Methods: A retrospective chart review utilized records from 203 current fearful patients at the Dental Fears Research Clinic at the University of Washington. A psychologist rated records for Diagnostic and Statistical Manual Axis I diagnoses, a dentist rated intake radiographs, and two dental examiners copied demographic and questionnaire data and counted appointments by type.
Results: In this sample, 77.8% of the patients had at least one additional diagnosis (mean number additional diagnoses: 1.89, SD=1.63, range=0-7). Age, gender, and number of missing, filled, or carious teeth were not related to having additional diagnoses. Patients with higher numbers of additional diagnoses had greater dental fear on the Dental Fear Survey (DFS; Spearman's rho=0.185, p=0.016), more negative beliefs about the dentist on the Revised Dental Beliefs Survey (R-DBS; rho=0.160, p=0.022), greater desire for control in the dental situation (rho=0.252, p=0.019), but lower levels of perceived control (rho=-0.292, p=0.006) as measured by the Revised Iowa Dental Control Index (R-IDCI), and required more psychological appointments (rho=0.190, p=0.008). Relationships between number of psychological appointments and additional diagnoses remained significant after negative beliefs (R-DBS), desired control, and perceived control (R-IDCI) were controlled for; the relationship between psychological appointments and additional diagnoses remained nearly significant (p=0.057) when dental fear (DFS) was controlled for. Finally, patients with at least one additional diagnosis were more likely to relapse and need psychological help after having had a treatment appointment with a dentist (t=2.826, df=36.498, p=0.008).
Conclusions: Fearful patients with additional psychiatric diagnoses had similar treatment needs as those without additional diagnoses, as approximated by number of carious teeth, but required additional psychological appointments to receive dental treatment. Supported by NIH TL1RR025016 and NIH/NIDCR K23DE016952