title: Risk factors for severe dental anxiety among medical students.
abstract: OBJECTIVE
  Severe dental anxiety (SDA) is the most severe form of dental anxiety, thus the aim of this study was to determine the factors associated with SDA in students of health-related disciplines.
  
  
  METHODS
  In this case-control study the cases were students with severe dental anxiety. The study was conducted at the Faculty of Medical Sciences, University of Kragujevac, Serbia. The participants were undergraduate students attending lectures during spring semester 2010/2011 (n = 1,812). A random sample of 800 students was assessed for the association between various risk factors and the severe dental anxiety. The main outcome measures were the data on demographics, dental anxiety, habits concerning oral hygiene, nutrition, general anxiety and (co)morbidity which were collected from the study participants by semi-structured questionnaire.
  
  
  RESULTS
  Less frequent visits to the dentist (OR adjusted = 7.02 [2.65; 18.60]) and visiting the dentist only when there is a dental problem (OR adjusted = 8.08 [1.28; 50.93]) were associated with severe dental anxiety. The same was true for improper oral hygiene (OR adjusted = 4.25 [1.16; 15.60]). Factors as changing toothbrush more frequently (OR adjusted = 0.33 [0.14; 0.76]) and having chronic disease (OR adjusted = 0.01 [0.00; 0.09]) were inversely associated with severe dental anxiety. The level of education of students was not associated with severe dental anxiety.
  
  
  CONCLUSIONS
  Inappropriate oral hygiene, less frequent changes of a toothbrush and less frequent visits to the dentist are important risk factors for severe dental anxiety.
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Slobodan M
authors: SM
authors: Janković
authors: Sector for Pharmacy, Military Medical Academy, Belgrade, Serbia.
authors: Dragana
authors: D
authors: Aleksić
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Zulfer
authors: Z
authors: Bahtijari
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Anica
authors: A
authors: Jelić
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Jelena
authors: J
authors: Klacar
authors: Faculty of Medicine, Military Medical Academy, University of Defence, Belgrade, Serbia.
authors: Aleksandra
authors: A
authors: Kovacević
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Natasa
authors: N
authors: Mijailović
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Olivera
authors: O
authors: Milovanović
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Aleksandra
authors: A
authors: Petrović
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Ana
authors: A
authors: Radovanović
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Miroslav
authors: M
authors: Sovrlić
authors: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Dejana Ruzić
authors: DR
authors: Zecević
mesh_terms: D001294:Attitude to Health; D016854:Dental Anxiety / Q000453:epidemiology / Q000523:psychology*; D003729:Dental Care / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D008297:Male; D009910:Oral Hygiene / Q000523:psychology; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000523:psychology; D055815:Young Adult