Associations between fear of COVID-19, dental anxiety, and psychological distress among Iranian adolescents

Maryam Tofangchiha, Chung Ying Lin, Janneke F.M. Scheerman, Anders Broström, Hanna Ahonen, Mark D. Griffiths, Santosh Kumar Tadakamadla, Amir H. Pakpour

Research output: Contribution to journalArticlepeer-review


Objectives: The present study evaluated the association of fear of COVID-19 with dental anxiety, oral health-related quality of life (OHRQoL), and psychological distress (depression, anxiety and stress), as well as exploring the mediating role of dental anxiety in the association of fear of COVID-19 with OHRQoL and psychological distress. Methods: A cross-sectional study was conducted among adolescents in high schools of Qazvin city (Iran) from March-June 2021, recruited through a two-stage cluster sampling method. All the adolescents completed a self-administered survey assessing (i) fear of COVID-19, (ii) depression, anxiety and stress, (iii) OHRQoL, and (iv) dental anxiety. Structural equation modelling was used to evaluate all the hypothesised associations, and the model fit was estimated. Results: A total of 2429 adolescents participated in the study. The conceptual model fitted the data well. Fear of COVID-19 had a direct effect on dental anxiety (B = 0.316; bias-corrected bootstrapping 95% CI = 0.282, 0.349), depression (B = 0.302; bias-corrected bootstrapping 95% CI = 0.259, 0.347), anxiety (B = 0.289; bias-corrected bootstrapping 95% CI = 0.246, 0.334), stress (B = 0.282; bias-corrected bootstrapping 95% CI = 0.237, 0.328), and OHRQoL (B = −0.354; bias-corrected bootstrapping 95% CI = −0.530, −0.183). Also, dental anxiety mediated the association of fear of COVID-19 with depression, anxiety stress, and OHRQoL. Conclusions: High levels of fear of COVID-19 were associated with high levels of dental anxiety and poorer OHRQoL. Moreover, fear of COVID-19 was positively associated with anxiety, depression and stress. Increased levels of dental anxiety were also associated with increased anxiety, stress, depression, and poorer OHRQoL.

Original languageEnglish
Article number19
JournalBDJ Open
Issue number1
Publication statusPublished - 2022 Dec

All Science Journal Classification (ASJC) codes

  • Dentistry(all)


Dive into the research topics of 'Associations between fear of COVID-19, dental anxiety, and psychological distress among Iranian adolescents'. Together they form a unique fingerprint.

Cite this