Children's Fear Survey Schedule-Dental Subscale Research Articles

Short Term Effects of Inhalation Sedation on Child Dental Fear and Anxiety.

Dental procedures profoundly affect a child's dental fear and anxiety, rendering dental treatment difficult. Inhalation sedation with a mixture of nitrous oxide and oxygen (NO2/02) breathed through a nosepiece is a form of light conscious sedation widely used in apprehensive children to help them relax and accept dental treatment. This, however, can have both shortand long-term effects on child dental fear and anxiety. This study aimed to assess the short-term immediate effect of inhalation sedation on child dental fear and anxiety scores. This analytical cross-sectional study was conducted at the Department of Paediatric Dentistry at Rehman College of Dentistry, Peshawar, Pakistan, over a period of 1.9 years (January 2019- October 2020). A total of 171 children aged 6-11 years were selected with moderate to severe dental anxiety using the Child Fear Survey Schedule-Dental Subscale (CFSS-DS), requiring pulp therapy in at least one of their deciduous molars. Baseline anxiety scores were calculated using Venham Clinical Anxiety Score (VCAS) and Venham Picture test (VPT) with a dental check-up and fluoride application. VCAS and VPT scores were then assessed at the end of their scheduled second dental visit involving dental anaesthesia and inhalation sedation. VCAS and VPT scores at the end of treatment were compared with the baseline scores. Out of 171 children, 86 were male and 85 were female, with a mean age of 7.77. Females showed a higher range of VCAS and VPT scores (p ≤0.001) compared to males. The VCAS and VPT scores declined just at the end of the second dental visit following dental anaesthesia with inhalation sedation (mean difference = 1.96 and 3.39, respectively), which was statistically significant (p ≤0.001). Inhalation sedation has a significant role in reducing child dental fear and anxiety in the short term.

Prevalence of dental fear among students of Hyderabad Sindh.

Background: Despite the advancements in making dentistry more comfortable, dental phobia remains a significant concern. Research suggests that children's dental anxiety may persist into adolescence, leading to avoidance of dental care and disruptive behavior during treatment. Early identification of children with dental fear is crucial for dental professionals to promptly employ appropriate pediatric management strategies. The study aims to assess the prevalence of dental fear among students in Hyderabad, Pakistan. Methodology: A cross-sectional study was conducted among 11- to 16-year-old male and female students in schools in Hyderabad, Pakistan. The Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) in English was utilized. The study included students in grades 6 to 8 residing in Hyderabad, with no general pathology and not on any medication. Data analysis was performed using SPSS version 25. Results: The study encompassed 295 participants, 45.1% females and 54.9% males. The percentage of participants experiencing dental fear (combining moderate and high fear) was 168 (57%), while 127 (41%) reported no dental fear. Analysis based on low to high levels of fear indicated slightly increased moderate and high fear levels in female participants (47.5% and 52%, respectively) compared to male students (36.5% and 47%, respectively). Conclusion: The study suggests the need for significant attention to preventing dental fear. School-based health policies and parents should focus on psychosocial factors associated with the fear of dental treatment, as many of these factors are preventable. Dental anxiety poses challenges not only for patients but also for dentists, occasionally complicating the successful execution of treatments.

A study on related factors affecting dental fear in preschool children.

This study aims to examine the manifestations of dental anxiety (DA) and its influencing factors during dental visits among preschool children. The data of 166 preschool children who visited the Department of Dentistry of our hospital from April 2021 to April 2023 with oral problems were retrieved. Their DA performance was investigated using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). In addition, based on their general data and potential risk factor information, we performed logistic regression analysis to identify the factors influencing DA. Of the 166 questionnaires distributed, a total of 160 valid questionnaires were retrieved. The average CFSS-DS score was 35.57 ± 3.51 points. Sixty-six children had DA, resulting in an incidence rate of 41.25%. The top 5 items with the highest CFSS-DS scores were fear of needles, dentists, tooth extraction, drilling and oral anesthesia. When the 66 children with DA were classified into a DA group and a non-DA group, we observed significant differences in age distribution, dental experience, only child status, general anxiety symptoms, dental condition, family income and specific dental treatment procedures, particularly tooth extraction, between them (p < 0.05). Multivariate logistic regression analysis revealed that preschool children aged ≤4 years, those with prior dental experiences, single-child status, general anxiety symptoms, suboptimal dental health, family incomes below 100,000 yuan/year, and those undergoing specific dental procedures, such as tooth extractions, were independently associated with a higher risk of DA (p < 0.05). The incidence of DA in preschool children is high, and they exhibit substantial fear of needles, dentists, tooth extraction, drilling and oral anesthesia. Preschool children aged ≤4 years, with prior dental experiences, single-child status, the presence of general anxiety symptoms, suboptimal dental health, family incomes below 100,000 yuan/year, and those undergoing dental procedures, particularly tooth extraction, could be more predisposed to DA.

Evaluation of children's oral diagnosis and treatment using imaging examination using AI based Internet of Things.

Although cone beam computed tomography (CBCT) plays an important role in the diagnosis and treatment of oral diseases, its image segmentation method needs to be further improved, and there are still objections about the clinical application effect of general anesthesia (GA) on children's dental fear (CDF). This study aimed to investigate the application value of CBCT based on intelligent computer segmentation model in oral diagnosis and treatment of children in the context of biomedical signals, and to analyze the alleviating effect of GA on CDF. Based on the regional level set (CV) algorithm, the local binary fitting (LBF) model was introduced to optimize it, and the tooth CBCT image segmentation model CV-LBF was established to compare the segmentation accuracy (SA), maximum symmetric surface distance (MSSD), average symmetric surface distance (ASSD), over segmentation rate (OR), and under segmentation rate (UR) between these model and other algorithms. 82 children with CDF were divided into general anesthesia group (GAG) (n= 38) and controls (n= 44) according to the voluntary principle of their families. Children in GAG were treated with GA and controls with protective fixed intervention. Children's fear survey schedule-dental subscale (CFSS-DS) and Venham scores were counted before intervention in the two groups. CFSS-DS scores were recorded at 2 hours after intervention and after recovery in children in GAG. CFSS-DS and Venham scores were performed in all children 1 week after surgery. The results showed that the S⁢A value of CV-LBF algorithm was higher than that of region growing algorithm (P< 0.05). OR, UR, MSSD, and ASSD values of CV-LBF algorithm were evidently lower than those of other algorithms (P< 0.05). CFSS-DS scores were lower in GAG than in controls 2 hours after intervention and at return visits after 1 week of intervention (P< 0.001), and Venham scores were lower in GAG than in controls after intervention (P< 0.001). After intervention, the proportion of children with Venham grade 0, 1, 2, and 3 was obviously higher in GAG than in controls (P< 0.001), while the proportion of children with Venham grade 4 and 5 was clearly higher in controls than in GAG (P< 0.001). The results revealed that the computer intelligent segmentation model CV-LBF has potential application value in CBCT image segmentation of children's teeth, and GA can effectively alleviate anxiety of children with CDF and can be used as biomedical signals.

Possible Risk Factors for Dental Fear and Anxiety in Children Who Suffered Traumatic Dental Injury.

Children who undergo painful experiences such as traumatic dental injury (TDI) during their early years are more likely to be at an increased risk of developing dental fear and anxiety (DFA). The purpose of this study was to identify potential risk factors for DFA of these children. The study participants were 220 parents/caregivers and their children who experienced TDI. Their socio-demographic backgrounds were investigated with the modified WHO Oral Health Questionnaire for Children that included questions about parents' knowledge and attitudes, while the DFA level was determined using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the Simplified Oral Hygiene Index (OHI-S Index) was used to assess oral hygiene status. The confirmed risk factors are parental knowledge, female gender, and degree of oral hygiene and pain in the last three months, while age, type of TDI, presence of soft-tissue injury, and number of subjective complaints were not confirmed. The overall model predicted approximately 54% of variance in DFA, R2 = 0.545, F (4.215) = 64.28 p < 0.001. These findings emphasise the importance of addressing pain management, improving oral hygiene, and enhancing parental knowledge to mitigate DFA in children with TDIs.

An Interactive Augmented and Virtual Reality System for Managing Dental Anxiety among Young Patients: A Pilot Study

Dental anxiety is a common health problem among children. It creates major issues for patients, parents, and dental professionals. Children who cancel or otherwise miss their dental appointments generally do so due to fear of the unknown and lack of understanding of what they can expect from the environment and treatment when they arrive there. Some distraction interventions are already used by dental professionals, such as using clown doctors, watching cartoons, and utilizing the tell–show–do (TSD) technique. Still, the problem is common, and the fail to attend (FTA) rates at clinics are high. Familiarizing children with the dental setting and procedures in advance may help to manage their anxiety. This paper aims to help in managing children’s dental anxiety in a simple, attractive, and age-appropriate way through the use of augmented reality (AR) and virtual reality (VR) technologies. The developed system is named “Dr. Barea”. It targets Arabic-speaking children aged from 7 to 10 years old. It uses model–view–control (MVC) as its architectural design pattern. The proposed solution consists of three main sections: a 360° VR video that simulates a dental clinic environment, an educational description on dental tools using AR technology, and interactive educational stories that educate children about dental hygiene. The system performance was evaluated using unit, integration, performance, and user acceptance testing. The results demonstrate that the proposed solution, which performed reasonably, achieved the usability requirements and was engaging for learning information about dental hygiene. A feasibility study with 16 children was conducted to evaluate the effectiveness of the proposed system. The Child Fear Survey Schedule—Dental Subscale (CFSS-DS) was used to measure children’s dental anxiety level. The T test was used to evaluate the differences between groups, and Fisher’s exact test was used to compare the distributions of gender and age between the groups. The CFSS-DS index in the VR group decreased after dental consultation (35.04 ± 9.14 before consultation and 32.32 ± 8.32 after consultation, p = 0.041). The implications of this study shall be beneficial to patients, parents, and dental professionals.

Pathways to dental fear from childhood to adolescence: A 10-year cohort study.

Dental fear affects children's oral health; there is, however, no evidence regarding the pathways linking possible predictors for its occurrence. This study aimed at exploring the direct and indirect effects of sociodemographic, clinical, behavioural and psychosocial factors on the development of dental fear in schoolchildren over time. This is a prospective cohort study, with 10 years of follow-up. The first assessment started in 2010 (T1) with a sample of 639 children aged 1-5 years from Southern Brazil. For this study, the follow-up (T2) of these individuals was performed in 2020. Dental fear was assessed at T2 using the Brazilian version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Socio-economic, demographic, psychosocial and oral health measures were collected in both assessments. A structural equation model was performed to assess the direct and indirect pathways among variables at T1 and T2 to predict the CFSS-DS scores at T2. Of the 639 children, 429 were re-evaluated at T2. Higher levels of untreated dental caries, younger individuals, dental visits for nonroutine reasons and low sense of coherence at T2 directly impacted dental fear at T2. Considering the indirect effects, the presence of dental caries and low household income at T1 indirectly impacted higher levels of dental fear over 10 years via dental caries at follow-up. Our findings suggest that socio-economic, demographic, clinical, psychosocial and behavioural conditions can influence dental fear from childhood to adolescence.

Association between Intelligence Quotient Dental Anxiety and Oral Health-related Quality of Life in Children: A Cross-sectional Study.

Determining the intelligence quotient (IQ) grades of children help in managing dental anxiety (DA) and maintaining the good oral health-related quality of life (OHRQoL). To assess the association between IQ, DA, and OHRQoL in children aged 10-11 years. This cross-sectional study was carried out among 202 children aged 10-11 years in the Southern part of Tamil Nadu, India. The IQ level, DA, and OHRQoL were measured using Raven's Coloured Progressive Matrices (RCPM), Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Child Oral Health Impact Profile Short Form (COHIP-SF) 19, respectively. Chi-squared test and Spearman rank order correlation test were used for analysis. The results revealed a significant negative correlation (p < 0.05; r = -0.239) between IQ and OHRQoL. DA was negatively correlated with IQ (r = -0.093) and OHRQoL (r = -0.065), but it was not statistically significant. The gender-based comparison revealed no significant difference in the distribution of girls and boys within different grades of IQ levels (p = 0.74), DA (p = 0.29), and OHRQoL (p = 0.85). Children with higher IQ showed low OHRQoL scores. DA was negatively correlated with IQ and OHRQoL. Asokan S, PR GP, Mathiazhagan T, et al. Association between Intelligence Quotient Dental Anxiety and Oral Health-related Quality of Life in Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(6):745-749.

Reliability and Validity of the Dental Anxiety Question Used With Children.

Dental fear screening is an important part of providing a positive pediatric dental experience. To improve efficiency, the development of a single-item dental fear assessment tool for children has been desired. In this psychometric analysis, the reliability and validity of the Dental Anxiety Question (DAQ) is studied when used in children aged 7 to 18 years. Participants completed the DAQ (pre-tx-DAQ), the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and a demographic information questionnaire before treatment. Participants repeated the DAQ after treatment (post-tx-DAQ) and once more at least 2 weeks later (follow-up-DAQ). Stability reliability within the DAQ scores and criterion validity with the CFSS-DS were evaluated. Stability reliability analyses between pre-tx-DAQ/post-tx-DAQ and post-tx-DAQ/follow-up-DAQ demonstrated significant positive correlations: Spearman rank correlation coefficient (rs) = 0.420, rs2 = 0.18, P &lt; .001, and rs = 0.563, rs2 = 0.32, P &lt; .001, respectively. Criterion validity analysis between the pre-tx-DAQ and CFSS-DS also demonstrated a significant correlation: Pearson correlation coefficient (r) = 0.584, r2 = 0.34, P &lt; .001. The stability reliability and criterion validity of the DAQ was proved among children.

Dental fear and its related factors among patients managed in a paediatric dental clinic of a university hospital in Tanzania

Objective: This study aimed to determine the prevalence of dental fear and its related factors among patients managed in a pediatric dental clinic of a university hospital in Tanzania.&#x0D; Material and Methods: This was a cross-sectional study carried out at the paediatric dental clinic of the Muhimbili University of Health and Allied Sciences(MUHAS) between November 2018 and April 2019. It included all paediatric dental patients aged between 6 and 12 years. A questionnaire used in this study captured information regarding patient's socio-demographic characteristics and the number of previous visits to the dental clinic. A fifteen-item Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) was used to assess the dental fear status in these pediatric patients.&#x0D; Results: A total of 223 paediatric dental patients aged between 6 years and 12 years were included in the study. The mean age of participants was 9.52 ± 1.74 years with a male to female ratio ofl: 1.04. The means CFSS-DS score was 31.1 ± 8.57. Fear scores were high for Injections (3.37 ± 1.13), a stranger's touch (2.81 ± 1.08) and choking (2.69 ± 0.99). The presence of dental fear was found to be significantly associated with the parents' education level (p=0.001) and previous dental visits (p &lt; 0.001 ).&#x0D; Conclusion: The results of this study suggest that the prevalence of paediatric dental fear was low among the participants of this study. The education level of parents and previous dental visits were determinants of dental fear in children. Injections, being touched by strangers, and choking were the common fear-provoking factors.

Comparison of two Intranasal Sedatives, Midazolam versus Dexmedetomidine, in Children with High Dental Fear: a Randomized Clinical Trial.

Statement of the Problem: Pharmacologic management of uncooperative behavior is a growing trend in dentistry. Determining the most appropriate drug, route of administration, and proper candidate for sedation have been the goal of several investigations.Purpose: The aim of this study was to compare the sedative effect of intranasal (IN) sedation of midazolam (MDZ) in compare to dexmedetomidine (DEX) while taking into consideration the effect of dental fear, and psychological status on sedation success.Materials and Method: This double-blind randomized clinical trial included 92 uncooperative dental patients aged 4-6. Study participants were randomly assigned to receive either 0.2mg/kg IN MDZ or 1µg/kg DEX. Sedation was evaluated using the Houpt sedation rating scale. Vital signs were recorded before and during sedation. Prior to sedation, the level of dental fear was determined through children's fear survey schedule-dental subscale (CFSS-DS). Psychological characteristics were screened using the strengths and difficulties questionnaire (SDQ). Data were analyzed using T-test, Mann-Whitney, Chi-square, and repeated-measures analysis of variance (ANOVA).Results: Overall ratings of sedation and subscales of sleep, crying, and movement were comparable between groups (p> 0.05); however, more acceptable behavior (overall scores (4+5+6) was observed in MDZ group compared to DEX group (64% vs. 47.7%) (p= 0.007). All participants were found to have abnormal levels of dental fear (CFSS-DS≥38). However, according to SDQ, the study participants have mainly shown normal behavioral status. A significant association was found between dental fear and sedation success (MDZ, p= 0.001, DEX, p= 0.03), while similar findings were not observed for psychological characteristics (MDZ, p= 0.09 and p= 0.41; DEX, p= 0.71 and p= 0.53). Physiological parameters remained within normal limits in both groups.Conclusion: Sedation with IN MDZ resulted in overall behaviors, which were more satisfactory in highly fearful pediatric dental patients. Despite baseline uncooperative behaviors, the psychological status of study participants were close to average and were not associated with sedation failure.

A digital intervention using virtual reality helmets to reduce dental anxiety of children under local anesthesia and primary teeth extraction: A randomized clinical trial.

IntroductionBehavior management of children during dental treatment is an important but challenging issue. As a new technique, VR has been applied in pediatric dental anxiety. But there is no final conclusion whether VR reduces children's dental anxiety.MethodsThe aim of the study is to assess the effectiveness of a digital intervention using virtual reality (VR) helmets on dental anxiety, pain perception, and behavior triggered for children, as well as occurrence of simulator sickness in local anesthesia and primary teeth extraction. A total of 128 children, who needed primary teeth extraction under local anesthesia, were randomly allocated into two groups: use VR helmets and traditional behavior guidance procedures (control). Modified Child Fear Survey Schedule Dental Subscale (CFSS‐DS), Wong‐Baker FACES Pain Scale, Houpt Scale, and Simulator sickness questionnaire (SSQ) were used to assess children's dental anxiety, pain perception, and behavior triggered and occurrence of simulator sickness.ResultsCFSS‐DS score in the VR group was significantly decreased after dental treatment (34.58±6.90 before operation and 32.32±15.58 after operation, p = .02). The score of Wong Baker Scale in the VR group (3.47±0.76) was significantly lower than that in the control group (5.56±1.13, p = .015). There was no significant difference in the Houpt Behavior Scale score and the SSQ score between the VR group and the control group (p = .35, p = .305).ConclusionThe use of VR helmets in primary teeth extraction can significantly reduce dental anxiety and pain perception in children without occurrence of simulator sickness.

Children’s Behavior toward Tooth Extraction: Comparison of Age, Chief Complaint, Method of Anesthesia, Dental Fear and Dental Anxiety with Level of Cooperation

Aim: To compare children’s behavior toward tooth extraction taking into account their gender, age, chief complaint, method of anesthesia, presence of dental fear and dental anxiety. Methodology: This cross sectional descriptive study was conducted at the Department of Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan, Pakistan, from June 2021 to November 2021. The Wright’s Clinical Classification and Children's Fear Survey Schedule Dental Subscale (CFSS-DS) were used respectively to assess the degree of cooperation and presence of dental fear anxiety (DFA) toward tooth extraction. Data was analyzed using SPSS 22. Results: Female children 167 (65%), age group of 7-8 years 83(98%), children presented with loose tooth 120 (66%), children received Inj. lignocaine 2%, 152 (70%) and children diagnosed with dental fear and anxiety 406(82%) showed uncooperative behavior toward tooth extraction. Chi squared test showed that gender (p=.01), age (p=.01), chief complaint (p=.04), method of anesthesia (p=.01), dental fear and anxiety (p=.01) were significantly associated with children’s level of cooperation toward tooth extraction procedure. Conclusion: Invasive procedure like tooth extraction brought out negative behavior hampering level of cooperation in pediatric dental treatments.

The relationship between dental fear and cooperation of children during dental treatments with their parents’ general health

Objective: Dental fear is a common phenomenon in children and parents can have a key role in the development of child's dental anxiety. There is moderate evidence to support the relationship between the parental general health and children’s dental fear. The aim of this study was to investigate the relationship between dental fear and cooperation of children during dental treatment with the general health of parents.Methods: This cross-sectional descriptive study was done on 130 children aged 6 to 12 at the Department of Pediatric Dentistry, Guilan University of Medical Sciences from May to September 2020.The personality traits and general health of parents were assessed by using the General Health Questionnaire (GHQ-28). The Frankl's behavior rating scale and Children's Fear Survey Schedule Dental Subscale (CFSS-DS) were used to respectively assess the degree of cooperation during dental practices and children’s dental fear. Statistical approaches included T-test, Chi-square and Pearson Linear correlation. A significant level of differences was taken as P&lt;0.05.Results: 69.3 % of children behaved positively and definitely positively during dental treatment. 56 boys and 74 girls with mean age of 9.13 ±2.02 years participated in this study. There was a significant correlation between the children's age with dental fear and cooperation level (P&lt;0.001). There was no significant difference in dental fear score (P=0.63) and cooperation level (P=0.99) between boys and girls. There was not statistically significant relationship between the general health of the parents and the level of children's cooperation and dental fear during dental treatment (P&gt;0.001).Conclusion: There was not relationship between parent's general health with children's dental fear and cooperation.

Does Dental Fear in Children Predict Untreated Dental Caries? An Analytical Cross-Sectional Study.

Despite free health care services in Saudi Arabia, the prevalence of caries in children is substantially greater in comparison to other high-income countries. Dental fear in children may be an important issue that needs attention. Therefore, the aim was to investigate the role of dental fear in predicting untreated dental caries in schoolchildren. This analytical cross-sectional study included children aged 8–10 years residing in Saudi Arabia. Dental status via oral examinations was surveyed with the WHO standardized chart and the Children Fear Survey Schedule—Dental Subscale was used to score dental fear. Descriptive, binary, and multivariable logistic regression analyses were performed to report the findings at 5% statistical significance. Overall, there were 798 schoolchildren with an average fear score of 36. Nearly 70.4% reported fear of someone examining their mouth. About 76.9% had at least one carious tooth in their oral cavity. Children with dental fear were 1.8 times (OR = 1.80; 95% CI = 1.26, 2.56) more likely to have at least one untreated carious tooth in their oral cavity than those who did not express fear during oral examinations and dental procedures. Thus, the current study concludes that fear of dentists and dental treatment procedures successfully predicts untreated carious teeth in schoolchildren.

Impact of Dental Rehabilitation Under General Anesthesia on Oral Health-Related Quality-of-Life and Dental Anxiety in Turkish Children

Objective: To analyze children's and parents' oral health-related quality of life (OHRQoL) and children's dental fears before and after the dental rehabilitation under general anesthesia (DRGA). Material and Methods: 104 parents and their 3 to 13-year-old children (5.90 ± 2.42) who received DRGA were surveyed before and after DRGA. The children were divided into two groups: Group 1 - healthy children (n=43) and Group 2 - children with medical problems (n=61). After recording their socio-demographic information, parents completed a self-administered questionnaire named Early Childhood Oral Health Impact Scale (ECOHIS), which includes two main parts - Child Impact Section (CIS) and Family Impact Section (FIS). On the other hand, the children received a dentist-administered questionnaire named Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Frankle Behavior Scale (FBS). For statistical analyses, Wilcoxon Signed-Rank, Mann Whitney-U, Kruskal-Wallis, and Spearman's Correlation tests were used. Results: A statistically significant decrease in all CIS, FIS, ECOHIS and CFSS-DS scores was observed after DRGA (p<0.01). This decline was greater in healthy children than in children with systemic problems (p<0.01). Conclusion: Children's and parents' OHRQoL showed better results after DRGA. The decreases in dental anxiety in children were observed after DRGA.

Evaluation of efficacy of computer-controlled local anaesthetic delivery system vs traditional injection system for minor pediatric surgical procedures in children

BackgroundOne of the biggest barriers to successful delivery of quality dental care to paediatric patients is fear related to injection of local anaesthetic. This study aimed to evaluate the efficacy of a computer-controlled local anaesthetic delivery (CCLAD) system when compared with a traditional anaesthetic injection. The two systems were compared with respect to reducing pain-related fear and anxiety. MethodsEighty children in the age group between 6 and 13 yrs requiring minor paediatric dental procedures on both sides of the dental arch were administered local anaesthesia using a CCLAD system and traditional injection system in two consecutive treatment sessions. The anxiety and fear related to the injection before and after the procedure was evaluated using Children's Fear Survey Schedule - Dental Subscale (CFSS-DS). The pain perception was evaluated using Wong-Bakers pain scale. ResultsThe percentage wise distribution of pain rating as filled out by the subjects after being administered the local anaesthesia using CCLAD system, and the conventional injection system showed that pain levels experienced by the subjects was lower with the CCLAD injection system than with the conventional injection system. The comparison of CCLAD and conventional groups pretest and post-test CFSS-DS scores showed significantly lower values for CCLAD group indicating lower anxiety levels. ConclusionThis study showed that the CCLAD system could be an useful alternative in administration of local anaesthesia. However, its effectiveness could be tested when used in highly anxious children. The disadvantages of CCLAD systems is that it requires a longer time during administration and cost.

Dental Fear in Children: Association with Dental Caries and Molar Incisor Hypomineralization.

The aim of this study was to investigate the prevalence of dental fear and to evaluate its association with dental caries and molar incisor hypomineralization (MIH) in schoolchildren aged 8-10 years from a municipality in Northeastern Brazil. Data from 466 students enrolled in urban public schools in a cross-sectional study were collected. Parents/guardians answered a questionnaire addressing sociodemographic characteristics, dental fear was measured by means of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and clinical examinations were performed by three calibrated examiners for diagnosis of dental caries, using the International Caries Detection & Assessment System - ICDAS II and a previously validated index for MIH. Descriptive data analysis was performed, and associations between dental fear, dental caries and MIH were analyzed using robust Poisson regression for complex samples (p<0,05). The prevalence of dental fear was 21.6%, and the mean total CFSS-DS score was 29.97 (CI 95%=29.05-30.89). In the multivariate adjusted model, the prevalence of dental fear was associated to family income (PR=1.78; CI 95%=1.02-3.08; p= 0.041). Monthly family income was associated with dental fear in children, whereas dental caries and MIH were not associated with dental fear.

Factors associated with gagging during radiographic and intraoral photographic examinations in 4-12-year-old children.

No studies are available in paediatric samples evaluating gagging during toothbrushing, radiographic and/or intraoral photographic examinations. The aims were to collectively examine potential factors associated with gagging during radiographs andintraoral photographs in 4-12-year-old children. Parents/guardians of 395 children (aged 4-12years old) completed questionnaires asking about their children's toothbrushing habits. Children completed Greek versions of the Gagging Assessment Scale (GAS) and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), while the dentist used the shorter version of the Gagging Problem Assessment (GPA-de-c/SF) to objectively assess gagging. X-ray and Photo Rating Scales were created to evaluate gagging during X-rays and photographs, respectively. Multivariate logistic regression was used to examine the relationship between the potential factors and gagging. 59 of 275 patients (21%) and 56 of 276 patients (20%) who needed X-rays and intraoral photographs, respectively, gagged. Children who gagged during X-rays had significantly higher GAS scores (p = 0.007). Boys, younger children, and those who gagged on GPA-de-c/SF were more likely to gag during X-rays, and children who gagged on GPA-de-c/SF were more likely to gag during photographs. Brushing habits were not related to dental fear or gagging. Of the variables which we studied, GPA-de-c/SF most strongly affected the odds of gagging during taking radiographs and/or intraoral photographs.

Evaluation of dental fear among pediatric age group and parental anxiety using validated assessment scales

Introduction: Dental fear and anxiety poses a significant problem in child patient management as such patients are more likely to avoid or delay seeking dental treatment, cancel dental appointments, and are considered to be the main barrier for successful completion of the dental treatment. Thus, early recognition and management of dental fear are imperative and the key to deliver effective dental treatment to the child patient. Aim: The aim of this study was to evaluate dental fear among children aged 4–12 years and parental anxiety using validated assessment scales. Methods: The study was conducted on 288 children who visited the Department of Pedodontics and Preventive Dentistry at Post Graduate Institute of Dental Sciences, Rohtak. The dental fear among children was measured using validated dental fear assessment scales, i.e., facial image scale and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Parental anxiety was assessed using Norman Corah's Dental Anxiety Scale (C-DAS). Children dental fear was compared with parental anxiety. The factors associated with dental fear (age, gender, parent gender, previous dental experience, socioeconomic status, and background area), and also, the first dental visit age was assessed. Results: A total of 288 children showed CFSS-DS of 25.36 ± 6.130, 105 were girls (36.5%) and 183 were boys (63.5%) with CFSS-DS of 25.56 ± 6.102 and 25.25 ± 6.160, respectively. This showed that there were no significant differences in fear between boys and girls. According to the facial image scale, 0.3% of children were reported to have dental fear. Parental anxiety showed C-DAS of 7.53 ± 4.674, 163 were female (56.6%) and 125 were male (43.4%) with C-DAS 9.53 ± 5.183 and 4.94 ± 1.852, respectively. Conclusion: Parental anxiety was not associated with children's dental fear. Among factors, age, previous dental experience, and socioeconomic status were associated with children's dental fear. The most common first dental visit age among the three groups was 5 years.