Relationship between Dental Anxiety, Psychological Distress, and Oral Health Status among Adolescents in Bengaluru City: A Cross-sectional Study

Abstract Background: Psychological factors play an important role in the etiology of dental anxiety and continue to affect individuals. Oral health care is the most unmet healthcare need in children and adolescents. There is a need to understand the influence of dental anxiety and psychological distress on oral health status among adolescents. The objective of the current study was to determine the relationship between dental anxiety, psychological distress, and oral health status among adolescents. Materials and Methods: A cross-sectional study was conducted among 400 adolescents aged 13–15 years old in Bengaluru city. Dental anxiety and psychological distress were assessed using Modified Dental Anxiety Scale and Hopkins Symptom Checklist, respectively. Oral health was assessed using the WHO Oral Health Assessment Form for Children, 2013. Chi-square test, Pearson correlation coefficient, multivariate linear regression analyses, and mediation analyses were performed. P <0.05 was considered significant. Results: The mean age of the participants was 13.94 ± 0.79 years. The proportion of dental anxiety and psychological distress among the participants was 43% and 16%, respectively. The mean DMFT was 2.02 ± 1.94. The mean number of teeth with gingival bleeding was 3.16 ± 1.44. DMFT scores significantly correlated with dental anxiety ( r = 0.376, P < 0.001) and psychological distress ( r = 0.278, P < 0.001). Gingival bleeding significantly correlated with dental anxiety ( r = 0.226, P < 0.001) and psychological distress ( r = 0.171, P < 0.001). Education of the head of family, dental anxiety, and psychological distress were significant predictors of oral health indicators. Psychological distress partially mediated the effect of dental anxiety on dental caries experience. Conclusion: Dental anxiety and psychological distress showed a relationship with oral health among adolescents. Hence, measures to alleviate dental anxiety and psychological distress among adolescents should be considered for better oral health outcomes.