{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:52:30Z","timestamp":1786359150900,"version":"build-2736575974"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004329","name":"Javna Agencija za Raziskovalno Dejavnost RS","doi-asserted-by":"publisher","award":["P3-0293"],"award-info":[{"award-number":["P3-0293"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"Javna Agencija za Raziskovalno Dejavnost RS","doi-asserted-by":"publisher","award":["P3\u20130339"],"award-info":[{"award-number":["P3\u20130339"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Previous studies on dental anxiety have examined the psychophysiological responses evoked in dentally anxious subjects by dental-related stimuli, but not during a real-life dental examination, which was achieved in the present study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The heart rate, skin conductance level, and heart rate variability of 25 subjects with dental anxiety and 25 healthy controls were examined. Anxiety was determined by the Modified Dental Anxiety Scale and the Dental Anxiety Scale\u2013Revised. The psychophysiological reactions of the two groups were compared during exposure to dental-related pictures, dental-related sounds, and an actual examination in a dental surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>All the dental-related stimuli provoked an increase in heart rate, i.e. visual stimuli (p&lt;0.001; 95% CI 0.98\u20133.95 bpm), auditory stimuli (p&lt;0.001; 95% CI 1.34\u20134.99 bpm), and a dental examination (p&lt;0.001; 95% CI 1.26\u20135.39 bpm). Dental-related pictures provoked inferior skin conductance level changes compared to dental-related sounds and the dental examination (visual modality <jats:italic>vs<\/jats:italic> auditory p&lt;0.001; 95% CI 0.039\u20130.152; visual modality <jats:italic>vs<\/jats:italic> examination p&lt;0.001; 95% CI 0.083\u20130.275). Heart rate variability manifested in a complex pattern of responses to the dental examination. However, when exposed to all three dental-related stimuli presentation conditions, the heart rate (F = 0.352, p = 0.556), skin conductance level (F = 0.009, p = 0.926), and heart rate variability parameters of subjects with dental anxiety did not differ in comparison to the healthy controls.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This pilot study represents an evaluation of psychophysiological reactions during a real-life dental examination compared to single modality stimuli, and shows that a real-life dental examination provokes an increase in heart rate, heart rate variability and skin conductance level. Additionally, autonomic responses did not differ between the experimental and control groups. The key issue for future studies is the effect of real-life situations on the physiological and psychological state of the subjects, which should be considered when planning new research and studied in depth.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0252128","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T17:58:08Z","timestamp":1622743088000},"page":"e0252128","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Real-life dental examination elicits physiological responses different to visual and auditory dental-related stimuli"],"prefix":"10.1371","volume":"16","author":[{"given":"Tadea","family":"Ko\u0161ir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1633-5983","authenticated-orcid":true,"given":"Jakob","family":"Sajovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Gro\u0161elj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ale\u0161","family":"Fidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gorazd","family":"Dreven\u0161ek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5949-0580","authenticated-orcid":true,"given":"Polona","family":"Seli\u010d-Zupan\u010di\u010d","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"key":"pone.0252128.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1472-6831-13-29","article-title":"UK population norms for the modified dental anxiety scale with percentile calculator: Adult dental health survey 2009 results","volume":"13","author":"G Humphris","year":"2013","journal-title":"BMC Oral Health"},{"key":"pone.0252128.ref002","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0005-7967(97)00016-8","article-title":"Overlap between dental anxiety and blood-injury fears: Psychological characteristics and response to dental treatment","volume":"35","author":"D Locker","year":"1997","journal-title":"Behav Res Ther"},{"key":"pone.0252128.ref003","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1046\/j.0909-8836.1998.eos106402.x","article-title":"Dental anxiety among 18-yr-olds in NorwayPrevalence and related factors","volume":"106","author":"E Skaret","year":"1998","journal-title":"Eur J Oral Sci"},{"key":"pone.0252128.ref004","doi-asserted-by":"crossref","first-page":"816","DOI":"10.14219\/jada.archive.1978.0394","article-title":"Assessment of a dental anxiety scale","volume":"97","author":"NL Corah","year":"1978","journal-title":"J Am Dent Assoc"},{"key":"pone.0252128.ref005","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1034\/j.1600-0722.2002.11204.x","article-title":"idr. 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