Method: Two groups of patients; 50 highly anxious and 500 regular patients (reference group) were invited to complete the Level of Exposure to Distressing Events Questionnaire (LOE-DEQ) during a visit to their dentist. The LOE-DEQ contains 28 items assessing the prevalence of 5 categories of potential distressing events, both inside and outside the dental setting, i.e., (1) aversive dental treatment related experiences (e.g., extractions causing extreme pain), (2) traumatic experiences concerning the dentist as a person (e.g., having had a rude or incompetent dentist), (3) extremely distressing emotional experiences during dental treatment (e.g., feeling embarrassed) and (4) other dentistry related traumatic experiences (e.g., being told unpleasant stories about dentistry by important others) , and (5) potential distressing events unrelated to the dental setting (e.g., being victim of sexual abuse).
Results: Each type of traumatic event appeared to be more prevalent in the highly anxious group than in the low anxious group [ps<0,001]. Most important predictors of a high level of anxiety were aversive dental treatment related experiences and extremely distressing emotional experiences during dental treatment. Together the two types of events accounted for 34% of the variance of the presence of a high level of dental anxiety.
Conclusion: The results suggest that the combination of a history of disturbing emotional experiences and several aversive dental treatment related experiences contribute most to the development of high levels of dental anxiety. Furthermore, the findings point at the need for educating dentists regarding the possible impact of invasive dental treatments and the importance of paying attention to the emotional well-being of patients during treatment.