Influence of Irrational Health Beliefs in Adults on Dental-Related Perceptions, Practices, and

Diseases in Adult and Pediatric Patients

Original ObjectivesTo determine whether or not general health-related

cognitive distortions (i.e irrational health beliefs) have any consequent effect on patients’ perceptions of dental treatment, personal oral health practices and presence of oral health diseases

Furthermore, this study will investigate whether or not parents’ cognitive distortions related to both general health information influence the perceptions of dental treatment, personal oral health practices and presence of oral health diseases in their children

What contributes to dental fear and anxiety? According to to one study (n=3937), dental fear is

strongly linked with the Cognitive Vulnerability Model.

This model suggests that one’s perceptions of certain characteristics of a situation creates a schema of vulnerability that contributes primarily to the development of fear and phobias

Three cognitive vulnerability-related perceptions, uncontrollability, unpredictability, and dangerousness, were strongly associated with dental fear (Armfield, Slade, Spencer, 2008)

Relevance to Clinicians Dental fear/anxiety triggers “vicious cycle

dynamic”, in which fear of dental treatment, lessened use of dental services, and consequent oral diseases consistently reinforce one another (Crego et al, 2014)

Alleviating/managing dental phobia would likely lead to a sharp decline in oral disease in the population

The onset of dental fear and anxiety usually occurs in childhood (Locker, Liddell, Dempster, Shapiro, 1999; Berggren, Maynert, 1984).

Parental Influence...Children’s dental fear and cognitive vulnerability

perceptions were significantly associated with those of their parents (Crego et al, 2013) .

More interestingly, mothers’ and fathers’ levels of cognitive vulnerability significantly predicted their children’s levels of dental fear

Other studies show that anxious adults and children tend to have distorted cognitions, such as overestimating danger and underestimating their ability to cope with danger, when faced with ambiguous situations (Bogels & Zigterman, 2000).

What are Health-Related Cognitive Distortions (Irrational Health Beliefs)? Overgeneralizations or irrationally drawn conclusions

about health-related experiences based on biased or unfounded evidence

“This advice was not useful when I had disease X, therefore it is not useful for any other condition”

“If everybody eats like this, it can’t be bad for you” “if anybody is going to have side effects, it’s going

to be me”“Both my parents smoke and they’re fine, so I’ll be

fine”

The Irrational Health Belief Scale (IHBS) 20-item measure of health-related cognitive

distortions among individuals Designed for the purpose of examining whether

critical health behaviors are influenced by a more general tendency to possess distorted beliefs about scenarios and information related to health (Christensen, Moran & Wiebe, 1999).

Reliability and validity verified

Higher IHBS scores: Less positive pattern of health practices (as defined

by Personal Lifestyle Questionnaire) In diabetic patients, higher hemoglobin HbA1,

indicative of poorer adherence to a professionally recommended diabetic regimen

Poorer adherence to cardiac rehabilitation in patients with cardiovascular disease

Greater illness frequency Anxiety and hypochondria

Hypochondria less + health practices -- irony?

Higher IHBS scores: Higher self-reported anxiety in general Lower perception of controllability

Uncontrollability previously linked with dental fearDental fear?

Dental Cognitions Questionnaire An assessment of the frequency and believability

of negative cognitions related to dental treatment Strongly discriminate between dental phobics and

non-phobics (de Jongh et al, 1995) Study shows dental phobics possess many

negative (several being irrational) cognitions and self-statements about what may happen throughout treatment

Unanswered questions..This study demonstrates an association between IHB’s

related to dentistry and dental phobia, but does not examine the broader potential relationship between general irrational health beliefs and dental phobia.

Studies have not explored how this relationship may consequently influence oral health practices and oral health statuses of patients, including caries incidence, periodontal status, and oral hygiene status.

Studies have not explored the implicated connection between parental cognitive distortions and their children’s perceptions, health habits, and health status

Hypotheses1) General irrational health beliefs in adults serve

as a predictor for dental-related fear/anxiety, poorer oral health practices and poorer oral health status

2) General irrational health beliefs in adults serve as a predictor for dental-related fear/anxiety, poorer oral health practices and poorer oral health status in their children – main focus

Methods/Materials2 Groups

Group A: Adults at SDM main clinic attending their own appts

Group B: Adults at ESL clinic attending their child’s appt

In both groups, IHBS survey and DCQ given to adults before their apptNote: Group’s must be surveyed after their TP appt

All survey participants receive a $10 Wal-Mart gift card upon completion

Methods/Materials cont.For group A

Adult EHR’s assessed for DMFT scores, periodontal diagnoses, brush/floss habits (from dental health history)

Perceptions of dental tx obtained from DMQ—second part of survey

For group B Child’s EHR’s assessed for dmet scores, periodontal

diagnoses, brush/floss habits (from dental health history) Perceptions of dental tx obtained from DMQ—second part of

survey Perceptions of child’s dental tx obtained from tx notes

ChallengesTime needed with EHR’s –must be in clinic!Misreported/incomplete information in EHR’s Perio diagnoses in children – almost always plaque-

induced gingivitis – may eliminate this variable altogetherDue to the difficulty in obtaining a large enough sample

size for Group A, it will be eliminated to focus on obtaining results for Group B Group A (n=5) Group B (n=45) Remaining surveys – 37

Will continue surveying at ESL!

Revised objectivesTo determine whether or not general health-related

cognitive distortions (i.e irrational health beliefs) have any consequent effect on patients’ perceptions of dental treatment, personal oral health practices and presence of oral health diseases

Furthermore, this study will investigate whether or not parents’ cognitive distortions related to both general and dental health information influence the perceptions of dental treatment, personal oral health practices and presence of oral health diseases in their children

Questions?

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