Evaluation of the effects of oral hygiene habits, dental anxiety, and fear levels on natural tooth color in young adults

Aim: The aim of this study is to investigate the effects of dental anxiety and fear levels on oral hygiene habits and tooth color in young adults. Material and Method: A total of 503 individuals aged between 18 and 35 participated in the study. During the clinical examination, the DMFT, gingival index, and plaque index were calculated. Tooth colors between the canines of the upper and lower jaws were measured and recorded using the Vita Easyshade V spectrophotometer. Each participant completed a questionnaire containing sociodemographic data, oral hygiene habits, the Modified Dental Anxiety Scale, and the Dental Fear Scale. For statistical analysis, the Kruskal–Wallis H and Dunn tests, One-Way ANOVA, and Spearman tests were employed, while the Asymptotically Distribution-Free (ADF) method was used for the Structural Equation Modeling (SEM). In statistical analyses, the significance level was set at p < 0.05. XX Results: Analysis of data obtained from 503 participants revealed high intermeasurement reliability (ICC > 0.85). The mean age of participants was 24.36 ± 4.58 years, and 64.6% were female. The mean scores for the Dental Anxiety Scale and the Dental Fear Scale were 10.99 ± 4.78 and 39.98 ± 16.39, respectively, with a strong positive correlation between the two (r = 0.834, p < 0.001). Gingival Index (GI) and Plaque Index (PI) scores showed significant associations with gender, parental education level, income, and oral hygiene habits (p < 0.05). PI and GI values were significantly lower among females, individuals who brushed regularly, and those who used dental floss. Smoking was associated with an increased daily intake of colored beverages (p < 0.001) but did not produce a significant difference in CIELab (Commission Internationale de l'Eclairage) tooth color values. SEM revealed significant relationships between dental anxiety and fear levels and periodontal indices, while a direct significant association with natural tooth color parameters (L, a, b) was observed only in the upper jaw (p > 0.05). Conclusion: In young adults, dental anxiety and dental fear show significant associations with periodontal health indicators. As anxiety increases, plaque and gingival index values rise, whereas dental fear appears to enhance oral‐care behaviors, resulting in lower index values. Additionally, the impact of psychological variables on tooth color was found to be significant only in the maxillary arch, which may be related to esthetic awareness. Keywords: Natural tooth color, Anxiety, Fear, Periodontal health, Oral hygiene habits