Dental anxiety and oral health outcomes among rural older adults.
OBJECTIVE
The objective of this study is to determine the degree to which rural older adults are able to complete a measure of dental anxiety and to assess the prevalence, as well as the demographic and oral health characteristics, of individuals reporting high dental anxiety.


METHODS
A population-based sample of 635 African American, American Indian and White older adults (age ≥ 60 years) completed an in-home survey, and 362 dentate participants completed an oral examination. Dental anxiety was measured using the four-item Corah's Dental Anxiety Scale (DAS). Gender, ethnicity, age, education, and oral health outcomes were compared between those who completed all four DAS questions (completers) and those who did not (noncompleters) as well as, among completers, those with high versus low DAS scores.


RESULTS
There were 94 (14.8%) noncompleters. Noncompletion was associated with older age, lower education, being edentulous, and having gingival recession. 12.4% of DAS completers had high DAS scores, which was more common among those aged 60-70 years, women, and those with oral pain and sore or bleeding gums. In logistic regression analysis, only sore and bleeding gums had a significant association with a high DAS score (odds ratio = 2.40, 95% confidence interval 1.09-5.26).


CONCLUSIONS
About one in eight rural older adults have high dental anxiety, which is associated with poor oral health outcomes. Identifying new approaches to measure dental anxiety among a population with limited interaction with dental care providers is needed.
Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA. rbell@wfubmc.edu
Ronny A
RA
Bell
Thomas A
TA
Arcury
Andrea M
AM
Anderson
Haiying
H
Chen
Margaret R
MR
Savoca
Gregg H
GH
Gilbert
Sara A
SA
Quandt
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D003430:Cross-Sectional Studies; D016854:Dental Anxiety / Q000150:complications* / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D003729:Dental Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010510:Periodontal Diseases / Q000209:etiology*; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D016388:Tooth Loss / Q000209:etiology; D014098:Toothache / Q000209:etiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data