Assessing dental coping strategies among fearful patients with regular and irregular dental care

Objectives: The aim of this study was to further develop and investigate a newly constructed 20 item questionnaire on strategies used by fearful adult patients with regular dental care or phobic avoidance to cope with dental treatment. Methods: The dental coping strategy questionnaire (DCSQ) was distributed among 77 individuals with dental phobic avoidance and 94 fearful patients with regular dental care. Previous factor and regression analyses showed that 3 of 4 identified factors predicted regularity or phobic avoidance of dental care. However, one of these factors was considered relating to catastrophizing thoughts and not to active coping strategies and was thus removed. Results: This 15 item version of DCSQ had an internal consistency alpha (Cronbach) of 0.81. The reduced questionnaire was analyzed to identify its factor structure and 5 factors explaining 65% of the total variance were found. The 5 factors were labelled 1) ‘self-efficacy statements’, 2) ‘self distraction’, 3) ‘distancing statements’, 4) ‘praying and dispair’, and 5) ‘optimism’. Factor 4 and to some extent factor 5 correlated significantly with dental anxiety and were assessed significantly higher and lower, respectively, among individuals with phobic avoidance. A logistic regression analysis revealed that these two factors (4 and 5), gender, and dental anxiety were predictive of regularity or phobic avoidance of dental care. Conclusions: The DCSQ showed potential to identify coping strategies among fearful patients relating to dental care behavior. However, these factors were constituted by a limited number of items and need to be futher developed. Supported by the Swedish Dental Society.