• Journal of Oral Medicine and Pain
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• v.20 no.2
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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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• v.49 no.5
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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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• v.18 no.6
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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.

• Journal of Oral Medicine and Pain
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• v.23 no.4
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• pp.387-401
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• 1998

This study was performed to investigate the emotional state related to dental fear, hospital anxiety and depresison, and frequency of stress symproms of orofacial region. For this study, Dnetal Fear Surfey(DFS) scale, the Hospital ANxiety and Depression(HAD) scale, and Stress Symptom Questionnaire(SSQ) designed by the author were used in 549 dental outpatients. Dental Fear Survey scale is composed of avoidance of dentistry(AVOI), physiologic response scale(PRS) and dental stimulus response scale(DSRS). The Hospital anxiety and Depresiosn scale is composed of hospital anxiety(HA) and hospital depressoin (HD). Data were analyzed statistically with SPSS program and the results were as follows : 1. The item of the highest positive response rate in DFS scale was 'feeling drill'(82.0%), and in the HAD scale was ' feel as if I am slowed down'(84.1%). 2. Mean score of AVOI, PRS, DSRS and HD were higher in the older group(>25yr) than the yoiunger group(<25yr) and female patients showed higher score of DSRS, HA than male patients. 3. Mean number of items of stress symptoms in extraoral region were 3.4, and in intraoral region, were 4.7. Tongue wymptoms were increased in the older toup and female patients had more stress symptoms than male patients. 4. Correlation between DFS scale and HAD scale were significantly positive and these scales were also apositively correlated with tongue symptoms. 5. As for treatment types, the patients treated in the department of periodontics,conservative dentistry, and oral surgery showed higher score of DFS scale than the patients with temporomandibular disorders or treatedin the department of orthodontics.

• The Journal of the Korean dental association
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• v.49 no.2
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• pp.95-103
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• 2011

Purpose : The purpose of this study was to identify and assess factors that may contribute to pain of patients undergoing implant surgery. Materials and Methods: A total of 24 patients who underwent implant surgery were included in the study. Each patient's anxiety was measured using Corah's dental anxiety score(DAS) and modified Spielberger's state-trait anxiety inventory(STAI) immediately after the operation. Also, level of pain was measured using visual analog scale(VAS) during the operation and 48 hours after the surgery. The effect of various factors, such as demographic variables, previous dental experiences and operation time were also analyzed. Results: Postoperative pain levels were relatively low than expected. However, DAS and STAI were high among patients, and it showed that patients had anxieties about implant surgery according to DAS and STAI values. The previous dental experience did not affect the pain level, but the duration of surgery and the presence of accompanied advanced surgery did. Conclusion: To reduce patient's pain, proper management of anxiety will be required and careful attention is needed when performing local infiltration.

• Journal of dental hygiene science
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• v.14 no.3
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• pp.411-416
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• 2014

The purpose of this study was to examine the effects of conscious sedation on pain and anxiety of patients in implant surgery. A total of 95 patients who underwent implant surgery were included in the study. In this study, the patient's anxiety and pain to evaluate the pre-operative Visual Analogue Scale (VAS), during-operative Pain Question (PQ), post-operative (Short-form McGill Pain Questionnaire [SF-MPQ], VAS) was used for tools such as questionnaires. The data were analyzed using the chi-squire, independent-samples t-test, multiple linear regression analysis. As a result, the pain reduction was significantly different between the sedative dental treatment and non-sedative dental treatment (p<0.05). The finding of the study multiple linear regression analysis showed that operation time, implant surgery experience, gender, age, operation form and Pain Catastrophizing Scale (PCS) with factors that affect the pain and anxiety (p<0.05). According to the results of the study, considered to be necessary to develop intervention strategies effective using the PCS when managing pain and anxiety of behavior management of this implant patient. Thus, it is advised to provide necessary practical guidelines and dental utilization behaviors on patients with conscious sedation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.369-376
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• 2021

In adult patients with dental phobia, dental treatment may be difficult, or may not be possible. Depending on the level of fear or anxiety, non-pharmacological or pharmacological behavior management techniques are used in the dental treatment of such patients. Among the pharmacological behavior management techniques, minimal sedation, that is, the lowest depth of sedation, can be easily obtained in adult patients using oral sedatives, does not require special equipment or tools, and does not affect ventilatory and cardiovascular function. Diazepam is an anxiolytic drug belonging to the benzodiazepine family that, in addition to relieving anxiety, produces muscle relaxation, and is a representative drug used in adult patients with fear of dental treatment. Herein, we report the case of a 50-year-old woman with severe dental fear who successfully underwent long-term dental treatment in approximately 20 visits with minimal sedation using oral diazepam. In addition, we reviewed the considerations for the use of benzodiazepines for minimal sedation.

• Journal of Korean Academy of Dental Administration
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• v.11 no.1
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• pp.89-95
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• 2023

Social phobia is a mental disorder that triggers physical reactions, such as cold sweats, headaches, and panic attacks, as a result of anxiety about a particular situation. Individuals with social phobia are thought to be more sensitive to dental anxiety and may have difficulty visiting the dentist as a result. This study aimed to determine the relationship between social phobia and dental fear among college students, who are reported to have a high prevalence of social phobia. A total of 120 survey responses were analyzed. To investigate the variation in dental fear levels based on the level of social phobia, the total social phobia score was divided into two groups: 41 points or more, and 40 points or less. The disparity in dental fear scores was then analyzed using a t-test. The study found that the average score for dental fear was statistically significantly higher in the group with a total social phobia score of 41 points or more compared to the group with a total score of 40 points or less (p<0.05). Furthermore, the group that scored 41 points or higher on the social phobia scale reported experiencing symptoms such as feeling nauseous at the dentist (3.29 points), sweating upon entering the dentist (3.13 points), and feeling afraid when looking at the dentist (3.13 points). The score was high (p<0.05). Therefore, dental patients exhibiting anxiety symptoms require a comfortable treatment environment to alleviate dental fear, and safe, pain-free dental treatment techniques must be employed.

• Journal of Oral Medicine and Pain
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• v.19 no.2
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• pp.137-151
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• 1994

In order to evaluate objectively the anxiety level in dental treatment, the author used Biotrainer(BF-120R), one of the skin temperature biofeedback apparatus, to examine 68 dental outpatients on their digital skin temperature change due to routine consecutive dental procedures(oral examination, anesthetic injection, cavity preparation, fissure sealing, polishing). The subjective anxiety level change was also evaluated by visual analog scale. The obtained results were as follows : 1. The skin temperature decreased through consecutive procedures and the temperature in each procedure decreased until 60sec, and then increased on 120sec. 2. The temperature changes in Preparation and Injection were greater than those in other procedures. 3. Generally, male exhibited more change of skin temperature in all procedures than female. 4. Type II, continuously decreasing after procedure, occupied the most in all patients and yhad the lowest beseline temperature. 5. The anxiety level of before-procedure was higher than that of after-procedure and the levels in Injection and Preparation were higher than in other procedures.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.91-103
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• 2017

General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation. Most guidelines address the management of pediatric patients under general anesthesia. However, little has been published regarding this method in patients with special needs. This article constitutes a review of the current literature regarding management of patients with special needs under general anesthesia.