule (CFSS-DS), and the State-Trait Anxiety Inventory for Children (STAI-C, form C-2). Results: Mean CFSS-DS score was 24.3 (SD 6.8); 30.5% had scores >36 indicating high dental fear. Adolescents with high CFSS-DS scores also had greater STAI-C and CDCA scores (higher need for control). Each CDCA item consists of a statement reflecting past dental experiences and a statement reflecting desired control in future dental situations. For 8 of the 10 most popular coping strategies, fearful patients less frequently reported that dentists performed supportive behaviors in the past (ex., the dentist answered questions my questions). And, the fearful patients wanted this support in the future more than non-fearful patients (interaction effects, all Ps<.026). The difference between what was experienced and the preference for control at the next appointment was greater for fearful than for non-fearful subjects. Conclusions: The results suggest that discrepancies between adolescents’ desire for control in dental settings and dentists’ behaviors may increase the young patient’s level of anxiety. Supported, in part, by Grant No. DE 09743 to the Regional Clinical Dental Research Center from NIH/NIDCR.