When the fear of dentist is relevant for more than one’s oral health. A structural equation model of dental fear, self-esteem, oral-health-related well-being, and general well-being
Received 18 March 2019
Accepted for publication 21 June 2019
Published 25 July 2019 Volume 2019:13 Pages 1229—1240
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Justinn Cochran
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Alexandra Vigu1,*, Dorin Stanciu2,3,*
1Department of Dental Materials and Ergonomics, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-napoca, Cluj-Napoca, Romania; 2Department of Psychology and Pedagogy, Technical University of Cluj-napoca, Cluj-Napoca, Romania; 3Riley College of Education and Leadership (rcoel), Walden University, Minneapolis, USA
*These authors contributed equally to this work
Purpose: To develop and test a complex model that captures the individuals’ general well-being and the specific oral-health-related well-being. We were specifically interested, as a specific research question, if self-esteem, dental fear, and the oral health-related well-being are credible predictors for the general well-being.
Patients and methods: A one-time associative research design measured dental-specific anxiety, self-esteem, oral-health-related specific well-being, and general well-being in 281 participants, 3rd and 6th year dental students (MAge =22.59 years, SDAge =3.13; 55% females), which completed a battery of relevant questionnaires: the Dental Fear Survey, the Rosenberg Self-Image Scale, the short form of Oral Health Impact Profile, and the Flourishing Scale. The data were subject to structural equation modeling in order to validate potential pathways of influence hypothesized based on previous evidence from the literature.
Results: We developed and tested a complex structural equations model, in which dental fear influences both the specific oral-health-related well-being and the persons’ self-esteem. In turn, self-esteem mediates the influence pathways between dental fear and oral-health-specific well-being, on the one hand, and the overall well-being, on the other hand.
Conclusion: Our research contributes directly to strengthening the theoretical basis for future interdisciplinary research, by providing, first, a tested and replicable model that surpasses the simple correlation or prediction, and second, empirical evidence for the significant mutual interdependence between psychological experiences, eg, self-esteem, and the two main aspects of well-being, ie, specific and general. From a practical, clinical viewpoint, our research provides further insights and justification for the importance of educating the patient, on all levels, from the individual clinical practice to community programs and public oral health policies, with respect to the importance of oral health.
Keywords: oral health, well-being, quality of life, self-esteem, anxiety, mediation, structural equation modeling
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