title: Dental anxiety among adults: an epidemiological study in South India.
abstract: BACKGROUND
  Dental anxiety is a major barrier for dental care utilization. Hence, identifying anxious individuals and their appropriate management becomes crucial in clinical practice.
  
  
  OBJECTIVE
  The study aims to assess dental anxiety, factors influencing dental anxiety, and anxiety towards tooth extraction procedure among patients attending a dental hospital in India.
  
  
  METHODS
  The study sample consisted of 1,148 consecutive patients aged 18-70 years. The assessment tools consisted of a consent form, history form, a questionnaire form containing the Modified Dental Anxiety Scale (MDAS) which was used to assess the level of dental anxiety, and an additional question on anxiety towards dental extraction procedure.
  
  
  RESULTS
  Among the study group, 63.7% were men and 36.3% were women. Based on the MDAS score, 45.2% of the participants were identified to be less anxious, 51.8% were moderately or extremely anxious, and 3% were suffering from dental phobia. Mean MDAS total score was 10.4 (standard deviation (SD) = 3.91). Female participants and younger subjects were more anxious (P < 0.001). Subjects who were anxious had postponed their dental visit (P < 0.001). Participants who had negative dental experience were more anxious (P < 0.05). Notably, 82.6% reported anxiety towards extraction procedure. Significant association was seen between anxiety towards extraction procedure and the respondents gender (P < 0.05), age (P < 0.001), education level (P < 0.05), employment status (P < 0.001), income (P < 0.001), self-perceived oral health status (P < 0.05), and their history of visit to dentist (P < 0.05).
  
  
  CONCLUSIONS
  Significant percentage of population was suffering from dental anxiety in this study population. A plethora of factors like age, gender, education level, occupation, financial stability, and previous bad dental experience influences dental anxiety to various levels. Extraction followed by drilling of tooth and receiving local anesthetic injection provoked more anxiety.
authors.affiliation: Department of Periodontics, Sri Ramaswamy Memorial Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Devapriya
authors.initials: D
authors.lastname: Appukuttan
authors.affiliation: Department of Periodontics, Sri Ramaswamy Memorial Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Sangeetha
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Department of Periodontics, Sri Ramaswamy Memorial Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Anupama
authors.initials: A
authors.lastname: Tadepalli
authors.affiliation: Department of Periodontics, Sri Ramaswamy Memorial Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Lokesh Kumar
authors.initials: LK
authors.lastname: Damodaran
keywords: Dental anxiety; Extraction; Modified Dental Anxiety Scale; Self-report; Tamil population