Children's Fear Survey Schedule Research Articles

How to evaluate adolescents’ dental anxiety? A review of instruments

How to evaluate adolescents’ dental anxiety? A review of instruments

Validity of the Brazilian version of the Dental Subscale of Children's Fear Survey Schedule.

Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) is a tool widely used to assess dental fear in children. To translate and to verify the psychometric properties, including factor analyses of the Brazilian version of the CFSS-DS (B-CFSS-DS) in two settings. The CFFS-DS was translated into the Portuguese language. In the first cross-sectional study (dental setting), 128 children (age: 4-12years) participated. Mothers were interviewed; children's dental fear was assessed through the CFSS-DS and the Venham picture test; and child behaviour was assessed using the Frankl Scale. The second was a longitudinal study, with 103 schoolchildren (age: 4-12years). Two receiver operating characteristic curves were drawn to establish the cut-off points. The B-CFSS-DS version showed good internal consistency in dental and school settings (Cronbach's α=0.88 and 0.77 respectively) and a good test-retest reliability (Weighted Kappa=0.767), as well as good criterion and discriminant validities. Factor analyses showed four factors. The Brazilian version of the CFSS-DS is a valid tool for dental fear assessment in children aged 4-12years. Further studies with representative samples should be performed to strengthen the findings of this study, especially in the school setting.

Dental fear and anxiety in Estonian and Vietnamese schoolchildren: A comparative study of two populations.

Dental fear and anxiety (DFA) has the impact on the development of dental caries. Ethnic background and oral health care system may contribute to DFA model. The aim of the study was to compare DFA in relation to dental health between Estonian and Vietnamese schoolchildren and to determine DFA cutoff point for schoolchildren of two countries. The sample comprised 900 schoolchildren (344 from Estonia and 556 from Vietnam). DFA was measured by using 11 fear items of the modified Dental Subscale of the Children's Fear Survey Schedule (CFSS‐DS). Dental health was recorded by using the dental caries experience index of mixed dentition (dmft/DMFT). Results showed that the mean score of dmft/DMFT in Estonian and Vietnamese schoolchildren was 5.2 ± 3.1 and 4.1 ± 3.2, respectively. The mean score of 11‐item CFSS‐DS of Vietnamese schoolchildren (20.8 ± 9.1) was significantly higher compared with Estonian schoolchildren (15.4 ± 4.4, p < 0.001). The DFA cutoff point of 11‐item CFSS‐DS in Estonian schoolchildren was 17.5, whereas in Vietnamese, it was 24.5. The lower ranking of DFA was significantly associated with Estonian schoolchildren who had more FT (p < 0.001). In conclusion, the level of DFA of schoolchildren was different in Estonia and Vietnam. Vietnamese schoolchildren had higher DFA scores and cutoff point of the modified CFSS‐DS than Estonian schoolchildren. The obtained results suggest that DFA in schoolchildren can be related to oral health care system of each country.

Development of the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C+): Dental anxiety and concomitant factors in pediatric dental patients.

The aim of this study was to develop the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C+) and also to explore factors associated with dental anxiety in clinical pediatric dental patients (PDPs). The study sample consisted of 421 PDPs aged 12-14, 104 of whom were selected for test-retest analysis. The psychometric evaluation included linguistic validity, exploratory factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest reliability (intra-class correlation coefficient, ICC). Construct validity was tested by comparing a commonly used instrument, the Children's Fear Survey Schedule Dental Subscale (CFSS-DS). Associations between parental dental anxiety, frequency of dental visits, dental caries, dental visit behaviour and children's dental anxiety were also examined. The Turkish version of the IDAF-4C demonstrated good internal consistency (Cronbach's alpha α=.96) and test-retest reliability (ICC=.87). Factor analysis showed a fit IDAF-4C model with a single factor, 8 items. Dental anxiety scores were significantly correlated with all measured variables (p<0.001). Girls showed significantly higher dental anxiety scores than boys (p<0.05). This study suggests that the Turkish version of the IDAF-4C+ is a valid and reliable instrument for assessing dental anxiety and fear in Turkish children.

Effect of Dentists' Appearance Related with Dental Fear and Caries aStatus in 6–12 Years Old Children

The aims of this study were to determine the prevalence of dental fear, the relationship between dental fear and dental caries and the dentist appearance most likely to reduce anxiety among children. In this way, dental treatment could be made more effective by changing the dentist's appearance. The "Children's Fear Survey Schedule-Dental Subscale" and a questionnaire 'designed to examine the children's preferences for their dentist's appearance', were administered to 810 patients between 6-12 years of age. Patients were examined after completing the questionnaires, and their DMFT/dmft indexes were determined. Patients were divided into three subgroups according to their CFSS-DS scores. Among patients, anxiety scores differed significantly by age and gender (p=0.046, p=0.001). Specifically, higher anxiety scores were identified among 6- to 8-year-olds and in female patients relative to their respective counterparts. A statistically significant association between anxiety and dental caries was detected. (DMFT p=0.030/dmft p=0.015), and DMFT/dmft scores were found to be higher among patients with high levels of dental anxiety than among patients with low levels of dental anxiety. Additionally, children were highly perceptive of and exhibited strong preferences for the appearance of their dentist. Anxiety and dental caries were associated; small alterations in a dentist's appearance may reduce dental anxiety among children.

General anxiety, dental anxiety, digit sucking, caries and oral hygiene status of children resident in a semi-urban population in Nigeria

BackgroundDigit sucking can represent untreated anxiety or other emotional problems. The aim of this study was to determine if digit sucking is a predictor of general anxiety and dental anxiety; and if general and dental anxiety are associated with caries and oral hygiene status of children resident in sub-urban Nigeria.MethodsThis was a secondary data analysis of a household survey conducted in Ile-Ife, Nigeria. The level of general anxiety and dental anxiety of 450 6 to12 year old children were measured using the Revised Child Manifest Anxiety Scale and Dental Subscale of the Child Fear Survey Schedule respectively. Presence of digit sucking habit, caries and oral hygiene status were determined. General anxiety and dental anxiety scores were dichotomized into low and high levels respectively. Logistic regression was conducted to determine if digit sucking was a predictor of general anxiety and dental anxiety; and if general anxiety and dental anxiety were predictors caries and good oral hygiene status. Adjustments were made for age and sex.ResultsDigit sucking is not a significant predictor of dental anxiety (p = 0.99) and general anxiety (p = 0.79). Children with high general anxiety (AOR: 5.02; 95% CI: 2.9–9.74; p < 0.001) and high dental anxiety (AOR: 1.74; 95% CI: 1.15–2.65; p = 0.009) had higher odds of having caries and good oral hygiene respectively.ConclusionDigit sucking was not a significant predictor of general anxiety and dental anxiety. General and dental anxiety however, had effects on the likelihood of having caries and good oral hygiene.

THE IMPACT OF GENDER ON CHILD DENTAL ANXIETY IN A SAMPLE OF EGYPTIAN CHILDREN (A CROSS-SECTIONAL STUDY)

INTRODUCTION: Despite the recent developments in the dental equipment and treatment procedures, dental fear and anxiety (DFA) arerelatively common among children and adults. Relating dental fear and anxiety to gender is a controversial issue in scientific literature.OBJECTIVES: The aim of this study is to examine the impact of gender on the child’s dental anxiety in a sample of Egyptian children.MATERIALS AND METHODS: One hundred and twenty-six children 6-10 years old (60 boys and 66 girls), at the Department of PediatricDentistry, Faculty of Dentistry Alexandria University were asked to participate in the study. Children answered the Child Fear Survey Schedule– Dental Subscale (CFSS-DS).RESULTS: About forty-six percent of the children in the studied sample were non-anxious, 30.2% were potentially anxious and only 23%were very anxious. Girls were significantly more dentally anxious than boys. (p=0.02).CONCLUSIONS: The level of DFA was affected by the child gender where girls were more dentally anxious than boys. Injection wasidentified as the most fearful item in the dental visit.KEYWORDS: Dental anxiety, dental fear, child gender, CFSS-D

Oral health status and parental perception of dental anxiety of attention deficit hyperactivity disorder and nonattention deficit hyperactivity disorder children in Bengaluru city: A cross-sectional study

Context: Attention deficit hyperactivity disorder (ADHD) is a complex, multifactorial disorder which is characterized by the symptoms of inattention and/or impulsivity and hyperactivity. In children with ADHD, cognitive and executive functions may be impaired leading to significant behavioral problems that may affect oral health. There is an extreme paucity of the studies related to oral health and dental anxiety among children with ADHD. Aim: The aim of this study is to assess and compare oral health status and parental perception of dental anxiety among ADHD and non-ADHD children. Materials and Methods: A cross-sectional comparative study was conducted among 100 ADHD and 100 non-ADHD children aged 6–17 years in Bengaluru city. A structured validated pro forma was used to collect demographic details, Decayed, Missing, and Filled Teeth (DMFT)/dmft, and gingival index (GI). The Dental Subscale of Children's Fear Survey Schedule was used to assess parental perception of dental anxiety. Data were analyzed using Chi-square test, Mann–Whitney U-test, and Pearson's correlation test (P < 0.05). Results: DMFT was significantly higher in ADHD (1.60 ± 1.6) than in non-ADHD group (1.15 ± 1.32) (P = 0.04). There was no significant difference between the groups for GI (P = 0.3). ADHD children exhibited significantly higher dental anxiety when compared to non-ADHD children (P < 0.001). Dental anxiety was significantly related to the caries experience among ADHD group (P < 0.001). Conclusion: Children with ADHD exhibited a poorer oral health status and higher dental anxiety than non-ADHD children. Hence, there is a need for diligent preventive dental care.

Oral health status and its relation with medication and dental fear in children with attention-deficit hyperactivity disorder.

The objective of this study was to determine the ora-dental health and its relation with medication and dental fear in a group of Turkish children with attention-deficit hyperactivity disorder (ADHD). The levels of dental fear of children were determined with The Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). The oral and dental health evaluation was performed. This study included a total of 117 children aged between 6 and 15 years and they were examined under two groups as "ADHD" (n = 59) and "Control" (n = 58). Ora-dental health variables were compared between the groups and were also analyzed in accordance with dental fear and medication. ADHD children and the control group exhibited similar CFSS-DS scores (15-32). No significant differences existed in df(t)/df(s), DMF(T)/DMF(S), d/D values, and presence of the white spot lesions. ADHD children's Mutans streptococci and Lactobacillus quantities were found significantly higher than the control group. The incidence of parafunctional habits of the ADHD children was also found high. ADHD children that were medicated exhibited similar dental caries prevalence and periodontal health status. Although ADHD group had similar dental-periodontal health status and dental fear level with the control group and using ADHD medicines did not make a significant effect on the ora-dental health parameters, the patients should be carefully followed up because they were categorized in high caries risk groups.

Variables influyentes en el miedo y el rendimiento infantil en Ceuta

The low performance in different academic areas causes an enormous preoccupation; this situation promotes the search of new formulas for teaching interventions. These fast changes cause that students must learn new abilities and capacities that let them conform to this process in continuous evolution. From this perspective, with preoccupation for the little academic achievements, the emphasis is on the enormous importance that the emotions and their suitable control for the improvement of itself could have. The objective was to reflect on the predictors of fear and the academic achievement, and the influence over each other, in children aged 6 to 12 from Ceuta City. To do so, we had 404 participants: 47.8% were boys, 52.2% girls; 68.8% were Muslims, and 31.2% Christians. As tools, we implemented the Fear Survey Schedule for Children and Adolescents-II (FSSC-II), the version that Ascensio et al. (2012) adapted to the Spanish language; we also used the children’s grades. The results showed medium-high levels on all of the research variables. The first predictor of fear was gender. Other predictors were status, performance, culture, and age. The predictors of performance were culture, fear, status, and gender. Age worked as a predictor in three factors. We have found a significant relationship between fear and performance. All this leads to consider and increase the emotional competencies as a necessary measure to improve the students’ process of learning, a situation needed in our education system.

Reliability and validity of the Italian versions of the Children's Fear Survey Schedule - Dental Subscale and the Modified Child Dental Anxiety Scale.

Children's dental fear and anxiety (DFA) causes significant problems in clinical practice. The 15-item Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) and the 8-item Modified Child Dental Anxiety Scale (MCDAS) are the most widely used measures of dental fear in children. The aim of this study is to examine the reliability and validity of the Italian versions of the CFSS-DS and MCDAS, also in comparison with a simple visual analogue scale (VAS). The CFSS-DS and MCDAS were translated into Italian by a consensus panel of experts and administered to 210 dental patients aged 4-11 years from three Italian Institutions. Internal reliability was assessed using the Cronbach's alpha correlation. A sub-sample of 60 children was selected for test-retest analysis. CFSS-DS and MCDAS, plus a VAS scale, rated both by children and parents, were validated using as gold standard the 4-item Frankl scale for behaviours assessed by dentists. Mean CFSS-DS score was 30.8 (SD: 11.1) and mean MCDAS score was 17.9 (SD: 7.2), significantly higher among children aged 4-7 years and among children at their first dental visit. The alpha value for internal reliability was 0.90 (95%, CI= 0.88-0.92) for CFSS-DS and 0.87 (95% CI=0.85-0.90) for MCDAS. Both CFSS-DS and MCDAS showed good test-retest reliability (rsp= 0.80; p<0.001 for both scales). CFSS-DS and MCDAS predicted a Frankl score &#8804;2 (i.e., indicating children with an uncooperative behaviour) with a fair accuracy (AUC=0.69 and AUC=0.68, respectively). The VAS scale was more effective in predicting a negative behaviour (AUC=0.78). The scales self-reported by children were only slightly more accurate than those reported by parents. The Italian versions of the CFSS-DS and MCDAS are valid and reliable tools for the assessment of dental fear in Italian children aged 4-11 years. A simple, one-item VAS, and dental fear and anxiety evaluation by parents may be valid and quick alternatives to multi-item indices to predict an uncooperative children behaviour.

Validación del Inventario de Miedo para Niños II en estudiantes de primaria y secundaria

In the current educational system, an enormous preoccupation by the low yield in the different academic areas exists, which promotes the search of new formulas of educational performance. This search cause that the pupils must learn new abilities and capacities with the purpose of conforming itself to this process in continuous evolution. From this perspective, with preoccupation by the little academic profits, the enormous importance is put of relief that can get to have the emotions and their suitable control for the improvement of himself. Socio-emotional states are starting to become more relevant and are now part of a reality in the field of Education. In this field there is high interest in emotional education programs, especially in earlier stages. These programs must be evaluated to check this efficiently. The objective of this paper is to validate a questionnaire to assess Fear, using as reference the Fear Survey Schedule for Children II (FSSC-II) (Ascensio et al., 2012) aimed at a sample of students from Primary to the end of Secondary Education. We focused on 961 participants from 8 different centers (4 schools and 4 high schools) that clearly reflect the city's pluricultural features. Considering age we focused on children from 6 to 18 years old. Considering gender, the 46.6% of them are boys and the 53.4% are girls. If we consider culture and custom religion, 66.3% are Muslims and 33.7% Christians. The technique used in this survey is a test developed to assess Fear (FSSC-II) adapted for its use in the Spanish language by Ascensio et al. (2012). The results show high levels of reliability. Our expectations about dimensions (5) were confirmed for the questionnaire. There are positive correlations between totals and the dimensions of the questionnaire. Therefore this questionnaire is an appropriate tool to evaluate the Fear in a teenager sample in our context.

Dental fear and caries in 6-12 year old children in Greece. Determination of dental fear cut-off points.

To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece. Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children&#x2041;s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale. Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of <0.05. First sample: The mean CFSS-DS score was 27.1&#177;10.8. Age was significantly (p<0.05) related to dental fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DS< 33 was defined as 'no dental fear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DS<33). Dental fear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).

The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear.

No studies assessing the association between gagging and dental fear are available in pediatric samples. To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment.

Psychometric Properties of Farsi Version of the Revised Fear Survey Schedule for Children.

This study examined the psychometric properties of the Farsi version of the Revised Fear Survey Schedule for Children (Ollendick, 1983), namely the FSSC-FA, in a sample of Iranian children and adolescents (N = 394, 206 girls) aged 9-11:11 years. The internal consistency coefficient was found to range from .79 to .96 for total and subscale scores. The authors used exploratory and confirmatory factor analyses to determine the factor structure of the FSSC-FA. The results showed that a 71-item, six-factor model provided a satisfactory fit for the structure of the FSSC-FA (RMSEA = .07, 90% CIs [.068, .072], CFI = .94, NNFI = .94, χ2/df = 2.94). With regard to gender and age differences in fears of the present sample, girls typically reported more fears than boys (Cohen's d = .28, 95% CIs [.08, .48], p < .001), but differences between older and younger participants were modest. The study also reported most common fears in the sample which were very similar to those reported by other studies except one item being specific to the Iranian population. Bearing in mind the limitations discussed, the results generally show that the FSSC-FA scores are valid and reliable to assess fears in Iranian youth.

Prevalence of dental anxiety in 10-14 years old children and its implications.

BackgroundThe aim of this study was to provide insight on dental fear amongst schoolchildren and evaluate the association between caries experience and fear of dental procedures.MethodsA sample size of 250 students (both sexes) of ages 10-14 years were enrolled in the study. Before dental examination, each participant was informed about the study and given the Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) questionnaire. Children who scored greater than 38 were included in the 'with dental fear' group and those who scored less than 38 were assigned to the 'without dental fear' group. All oral check-ups were carried out on the school premises according to WHO criteria.ResultsThere were 105 children (42%) who experienced dental fear. As CFSS-DS scores increased, scores on the Decayed, Missing and Filled Surfaces Index (DMFS) also increased. Scores were highest on "injections" followed by "dentist drill" and "feeling of choking". Children were significantly less anxious about items of dental treatment if they had experienced that particular form of treatment. Female participants were found to be more dentally anxious than the male participants.ConclusionsThe data revealed dental fear in 10-14 years old children and showed that dental fear scores decreased with increase in age and experience.

Pro-Activeness of Parents in Accepting Behavior Management Techniques: A Cross-Sectional Evaluative Study.

The contemporary parents are more active and participate in the decision making during dental treatment. To assess the parents' acceptance towards behavior management techniques commonly used in the pediatric dentistry in different dental situation. Fifty-one parents participated in the study. Children's dental fear was assessed by the parents before attending power point presentation using Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Parents viewed power point presentation of eight behavior management techniques being used during pediatric dental treatment. The techniques were: 1) Voice control; 2) Tell-Show-Do; 3) Positive reinforcement; 4) Parental presence or absence; 5) HOME; 6) Physical restraint; 7) N2O-O2 sedation; 8) General anesthesia. Parents were asked to arrange various behavior management techniques from most accepted technique to least accepted technique in various dental situations according to their view. All the parents completed the questionnaire. Most children show increased anxiety related to dental component of CFSS-DS scale particularly during the administration of local anesthetic. In present study most preferred behavior management technique was Tell-Show-Do followed by positive reinforcement and least preferred behavior management technique was general anesthesia followed by physical restraint. Children's anxiety level increases during the condition related to dentistry which can be overcome by developing positive approach in children and parents towards dentistry and by utilizing various behaviour management strategies. A generalized low parental tolerance level for firm management techniques was seen in the present study population.

Relationship between Child and Parental Dental Anxiety with Child's Psychological Functioning and Behavior during the Administration of Local Anesthesia.

The aims of this study were to determine: 1) the relationship between children's psychological functioning, dental anxiety and cooperative behavior before and during local anesthesia, 2) the relationship of parental dental anxiety with all the above child characteristics. There was a convenient sample of 100 children (4-12 years). Child dental anxiety and psychological functioning were measured using the "Children's Fear Survey Schedule" (CFSS-DS) and the "Strengths and Difficulties Questionnaire" (SDQ) respectively. Parental dental anxiety was measured using the "Modified Dental Anxiety Scale" (MDAS). All questionnaires were completed by parents. Before and during local anesthesia, the child behavior was scored by one experienced examiner, using the Venham scale. Non-parametric tests and correlations (Mann-Whitney, Spearman's rho) were used for the analysis. The mean SDQ score was 10±5.6 for boys (n=60) and 8.3±4.8 for girls (n=40) (p=0.038), but there was no correlation with children's age. The mean CFSS-DS score was 33.1±11.86 and there was no correlation with age or gender. Children with higher levels in the pro-social subscale of the SDQ had significantly less anxiety and better behavior before local anesthesia. Higher mean CFSS-DS scores were significantly associated with uncooperative behavior during local anesthesia (p=0.04). There was no correlation between parents' and their children's dental anxiety, psychological functioning and behavior. 46% of the children had previous dental experience in the last 6 months. As time since the last dental treatment increased, an improvement was found in children's behavior during local anesthesia. Child psychological functioning was related to dental anxiety and behavior during dental appointment involving local anesthesia.

Predicting children's behaviour during dental treatment under oral sedation.

The primary aim of this study was to assess whether parents' own anxiety and their perception of their child's dental fear and child's general fear can predict preoperatively their child's behaviour during dental treatment under oral sedation. The secondary aim was to assess whether the child's age, gender and ASA classification grade are associated with a child's behaviour under oral sedation. Cross-sectional prospective study. The Corah's Dental Anxiety Scale (DAS), Children's Fear Survey Schedule Dental-Subscale (CFSS-DS) and Children's Fear Survey Schedule Short-Form (CFSS-SF) questionnaires were completed by parents of children undergoing dental treatment with oral midazolam. Behaviour was rated by a single clinician using the overall behaviour section of the Houpt-Scale and scores dichotomised into acceptable or unacceptable behaviour. Data were analysed using χ (2), t test and logistic regression analysis. In total 404 children (215 girls, 53%) were included, with the mean age of 4.57years, SD=1.9. Behaviour was scored as acceptable in 336 (83%) and unacceptable in 68 (17%) children. The level of a child's dental fear, as perceived by their parent, was significantly associated with the behaviour outcome (p=0.001). Logistic regression analysis revealed that if the parentally perceived child's dental fear (CFSS-DS) rating was high, the odds of the child exhibiting unacceptable behaviour under oral sedation was two times greater than if their parents scored them a low dental fear rating (OR 2.27, 95% CI 1.33-3.88, p=0.003). CFSS-DS may be used preoperatively to help predict behaviour outcome when children are treated under oral sedation and facilitate treatment planning.

Longitudinal Changes in Dental Fear and Coping Behavior in Children, Adolescents, and Young Adults With Cleft Lip and/or Cleft Palate.

To determine changes in dental anxiety levels of cleft lip and/or palate (CL/P) children and to explore the role of coping strategies in the development of their dental anxiety. Prospective study. Free University Medical Center Amsterdam. A sample of CL/P children (at T1: n = 153, 4 to 18 years, 67 girls; at T2: n = 113, 7 to 21 years, 51 girls). Data were available at both time points for 102 children. Dental anxiety and coping strategies were assessed at the start of the study (T1; mean age: 9.8 years, standard deviation 4.1) and 3 years later (T2; mean age: 13.4 years, standard deviation 3.8). These scores were compared to a normative group of Dutch children. The severity of dental anxiety was indexed using the Parental Version of the Dental Subscale of the Children's Fear Survey Schedule. Dental coping strategies were assessed with the Dental Cope Questionnaire. Overall, dental anxiety decreased to a level equal to normative scores of Dutch children. However, 5% of the children became more anxious. At T2, children used significantly fewer coping strategies. Children whose level of dental anxiety increased significantly used more destructive coping strategies than children whose level of dental anxiety decreased significantly or remained stable. Results suggest that dental anxiety levels of most CL/P children gradually decline over time. Whereas some coping strategies have the potential to be protective, more destructive coping strategies may put children at greater risk for developing and maintaining their dental anxiety.