Ann Catrin Høyvik

• Kimmie-Dhansay, Faheema; Høyvik, Ann Catrin; Bhayat, Ahmed; Hussain, Faezah; Karunakaran, Arannikah & Kaya, Besime [Show all 12 contributors for this article] (2025). Dental anxiety and empathy among undergraduate oral health students in Norway, South Africa and Namibia. Acta Odontologica Scandinavica. ISSN 0001-6357. 84, p. 181–181. doi: 10.2340/aos.v84.43424. Full text in Research Archive Show summary

  Purpose/objectives: Dental anxiety is a common type of fear that can complicate dental treatment. The dental practitioner is crucial in both treating dental fear and anxiety as well as prevent it from arising. The ability to feel empathy is important in that matter. The dental practitioner’s own level of dental anxiety can possibly affect his or her ability to treat patients in an empathetic manner. The aim of this study was to assess and examine the relationship between level of empathy and dental anxiety in undergraduate oral healthcare students from Namibia, South Africa and Norway. Material and methods: A cross-sectional study was performed. Questionnaires were distributed, and responses were analyzed anonymously. Dental anxiety was assessed using Modified Dental Anxiety Scale (MDAS), and empathy level was assessed using Toronto Empathy Questionnaire (TEQ). Data were presented as means or medians and analyzed using a linear regression model in STATA with a 5% level of significance. Results: The response rate was 16.0%, and 298 completed questionnaires were received. MDAS was low in all groups (medians 7–10), however, significantly lower in Norway compared to Namibia and South Africa. The mean TEQ score was 46.8 in Namibia, 47.5 in South Africa and 50.4 in Norway, all above average empathy levels but significantly higher in Norway than in Namibia and South Africa. Conclusions: Oral healthcare students in Africa and Norway showed high empathy and low dental anxiety, which is reassuring for future oral health care professionals.

• Høyvik, Ann Catrin; Willumsen, Tiril; Lie, Birgit & Hilden, Per Kristian (2024). Torture victims’ perspective on dental treatment: “Every sign you make, every move you take” – A qualitative study. European Journal of Oral Sciences. ISSN 0909-8836. p. 1–11. doi: 10.1111/eos.13007. Full text in Research Archive Show summary

  Torture victims struggling with post-traumatic stress often experience elements in the dental treatment situation that may trigger trauma-related reactions. The aim of the study was to explore intervention strategies that will enable dental health workers to adapt dental treatment to the needs of torture survivors. Exploratory interviews were conducted with 10 torture-exposed resettled refugees with dental treatment experience in Norway. The data was analyzed using qualitative content analysis, which suggested that to minimize trauma-reactions, dental personnel should focus on creating a safe therapeutic space and strengthening the patient's sense of control. Four main categories of clinical advice were proposed: (i) Acquire knowledge about psychology, consequences of torture, cultural differences, trauma-informed care, and the patients’ individual needs; (ii) Recognize the trigger-potential of busyness or delays; (iii) Avoid surprises, such as sudden moves or actions and explore triggers individually, but make sure not to evoke images of interrogation, and; (iv) Provide overview both with respect to visibility in the clinical room, and to predictability regarding the dental treatment. Although undergoing dental treatment may be challenging for torture-exposed individuals, it is possible to reduce the predicaments considerably by making feasible adaptions to the treatment and adopting a trauma-informed approach.

• Hauge, Mariann Saanum; Høyvik, Ann Catrin; Strøm, Kjetil & Willumsen, Tiril (2023). Norske tannlegers kompetanse og behandling av tannbehandlingsangst. Norsk tannlegeforening Tidende. doi: 10.56373/2023-4-3. Full text in Research Archive
• Høyvik, Ann Catrin; Willumsen, Tiril; Lie, Birgit & Hilden, Per Kristian (2021). The torture victim and the dentist: The social and material dynamics of trauma re-experi-encing triggered by dental visits. Journal on Rehabilitation of Torture Victims and Prevention of Torture. ISSN 1018-8185. 31(3), p. 70–83. doi: 10.7146/torture.v32i3.125290. Full text in Research Archive Show summary

  Introduction: The flow of refugees towards Europe over the past decade has placed increased demands on the health care services. A significant proportion of refugees have been subjected to torture involving their mouth or teeth, still the importance of oral health challenges is often overlooked or underestimated in the rehabilitation of torture victims. In this qualitative study, we set out to explore the processes that complicate torture victims’ ability to engage in and tolerate dental procedures.
 Methods: Ten resettled refugees with experience of torture were recruited among patients affiliated with specialized clinics for oral health rehabilitation in Norway. Data were collected through semi-structured exploratory interviews, and analyzed using a qualitative content analysis approach.
 Results and discussion: We present an exploration of what we have called the social and material anatomy of the triggering event; the process through which trauma-related reactions are produced in torture victims in the course of undergoing dental treatment. All professionals who work with torture survivors should be aware that these individuals often suffer from oral health problems that may affect both their physical and their psychological quality of life. However, although dental treatment is essential, it may still represent a major challenge. Our data suggest, we propose, that dental treatment often involves an experience being suspended, albeit temporarily, in an objectified position, acted on by subjects capable of producing deeply undesirable mental, emotional or bodily states. Three main categories emerged as the most prominent factors with such an agentic capacity: 1) pain, 2) traumatic memories and 3) the dentist. Submitting to dental treatment hence requires the patient’s willingness to give in to the actions of these factors, and avoiding treatment may therefore, in this situation, represent a means of retaining control.

• Høyvik, Ann Catrin; Lie, Birgit; Grjibovski, Andrei M. & Willumsen, Tiril (2018). Oral Health Challenges in Refugees from the Middle East and Africa: A Comparative Study. Journal of Immigrant and Minority Health. ISSN 1557-1912. p. 1–8. doi: 10.1007/s10903-018-0781-y. Full text in Research Archive Show summary

  The aim was to explore and compare oral health and need for dental treatment in newly arrived refugees from the Middle East and Africa to Norway. Oral examination and structured interviews were performed with attending interpreters. Associations between origin and measures for oral health were studied with multiple linear regression. Half of the refugees (n = 132) reported oral impacts on daily performances (OIDP) and mean number of decayed teeth (DT) was 4.3 (SD 3.5). Refugees from the Middle East had more DT (1.38, p = 0.044), higher sum of decayed, missing and filled teeth (DMFT) (3.93, p = 0.001) and lower OIDP-score (− 3.72, p = 0.026) than refugees from Africa. Refugee oral health is generally poor, with more extensive challenges in refugees from the Middle East. However, few missing teeth, and manageable caries-gradient at the time of registration indicate that most refugees have the prerequisites for a good dentition, provided they get the necessary treatment.

• Høyvik, Ann Catrin; Lie, Birgit & Willumsen, Tiril (2018). Dental anxiety in relation to torture experiences and symptoms of post-traumatic stress disorder. European Journal of Oral Sciences. ISSN 0909-8836. p. 65–71. doi: 10.1111/eos.12592. Full text in Research Archive Show summary

  Torture victims often show symptoms of dental anxiety when receiving dental care, but little systematic research is available. The purpose of this study was to explore torture experiences, symptoms of post‐traumatic stress disorder (PTSD), and dental anxiety in refugees in Norway and to test the hypothesis that refugees with torture experiences are more prone to dental anxiety than refugees with no such experiences. A total of 173 refugees were interviewed shortly after an oral examination. The Modified Dental Anxiety Scale (MDAS) and the Harvard Trauma Questionnaire‐PTSS16 were administered verbally through attending interpreters. Among torture victims (47%, n = 81), the prevalence of torture experiences involving mouth or teeth was 35% and 23%, respectively. Harvard Trauma Questionnaire mean sum scores were statistically significantly higher in torture victims (34.3 vs. 24.8). Torture survivors report a larger number of symptoms of PTSD, and dental anxiety shows a higher prevalence in refugees reporting PTSD symptoms than in refugees who do not report such symptoms. When analysed using logistic regression models, the data showed the odds of high levels of dental anxiety being 6.1 times higher in refugees with torture experiences compared with other refugees and 9.3 times higher in torture victims with PTSD symptoms. Oral health professionals should be aware of these associations when providing dental care to refugees. The hypothesis that tortured refugees are more prone to dental anxiety is supported.

• Høyvik, Ann Catrin; Holst, Dorthe & Schuller, A.A. (1999). Færre unge går til tannlege en gang i året. Grunn til bekymring? Den norske tannlegeforenings Tidende. ISSN 0029-2303. 8. Full text in Research Archive

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• Høyvik, Ann Catrin; Tønnesen, Espen Andreas & Willumsen, Tiril (2025). Oral helse hos flyktninger og asylsøkere: Status, utfordringer og tilrettelegging av tannbehandling ved psykologiske traumer. Aktuel Nordisk Odontologi. ISSN 1902-3545. doi: 10.18261/ano.50.1.3. Full text in Research Archive Show summary

  The influx of refugees to the Nordic countries entails an increasing need for oral health services to a population with more oral health challenges than the host population. Regardless of originating country, refugees present with high degree of caries, periodontitis, and tooth loss, followed by oral pain, infections and impaired oral health-related quality of life. Knowledge about prevention of oral health diseases varies, and information must therefore be culturally adjusted and translated to relevant languages. Psychologically traumatized refugees experience more oral health challenges and are more prone to dental anxiety. It is possible to help these refugees master the dental treatment situation provided the dental practitioner 1) acquires relevant trauma knowledge, 2) spends enough time /avoids signaling stress, 3) avoids surprising the patient with sudden triggers, and 4) provides overview of the consultation step by step.

• Maroufi, Sada; Milanovic, Blagica; Hove, Lene Hystad; Høyvik, Ann Catrin; Torgersen, Gerald R. & Fjeld, Katrine Gahre (2025). SimSamBot – Development of an AI-Based Training Robot Assisting Students in Communication with Dementia Patients. Full text in Research Archive Show summary

  Background The increasing prevalence of dementia presents unique challenges for dental professionals, particularly in communication and patient management. Effective communication is critical to providing compassionate, patient-centered care, yet dental students often lack the necessary training to interact confidently with dementia patients. Aims and Objectives This project aims to equip dental students with the skills and knowledge required to communicate effectively with dementia patients. Specific objectives include: 1 Developing a communication training module tailored to dementia care; 2 Enhancing students’ ability to recognize and adapt to the needs of patients with cognitive decline; and 3 Promoting empathy and understanding through experiential learning approaches. Materials and Methods A large language model (LLM) acting as communication robot is supplied with data on the patient groups it simulates. Information is collected through literature reviews and audio recordings of clinical consultations with dementia patients, with consent from the healthcare provider, patient and relatives if needed. Recordings are anonymized and transcribed immediately after consultations, with the original recordings subsequently deleted. Only anonymized data is used in the robot. Results While full implementation is forthcoming, anticipated outcomes include improved student confidence in communicating with dementia patients, enhanced empathy, and better preparedness for clinical practice. Discussion and Conclusion This initiative addresses a critical need in dental education by preparing students for the complexities of dementia care. By fostering effective communication skills, this project aligns with ADEEʼs vision of reimagining education to meet evolving societal needs. The outcomes will contribute to improved oral health care for dementia patients while advancing the pedagogical standards of dental education globally.

• Høyvik, Ann Catrin; Weie, Ingrid Volden; Tveter, Karianne & Willumsen, Tiril (2019). Are dentists familiar with the rights of torture survivors? Full text in Research Archive
• Torper, Jorun; Strøm, Kjetil; Høyvik, Ann Catrin & Willumsen, Tiril (2018). Pasientkommunikasjon. In Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Ed.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. p. 53–71. Full text in Research Archive
• Høyvik, Ann Catrin & Woldstad, Marit Irene (2018). Tannbehandling av torturoverlevere. In Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Ed.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. p. 251–260. Full text in Research Archive
• Høyvik, Ann Catrin; Lie, Birgit & Willumsen, Tiril (2017). Are refugees with torture experience more prone to dental fear? Full text in Research Archive
• Høyvik, Ann Catrin; Shahnavaz, Shervin & Willumsen, Tiril (2016). Flyktninger og tannhelse. Aktuell Nordisk odontologi. ISSN 1902-3545. 41, p. 86–97. Full text in Research Archive
• Ebrahimi, M.; Høyvik, Ann Catrin; Aass, Anne Merete & Gjermo, Per E (1998). Association between toothbrushing time and plaque score with three different toothbrushes (Abstr 686). Journal of Dental Research. ISSN 0022-0345. 77. Full text in Research Archive
• Ebrahimi, M.; Høyvik, Ann Catrin; Aass, Anne Merete & Gjermo, Per E (1998). Association between toothbrushing time and plaque score with three different toothbrushes. Full text in Research Archive

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