Oral diseases have a substantial impact on a person’s general health and are typically given less priority in developing countries like India. 1 Anxiety is typically described as a perceived threat over a new or uncertain process. On the other hand, fear is a known risk or threat that triggers a bodily reaction in response to it.2 Dental anxiety (DA) is characterized as a patient’s situation –specific stress reaction towards dental procedures. Among prevalent Anxiety situations, Dental anxiety is ranked 5^th with 6-15% of the population experiencing strong DA. 2

Dental fear and anxiety may be the reason for many patients’ avoidance of dental care. The causes of dental anxiety are complex and include a variety of factors such as socio economic status, traumatic dental experiences in the past, lack of dental awareness, inconsistent dental attendance and attitude of the dentist. Dental anxiety is a person’s extreme, fearful psychological response to a potential or current dental intervention that they perceive as being hazardous or harmful. The Worst kind of dental anxiety is called severe dental anxiety. 3

Individual differences exist in dental anxiety, which is correlated with age, gender, educational attainment, socio economical level, and culture. For effective management and treatment results, it is imperative to identify the dental anxiety sufferers 4. It has been noted in earlier research that dental instruments may contribute to dental anxiety because, when it inserted into the mouth, they can cause a gag reflex and make breathing difficult. As a result, patients who are sensitive to these things may be more likely to have dental anxiety. 5

Reports of dental anxiety and phobia are more common among Women. Despite their low pain threshold, they tend to exhibit their anguish more visibly. Men may be less likely to openly disclose feeling concerned about dental care because they are socially and culturally conditioned to hide their emotions. Additionally, it was noted that women experienced greater Dental anxiety prior to receiving treatment. 6

Reducing a patient’s anxiety when a dental problem arises can enhance the quality of dental care and, in turn, the patient’s quality of life. An anxious patient exhibits diminished pain sensitivity and postpones or cancels his dental appointment. During treatment, this serves as a deterrent for the patient as well as the dentist. 7

Severe dental anxiety can lead to misdiagnosis and have an impact on the patient-dentist relationship. A useful indicator of dental anxiety that may be applied in clinical and research contexts is one tool for deciphering, recognizing, and minimizing the condition. Clinicians must identify the illness and consider treatment options. Measurement concerns must be carefully considered by researchers when evaluating trends and drawing comparisons. 8

Hence, the aim of this study was to evaluate and compare the prevalence of dental anxiety based on the socio demographic status and previous dental visits among the selected colleges in Salem, Tamil Nadu.

The Current investigation comprised of 385participants. This Research sample was composed of 159 boys and 226 females aged 17 years and above. The Majority of those taking part were 18 to 20 years (81%). 44% of the Participants family income were <Rs.12444 (Table 1).

In the study population, dental anxiety was prevalent with 85%. When it comes to dental procedures, participants showed higher level of anxiety. Majority of those taking part were anxious for (slightly extreme anxious) tooth drilled procedure (Frequency 74%, 2.69 +1.34SD) followed by higher anxiety for local anesthetic injection (67%, 2.47 +1.349SD) and for scaling treatment (64%, 2.21+1.15SD). In this, 69% of the participants were experiencing anxiety while waiting for the dental treatment (Table 2).

Out Of 385 participants, 105 participants had previously visited dentist (28%). In this, 19% were undergone for tooth cleaning and 10% participants were undergone for Root Canal Treatment (Figure 1).

Compared to men, women showed a noticeably higher level of dental anxiety for being scheduled for the forthcoming appointment (p<0.05) and Sitting in the waiting room (p<0.05) [Table 3].

Table 4

	Not anxious	Slightly anxious	Fairly anxious	Very anxious	Extremely anxious	p-value
RS.37325-62272	79	61	47	42	11
RS.12445-37324	139	124	79	57	31	0.046881*
<RS.12444	280	217	158	137	48

*statistically significant

Among the study participants, it was shown that there is a significant association between dental anxiety and total family income (< Rs.32,375).

Participants Total family income < Rs.12,500 has shown the highest level of dental anxiety. (p<0.05) (Table 4).

The Modified Dental anxiety scale (MDAS) is a tool for assessing dental anxiety. The benefit of MDAS is that reported appropriate cut-off has been supported by clinical and scientific data. The Corah’s Dental anxiety scale was modified to create MDAS, which included information regarding local anesthetic injection. 10

The Present study revealed that 85% of participants experienced Dental anxiety. This prevalence was more than the findings of studies conducted by do Nascimento et al. (23%), 11, Malvania and Ajithkrishnan (46%) 12, Madfa et al. (63%) 13, and Fotedar et al. (29%) 14. Geographical variance or methodological variations can be partially blamed for this discrepancy 4. It also implies that a large portion of the research population experienced anxiety related to receiving dental care, despite the technological advancements made in contemporary dentistry. 15

The present study Sheds lights on the association between dental anxiety and gender. Compared to their male counterparts, women were more likely to experience dental anxiety and phobia; 62% of female respondents said they had dental fear. Numerous other types of research confirmed this noteworthy correlation 16, 17, 18, 19 Despite the fact that kanegane et al. discovered no connection between gender and dental anxiety in the literature. 20

According to Deogade et al. and Waseem et al., women are more Willing than males to talk about their anxieties because they perceive fewer social repercussions from doing so 21, 22. Women may be better at expressing their fears, which could account for this discrepancy. Dental anxiety may also be linked to physiological disorders such social anxiety, panic attacks, sadness, Tension and dread, which are more prevalent in women 14. Our findings are Consistent with the most current data, which show that women have higher Level of dental anxiety (62% among 226 participants).

The current study found that participants with family incomes under <Rs.37,325 had high levels of dental anxiety (p<0.05) (Table 4) This pattern aligned with the findings of many other research as well, which found that Dental anxiety increased with a lower socio economic status 23, 24, 21. The Majority of the time, it can be related to the expense of the dental procedure 23, which is thought to be a more costly kind of treatment. It was evident that, in comparison to communities that were not impoverished, those who lived in areas with greater need were likely to experience dental anxiety. 25

Indeed, there is a strong correlation between dental anxiety and a person’s age, gender, financial status, and degree of education. These variables include the people’s exposure to dentists and their care, their comprehension of life’s inequalities, and their financial capacity for dental care. By being aware of these characteristics, dentists may better educate patients and help them comprehend dental treatments that can effectively allay their fear 26.

This Cross-sectional study was carried out on small sample of college students who were all from same age groups and same educational qualification. Thus, research on a wider population is required to investigate the connection between dental anxiety and educational qualification. It is necessary to do more research using various designs in order to look into the many causes of dental anxiety.

The study’s results imply that a significant number of the participants had dental anxiety. Gender and family income were the two socio demographic characteristics that were most strongly linked to dental anxiety.

Our research led us to establish the following trends:

The degree of Surgical pain and recovery is typically accurately predicted by preoperative anxiety. Dental fear has been reduced by techniques that focus on the four Primary stimuli of anxiety triggers: Vision (needles), smell (cut dentine), Hearing (drills) and feeling (vibrations). Aromatherapy, specifically lavender, orange and apple fragrances has been demonstrated to have a significant anxiolytic effect on patients as they wait for dental treatment. We may envisage a brave and fear less dental visits in the future with numerous new technologies that are coming forth, such the plasma torch tooth brush technique to ease dental concerns. 7