Moderate and high dental fear by sex and age using the Children’s Fear Survey Schedule-Dental Subscale

Objective: To assess the relationship between the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire’s items and sex and age in children with moderate and high dental fear levels. Methods: Cross-sectional study carried out in a municipality in the Northeastern region of Brazil with 185 children aged 8-10 years of both sexes, who had a minimum score of 32 on the CFSS-DS questionnaire, corresponding to dental fear. Descriptive statistical analysis and the Kolmogorov-Smirnov, Mann-Whitney U, and Kruskal-Wallis tests were performed. The significance level adopted was 5%. Results: Most children were female (59.5%) and 9 years old (37.3%). The average of the total CFSS-DS score was 40.44 ± 6.81 (with a minimum of 32 and a maximum of 75). According to the CFSS-DS, 53.5% of children had high dental fear. Items “Injections,” “Having a stranger touch you,” “The dentist drilling,” “Having somebody put instruments in your mouth,” “Choking,” and “Having to go to the hospital” had the highest median values. A significant difference was observed between ages for the item “Having a stranger touch you” (p=0.001). Conclusion: The item “Having a stranger touch you” in the CFSS-DS questionnaire showed a statistically significant difference with age, while no differences were found regarding sex.

Childhood dental fear in children aged 7-11 years old by using the Children’s Fear Survey Schedule-Dental Subscale

In children, dental fear is not only associated with fear of pain or invasive procedures, but it is also correlated with separation from parents or confronting unfamiliar people or environments. The Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) was developed to evaluate dental fear in children, and this scale is now used across the world for evaluating dental fear. The aim of this study was to evaluate dental fear in children between 7–11 years of age and to find out the association between caries and fear of dental treatment. A total of 300 subjects of both sexes were enrolled in the study. Prior to the oral examination, all patients’ attendants were informed about the study, and the subjects were asked to fill in a questionnaire regarding the CFSS-DS scale. The data obtained through the questionnaires were analyzed using the Chi-Square test. Fear scores were highest for “injections” (3.91±0.17), “dentist drilling” (3.91±0.10) and “choking” (3.65±0.82). It was also observed that subjects who had already visited a dental clinic or those who were familiar with the dental environment at an early stage of life were less anxious than patients who were receiving dental treatment for the first time. In this study, we found that female subjects were more anxious in comparison to male patients. Once the child’s fear is identified, the dentist can use various behavior modification techniques to eliminate fear, explain the steps, and use the instruments accordingly until fear has vanished.

Medo odontológico e cárie dentária em crianças: uma revisão crítica da literatura

O medo odontológico é um problema grave que afeta negativamente a saúde bucal. Esta revisão crítica da literatura objetivou identificar os estudos existentes sobre o medo odontológico associado à experiência de cárie dentária em crianças. Tratou-se de estudo bibliográfico realizado nas bases de dados PubMed, Web of Science e Scopus, por meio dos artigos indexados até outubro de 2019. Os termos utilizados foram: “Dental fear”, “Dental anxiety”, “Dental caries” e “Children”. As informações coletadas foram: autor, o ano de publicação, país, desenho do estudo, número amostral, faixa etária (em anos), o instrumento utilizado para avaliar o medo odontológico e os principais resultados. Os dados foram analisados utilizando-se o Microsoft Excel, sendo apresentados descritivamente. Foram obtidos 533 artigos e 28 foram incluídos. A maioria dos estudos foram realizados por pesquisadores brasileiros (32,1%). O número de participantes variou de 99 a 2734 crianças. A idade mais frequente foi de 12 anos (59,3%) e o instrumento mais utilizado foi o questionário Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) (32,1%), com os respondentes sendo as próprias crianças (82,1%). A prevalência de medo odontológico variou de 5,2% a 66,0%, e os valores de escore médio variaram de 1,50 a 37,0. Os estudos sobre o medo odontológico associado à experiência de cárie dentária em crianças foram realizados em maior número no Brasil, utilizando o questionário CFSS-DS. Existe ampla variabilidade na prevalência e valores de escore médio em diferentes países.

Medo odontológico em escolares: um estudo piloto utilizando o Children’s Fear Survey Schedule - Dental Subscale

Estimar a prevalência de medo odontológico em escolares e verificar sua associação com o sexo, a faixa etária e os hábitos de saúde bucal. Estudo transversal composto por 44 estudantes do ensino fundamental de escolas públicas. Foram coletados dados referentes a questões sociodemográficas e aos hábitos de saúde bucal das crianças e aplicado o questionário Children’s Fear Survey Schedule - Dental Subscale (CFSS-DS). Foi realizada a análise descritiva dos dados, testes Exato de Fisher e U Mann-Whitney (p<0,05). A prevalência de medo odontológico foi de 6,8% e a média do escore total do CFSS-DS foi de 26,43 ± 7,20, mediana de 24,50, IIQ25-75 21-33, escore mínimo de 16 e máximo de 42. A maioria das crianças apresentaram baixo nível de medo odontológico (95,5%). Os níveis de medo odontológico não apresentaram associações estatisticamente significantes entre o sexo (p=0,162), a faixa etária (p=0,181), ter visitado o dentista alguma vez na vida (p=0,201), a queixa de dor (p=0,522) e de sensibilidade dentárias (p=0,181). A prevalência de medo odontológico foi baixa e a maioria das crianças apresentaram baixo nível de medo odontológico. Não se verificou associação entre o medo odontológico e as variáveis sexo, faixa etária, ter visitado o dentista alguma vez na vida, queixa de dor e queixa de sensibilidade dentária.

Evaluation of the relationship between MIH severity and dental fear among the children

Objective: Molar incisor hypomineralization (MIH), a quite common condition in pediatric dentistry, whose treatment might seem complicated, manifests itself with severe dental anxiety and fear that can cause behavioral problems. Although dental fear is seen in almost all cases, it is believed that dental fear will increase as the severity of MIH increases. This study evaluates the relationship between MIH severity and dental fear. Material and Methods: Children Fear Survey Schedule-Dental Subscale (CFSS-DS) was used to measure dental fear in 58 (51.79%) children whose teeth suffered from mild, moderate or severe MIH and 54 (48.21%) children with healthy teeth. Scores between 1 (not afraid at all) and 5 (very afraid) were given according to the responses. Each question was evaluated separately in order to obtain the total score. Results: Children with severe MIH who participated in the study were proved to be more afraid of the dentists, drill sounds, injections, placement of instruments in the mouth, choking and going to the hospital; and there was a statistically significant difference (p<0.05). Conclusion: Although it was observed that the severity of MIH and dental fear are correlated and dental fear increases with the increase in the MIH severity, further studies in this subject are necessary.

Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years

The aim was to investigate changes in dental fear and anxiety (DFA) and verify factors associated with DFA in children. A longitudinal cohort study that included 160 children aged 7 years was carried out. A questionnaire was completed by parents at two time points and evaluated the immigrant background, maternal education, whether the child had ever had toothache, and whether the parents had dental fear. The oral clinical examination evaluated decayed, extracted, and filled primary teeth (deft). The children’s fear survey schedule dental subscale (CFSS-DS) was used to assess the dental fear of the children. Multilevel mixed-effects logistic regressions analyses were used. The CFSS-DS found that 7% of the children had dental fear at age 7 and mean CFSS-DS was 22.9. At 9 years of age, 8% reported dental fear and the mean increased to 25.4. Parental dental fear, experience of toothache, and report of painful dental treatment and caries development between 7 and 9 years of age were factors that were significantly related to development of DFA. There was a change in DFA between 7 and 9 years of age. Dental fear and anxiety is a dynamic process in growing individuals and is significantly related to painful symptoms and experiences of dental care as well as parental dental fear.