title: Perceived need for local anesthesia in tooth drilling among Anglo-Americans, Chinese, and Scandinavians.
abstract: This study explored ethnic differences in perceptions of pain and the need for local anesthesia for tooth drilling among age- and gender-matched Anglo-American, Mandarin Chinese, and Scandinavian dentists (n = 129) and adult patients (n = 396) using a systematic qualitative research strategy. Semistructured qualitative interviews determined: (a) the relative frequency of use or nonuse of anesthetic for similarly specified tooth drilling, (b) the reasons for nonuse of anesthetic as reported by dentists about their patients, and (c) the distribution of reasons for not using anesthetic. American dentists (n = 51) reported that about 1% of their adult patients did not use anesthetic compared with 90% among Chinese (n = 31) and 37.5% among Scandinavian dentists (n = 40). Of patients, Americans (n = 112) reported 6% nonuse of anesthetic for tooth drilling compared with 90% of 159 Chinese and 54% of 125 Scandinavians. Reasons among Anglo-Americans and Scandinavians were similar (ranked): the sensation was tolerable, to avoid numb feelings afterwards, and fear of injections. Danish patients were an exception; the fact that they had paid extra and out-of-pocket for anesthetic ranked second. In contrast, Chinese dentists made their decisions not to use anesthetics because they explained drilling as only a suan or "sourish" sensation, whereas injections were described as "painful." It was concluded that ethnic pain beliefs and differences in health-care systems are powerful psychosocial variables that affect pain perception and the perceived need for anesthetic.
authors.affiliation: Department of Oral Medicine, University of Washington, Seattle 98195-6370, USA. roding@u.washington.edu
authors.forename: R
authors.initials: R
authors.lastname: Moore
authors.forename: I
authors.initials: I
authors.lastname: Brødsgaard
authors.forename: T K
authors.initials: TK
authors.lastname: Mao
authors.forename: M L
authors.initials: ML
authors.lastname: Miller
authors.forename: S F
authors.initials: SF
authors.lastname: Dworkin
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel / Q000208:ethnology*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003431:Cross-Cultural Comparison; D003718:Denmark; D016854:Dental Anxiety; D003737:Dental Cavity Preparation; D003812:Dentist-Patient Relations; D003815:Dentists / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000208:ethnology* / Q000517:prevention & control / Q000523:psychology*; D013548:Sweden; D013624:Taiwan; D014481:United States