• 치위생과학회지
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• 제17권1호
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• pp.20-29
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• 2017

본 연구는 $IDAF-4C^+$를 국내 실정에 적절하게 적용할 수 있도록 수정 보완하여, 치과 방문 환자의 치과 불안 정도를 평가할 수 있는 도구를 개발하고 타당도와 신뢰도를 평가하고자 시행하였다. 치과 불안 및 공포 원 도구 23문항을 번역한 후 번역 정확도, 내용분석 및 내용타당도 검증을 통하여 3문항을 삭제하고 14문항을 수정하여 총 20문항을 분석하였다. 연구 결과 탐색적 요인분석에 의한 요인 적재량이 0.4 이하인 1개의 문항이 삭제되었으며, 선행연구의 이론구조에 맞지 않게 적재된 1개의 문항이 삭제된 결과 18문항들이 추출되었다. 치과 불안 및 공포 측정 도구의 하위요인으로는 치과 불안, 공포, 자극으로 구분되었다. 또한 확인적 요인분석을 통한 측정 도구의 각 하위별 적합지수를 충족시키기 위해 4개 문항이 삭제되어, 최종 3개의 하위요인의 14문항으로 구성된 측정 모델의 적합도는 기준을 충족하였다. 모든 요인의 개념신뢰도, 표준화 회귀 계수값이 일반적 기준을 충족시켜 집중타당도가 입증되었다. 모든 요인의 평균분산추출값은 각 요인 간 상관관계 제곱값보다 크게 나타나 판별타당도도 입증되었다. 내적일관성을 검증한 결과 Cronbach's ${\alpha}$는 치과 불안 항목 0.920, 공포 항목 0.613, 자극 항목 0.866으로 나타나 신뢰할 만한 수준의 측정도구임을 나타냈다. 한국어판 $IDAF-4C^+$의 타당도와 신뢰도는 적합하다고 검증되었다. 향후 국내 환자의 치과 불안 및 공포 조절 도구로 임상과 연구에 활용되어 구강건강 증진에 도움을 줄 수 있을 것으로 생각된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.155-165
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• 2021

Background: This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions. Methods: The State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed. Results: The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety. Conclusions: The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.25-29
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• 2016

Background: The most important reason for pre-operative administration of medication is to reduce anxiety. Alleviation of fear and anxiety about surgery enables patients to remain comfortable during treatment. Dexmedetomidine (DEX) is a fast-acting drug that is used as a premedication in different circumstances because it has sedative and anti-anxiolytic effects, and stable hemodynamics. It also has the advantage of intranasal administration. The aim of this study was to investigate the effects and hemodynamic stability of DEX by retrospectively analyzing cases in which DEX was administered nasally as a premedication. Methods: Ten patients treated at Dankook University Dental Hospital, recruited between February and April 2015, received intranasal delivery of $2{\mu}g/kg$ DEX, 30 minutes prior to general anesthesia. Anesthesia records of anxiety, blood pressure, respiration, pulse, estimated arterial oxygen saturation ($SpO_2$), and partial pressure, or maximum concentration, of carbon dioxide ($ETCO_2$) were analyzed. Results: Administration of DEX prior to a general anesthetic effectively relieved anxiety. Respiratory depression, the most severe adverse effect of other sedatives, was not observed. Hemodynamic stability under general anesthesia was maintained during treatment and a reduction in emergence delirium was observed upon completion of treatment. Conclusions: Premedication administration of DEX is safe for pediatric patients undergoing dental treatment under general anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.89-94
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• 2016

Anxiety and phobia in dental procedures are common deterrents for patients visiting the dental care unit. For these individuals, procedural sedation may aid in completion of dental treatments. In most cases, the patients are conscious during sedation, thereby allowing spontaneous ventilation. Intravenous sedation (IVS) is widely used during dental treatment to relieve patient anxiety. IVS is the most effective route of administration to achieve this goal, but it requires advanced training, more than that provided during undergraduate education. During IVS, rapid onset, repetitive drug administration, easy titration, and rapid recovery from sedation can be achieved. However, conscious sedation during IVS can result in deep sedation that can cause respiratory and cardiovascular depression. Therefore, the characteristics of intravenous sedatives should be known. The purpose of this review is to discuss the characteristics and usage of intravenous sedatives currently used for dental procedures.

• 한국치위생학회지
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• 제12권1호
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• pp.37-46
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• 2012

Objectives : This research was investigated to evaluate the psychological characteristics and changes of psychological state among dental orthodontic patients. Methods : This cross-sectional questionnaire research was conducted with 230 dental orthodontic patients in Busan from December 23, 2009 to March 6, 2010. The psychological analysis of dental orthodontic treatment patients was performed with Symptom checklist-90-revision(SCL-90-R) considering 5 general characteristics and 2 treatment period related characteristics. Estimated psychological results were changed T-score. Data analysis was performed with descriptive analysis, t-test and ANOVA using SAS(ver 9.1) program. Results : The levels of T-score of SCL-90-R were $43.88{\pm}7.50$ in hostility(HOS), $43.38{\pm}4.64$ in phobic anxiety(PHOB), $43.20{\pm}6.24$ in somatization(SOM), $42.13{\pm}6.71$ in paranoid ideation(PAR), $41.39{\pm}8.16$ in interpersonal sensitive(I-S), $41.01{\pm}7.90$ in obsessive-compulsive(O-C), $40.96{\pm}5.37$ in psychoticism(PSY), $40.96{\pm}5.19$ in anxiety(ANX) and $39.81{\pm}6.80$ in depression(DEP), respectively. The T-score of phobic anxiety in before treatment group was higher than that of treatment groups. The T-score of interpersonal sensitive and paranoid ideation in over 36 months treatment period group were higher than that of other treatment period groups. Conclusions : Phobic anxiety(PHOB), interpersonal sensitive(I-S) and paranoid ideation(PAR) were affected in pre-treatment and long-term treatment dental orthodontic patients. Psychological management methods considering treatment period are needed to improve mental health of dental orthodontic patients.

• 한국치위생학회지
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• 제17권3호
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• pp.449-463
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• 2017

Objectives: The objective of this study was to identify the relationship between emotional labor and occupational stress of the dental hygienists, and the effects of emotional labor on their occupational stress and health problems including depression, anxiety and sleep. Methods: The survey was conducted using the questionnaires about dental hygienists' working in medical institutions in Busan, Gyeongsangnam-do from August 19th and October 7th, 2016. Total of 225 participants were selected for data analyses. Frequency analysis, t-test, ANOVA, Pearson's correlation coefficient analysis, and regression analysis were conducted using SPSS Windows ver. 21.0 program(SPSS Inc., Chicago, IL. USA). Results: The analysis of the factors affecting emotional labor, occupational stress, anxiety, and sleep by participants' characteristics showed that those with higher education level, work position and annual salary had higher emotional labor. In addition, participants who worked 5 days every other week and were responsible for patient consultation had higher emotional labor. The analysis of correlations among emotional labor occupational stress, anxiety, and sleep showed positive correlations between emotional experience and emotional expression, occupational stress and emotional expression, and anxiety and emotional expression. On the other hand, negative correlation was found between anxiety and emotional experience. Regression analysis was conducted to examine the effect of emotional labor on job stress. Emotional labor was a factor affecting job stress and anxiety. Conclusions: In order to improve emotional control and vulnerability to stress among dental hygienists, intra-organizational training opportunities and mental health care strategies are needed. Additional broad-based studies are required to identify the factors affecting the occupational stress and emotional labor and to develop relevant intervention measures.

• 대한소아치과학회지
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• 제21권2호
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• pp.456-462
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• 1994

The purpose of this study was to investigate the relationship between the caries experience and anxiety level to the dentist in the preschool children. 511 preschool children were brought to the dental hospital and examined for caries experience. Caries experience was measured as dDT index, fFT index, dDfFT index, dDT rate, and fFT rate. Children were requested to draw a dentist. Drawings were analyzed by the method of Human Figure Drawing Anxiety Score. Pearson correlation coefficents and their significance were calculated between caries experience and anxiety scores. There were significant negative correlation between fFT index and anxiety scores, between dDfFT index and anxiety scores, and between fFT rate and anxiety scores. There was significant positive correlation between dDT rate and anxiety scores. The results seemed to suggest that dental treatment experience reduced children's anxiety toward dentists. But, because there was obvious negative correlation between age and anxiety scores, age factor should be considered in the interpretation of the results.

• Journal of Oral Medicine and Pain
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• 제20권2호
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• pp.385-397
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• 1995

The purpose of this study is to document the stress symptoms (Anxiety and depression) among dental students and the difference of stress level between classes and by gender. All students in dental college, Seoul National University, in the 1995 academic year, were tested with the Spielberger's State-Trait Anxiety Inventory and Beck Depression Inventory just before the first semestral examination when the stress levels of students are expected to be the highest. 303 students answered the test. The obtained results were as follows : 1. State Anxiety inventory scores of the second-year and first-year students were significantly higher than those of the fourth -year and third-year(p(0.01), and all classes showed mean state anxiety scores more than mild. 2. Trait Anxiety inventory scores of the second-year and first-year students were significantly higher than those of the third-year and forth-year(p(0.01), and all classes showed mean Trait Anxiety scores more than mild. 3. Beck Depression inventory scores of the second -year students were significantly higher than those of the third-year and fourth-year(p(0.01), and twenty two students(7.3%) among the fourth classes showed depression symptoms. 4. In the comparison of the mean scores of the State-Trait Anxiety Inventory and Beck Depression Inventory between male and female students, State Anxiety Inventory scores of the second-year female students were significantly higher than those of the second year male students(p(0.05), and there was no significant difference elsewhere.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권5호
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• pp.252-261
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• 2023

Objectives: Patients undergoing oral surgery exhibit high anxiety, which may elevate their cortisol levels and affect postoperative recovery. Overweight patients are often encountered in the dental clinic due to the increasing prevalence of overweight. We aimed to investigate the relationships between preoperatively assessed body mass index (BMI), serum cortisol and high-sensitivity C-reactive protein (hs-CRP) levels, and visual analog scale (VAS) scores and preoperative anxiety in patients undergoing mandibular third molar (MM3) extraction and to identify predictors of postoperative complications. Patients and Methods: We analyzed 43 patients (age, 20-42 years) undergoing MM3 extraction. At the first visit, patients completed the Modified Dental Anxiety Scale (MDAS) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaires. Their BMI and VAS scores were also calculated. The participants underwent blood tests 1 hour before MM3 extraction. On the first postoperative day, the participants' VAS scores and serum hs-CRP levels were reevaluated. Results: We found that BMI was significantly correlated with preoperative VAS scores. Further, BMI and preoperative hs-CRP levels were significantly correlated among women and patients undergoing extractions of fully impacted MM3s. No correlations were found between serum cortisol and other variables. The preoperative MDAS and VAS scores were significantly positively correlated, especially among patients undergoing extractions of fully impacted MM3s. Multiple linear regression showed that BMI and the eruption status of the MM3 were significant predictors of postoperative hsCRP levels and VAS scores, respectively. Conclusion: In MM3 removals, patients with higher BMI showed elevated hs-CRP and higher VAS scores before surgery. Patients with higher anxiety among those undergoing extractions of fully impacted MM3s showed higher preoperative VAS scores. The two main predictors of postoperative complications were BMI and MM3 eruption status.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권6호
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• pp.367-373
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• 2018

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.