Individual changes in dental fear among children and parents: a longitudinal study

Concordance of Fathers and Mothers in the Assessment of Their 5-Year-Old Child's Dental Fear

The aim of this study was to evaluate the concordance of parents' assessments of their child's dental fear. Cross-sectional secondary analysis used data from the multidisciplinary FinnBrain Birth Cohort Study. Child dental fear was assessed at age 5 with the Finnish translation of the modified Children's Fear Survey Schedule Dental Subscale (CFSS-M) by both fathers (n = 588) and mothers (n = 1100). Reply alternatives were from 1 = not afraid to 5 = very afraid and 6 = no experience coded as missing and 1. In total, 514 mother-father pairs were eligible for the analyses. Descriptive statistics, percentage agreement and Cohen's Kappa coefficients were used in the analyses. The concordance of parents' assessments was poor (Kappa range 0.072-0.258). The majority of parents replied "No Experience" to items related to invasive treatment or being unable to breathe. Thus, coding of this reply alternative had a significant impact on the mean values of the child's fear. When assessing the fear of a five-year-old child, it might not be safe to rely only on one parent's assessment, and whether or not the child has experience with the question asked should also be considered.

The Influence of Family Milieu on Dental Anxiety in Adolescents—A Cross-Sectional Study

Parents play a significant role in the development of dental anxiety in their adolescent children. This cross-sectional study aimed to evaluate the influence of family milieu on adolescents’ dental anxiety. The level of dental anxiety (Dental Anxiety Scale—DAS) was evaluated in 100 adolescent dental patients (ages 13–18 years) and their parents. Parents supplied information about family demographics and their personal experiences of dental treatment. Concomitantly, the family’s behavior was observed during the dental encounter. The adolescents’ mean DAS score was 9.83 ± 2.05. Adolescents’ DAS was higher when their parents’ memories from their own dental encounters were negative. A positive correlation was found between adolescents’ dental anxiety and that of their father (r = 0.52, p < 0.001) and mother (r = 0.79, p < 0.001). The following variables showed a significant ability to predict adolescents’ dental anxiety (stepwise regression): mother’s DAS (B = 0.57), adolescent’s behavior at the dental visit (B = 0.87), being the firstborn child (B = −0.44), father’s DAS (B = 0.13), and mother’s level of education (B = −0.10). The results showed that intra-family relationships and behavior, parents’ education, dental fear, and memories from previous treatments play an important role in defining the level of dental anxiety in their adolescent children.

Dental fear in school children and young adults attending public dental health care: prevalence and relationship to gender, oral disease and dental treatment; trends over 40 years

Purpose

To study prevalence of dental fear and the relationship to gender, oral disease and dental treatment between 1973 and 2013 in school children and young adults attending public dental health care.

Methods

Every ten years from 1973 to 2013 random samples of about 100 individuals in each of the age groups 10, 15 and 20 years took part in a repeated cross-sectional study based on clinical parameters and a questionnaire. Dental fear was estimated by the question: “What do you feel at the prospect of an appointment with a dentist?”. 75–99% of the samples answered the question. Agreement to at least one of the alternative answers: ill at ease, frightened and sick defined dental fear. Frightened and/or sick indicated severe dental fear. The prevalence of caries, gingivitis and number of filled tooth surfaces were calculated. Chi-square tests were used to show differences in proportions between groups and linear regression to show trends over time.

Results

Prevalence of dental fear declined in all age groups over time. In the 20-year olds dental fear was found in 29% of the sample and severe dental fear in 12% of girls and 5% of boys in 2013. Individuals with dental fear had higher mean caries prevalence and number of filled tooth surfaces compared with individuals without dental fear.

Conclusions

This 40-year time trend study showed a reduction in dental fear prevalence in school children and young adults offered regular public dental health care based on prevention and a psychological approach. The prevalence of dental fear was still high in 2013 despite a significant decline in caries during the study period. Further improvements in the psychological approach when treating children are thus needed.

Dental fear among adolescents with cleft

BACKGROUND

Dental fear is a prevalent phenomenon among children and adolescents globally.

AIM

To investigate dental fear among 18-year-olds with cleft lip and/or palate (CLP) at their final follow-up cleft clinic visit, and to evaluate the association between dental fear and OHRQoL.

DESIGN

This cross-sectional study included the cohort of children with CLP treated at the Oulu University Hospital Cleft Lip and Palate Center, in northern Finland since 1995. A total of 62 of 64 individuals participated in this study. The validated Finnish version of the Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL. Dental fear was studied using the validated Modified Dental Anxiety Scale (MDAS) and cognitive vulnerability model (CVM).

RESULTS

Almost two fifths of the participants reported moderate dental fear. Participants with cleft including lip and participants reporting impact on OHRQoL reported higher mean MDAS scores. In an unadjusted model, adolescents with cleft including lip had risk for higher dental MDAS scores compared with the ones with cleft including only palate.

CONCLUSIONS

Dental fear is common among adolescents with CLP, specifically among those with clefts involving the lip. OHRQoL and dental fear seem to be associated.

Changes in dental fear and its relations to anxiety and depression in the FinnBrain Birth Cohort Study

This study aimed to: (i) evaluate short-term changes in dental fear during a 9-month period among women and men, and (ii) evaluate whether the course and magnitude of changes in dental fear were associated with changes in depression and anxiety. The longitudinal data of the FinnBrain Birth Cohort Study were used. Out of 3808 women and 2623 men, 1984 women and 1082 men filled in the Modified Dental Anxiety Scale (MDAS) at gestational weeks 14 and 34, and 3 months after childbirth. Other questionnaires used were the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Symptom Checklist-90. All scales were analyzed as sum scores. The MDAS was also trichotomized to assess the stability of dental fear. Statistical significances of the changes in dental fear, depression, and general anxiety were evaluated using repeated-measures Friedman tests. Correlation coefficients were used to describe the associations between measures (Spearman) and their changes (Pearson). Dental fear more often increased than decreased, but for the majority it was stable. On average, dental fear, depression, and anxiety symptoms correlated throughout the study. The correlations tended to be stronger with depressive symptoms. However, the relationships between changes in dental fear, depression, and anxiety were not systematic.

Stimuli involved in dental anxiety: What are patients afraid of?: A descriptive study

BACKGROUND

Dental anxiety is a psychological response inducing aversion following a dental ill-defined stimulus, non-imminent and perceived as potentially dangerous. It is better to intervene during childhood than to resolve in adulthood when dental anxiety is more settled.

AIM

The purpose of this study is to determine the nature of dental anxiety-provoking stimuli in young patients.

DESIGN

A questionnaire was submitted to 566 children between 3 to 18 years in health institutions and schools in Brussels, Belgium. The items were divided into 3 groups: environment (ENV), local anaesthesia (LA), and intervention (INT) and summarized through averaging per group. Descriptive analysis and non-parametric testing were combined with logistic regression after discretization, above mild, for the group averages.

RESULTS

About 7.2% of the respondents expressed high to severe dental anxiety. Several items presented a clear bimodal distribution dividing the population in fearless and fearing patients, for example, sight and feel of the syringe, sight and taste of blood and extraction. Others presented with a gradually lower incidence with increasing fear level. Fear for the environment was generally low. Gender and ethnic origin contribute significantly to the prediction of fear caused by LA. For fear caused by INT, first the place of questioning enters the models, thereafter follow: negative experience, frequency of dental visit, and gender (P < .05).

CONCLUSIONS

While the dental environment is in general not causing fear, the invasive part of the anaesthesia and the invasive dental procedures are involved. Fear seems to be related to culture, previous experience, and gender.

Oral health self-perception, dental caries, and pain: the role of dental fear underlying this association

BACKGROUND

Oral health perception has multidimensional nature and can be influenced not only by clinical conditions but also by psychosocial characteristics.

HYPOTHESIS

Dental fear could modify the association between dental caries and dental pain and the perception of negative impact.

DESIGN

A cross-sectional study was conducted with (n = 1,196) children aged 8-12 years attending public and private schools in Pelotas/Brazil. Children were interviewed and examined. Oral health perception was assessed using a global oral health impact item. Crude and adjusted multivariable regression models were built and effect modification of dental fear in the association between clinical indicators and perception of impact was tested.

RESULTS

Compared with children without fear and caries, children with fear and dental caries presented a 1.45 higher prevalence of negative impact (95% CI: 1.18-1.79) while those without fear and with dental caries had a 1.31 higher prevalence (95% CI: 1.11-1.54) after adjustments. Also, the prevalence of negative perception was higher for children with fear and dental pain (PR: 2.95; 95% CI: 1.59-2.39) and for children without fear and with pain (PR: 1.53; 95% CI: 1.29-1.80), compared to children without fear and pain.

CONCLUSION

The presence of fear increased the effect of pain and caries on children's oral health perception.

A longitudinal study of changes and associations in dental fear in parent/adolescent dyads

BACKGROUND

Dental fear seems to fluctuate, but concordance of changes in dental fears between parent/adolescent dyads has not been reported.

AIM

To study longitudinally the associations between adolescent and parental dental fears and their changes.

DESIGN

Adolescents and parents reported their dental fear independently of each other when adolescents were between 11-12 and 15-16-year-olds. Eight hundred and seventeen eligible parent/adolescent dyads were included in the analyses. Dental fear was measured with a single question using five response alternatives. Associations between adolescent and parental dental fears and their changes were analysed using χ² tests and correlation coefficients.

RESULTS

Prevalence of dental fear remained rather similar during the study. There was a positive association between adolescent and parental dental fears in early adolescence (P < 0.001) but at middle adolescence only among parent/girl dyads (P = 0.007 for girls, P = 0.341 for boys). Changes in dental fear among parent/adolescent dyads did not correlate statistically significantly. Difference between girls' and boys' change in dental fear was statistically significant (P = 0.001). Dental fear increased more often among girls than among boys. Boys had stable low/no dental fear more often than girls did.

CONCLUSION

Adolescents' and parents' dental fears seemingly change independently of each other.