Abstract

Objectives: Even though dental anxiety is common, it frequently goes unrecognised. Since 2020, COVID-19 has posed a health care concern. The purpose of this study was to assess dental fear as reported by patients and as identified by dentists. Validating a color-coded device for calculating dental fear was another goal. The impact of COVID-19 on attendance and fear was evaluated.

Methods: After the first (T1) and third waves (T2) of the pandemic, a cross-sectional study was carried out at the primary urgent dental care of Oulu, Finland, in the spring of 2020 and 2021. The Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a novel "traffic light" colour coding for dental dread were used to collect data for analyses (CCF). With the help of structured and open-ended questions, the impact of COVID-19 on dental fear and attendance was evaluated. 273 people who wished to remain anonymous filled out the surveys.

Results: Among the participants, 106 (38.8%) and 167 (61.2%) went to the dentist in T1 and T2, respectively. They were 45.1 years old on average. 10.6% of the individuals reported having a severe fear score on the MDAS of 19 or above. In the CCF "traffic light" system, 87% of individuals who had severe dental anxiety selected the colour red. The participants' and dentists' assessments of dental dread were only weakly correlated (P .001), and there was no agreement with the red code (Cohen's kappa value = 0.035). After the first wave (T1), the younger individuals' MDAS scores were higher than those of the older participants' (P =.021). For those with the most severe self-reported dental fear as determined by the MDAS, COVID-19 had the greatest impact on dental attendance and dental dread.

Conclusions: Color-coded traffic lights are simple to use and appear to be effective for detecting severe dental phobia. They may be helpful tools, particularly given that it may be challenging for dentists to identify dental fear. For those who are most afraid, the COVID-19 pandemic has made dental care more difficult.