Asian Journal of Dental Sciences

Volume 7, Issue 1, Page 387-396, 2024; Article no.AJDS.128796

The Impact of Procrastination and

Psychosocial Factors on Dental
Attendance and Oral Health Status
Arushi Chandra a*
a ITS Centre for Dental Studies and Research, Ghaziabad, India.

Author’s contribution

The sole author designed, analysed, interpreted and prepared the manuscript.

Article Information
DOI: https://doi.org/10.9734/ajds/2024/v7i1217

Open Peer Review History:

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review comments, different versions of the manuscript, comments of the editors, etc are available here:
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Received: 14/10/2024
Original Research Article Accepted: 19/12/2024
Published: 21/12/2024

ABSTRACT

Aim: The aim of the study is to explore the relationship between procrastination and dental
attendance, focusing on delay in seeking dental care, in spite of having a low self-reported oral
health status. In addition, the study includes a survey based investigation on the reasons of delay in
dental care.
Objective: Dental attendance is important to determine oral health, and regular dental visits
positively influence people’s quality of life. Regular dental check-ups are preventive measures to
assess oral health status and progression of oral disease. Thus, delay in oral examination and
treatment can be assumed to affect oral health negatively.
Dental anxiety has often been referred to be one of the reasons for avoidance or delay in dental
care. Studies show the relation between dental anxiety and delay of dental visits, where high levels
of anxiety predicts the length of delay.
However, delay in dental care could also be due to various other reasons. Such as, expenses of the
treatment, time consuming or not necessary without any acute symptoms.
_____________________________________________________________________________________________________

*Corresponding author: Email: [email protected];

Cite as: Chandra, Arushi. 2024. “The Impact of Procrastination and Psychosocial Factors on Dental Attendance and Oral
Health Status”. Asian Journal of Dental Sciences 7 (1):387-96. https://doi.org/10.9734/ajds/2024/v7i1217.
 Chandra; Asian J. Den. Sci., vol. 7, no. 1, pp. 387-396, 2024; Article no.AJDS.128796

Procrastination is the failure to initiate or complete a task. It is one of the leading demerits of the
present scenario, this article highlights how this can lead to delayed dental care that in turn impairs
oral health. It is also associated with health outcomes like stress and treatment delay, thus
increasing procrastination decreases health status. Dental patients might delay treatment for
conditions that are perceived not be very serious, acute or with no or low intensity symptoms
because undergoing clinical examination might be unpleasant in itself.
Therefore, delaying seeking dental care or avoiding treatment is a problem for dental public health.
Procrastination can be an important construct regarding oral health, affecting the delay of dental
care among patients.
Materials and Methods: The residents of the city of Muradnagar in the Ghaziabad district of Uttar
Pradesh who attended the oral health camps held by the ITS-CDSR Muradnagar campus in various
nearby communities were the subjects of the study. In April and May of 2023, data were gathered
through convenience sampling with a paper-based questionnaire.
Results: Most participants were middle class, with 60.7% attending regular dental visits, though
93.4% reported delays in care. High dental anxiety, stress, and procrastination were significantly
linked to poor oral health and delayed visits. Those with better self-reported oral health and regular
visits had lower anxiety and procrastination. Delays were strongly influenced by cost, stress, fear,
and perceived necessity, with necessity being the strongest factor. Poor oral health and higher
dental anxiety were associated with a willingness to attend future visits. Overall, psychometric
factors significantly impacted oral health behaviours, highlighting the need for strategies to address
psychological barriers to improve dental care access.
Conclusion: This study found a significant relationship between procrastination, psychometric
scales and delay of dental care. The delay is majorly due to lack of knowledge amongst the
participants as a significant group believed that there is no need for a dental visit without any acute
symptoms.

Keywords: Dental care; public health dentistry; procrastination; psychometric scales; oral health;
Kuppuswamy’s socio economic status scale; dental anxiety; oral health behaviour;
delivery of dental care.

1. INTRODUCTION Studies shows relation between dental anxiety

and avoidance of dental visits, with high level of
Regular dental attendance is a key oral health dental anxiety is proportional to length of
behaviour [1]. The National Institute of Health avoidance [6]. Delaying dental attendance could
and Care Excellence (NICE) recommends that all also be due to various other reasons, such as the
adults should have dental screening between 3 patient might think that treatment or dental
months and 2 years based on their oral health examination is overly expensive, time consuming
risks [2]. A regular dental attenders is someone or it is unnecessary without any acute symptoms
who attends for routine dental recalls regardless [7].
of their dental needs. Non regular dental
attenders are the people who go for dental visits Socio-economic status has a long held interest
when they have a dental problem. Non regular for its effects on general and oral health.
dental attendance is associated with poorer oral Evidence indicates that the socio-economic
health compared with those who do regularly inequalities are associated with oral health status
attend [3]. Regular dental check-ups and weather subjectively (self rated oral health) or
scheduled appointments are preventive objectively (clinically diagnosed oral health
measures by which oral health problems and oral status) determined [8]. Education and income are
disease progression are assessed. This is most common indicators used in epidemiology
important as various oral diseases lacks for socio- economic status measurement [9] and
symptoms in early phases. Delaying an oral can be measured by Modified Kuppuswamy’s
examination or treatment is therefore thought to Socio-Economic Status Scale. Studies have
have a negative impact on oral health [4]. shown that oral health and dental diseases are
negatively correlated with socioeconomic status
Dental anxiety or negative dental treatment [10], higher socioeconomic status means better
experience has often been referred to as a oral health perception and lesser delay in dental
foundation for much avoidance behaviour [5]. care.

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Procrastination is a form of self regulatory failure In the camps organised by ITS-CDSR, the
that describes failure to initiate or complete tasks questionnaire was distributed to 374 patients, of
[11]. It is associated with less favourable health whom 300 completed the survey. The majority of
outcomes like stress, anxiety and treatment participants were female, with a mean age of 26
delay. Thus, increasing procrastination to 50 years. All participants actively consented to
decreases health status [12]. Task avoidance participate before accessing the questionnaire,
has been identified as a strong procrastination and responses were anonymous. The
predictor [13]. Dental patients might tend to delay questionnaire consisted of questions regarding
treatment for conditions that are perceived not to oral health dental attendance or oral health
be serious, acute or presents with low intensity behaviour, Kuppuswamy’s Socio-Economic
symptoms [4]. Although delay in dental visits Status Scale in addition to 3 psychometric
might have consequences, such as when patient scales, which are Modified Dental Anxiety Scale
delay seeking treatment or examination for (MDAS), Perceived Stress Scale (PSS), Irrational
symptoms related to oral cancer [14] or Procrastination Scale (IPS).
periodontal disease [15]. Therefore, delaying
seeking dental care or avoiding treatment is a 2.1 Questionnaire
problem for dental public health and
procrastination can be an important aspect in Age and gender and socio-economic status were
health behaviour affecting the delay of delay care the socio demographic characteristics included in
among patients [4,16,17]. the study. According to Kuppuswamy’s Socio-
Economic Scale, participants were asked about
The purpose of this study is to investigate the link the head of the family’s education, income, and
between procrastination and dental attendance, profession. On a scale from 1 to 5, where 1 is
with a particular emphasis on the delay in stated to be very poor and 5 is very good for the
seeking dental care while having poor oral health former question, and 1 is stated to be very
according to self-report. In addition the study also dissatisfied and 5 is very satisfied for the latter,
includes a survey based investigation on reasons participants were asked how they perceived their
of delay in dental care. oral health and how satisfied they were with their
oral health status. By asking participants about
2. MATERIALS AND METHODS their regular, previous, and upcoming dental
appointments, it was possible to assess their
The residents of the city of Muradnagar in the dental attendance. The Kuppuswamy’s Socio-
Ghaziabad district of Uttar Pradesh who attended economic Scale had a Cronbach’s alpha level of
the oral health camps held by the ITS-CDSR 1.
Muradnagar campus in various nearby
communities were the subjects of the study. In Participant’s regular dental visits were assessed
April and May of 2023, data were gathered by asking, “Do you go to the dentist regularly?”,
through convenience sampling with a paper- past dental visits were assessed by asking,
based questionnaire. “When did you last went to the dentist?” and
future dental visits were assessed by asking,
A pilot study was also conducted prior to the “Would you want to go to the dentist regularly?”.
main study on 30 participants of similar The various response options for the frequency
community to assess the feasibility of the study of dental visits were available to participants.
and to determine the sample size. It was Similarly, delay in dental care is assessed by
revealed from pilot study that the correlation asking, “Do you ever delay in dental treatment or
coefficient of delay with other variable is 0.162. examination by the dentist?”. There were four
Therefore using the following formula the sample responses available to participants: “never,”
size is 297. “sometimes,” “often,” and “always; where
response 1-2 indicated little or no delay,
(The standard normal deviate for α = indicated moderate to high delay in dental
Zα = 1.9600 for 95% confidence interval and care.
α 5%
The standard normal deviate for β = The question, "What Is the reason behind
Zβ = 0.8416 for power 80% and β 20% postponing dental care?, ”was used to evaluate
C = 0.5 * ln[(1+r)/(1-r)] = 0.1634 the potential causes of delay. Where articulations
Total sample size = N = [(Zα+Zβ)/C]2 + 3 connected with the classifications Stress, Fear,
= 297) [18] Cost, Time and Need were given. The assertions

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were stated as “Getting dental treatment or (MDAS). MDAS consists of 5 statements and
assessments by dental specialists are … … … “, participants responds to them using likert scale
finished with the accompanying portrayal 1-5 and is used by summarizing the scores of all
‘distressing’, ‘scary’, ‘excessively expensive’, the statements. This scale differentiate
‘excessively time consuming’ and ‘not necessary participants between low (5-10), moderate (11-
without symptoms’. On a likert scale from 0 18) and severe (>18). The MDAS had a
(doesn’t describe me at all), 1 (seldom describes Cronbach’s alpha level of 1.
me), 2 (describes me occasionally), 3 (describes
me often), and 4 (describes me well), each Stress levels in the participants was evaluated
participant was required to indicate how using the Perceived Stress Scale (PSS). PSS is
accurately the statements described them. In the a global measure of stress and requires 10
examination, the responses were summed up, statements about stressful situations in last
showing how frequently the reasons were month. Participants responds to them on a likert
expressive for the defer in dental consideration. scale of 0-4 and was used by summarizing score
of the items. Higher scores indicates more
Dental anxiety in the participants was evaluated perceived stress. The PSS had a Cronbach’s
by using the Modified Dental Anxiety Scale alpha level of 1.

Table 1. Descriptive overview of demographics, socio economic status, self reported oral
health and variables of dental visits

Variable Category Participants Male Female

n (%) n (%) n (%)
Total 300 (100%) 141 (47%) 159 (53%)
Age 18-25 83 (27.7%) 32 (38.5%) 51 (61.5%)
26-40 126 (42%) 66 (52.4%) 60 (47.6%)
>40 91 (30.3%) 43 (47.8%) 48 (52.8%)
Socio-Economic Upper 23 (7.7%) 10 (7.1%) 13 (8.2%)
Status Upper middle 98 (32.6%) 48 (34.1%) 50 (31.4%)
Lower middle 101 (33.7%) 47 (33.3%) 54 (34%)
Upper lower 50 (16.7%) 25 (17.7%) 25 (15.7%)
Lower 28 (9.3%) 11 (7.8%) 17 (10.7%)
Self reported oral Very poor 22 (7.3%) 11 (7.8%) 11 (7%)
health Poor 82 (27.4%) 38 (27%) 44 (27.7%)
Neutral 131 (43.7%) 67 (47.5%) 64 (40.2%)
Good 58 (19.3%) 23 (16.3%) 35 (22%)
Very good 7 (2.3%) 2 (1.4%) 5 (3.1%)
Regular dental visits Never 22 (7.3%) 10 (7.1%) 12 (7.5%)
Acute only 96 (32%) 48 (34%) 48 (30.2%)
Every second year 98 (32.7%) 45 (32%) 53 (33.4%)
Once a year 63 (21%) 25 (17.7%) 38 (23.9%)
>Once a year 21 (7%) 13 (9.2%) 8 (5%)
Future dental visits Never 4 (1.3%) 1 (0.7%) 3 (1.9%)
Acute only 45 (15%) 20 (14.2%) 25 (15.7%)
Every second year 79 (26.3%) 40 (28.3%) 39 (24.5%)
Once a year 146 (48.7%) 65 (46.1%) 81 (51%)
>Once a year 26 (8.7%) 15 (10.6%) 11 (6.9%)
Past dental visits Never 30 (10%) 13 (9.2%) 17 (10.7%)
1-6 months back 68 (22.6%) 33 (23.4%) 35 (22%)
1 year back 95 (31.7%) 42 (29.8%) 53 (33.3%)
2 years back 74 (24.7%) 33 (23.4%) 41 (25.8%)
>2 years back 33 (11%) 20 (14.2%) 13 (8.2%)
Delay in dental care Never 20 (6.6%) 11 (7.8%) 9 (5.7%)
Sometimes 93 (31%) 51 (36.2%) 42 (26.4%)
Often 119 (39.7%) 45 (31.9%) 74 (46.5%)
Always 68 (22.7%) 34 (24.1%) 34 (21.4%)

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Table 2. Descriptive overview of the variables of psychometric scales

Psychometric Category Participants Male Female

Scales (variables) n (100%) n (100%) n (100%)
Total 300 (100%) 141 (47%) 159 (53%)
MDAS Mild (5-10) 41 (13.7%) 18 (12.8%) 23 (14.5%)
Moderate (11-18) 153 (51%) 76 (53.9%) 77 (48.4%)
High (>18) 106 (35.3%) 47 (33.3%) 59 (37.1%)
PSS Low (0-13) 66 (22%) 35 (24.8%) 31 (19.5%)
Moderate (14-26) 165 (55%) 77 (54.6%) 88 (55.3%)
High (27-40) 69 (23%) 29 (20.6%) 40 (25.2%)
IPS Low (<19) 63 (21%) 35 (24.9%) 28 (17.6%)
Moderate (19-37) 144 (48%) 66 (46.8%) 78 (49%)
High (>37) 93 (31%) 40 (28.3%) 53 (33.3%)

Procrastination was measured using the upper middle class. Only 43.7%, 19.3%, and
Irrational Procrastination Scale (IPS). IPS is a 9 2.3% of participants, respectively, reported
statements scale where responses to the having neural, good, or very good oral health
statements were made on a likert scale from 1-5 status as self-reported by them. A total of 60.7%
to indicate that the statements describes the, well of members had customary dental visits
(5) or not (1). The statements used were consistently year or on a more regular basis.
situation based where postponement of tasks 7.3% of participants said they did not go to the
affected the participants. The scale is used by dentist on a regular basis, while 32% said they
summarizing scores of the statements. Higher only went to the dentist when they had acute
the score, higher is the procrastination tendency. symptoms. A large portion of the members that is
The IPS had a Cronbach’s alpha level of 1. 83.7% wanted regular dental visit in future. A
total of 93.4 percent of participants reported
2.2 Statistical Analysis experiencing delays in dental care sometimes,
often and always.
The collected survey data were compiled in a
Microsoft Excel Sheet, and SPSS version 24 was 3.2 Psychometric Scales
used for statistical analysis. The reliability of the
scales used in this study—the MDAS, PSS, IPS, The median and mean values of the
and Kuppuswamy’s Socio-Economic Status psychometric scales and the spearman’s
Scale—was examined using reliability analysis. correlation among them in this study are shown
in Table 4.
The sample’s dental attendance was investigated
using non-parametric exploratory analysis. Using Descriptive statistics in Table 2 show that 51% of
spearman’s correlation analysis, the bivariate the population experiences moderate dental
association was evaluated. A correlation score of anxiety of dental procedures and examinations,
0.2-0.4 is regarded as weak, 0.4-0.6 as with males having more anxiety. About 35.3% of
moderate, and 0.6-0.8 as strong. all participants suffered from severe dental
anxiety, and females were affected more often
Descriptive statistics including mean median than males. Only 13.7% of participants had a
standard deviation and interquartile range were mild dental anxiety, with a similar distribution for
arranged for the psychometric scales. males and females.

3. RESULTS Survey data also show that 55% of participants

experienced moderate levels of stress,
3.1 Socio Economic Status, Self Reported regardless of gender. Approximately 23% and
Oral Health and Dental Visits 22% of participants reported high and low stress
levels, which were more common in females and
Table 1 displays demographics and other males, respectively. Similarly, when
variables. Among the members larger part of the procrastination tendency was calculated, the
population were in the middle class as per data showed that approximately 48% of the
Kuppuswamy’s Socio-Economic Status Scale, participants exhibited moderate procrastination
33.7% were of lower middle and 32.6% were of tendency. Among them, there were more

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females than males. Low levels of procrastination delaying dental care is more frequent among
were predominant in male participants, only 21% older participants and the one with high DMFT
of the population, while 31% of the population scores which showed poor oral health in the
exhibited high levels of procrastination, more study, but no significant relationship was seen
females. between gender, socio-economic status and
delay in dental care. Further, correlation analysis
The data in Table 3 show that the median values showed significant negative association between
for MDAS, PSS, and IPS were 19, 21.5, and 26, the delay in dental care and self reported oral
respectively Indicating that 50% of the data had health and future dental visits, respectively.
values above the median and the remaining 50% These associations indicated that the participants
had values below the median. The IQR scores with poor self reported oral health and those who
were also calculated to measure data variability, doesn’t want to go for regular dental visits in
with scores of 6.5 and 4.5 on the psychometric future were more likely to delay dental care.
scales MDAS, PSS, and IPS, respectively. Mean
scores on the psychometric scale were In order to check for the effects of psychometric
calculated by measuring the actual mean of the scales on the delay in dental care, correlations
data and indicated that, on average, the showed that all three psychometric scales had
population had moderate dental anxiety, positive and significant relationship with the delay
perceived stress and procrastination tendencies. in dental care, indicating that participants with
To measure the spread of data, the mean high dental anxiety, perceived stress and
standard deviation was calculated, which was procrastination tendencies tend to delay dental
3.7, 4.5, and 3.94 for MDAS, PSS, and IPS, care more.
respectively.
3.4 Reasons for Delay in Dental Care
The spearman's correlation analysis revealed a
positive and significant correlation between A correlation analysis showed that the delay in
MDAS and PSS, MDAS and IPS, and PSS and dental care is associated positively and
IPS, for which the correlation coefficients were (r significantly with all the potential reasons
= 0.45: P<.01), (r = 0.28: P<.01) and (r = 0.37: provided in the questionnaire (Table 5), and the
P<.01). Indicating that the participants with high strongest association was found between the
levels of perceived stress had greater anxiety delay in dental care and necessity (r = 0.53).
about dental treatments and examinations and
were more likely to procrastinate dental Table 6 shows that IPS is correlated significantly
visits whereas participants with lower levels of and positively with all the reasons for the delay in
perceived stress had less anxiety and dental care, but the strongest correlation was
were less likely to procrastinate dental visits. found with necessity. Indicating that mostly
participants delay dental care because they feel
A correlation analysis was performed to further that dental visits are not necessary without acute
examine the relationship between psychometric symptoms. MDAS is associated significantly and
scales and oral health status. It showed a positively with stress and fear and PSS is
negative relationship of dental anxiety and associated with significantly with stress, fear,
procrastination with the participants’ self reported time and necessity. Both MDAS and PSS are
oral health, implying that low dental anxiety and associated strongly with stress.
procrastination was related to high self reported
oral health and showed a positive relationship 3.5 Oral Health Status, Dental Attendance
between DMFT scores and psychometric scales, and Psychometric Scales
indicating that low dental anxiety, perceived
stress and procrastination was related to low It was found that participants with more regular
DMFT scores which means good oral health dental visits reported less perceived stress and
status. procrastination tendency as the are negatively
but significantly associated with regular dental
3.3 Delay in Dental Care visits (PSS: r= -0.14*, IPS: r = -0.2**) but no
significant association with MDAS (r= -0.5) was
The correlation analysis revealed a positive and found (Table 7).
significant correlation between delay in dental
care and age and DMFT score, respectively, Age, DMFT scores and MDAS shows positively
(age; r = 0.22) (DMFT; r =0.33) indicating that significant association with the past dental visits,

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indicating that participants last dental visit were study, the larger part of participants were middle
frequent as with increasing age, dental anxiety class. The result shows strong relationship
and DMFT score also increases resulting in poor between procrastination, dental anxiety and
oral health status and therefore need for dental stress. Also all the psychometric scales are also
visit increases. strongly related with the delay in dental care.
This indicates that participants with dental
Also, DMFT scores and MDAS shows positive anxiety and stress tends to procrastinate and
correlation with future dental visits, indicating that therefore they end up delaying the dental care.
participants with higher dental anxiety were There is negative association between regular
reported to have poor oral health i.e. high DMFT dental visits and procrastination, but no
scores, but they agreed for more frequent dental significant association with past and future dental
visits in future. visits.

4. DISCUSSION In this sample the past dental visits shows

association with age, oral health status and
The primary goal of dental visits is to find dental attendance stating that in past as the age
problems early, various oral diseases can be of the participant increase the frequency of
managed if caught early. Treating problems early dental visits increase, which might be because of
keeps oral diseases from getting worse and the increasing poor oral health with age which
costs less than later treatment would take. In our may lead to increasing dental attendance.

Table 3. Psychometric scales properties and spearman’s correlations

Median (IQR) Mean (SD) MDAS PSS IPS

MDAS 19 (6) 17.4 (3.7) 1.00 0.45** 0.28**
PSS 21.5 (5) 22.7 (4.5) 0.45** 1.00 0.37**
IPS 26 (4.5) 26 (3.9) 0.28** 0.37** 1.00
P-value <.05 * and <.01 **, IQR = interquartile range, SD = standard deviation

Table 4. Spearman’s correlation of psychometric scales with oral health status

MDAS PSS IPS

Self reported oral health -0.19** 0.91 -0.17**
DMFT scores 0.34** 0.25** 0.37**
P-value <.05 * and <.01 **

Table 5. Spearman’s between the delay in dental care, demographics, reasons for the delay,
oral health and attendance and psychometric scales

Variables Scales Delay in dental care

Demographics Age 0.22**
Gender 0.69
Socio-Economic Status 0.95
Reasons for delay in dental care Cost 0.20**
Stress 0.35**
Fear 0.34**
Time 0.15**
Necessity 0.53**
Oral health and dental attendance Self reported oral health -2.59**
DMFT score 0.33**
Regular dental visits -0.54
Future dental visits -0.17**
Past dental visits 0.12*
Psychometric scales MDAS 0.31**
PSS 0.29**
IPS 0.45**
P-value <.05 * and <.01 **

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Table 6. Spearman’s correlation between reasons for delay in dental care and psychometric
scales

Reasons for delay in dental care MDAS PSS IPS

Cost 0.58 0.52 0.25**
Stress 0.4** 0.35** 0.29**
Fear 0.31** 0.29** 0.21**
Time 0.72 0.15** 0.12*
Necessity 0.72 0.28** 0.38**
P-value <.05 * and <.01 **

Table 7. Spearman’s correlation between dental attendance variables, age, dental health and
psychometric scales

Variables Category Regular dental Past dental Future dental

visits visits visits
Demographics Age 0.71 0.17** 0.035
Oral health Self reported oral health 0.58 -0.04 -0.045
DMFT score -0.05 0.29** 0.29**
Psychometric MDAS -0.52 0.15** 0.15**
scales PSS -0.14* 0.07 0.79
IPS -0.20** 0.05 0.58
P-value <.05 * and <.01 **

Therefore, past dental visits might be a better examination or treatment without any acute
measure of actual attendance because the data symptoms.
is solely based on self reported measures:
whereas regular dental visits are likely to be In contrast to this study, a comparable
inquired by previously learned behaviour and exploratory investigation on university students at
might be affected by social norms. The Arctic University of Norway revealed no
significant relationship between procrastination
Procrastination is lack of execution of a task. A and delay in dental treatment but a positive
large proportion of participants in this sample association was found between psychometric
expressed desire for regular dental attendance in scales (MDAS, PSS) and the delay. The
future which indicate the intention to visit dentist perceived expense of the dental examination or
is present. However approximately more than 90 treatment was the cause of dental care delays
percent of participants stated that they delayed among university students in over half of the
dental care to varying degrees which shows cases [9].
problem of execution related to dental visits
rather than lack of intention. A research has 5. CONCLUSION
demonstrated a negative relationship between
overall health behaviours and procrastination This study found a significant relationship
[12], which indicates that procrastinators tend to between procrastination, psychometric scales
practice less health promoting behaviours. This, and delay of dental care. Procrastination had
procrastination might still be an important factor different relation to past, present and future
in determining oral health behaviour and oral dental attendance and could play important role
health status. in oral health behaviour. In view of study the
delay is majorly due to lack of knowledge
As the study shows significant association amongst the participants as a significant group of
between procrastination and delayed dental care, participants believed that there is no need for a
there are various reasons for the delay. The most dental visit without any acute symptoms.
frequent and most significantly associated
response when asked various reasons behind Further this exploration is likewise helpful in
the delay in dental care, was the necessity. understanding the behavioural patterns of the
Showing that the population in the sample, patients, and carrying out mediations and
believe that it is not necessary to go for dental working on the public dental consideration.

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It is not applicable.
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COMPETING INTERESTS 94:19–26
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