Dental anxiety among students in Indonesia: the role of demographic, behavioral, social, and spiritual support

Background: During dental procedures, an individual may experience anxiety, which is referred to as dental anxiety (DA). This fear presents a dilemma for both dentists and patients because it causes people to avoid or even deny dental care, thereby affecting their oral health and quality of life. Objectives: This study aimed to (1) identify factors related to DA and (2) construct a model from various factors, including oral health habits and social support, among students in Indonesia. Methods: A cross-sectional study design was used in the form of a self-report questionnaire administered online to 554 students selected using convenience sampling. The questionnaire consisted of Modified Dental Anxiety Scale (MDAS) items and questions about demographic information (field of study, year of intake / batch, etc.), oral health behaviors (frequency of toothbrushing, dental visit, etc.), social (parents, friends, others) and spiritual support (calm down and pray). The data were analyzed with chi-square tests, logistic regression and structural equation modelling using various statistical software programs, such as IBM SPSS and WarpPLS. Results: The final sample considered of 554 students, 155 (28%) of whom had a high DA score. Of the students, 286 (51.6%) were attending the School of Health Science cluster, and the largest single group (37%) belonged to the 2020 year of intake (batch). The fields of study, frequency of toothbrushing, reason for the last dental visit, oral health problem experience, self-ratings of oral health (SROH), and support from friends and spiritual support were significantly associated with DA. These results were supported by the odds ratios of the various variables, which ranged from 0.85 to 2.79. The coefficient of determination of the proposed model’s (R²) value was 0.15. Conclusions: Dental anxiety among students in Indonesia was significantly associated with the demographic (fields of study), behaviors (frequency of toothbrushing, reason for the last dental visit, past dental experience, SROH), social support (from friends) and spiritual support. Although the proposed SEM model accounted for 15% of the variance in DA, further studies are needed to explore other potential contributing factors to better understand and address dental anxiety in this population.