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A prospective observational pre-post study of dental anxiety associated with rubber dam isolation in patients undergoing restorative procedures

Sep 2026 · Beni-Suef University Journal of Basic and Applied Sciences · Vol 15 · 0 citations · 29 references

TL;DR

Factors such as occupation influenced anxiety levels after rubber dam usage, and the results were statistically significant, with unemployed participants exhibiting higher anxiety than students and employed individuals.

Abstract

To assess pre-treatment and post-treatment dental anxiety levels in patients undergoing restorative procedures using rubber dams. A prospective observational pre-post study was conducted on 102 patients treated at the Department of Conservative Dentistry and Endodontics of a reputed private Dental College. Informed consent was obtained from all the participants. A pre-treatment questionnaire assessing baseline anxiety (MDAS) was administered before the procedure. The patients were then educated about the rubber dam kit and its clinical significance. At the end of the dental procedure, a post-treatment questionnaire was administered. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 25.0, with a significance level set at p < 0.05. Descriptive statistics, mean calculation, Chi square test and Linear Regression analysis was performed. A total of 102 participants were included, comprising 52.0% males and 48.0% females. The mean pre-treatment MDAS score was 9.84 ± 4.54. Overall, 53.9% of participants demonstrated low anxiety, 40.2% moderate anxiety, and 5.9% high anxiety. Female participants reported significantly greater tenderness-related anxiety during rubber dam placement and removal. Occupation showed significant associations with anxiety measures (p < 0.05), with unemployed participants exhibiting higher anxiety than students and employed individuals. Multiple linear regression identified occupation as a significant predictor of dental anxiety (β = 0.250, p = 0.006), while age and gender were not significant predictors. Verbal explanation of the rubber dam procedure improved treatment acceptance and reduced anxiety among participants Within the limitations of the study, factors such as occupation influenced anxiety levels after rubber dam usage, and the results were statistically significant. Pressure or discomfort felt on the gums during the placement and removal of the rubber dam increases anxiety in patients. A verbal explanation of the rubber dam prior to treatment had a positive effect on treatment acceptance and reduced anxiety.

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