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Dental anxiety, oral health‐related quality of life, and general well‐being: A self‐determination theory perspective

Recent research indicated that patients’ perception of controlling dental treatment contexts, patients’ need frustration in treatment, and their dental anxiety were strongly positively associated (Halvari, Halvari, & Deci, 2017). Dependent on population, 10–20% of adults in Western societies suffer from dental anxiety (Buunk-Werkhoven, Dijkstra, & van der Schans, 2009; Johnsen et al., 2003). Both patients’ perception of controlling oral health care professionals and their fear of dental treatment or certain aspects of it (ter Horst & de Wit,1993) are related to low dental attendance and poor oral health and functioning (Hägglin, Berggren, Hakeberg, & Ahlqwist, 1996; Halvari et al., 2017). According to the model tested in the present study (see Figure 1), it would be important to answer questions including whether patients’ perception of controlling dental treatment contexts and patients’ need frustration in treatment are indirectly positively associated with poor oral health through dental anxiety; whether high dental anxiety along with the patients’ high dysregulation of dental anxiety would make patients’ perception of practitioners even more controlling through a feedback loop, which, in turn, would be associated with poor oral health through the patients’ need frustration and dental anxiety. These research questions have not been tested in the dental field before, although the potential practical implications of reducing contextual controllingness might reduce dental anxiety and improve both oral health and general well-being. Received: 7 February 2018 | Revised: 27 October 2018 | Accepted: 28 January 2019 DOI: 10.1111/jasp.12583