Patients’ multifaceted views of dental fear in a diagnostic interview

Figures & data

Figure 1. A summary of the sample and qualitative content analysis in the study.

Table 1. The contexts and contents of the main categories and the number of categories/sub-categories or dimensions related to them.

Contexts and contents related to the four main categories	Number of categories/subcategories (s) or dimensions (d)
A. Before dental treatment (Table 2)
A.1. Difficult emotions	3/7 (s)
A.2. Self-coping behavioural patterns	5/12 (s)
A.3. Disturbing physiological reactions	3/2 (s)
A.4. Cognitions related to dental fear	1/5 (d)
B. During dental treatment (Table 3)
B.1. Uncontrollable emotions	6/10 (s)
B.2. Behavioural coping strategies	2/8 (s)
B.3. Strong physiological reactions	1/6 (s)
B.4. Cognitions related to dental fear	1/9 (d)
C. After dental treatment (Table 4)
C.1. Ambivalent emotions	1/4 (s)
C.2. Behavioural means for coping	2/- (s)
C.3. Long-lasting physiological reactions	1/- (s)
C.4. Cognitions related to dental fear	1/6 (d)

Table 2. Categories and subcategories/dimensions before dental treatment.

Categories	Sub-categories
A.1. Content: Difficult Emotions
The content of the fear was clear	New situation
	Embarrassment/shame
	Activation of fear
The content of the fear was undefined	Unpleasant feeling
	Anxiety in the morning before the appointment
The current fears were connected with earlier experiences	Fearful memories of past situations
	Flashbacks related to intimidating treatments and procedures
A.2. Content: Self-coping behavioural strategies
Avoidance behaviour	Postponing/cancelling an appointment or avoidance of treatment
Exposure behaviour	Forcing oneself to visit the dentist
	Challenging oneself to face the situation
Use of medicines or harmful substances to control fear	Managing pain with painkillers instead of visiting the dentist
	Calming oneself with tranquillizers or tobacco
Use of self-help to alleviate the fear	Calming oneself through mental imagery or relaxation exercises
Other means to alleviate the fear	Choosing a treatment time spontaneously
	Selecting the place of treatment based on a recommendation
	Turning to social support
	Avoiding thoughts of fearful situations
	Visiting the dentist with low expectations
	Counting down the time before the appointment
A.3. Content: Disturbing physiological reactions
Difficulties sleeping
Clear physiological reactions	Increased heart rate
	Perspiration
Restlessness
Category	Dimensions
A.4. Content: Cognitions related to dental fear
Origins of fear	Earlier negative treatment experiences
	Role of an overbearing professional caregiver
	Alternations in fear intensity
	A person’s own dysfunctional explanation of their fear
	Connection between dental fear and other fears/psychiatric disorders/problems

Table 3. Categories and subcategories/dimensions during dental treatment.

Categories	Sub-categories
C.1. Content: Uncontrollable emotions
The fear of an extreme reaction	Fear of an allergenic reaction
	Fear of choking
	Fear of drowning
	Shortness of breath
	Fear of a panic attack
The fear of failure in a technical procedure
The fear related to the dentist’s behaviour
Objects of fear	Fear of pain
	Fear of injections
	Distrust in own ability to cope with the fear
Uncertainty	Dentist’s unclear language
	Sounds/smells at the dentist’s office
Recollection of previous treatment situations
C.2. Content: Behavioural coping strategies
Active/passive action	Tolerating the fear
	Striving to control one’s own physiological reactions and emotions
	Clasping hands
	Stopping a procedure mid-treatment
	Signalling the dentist to pause treatment
	Seeking helpful strategies
	Avoiding talking about the fear
The tendency to manage on one’s own/ seeking support from caregivers	Being outspoken about the fear
	Avoiding talking about the fear
C.3. Content: Strong physiological reactions
Panic and anxiety symptoms	Panic
	Increased heart rate/palpitations
	Sensation of fainting/ feeling paralysed
	Sensation of being strangled
	Difficulties in swallowing
	Feeling of a constricted throat
Category	Dimensions
C.4. Cognitions related to dental fear
Fear-alleviating factors	Understanding and empathetic attitude of the caregiver
	Positive tone of the appointment
	Possibility to interrupt the treatment
	Dentist communicate information during the treatment
	Interactive negotiation of the treatment
	The patient employs strategies to mediate their emotions
	Distancing oneself
	Positive effects of regular dental care attendance
	Facing problems afterwards

Table 4. Categories and subcategories after dental treatment.

Categories	Sub-categories
C.1. Content: Ambivalent emotions
Confusion about the treatment session	Odd reaction
	Contradiction in views
	Dismissing previous positive experiences during dental visits
	Uncertainty of the necessity of a treatment
C.2. Content: Behavioural means for coping
Rewarding oneself
Becoming passive
C.3. Content: Long-lasting physiological reactions
The calming of physiological reactions
Category	Dimensions
C.4. Content: Cognitions related to dental fear
Negative/fear-provoking factors	Negative thoughts related to treatment
	State of helplessness
	Inability to control fear in the treatment situation
	Catastrophic thoughts related to swallowing
	Harmful effects of the fear and its negative consequences
	Shame about the fear

Data availability statement

The data set and analysis material used in this study are reserved at the University of Eastern Finland (UEF) in databases for researchers:\\research.uefad.uef.fi\groups by the name ˈpelkotutkimusˈ and on memory sticks saved in researcher rooms’ locked boxes. Please contact the first author for data set questions.