Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Study of online information for anxious patients requiring dental extractions


Introduction Standard practice for dental extractions is to provide treatment under local anaesthesia (LA) without additional sedation or general anaesthesia. Even in oral surgery departments, the majority of patients receive this anxiety-provoking treatment under LA alone. All patients undergoing extractions could benefit from information on relaxation and anxiety management. This study aims to perform an in-depth analysis of the quality of websites that provide information on dental extractions and anxiety.

Materials and methods Key phrases were searched on Google. The content, reliability and readability of the top ten websites for each key phrase were qualitatively evaluated using three tools: DISCERN, Flesch-Kincaid, and a specialised oral surgery website checklist (OSWC).

Results Patient education was limited, with 70% of websites being either advertisements, forums or articles for healthcare professionals. The majority of websites poorly described treatment such as sedation and only 16% provided methods for relaxation. Readability was poor, with 92% above average UK adult literacy ability.

Conclusion Extraction patients should be signposted to effective resources before treatment or referral. Dental anxiety advice can easily be incorporated into all treatment plans, with recommended website links included in digital communication, such as text messages or practice websites.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1.

    Ofcom. Adults' Media Use and Attitude Report. 2018. Available at (accessed August 2019).

  2. 2.

    Ali S, Woodmason K, Patel N. The quality of online information regarding dental implants. Br Dent J 2014; 217: E16.

  3. 3.

    Van Den Bosch S, Heijmans M, Faber M, Bergé S. Quality of online information about cleft lip and palate. Int J Oral Maxillofac Surg 2013; 42: 1205.

  4. 4.

    Rogers S N, Rozek A, Aleyaasin N, Promod P, Lowe D. Internet use among head and neck cancer survivors in the North West of England. Br J Oral Maxillofac Surg 2012; 50: 208-214.

  5. 5.

    Ritchie M, Awal D, Eyeson J D. Availability of apicoectomy information online. Oral Surg 2016; 9: 102-106.

  6. 6.

    Power A, Gallagher A, Betts S. The quality of patient information on the internet: the poorly advised patient. Br J Oral Maxillofac Surg 2015; 53: e65.

  7. 7.

    Morahan-Martin J M. How internet users find, evaluate, and use online health information: a cross-cultural review. Cyberpsychol Behav 2004; 7: 497-510.

  8. 8.

    Nasser D, Dunne S. Educating patients. Br Dent J 2014; 216: 211.

  9. 9.

    Dunne S, Cummins N M, Hannigan A, Shannon B, Dunne C, Cullen W. A method for the design and development of medical or health care information websites to optimize search engine results page rankings on Google. J Med Internet Res 2013; 15: e183.

  10. 10.

    General Dental Council. Standards for the dental team. 2013. Available at (accessed August 2019).

  11. 11.

    Google. Available at (accessed August 2019).

  12. 12.

    Protofuse. The first page of Google, by the numbers. 2014. Available at (accessed August 2019).

  13. 13.

    Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 1999; 53: 105-111.

  14. 14.

    Charnock D, Shepperd S. Learning to DISCERN online: applying an appraisal tool to health websites in a workshop setting. Health Educ Res 2004; 19: 440-446.

  15. 15.

    Kincaid J P, Fishburne R P Jr, Rogers R L, Chissom B S. Derivation of new readability formulas (automated readability index, fog count and flesch reading ease formula) for navy enlisted personnel. 1975.

  16. 16.

    WebFX. Readability Test Tool. Available at (accessed August 2019).

  17. 17.

    NHS. Fear of the dentist: healthy body. Available at (accessed August 2019).

  18. 18.

    Dental Fear Central. Available at (accessed August 2019).

  19. 19.

    Kani E, Asimakopoulou K, Daly B et al. Characteristics of patients attending for cognitive behavioural therapy at one UK specialist unit for dental phobia and outcomes of treatment. Br Dent J 2015; 219: 501.

  20. 20.

    Mayor S. NICE advocates computerised CBT. BMJ 2006; 332: 504.

  21. 21.

    Government Digital Service. Content design: planning, writing and managing content. 2016. Available at (accessed August 2019).

  22. 22.

    Bakker D, Kazantzis N, Rickwood D, Rickard N. Mental health smartphone apps: review and evidence-based recommendations for future developments. JMIR Ment Health 2016; 3: e7.

  23. 23.

    NHS. Student health app. Available at (accessed August 2019).

  24. 24.

    Anxiety UK. Available at (accessed August 2019).

  25. 25.

    Mind. Available at (accessed August 2019).

  26. 26.

    National Institute for Health and Care Excellence. Available at (accessed August 2019).

  27. 27.

    NHS England. Encouraging people to choose self care for life. 2018. Available at (accessed August 2019).

Download references


The author acknowledges the contribution of work and support of Mrs E.Carson, Research Scientist at James Cook University Australia and the access to the audit conducted by Dr F.Santis, Oral Surgery Speciality Dentist at Epsom and St Helier University Hospitals NHS Trust.

Author information



Corresponding author

Correspondence to Victoria Mellish.

Electronic supplementary material

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Mellish, V. Study of online information for anxious patients requiring dental extractions. Br Dent J 227, 399–402 (2019).

Download citation


Quick links