The effect of vocational awareness level on dental anxiety and oral health among the students of dentistry

Document Type: Original Article


1 Assistant Professor, Department of Periodontology, School of Dentistry, Van Yuzuncu Yil University, Van, Turkey

2 Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Van Yuzuncu Yil University, Van, Turkey

3 Assistant Professor, Department of Endodontics, School of Dentistry, Usak University, Usak, Turkey

4 Department of Periodontology, School of Dentistry, Dicle University, Diyarbakir, Turkey


BACKGROUND AND AIM: The purpose of this study was assessing oral health status and dental anxiety differences between the freshman and senior dental students and the effect of awareness on dental practices.
METHODS: Freshman (n =71) and senior dental students (n = 41) were included in this study. All participants were applied Corah Dental Anxiety Scale (C-DAS) and asked for the frequency of dental visits in a year. Gingival index (GI), plaque index (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and decayed, missing, and filled teeth (DMFT) index were recorded. Number Cruncher Statistical System (NCSS) program and Shapiro-Wilk, t, Mann-Whitney U, Pearson chi-square, and Fisher-Freeman-Halton tests were used for statistical analysis (P < 0.0500).
RESULTS: C-DAS score of the freshman students was found significantly higher than the senior students (P < 0.0500). There was a statistically significant difference in the frequency of dental visits between freshman and senior students (P < 0.0010). GI, PI, and BOP values of the freshman students were significantly higher than the senior students (P < 0.0010). There was no statistical differences between PD and CAL measurements (P > 0.0500). It was found that the DMFT index score of freshman students was significantly higher than the senior students (P < 0.0010).
CONCLUSION: This study has shown that dental anxiety decreases as awareness and consciousness increase in terms of dental practice. More anxious participants’ oral health is weak, individuals with high dental anxiety make fewer visits to the dentists and need more dental practices.


1. Berggren U, Meynert G. Dental fear and avoidance: Causes, symptoms, and consequences. J Am Dent Assoc 1984; 109(2): 247-51.
2. Yildirim TT. Evaluating the relationship of dental fear with dental health status and awareness. J Clin Diagn Res 2016; 10(7): ZC105-ZC109.
3. Ng SK, Leung WK. A community study on the relationship of dental anxiety with oral health status and oral health-related quality of life. Community Dent Oral Epidemiol 2008; 36(4): 347-56.
4. Akarslan ZZ, Erten H. Dental fear and anxiety. Hacettepe Dis Hek Fak Derg 2009; 33(1): 62-8. [In Turkish].
5. Renz A, Ide M, Newton T, Robinson PG, Smith D. Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases. Cochrane Database Syst Rev 2007; (2): CD005097.
6. Williams RC. Periodontal disease. N Engl J Med 1990; 322(6): 373-82.
7. Cunha-Cruz J, Hujoel PP, Kressin NR. Oral health-related quality of life of periodontal patients. J Periodontal Res 2007; 42(2): 169-76.
8. LeResche L, Dworkin SF. The role of stress in inflammatory disease, including periodontal disease: Review of concepts and current findings. Periodontol 2000 2002; 30: 91-103.
9. Seltzer S, Bender IB, Ziontz M. The interrelationship of pulp and periodontal disease. Oral Surg Oral Med Oral Pathol 1963; 16: 1474-90.
10. Konig KG. Clinical manifestations and treatment of caries from 1953 to global changes in the 20th century. Caries Res 2004; 38(3): 168-72.
11. Seydaoglu G, Dogan MC, Uguz S, Inanc BY, Celik M. Reliability and validity of the Turkish version of the corah dental anxiety scale and the frequency of dental anxiety. Ondokuz Mayis Univ Dis Hekim Fak Derg 2006; 7(1): 7-14. [In Turkish].
12. Corah NL, Gale EN, Illig SJ. Assessment of a dental anxiety scale. J Am Dent Assoc 1978; 97(5): 816-9.
13. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964; 22: 121-35.
14. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533-51.
15. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975; 25(4): 229-35.
16. World Health Organization. Oral health surveys: Basic methods. Geneva, Switzerland: WHO; 1997.
17. Klein H, Palmer CE, Knutson JW. Studies on dental caries: I. Dental status and dental needs of elementary school children. Public Health Rep 1938; 53(19): 751-65.
18. Erguven SS, Isik BK. Comparative evaluation of dental anxiety and fear levels between first and final year dental students. Acta Odontol Turc 2013; 30(2): 70-6.
19. Menziletoglu D, Akbulut MB, Buyukerkmen EB, Isik BK. Evaluation of dental anxiety-fear faculties of dental faculty students. Selcuk Dent J 2018; 5: 22-30. [In Turkish].
20. Firat D, Tunc EP, Sar V. Dental anxiety among adults in Turkey. J Contemp Dent Pract 2006; 7(3): 75-82.
21. Tunc EP, Firat D, Onur OD, Sar V. Reliability and validity of the modified dental anxiety scale (MDAS) in a Turkish population. Community Dent Oral Epidemiol 2005; 33(5): 357-62.
22. Thomson WM, Locker D, Poulton R. Incidence of dental anxiety in young adults in relation to dental treatment experience. Community Dent Oral Epidemiol 2000; 28(4): 289-94.
23. Economou GC. Dental anxiety and personality: Investigating the relationship between dental anxiety and self-consciousness. J Dent Educ 2003; 67(9): 970-80.
24. Kirova DG. Dental anxiety among dental students. Journal of IMAB-Annual Proceeding 2011; 17(2): 137-9.
25. Peretz B, Mann J. Dental anxiety among Israeli dental students: A 4-year longitudinal study. Eur J Dent Educ 2000; 4(3): 133-7.

26. Sohn W, Ismail AI. Regular dental visits and dental anxiety in an adult dentate population. J Am Dent Assoc 2005; 136(1): 58-66.
27. Peretz B, Katz J, Zilburg I, Shemer J. Treating dental phobic patients in the Israeli Defense Force. Int Dent J 1996; 46(2): 108-12.
28. Sgan-Cohen HD, Lowental U. Sources of stress among Israeli dental students. J Am Coll Health 1988; 36(6): 317-21.
29. Schuller AA, Willumsen T, Holst D. Are there differences in oral health and oral health behavior between individuals with high and low dental fear? Community Dent Oral Epidemiol 2003; 31(2): 116-21.
30. Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: Exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health 2007; 7: 1.
31. Milgrom P, Fiset L, Melnick S, Weinstein P. The prevalence and practice management consequences of dental fear in a major US city. J Am Dent Assoc 1988; 116(6): 641-7.
32. Albandar JM, Brunelle JA, Kingman A. Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. J Periodontol 1999; 70(1): 13-29.
33. Boyce RA, Kirpalani T, Mohan N. Updates of topical and local anesthesia agents. Dent Clin North Am 2016; 60(2): 445-71.