Fear of Injections among Norwegian 18-yr-olds

Objectives: To determine the prevalence of fear of intra- and extra-oral injections and combinations of these, and to explore a possible relationship to avoidance of dental treatment. Methods: A randomised sample (N=1199, 528 males) of 18-yr-olds in 2001 completed questionnaires in classrooms. Fear of injections (intraoral local anesthesia and extraoral blood draws) was measures on 100 mm VAS-scales. Avoidance of dental treatment was evaluated by asking about the likelihood for completing treatment when local anesthesia was needed. Results: Eighteen percent of the subjects had never had a dental injection, while 21% had never had a blood draw. Mean VAS score for fear of dental injections was significantly higher than for blood draws (22.0 vs 19.6, p<0.01). Dental injections were also perceived more painful (VAS 24.4 vs 16.3, p<0.001) and more unpleasant (VAS score 31.8 vs 21.8, p<0.001) than extraoral injections. When defining ‘fearful’ as VAS score higher than one SD above the mean, 16% and 17% were fearful of intraoral injections and blood draws respectively. Eight percent were only fearful of intraoral injections, 9% only of extraoral and 8% of both. Seven percent of the subjects reported a likelihood of less than 50% for proceeding with dental treatment when in need of an injection. This was not related to whether they had previous experience of dental injections or not. There was a significant relationship (p<0.001) between the likelihood for not proceeding with dental treatment and fear of dental injections and blood draws. Conclusions: About 25% of the adolescents are fearful of injections with 8% overlap between fear of intra- and extraoral injections. About 7% of subjects may avoid dental treatment when a dental injection is needed, and this is strongly related to their fear of injections.