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Abstract
The aim of this cross-sectional study was to investigate factors associated with dental anxiety in children treated under moderate sedation. Prior to treatment, each child's dental anxiety was evaluated using the modified Venham Picture Test (VPT). Interviews were also conducted with parents/guardians to gather information on the child's dental anxiety (Corah's Dental Anxiety Scale [DAS]), age and sex, shyness or anxiety in the presence of strangers, and dental history, as well as socioeconomic factors. All the children were sedated, and had at least one tooth restored using the atraumatic restorative treatment technique. Child behavior was assessed using the Frankl scale. Data analysis involved descriptive statistics and bivariate tests. The median VPT score was 2.0 (range: 0 to 8). Children who were shy in the presence of strangers (yes: median 2.0 [0-8]; no: 0.5 [0-4]; p = 0.018), and those with negative behavior during dental care (negative: 3.0 [0-8]; positive: 1.0 [0-8]; p = 0.014) had greater anxiety. The child's dental anxiety was associated with the mother's education level (≤ 8 years: 4 [2-7]; > 8 years: 1 [0-8]; p = 0.016). The dental anxiety of children treated under sedation is associated with negative behavior, shyness, and the mother's education level.
Highlights
Submitted: June 29, 2020 Accepted for publication: February 9, 2021 Last revision: March 8, 2021Anxiety regarding dental treatment exerts a negative impact on both the child’s comfort level, and the outcome of the dental procedure
A recent systematic review reports that dental anxiety in preschool children has been assessed by a proxy measure in most studies published since 1998.6
The aims of the present study were to assess children’s dental anxiety through child self-reports, and identify associated factors in uncooperative preschool children treated under sedation
Summary
Submitted: June 29, 2020 Accepted for publication: February 9, 2021 Last revision: March 8, 2021. Anxiety regarding dental treatment exerts a negative impact on both the child’s comfort level, and the outcome of the dental procedure. Anxious children tend to anticipate dental care in an unrealistic way,[1,2] This anticipation incites uncooperative behavior,[3] which can make it difficult for the dentist to perform procedures.[4,5] The prevalence of dental anxiety is 10 to 20% in children and adolescents.[6] Given the negative implications of dental anxiety, it is important to identify anxious children, and associated factors, in order to provide adequate dental treatment planning. Children’s dental anxiety can be assessed by observing their behavior, by performing a psychometric evaluation using a questionnaire answered by the parent/guardian or child, and by analyzing physiological responses, such as altered salivary cortisol.[6,7] A recent systematic review reports that dental anxiety in preschool children has been assessed by a proxy measure (mainly parental reports) in most studies published since 1998.6
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