Influence of parental anxiety on children’s behaviour during their visits to dental clinic: a short clinical study

Background Anxiety and fear of dental treatment in children have been recognized as sources of serious health problems. Parents are known to subtly transmit feelings of fear and anxiety to their children Commonly which has influence on children’s dental anxiety are maintenance of general health of the child, past dental history, oral hygiene practices and attitudes in the family towards oral health and high dental anxiety of parents, all of these contributed to sustained and elevated levels of children’s dental anxiety. Aim This study was undertaken to evaluate the influence of parental anxiety on their children during their visit to dental clinics. Objective To determine the relationship between parental anxiety level and that of a child. Methods A short clinical study was performed to assess the influence of parental anxiety on their children during their visit to dental clinics. Twenty subjects were randomly selected and their parents were given the Modified Dental Anxiety Scale Questionnaire (MDAS) and their physiologic parameters were measured during each visit. Similarly, the children’s responses were analyzed using the Facial Image Scale (FIS) and their physiologic parameters were measured. Results The values show a positive correlation (P < 0.05) between the scores (MDAS and FIS) and physiologic parameters (blood pressure and heart rate) of parents and their children. Conclusion The dental anxiety levels in parents influence the anxiety levels in children.

Prevalence and risk factors of children’s dental anxiety in China: a longitudinal study

ObjectivesDental anxiety remains widespread among children, may continue into adulthood and affect their oral health-related quality of life and clinical management. The aim of the study was to explore the trend of children’s dental anxiety over time and potential risk factors.DesignLongitudinal study.MethodsChildren aged between 5 and 12 years were investigated with the Chinese version of face version of Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Frankl Behavior Rating scale from 2008 to 2017, and influential factors were explored.ResultsClinical data were available from 1061 children, including 533 (50.2%) male participants and 528 (49.8%) female participants. The total CFSS-DS scores ranged from 16 to 66, with a mean of 24.8±10.3. The prevalence of dental anxiety is 11.59%. No significant differences in total CFSS-DS scores between girls and boys were found. According to the Frankl scale, 238 children were allocated to the uncooperative group and the remaining 823 children were allocated to the cooperative group. Scores of CFSS-DS were negatively correlated with the clinical behaviour level of Frankl. Children aged 11–12 years old had significantly decreased scores compared with other age groups, and there was a decline in the scores of the group aged 8–10 years old over time. The factor analysis divided 15 items of CFSS-DS into four factors, and the total scores of ‘less invasive oral procedures’ items belonging to factor III decreased significantly over time in the group aged 8–10 years old.ConclusionsAge is a significant determinant for children’s dental anxiety, and dental anxiety outcomes have improved for Chinese children aged 8–10 years. This study is one of the few reports on changes of children’s dental anxiety in a new era of information, but the results may be extrapolated to other populations with caution.

Is the perception of anxiety in dental care by children and their parents concordant?

ABSTRACT Objectives: This research evaluated the caregivers’ perception on dental anxiety of their children and verified its association with independent variables: caregivers’ dental anxiety and the reason for their last dental appointment, socioeconomic factors, caregivers and children’s last dental visit, children’s oral health status, dental anxiety and kind of dental appointment. Methods: Fifty-eight children aged 6 to 9 years old and their caregivers participated in the study. For this cross-sectional study the participants were selected from a clinical study where half of the children received fluortherapy and the other half tooth extraction. The caregivers answered questions about socioeconomic status and to evaluate their dental anxiety and the perception on children’s dental anxiety they answered the Dental Anxiety Scale and Dental Anxiety Question, respectively. To evaluate children’s dental anxiety the Modified Venham Picture Test was applied and their oral health status was verified with the DMFT index. Data were analyzed with Chi-square, Fisher’s Exact and Mann-Whitney’s test. Results: The frequency of the caregivers’ perception on dental anxiety of their children were 50.9%. However, 41.4% of children reported dental anxiety. There was a significant difference between Dental Anxiety Question and Modified Venham Picture Test (p=0.002). There was no relationship between caregivers’ perception on dental anxiety of their children and other independent variables. Conclusion: There was a significant difference between children’s dental anxiety and the perception of it by those caregivers.

Children’s Dental Anxiety during the COVID-19 Pandemic: Polish Experience

Dental fear and anxiety is a significant issue that affects pediatric patients and creates challenges in oral health management. Considering that the coronavirus disease 2019 (COVID-19) pandemic, along with its associated sanitary regime, social distancing measures and nationwide quarantines, could itself induce public fears, including in children, it is of great interest to explore whether this situation and the necessity of reorganizing dental care could potentially affect the emotional state of pediatric patients facing a need for urgent dental intervention. The present study assessed the emotional state of children ≤ seven years old (n = 25) requiring dental healthcare during a nationwide quarantine in Poland, as well as the anxiety levels of their caregivers. The Faces Anxiety Scale was adopted, and the evaluation was independently performed by the dentist, caregivers and children themselves. The level of anxiety in caregivers was also measured. As demonstrated, children requiring dental intervention during the nationwide quarantine did not reveal a significantly higher anxiety level as compared to the age- and indication-matched pre-pandemic control group (n = 20), regardless of whether their emotional state was evaluated by the dentist, caregivers, or by themselves. However, the share of children scoring the lowest anxiety level in all assessments was smaller in the pandemic group. Boys in the pandemic group had a higher anxiety level, as indicated by a caregiver assessment, and displayed a negative correlation with age in all three types of evaluation. Moreover, caregiver anxiety levels were higher in the pandemic group as compared to the pre-pandemic subset and revealed stronger correlations with the dental anxiety in children. The results suggest that the reorganization of oral healthcare under the pandemic scenario did not have a profound effect on children’s dental anxiety. Nevertheless, findings in young boys highlight that they may be more vulnerable and require special care to mitigate their anxiety and decrease the risk of dentophobia in the future—these observations must be, however, treated with caution due to the small sample size and require further confirmation. Moreover, it is important to reassure caregivers of the safety of the dental visit during the pandemic to minimize the effect of their own anxiety on dental fears in children.

Experiential learning for children's dental anxiety: a cluster randomized trial

Background: Dental anxiety (DA) has an impact on the quality of dental treatment and may have long-lasting implications for children. A recent study introducing experiential learning (EL) into children’s oral health promotion resulted in better oral hygiene. The purpose of the study is to evaluate whether EL can reduce children's DA. Methods: In September 2018, we recruited 988 children aged 7-8 years from 24 classes to participate in a cluster-randomized trial. Classes were randomly assigned to EL (in which children received a lively presentation on oral health and participated in a role play in a simulated dental clinic in the classroom) or the Tell-Show-Do (TSD) group (in which children received a conventional TSD behavior management). The primary outcome was the prevalence of high DA after the procedure of pit and fissure sealant (PFS), assessed by a modified Children's Fear Survey Schedule-Dental Subscale. Secondary outcomes were changes in blood pressures (BP) and pulse rates (PR) before and after the PFS procedure. The intervention effects were estimated by means of mixed effect models, which included covariates of gender and school (and baseline value for BP and PR only), and a random cluster effect.Results: In 396 children of the EL group who received the PFS treatment, the prevalence of high DA (score ≥ 38) was 18.5%, compared with 24.3% in 391 children of the TSD group (OR=0.65; 95% confidence interval, 0.46-0.93; P=0.019). The increases in BP and PR after the PFS were also significantly less in the EL group. Conclusion: School-based experiential learning intervention before a dental visit is feasible and effective in reducing children’s dental anxiety during PFS.Trial registration: The trial was registered in Chinese Clinical Trial Registry on 5 January 2020 (No.: ChiCTR2000028878, retrospectively registered), http://www.chictr.org.cn/edit.aspx?pid=47970&htm=4.

Experiential learning for children's dental anxiety: a cluster randomized trial

Background: Dental anxiety (DA) has an impact on the quality of dental treatment and may have long-lasting implications for children. A recent study introducing experiential learning (EL) into children’s oral health promotion resulted in better oral hygiene. The purpose of the study is to evaluate whether EL can reduce children's DA. Methods: In September 2018, we recruited 988 children aged 7-8 years from 24 classes to participate in a cluster-randomized trial. Classes were randomly assigned to EL (in which children received a lively presentation on oral health and participated in a role play in a simulated dental clinic in the classroom) or the Tell-Show-Do (TSD) group (in which children received a conventional TSD behavior management). The primary outcome was the prevalence of DA after the procedure of pit and fissure sealant (PFS), assessed by a modified children's fear survey schedule-dental subscale. Secondary outcomes were changes in blood pressures (BP) and pulse rates (PR) before and after the PFS procedure. The intervention effects were estimated by means of mixed effect models, which included covariates of gender and school (and baseline value for BP and PR only), and a random cluster effect.Results: In 396 children of the EL group who received the PFS treatment, the prevalence of DA (score ≥ 38) was 18.5%, compared with 24.3% in 391 children of the TSD group (OR=0.65; 95% confidence interval, 0.46-0.93; P=0.019). The increases in BP and PR after the PFS were also significantly less in the EL group. Conclusions: School-based experiential learning intervention before a dental visit is feasible and effective in lowering children’s dental anxiety during PFS.Trial registration: The trial was registered in Chinese Clinical Trial Registry on 5 January 2020 (No.: ChiCTR2000028878, retrospectively registered), http://www.chictr.org.cn/edit.aspx?pid=47970&htm=4.