Patients′ Multifaceted Views of Dental Fear in the Diagnostic Interview

Objectives: To examine how patients, perceive their dental fear in the diagnostic interview utilizing the Index of Dental Anxiety and Fear (IDAF-4C-index).
Methods: The sample (n=7, age from 31 to 62 years) consisted of patients who reported moderate or severe dental anxiety, according to the Modified Dental Anxiety Scale (MDAS). The patients were recruited from private dental clinics in eastern Finland and they had problems to cope with the conventional dental treatment. These patients attended the modulated diagnostic interview that followed a protocol aiming to map patients’ dental fear before dental treatment. The interview data were analyzed using a theory driven content analysis. The themes of the content analysis consisted of the four components of dental fear derived from the IDAF-4C-index: emotional, behavioral, cognitional and physiological.
Results: Within these four themes, treated as the main categories, 26 further categories related to the patients’ interpretations of dental fear were identified. Out of these 26 categories, 23 depicted various facets of emotions, behavior and physiological reactions in three contexts: ’Before dental treatment’; ’During dental treatment’; and ’After dental treatment’ consisting of 11, nine and three categories, respectively. The remaining three categories were related to the patients’ cognitions, namely, ’The origins of the fear’, ’The person’s perceptions of the mitigation of fear’ and ’Negative/fear provoking factors’. Emotions composed 10 categories illustrating the sensations of uncontrollable dental fear, the eight categories of behavior illustrated self-coping strategies and the five categories of physiological reactions illustrated strong or long-lasting physiological reactions, including panic and anxiety symptoms.
Conclusions: The emotional, behavioral, cognitional and physiological components of the IDAF-4C-index adequately described dental fear. Consequently, the IDAF-4C can be described as a useful tool for dentists to catch a comprehensive and multifaceted picture of the patients’ views of their dental fear in a diagnostic interview.