National High Blood Pressure Education Program.

The Corah dental anxiety scale is shown to be a reliable tool for use in dental offices or research projects for measuring anxiety of dental procedures. Old and new data were considered in an evaluation of the Corah Dental Anxiety Scale. The data indicate that the scale can be used in the dental office or in research projects and is a reliable, valid, and useful measure of anxiety of dental treatment.

https://jada.ada.org/article/S0002-8177(78)75017-8/pdf

Assessment of a dental anxiety scale

A questionnaire was used to identify fear stimuli and reactions associated with dentistry. The sight of the anesthetic needle and the sight, sound, and sensation of the d rill were rated the most fear-eliciting stimuli. Females rated themselves more fearful than males did and high school students reported being more fearful than college or junior high school students. Expectations of trauma from dentistry, much previous painful dental work, and perceived ill treatment by dentists were the major perceived sources of the reported fear reactions. Implications for prevention and treatment are discussed.

https://jada.ada.org/article/S0002-8177(73)64027-5/pdf

Origins and Characteristics of Fear of Dentistry

Distraction is thought to be an effective strategy for coping with pain-produced distress. The purpose of this article is to offer explicit conceptual explanations of why and when distraction will be effective and to review research related to this conceptual scheme. A theoretical case for the effectiveness of distraction is drawn from assumptions about (a) the importance of cognition in mediating the pain experience, and (b) the limited capacity available for focusing attention on different stimulus events. Combining these assumptions led to four principles that were examined with available data. Principle 1: Distraction will reduce distress as compared with uninstructed and placebo control conditions. Principle 2: Distraction techniques that require more attentional capacity will be more effective. Principle 3: Distraction will have stronger effects on pain stimuli of low intensity. Principle 4: Distraction will be more effective than sensation redefinition for mild pain stimuli, but the reverse will be true for intense pain stimuli. The data supported these principles, and this review discusses implications and research necessary for helping persons to cope with pain. Common sense suggests that an effective way to cope with pain is to distract oneself from the sensations or emotional responses resulting from the painful stimulus. When persons are asked to evaluate coping strategies, for example, distraction is rated as highly effective and is strongly preferred over alternative techniques (Ahles, Blanchard, & Leventhal, 1983; Corah, Gale, & Illig, 1979a, 1979b; Hackett & Horan, 1980; McCaul & Haugvedt, 1982). Kant (cited in Turk, 1978) illustrated the common sense use of distraction as follows:

Distraction and coping with pain.

Objectives. The objectives of this article were to examine the literature published from 1982 to 2006 and to evaluate prevalence of dental fear and anxiety (DFA) and dental behaviour management problems (DBMP) in children and adolescents, and their relationships to age, sex, general anxiety, temperament, and general behavioural problems.

Methods.  A broad search of the PubMed database was performed using three combinations of search terms.

Results.  A large proportion of the identified articles could not be used for the review owing to inadequate endpoints, measures or poor study design. Thirty-two papers of acceptable quality were identified and reviewed. The prevalence of both DFA and DBMP were estimated to 9%, with a decrease in prevalence with age. DFA/DBMP were more frequent in girls. DFA/DBMP were related to general fear and both internalizing and externalizing behavioural problems, although these relationships were not clear-cut. Temperament was related to both DFA and DBMP but with different temperamental characteristics, while general behavioural problems mainly correlated with DBMP.

Conclusions.  DFA/DBMP are common, and several psychological factors are associated with the development of these problems. In order to better understand these relationships, a number of issues concerning design of research and measurement of DFA/DBMP have to be dealt with.

Dental fear/anxiety and dental behaviour management problems in children and adolescents : a review of prevalence and concomitant psychological factors

Development of a Dental Anxiety Scale

Behavioral methods of patient stress reduction during amalgam restorations were evaluated. Eighty adult patients were randomly assigned to one of four groups of 20 each: a control group, a relaxation group, a perceived control group, and an active distraction group. Both relaxation and distraction were found to be effective in reducing patient discomfort.

Psychological Stress Reduction During Dental Procedures

A two-page questionnaire on stress in dentistry was completed by dentists participating in the Health Screening Program at the 3982 ADA Annual Session. The ques­tions focused on the dentists' perceived sources of stress. Six items form a pattern for stress: some are unique to dentistry, others relate to today’s fastpaced society.

Sources of dentists' stress.

This report describes techniques that can be easily adapted in a dental office to relieve anxiety and slress Relaxation and distraction techniques designed to reduce stress during operative dental procedures were evaluated Both techniques can be effective in alleviating anxiety and stress

Norman L. Corah

Papers

Development of a Dental Anxiety Scale

Assessment of a dental anxiety scale

Psychological Stress Reduction During Dental Procedures

Sources of dentists' stress.

The use of relaxation and distraction to reduce psychological stress during dental procedures