Effects of Dental Fear on Depression Symptom and Stress in Adults

일부 성인의 치과공포가 우울 증상과 스트레스에 미치는 영향

  • 박은선 (혜전대학교 치위생학과)
  • Received : 2017.06.19
  • Accepted : 2017.06.28
  • Published : 2017.09.28


The purpose of this study was to determine the association of some adult dental fear and depression, and stress. Among the patients who came to the dental clinic for periodontal treatment, 68 patients who agreed to participate in the study and who met the selection criteria were included. Dental fear, depression symptom questionnaire, salivary cortisol, which can objectively evaluate blood pressure, pulse, and stress. The results of the analysis showed that depressive symptom was related to 'delayed treatment promise', 'cancellation of treatment appointment', 'increased muscle tension', 'rapid breathing when entering dentistry', 'fear when waiting in the waiting room', 'fear when you smell the hospital', 'fear when looking at the dental clinic', 'fear when seeing the anesthetic needle', 'fear when tooth whistle was heard', 'fear when teeth were removed', and 'total fear of dentistry'(p<0.05). Stress symptoms were higher in 'having sweated in the dentist', 'faster pulse', 'fear of entering the dentist' and 'total fear of the dentist'(p<0.05). Based on these results, it is necessary to study the effective methods to control the depressive symptoms and stress of patients who visit dental clinics, and it seems that continuous management is needed to prepare methods such as relaxation therapy for dental fear patients.


Dental Fear;Depression;Stress;Salivary Cortisol


  1. D. Appukukkan, S. Subramanian, A. Tadepalli, and L. K. Damodaran, "Dental anxiety among adults: an epidemiological study in South India," N Am J Med Sci, Vol.7, No.1, pp.13-18, 2015.
  2. 정미애, 하정은, 김민지, "구강보건교육 진행 방식에 따른 초등학생의 치과공포지수 차이," 한국콘텐츠학회논문지, 제16권, 제5호, pp.96-103, 2016.
  3. 김수경, 김미희, 최현지, 황정근, "일부 성인의 치과 공포감 관련 요인," 한국치위생학회, 제14권, 제6호, pp.881-886, 2016.
  4. M. Tellez, C. M. Potter, D. G. Kinner, D. Jensen, E. Waldron, R. G. Heimberg, S. Myers Virtue, H. Zhao, and A. I. Ismail, "Computerized tool to manage dental anxiety: a randomized clinical trial," J Dent Res, pp.174s-180s, 2015.
  5. M. Blomqvist, G. Dahllof, and S. Bejerot, "Experiences of Dental care and dental anxiety in adults with autism spectrum disorder," Autism Res Treat, pp.1-9, 2014.
  6. M. Lenk, H. Berth, P. Joraschky, K. Petrowski, K. Weidner, and C. Hannig. "Fear of dental treatment an underrecognized symptom in people with impaired mental health," Dtsch Arztebl Int, Vol.110, No.31-32, pp.517-522, 2013.
  7. V. Pohjola, A. K. Mattila, M. Joukamaa, and M. Lahti, "Anxiety and depressive disorders and dental fear among adults in Finland," Eur J Oral Sci, Vol.119, pp.55-60, 2011.
  8. 윤현서, 박지현, "치과내원환자의 주관적 구강건강인식과 치과공포의 관련성," 한국콘텐츠학회논문지, 제12권, 제6호, pp.321-379, 2012.
  9. R. Moore, H. Birn, E. Kirekegaard, and I. Broedsgaard, "Prevalence and characteristics of dental anxiety in danish adults," Community Dent and Oral Epid, Vol.21, No.5, pp.292-296, 1993.
  10. 심연수, 김아현, 안소연, "청주시 일부 중학생들의 치과공포도와 치과공포 요인," 한국콘텐츠학회논문지, 제13권, 제9호, pp.295-304, 2013.
  11. J. P. Sharmila, P. S. Preetam, A. P. Jayakumar, S. Anand, T. P. Anil, and B. T. Sridevi, "Assessment of the changes in the stress-related salivary cortisol levels to the various dental procedures in children," Journal of Indian Society of Pedodontics and Preventive Dentistry, Vol.33, No.2, pp.94-99, 2015.
  12. R. A. Kleinknecht, R. K. Klepac, and L. D. Alexander, "Origins and characteristics of fear of dentistry," J Am Dent Assoc, Vol.86, pp.842-848, 1973.
  13. L. L. Matharu, A. P. Mcintosh, and J. W. Lo, "Predicting children's behaviour during dental treatment," Arch Paediatr Dent, Vol.17, No.3, pp.157-163, 2015.
  14. A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, and J. Erbaugh, "An inventory for measuring depression," Arch Gen Psychiatry, Vol.4, pp.561-571, 1961.
  15. 이영호, 송종용, "BDI, SDS, MMPI-D 척도의 신뢰도 및 타당도에 대한 연구," 한국심리학회지, 제10권, pp.98-113, 1991.
  16. J. W. Hughes, D. M. Fresco, R. Myerscough, M. H. van Dulmen, M. H. Carlson, and R. Josephson, "Randomized controlled trial of mindfulness-based stress reduction for prehypertension," Psychosom Med, Vol.75, pp.721-728, 2013.
  17. B. W. Maclaughlin, D. Wang, A. M. Noone, N. Liu, N. Harazduk, M. Lumpkin, A. Haramati, P. Saunders, M. Dutton, and H. Amri, "Stress biomarkers in medical students participating in a mind body medicine skills program," Evid Based Complement Alternat Me, pp.1-8, 2011.
  18. H. Jeong, J. Y. Jeong, and D. W. Lee, Dental sedation methods that dentists should know before opening an office, Myeongmun Publishing, 2011.
  19. R. W. de Carvalho, P. G. de Carvalho Bezerra Falcao, G. J. de Luna Campos, E. S. de Souza Andrade, B. C. do Egito Vasconcelos, and M. A. da Silva Pereira, "Prevalence and Predictive Factors of Dental Anxiety in Brazilian Adolescents," Journal of Dentistry for children, Vol.80, No.1, pp.41-46, 2013.
  20. E. Skaret, M. Raadal, E. Berg, and G. Kvale, "Dental anxiety and dental avoidance among 12 to 18 years olds in Norway," Eur J Oral Sci, Vol.107, No.6, pp.422-428, 1999.
  21. C. K. Lalabonova, "Impact of dental anxiety on the decision to have implant treatment," Folia Med (Plovdiv), Vol.57, No.2, pp.116-121, 2015.
  22. Y. Liu, X. Huang, X. Yan, H. Lin, J. Zhang, and D. Xuan, "Dental fear and its possible relationship with periodontal status in Chinese adults: a preliminary study," BMC Oral Health, Vol.15, pp.1-7, 2015.
  23. F. Kebriaee, A. Sarraf Shirazi, K. Fani, F. Moharreri, A. Soltanifar, Y. Khaksar, and F. Mazhari, "Comparison of the effects of cognitive behavioural therapy and inhalation sedation on child dental anxiety," Eur Arch Paediatr Dent, Vol.16, pp.173-179, 2015.
  24. S. Bina, L. Ashok, and G. P. Sujatha, "Evaluation of salivary cortisol and psychological factors in patients with oral lichen planus," Indian J Dent Res, Vol.20, No.3, pp.288-292, 2015.
  25. P. A. Doerr, W. P. Lang, L. V. Nyquist, and D. L. Ronis, "Factors associated with dental anxiety," J Am Dent Assoc, Vol.129, No.8, pp.1111-1119, 1998.
  26. H. W. Tsang, W. M. Cheung, A. H. Chan, K. M. Fung, A. Y. Leung, and D. W. Au, "A pilot evaluation on a stress management programme using a combined approach of cognitive behavioural therapy (CBT) and complementary and alternative medicine (CAM) for elementary school teachers," Stress Health, Vol.31, pp.35-43, 2015.
  27. A. K. Artemiadis, A. A. Vervainioti, E. C. Alexopoulos, A. Rombos, M. C. Anagnostouli, and C. Darviri, "Stress management and multiple sclerosis: a randomized controlled trial," Arch Clin Neuropsychol, Vol.27, pp.406-416, 2012.
  28. A. Jones, P. M. Bentler, and G. Petry, "The reduction of uncertainty concerning future pain," J Abnorm Psychol, Vol.71, pp.87-94, 1966.