Aim: To study influence of age, gender of the children, and their accompanying person\'s characteristics in managing fear of children on successive visits to the dental office.
Materials and methods: An observational study was conducted in 50 children (5–8 years) and the accompanying persons. Children were divided into two groups according to their age: Group I: 5–6 years old and group II: 7–8 years, who required multiple visits for restorative treatment. The modified dental anxiety scale (MDAS) and children\'s fear survey schedule-dental subscale (CFSS-DS) questionnaires were used to evaluate accompanying person anxiety and child fear, respectively. Other factors like accompanying person, their education, age and sex of the child, and their relation to child fear level were also evaluated.
Results: The child fear level was observed to significantly decrease on successive three visits (p value < 0.001) using the post hoc comparison test. Parental (accompanying person) anxiety (p value = 0.044) and parent education level (p value = 0.048) were observed to be two factors affecting child anxiety significantly. Also, educational level and area of residence were observed to affect parental anxiety significantly (p value = 0.001).
Conclusion: Dental fear among children was observed to significantly decrease on successive visits. Age and sex of the child were observed to have no effect on child fear. Parent anxiety and their education level were observed to directly affecting child\'s behavior in the dental office.
Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent 2007;17(6):391–406. DOI: 10.1111/j.1365-263X.2007.00872.x.
Aartman IH, van Everdingen T, Hoogstraten J, et al. Self-report measurement of dental anxiety and fear in children: a critical assessment. ASDC J Dent Child 1998;65(4):252–258.
Shinde SD, Hegde RJ. Evaluation of the influence of parental anxiety on children's behavior and understanding children's dental anxiety after sequential dental visits. Indian J Dent Res 2017;28(1):22–26. DOI: 10.4103/ijdr.IJDR_181_16.
Lahti S, Luoto A. Significant relationship between parental and child dental fear. Evid Based Dent 2010;11(3):77. DOI: 10.1038/sj.ebd.6400736.
Themessl-Huber M, Freeman R, Humphris G, et al. Empirical evidence of the relationship between parental and child dental fear: a structured review and meta-analysis. Int J Paediatr Dent 2010;20(2):83–101. DOI: 10.1111/j.1365-263X.2009.00998.x.
Forgione AG, Clark RE. Comments on an empirical study of the causes of dental fears. J Dent Res 1974;53(2):496. DOI: 10.1177/00220345740530025501.
Johnson R, Baldwin DC Jr. Maternal anxiety and child behavior. ASDC J Dent Child 1969;36(2):87–92.
Wright GZ, Alpern GD. Variables influencing children's cooperative behavior at the first dental visit. ASDC J Dent Child 1971;38(2):124–128.
Ramos-Jorge ML, Marques LS, Pavia SM, et al. Predictive factors for child behaviour in the dental environment. Eur Arch Paediatr Dent 2006;7(4):253–257. DOI: 10.1007/BF03262561.
Giri J, Pokharel PR, Gyawali R, et al. Translation and validation of modified dental anxiety scale: the Nepali version. Int Sch Res Notices 2017;2017:5495643. DOI: 10.1155/2017/5495643.
Deogade SC, Suresan V. Psychometric assessment of anxiety with the modified dental anxiety scale among central Indian adults seeking oral health care to a dental school. Ind Psychiatry J 2016;25(2): 202–209. DOI: 10.4103/ipj.ipj_16_16.
Malhotra R, Gandhi K, Kumar D, et al. A comparative study to evaluate parent's ability to assess dental fear in their 6-to 10-year-old children using children's fear survey schedule—dental Subscale. Int J Clin Pediatr Dent 2018;11(3):205. DOI: 10.5005/jp-journals-10005-1512.
Singh P, Pandey RK, Nagar A, et al. Reliability and factor analysis of children's fear survey schedule-dental subscale in Indian subjects. J Indian Soc Pedod Prev Dent 2010;28(3):151–155. DOI: 10.4103/0970-4388.73788.
Humphris GM, Freeman RE, Tutti H, et al. Further evidence for the reliability and validity of the modified dental anxiety scale. Int J 2000;50(6):367–370. DOI: 10.1111/j.1875-595x.2000.tb00570.x.
Cuthbert MI, Melamed BG. A screening device: children at risk for dental fear and management problems. ASDC J Dent Child 1982;49(6):432–436.
Humphris GM, Dyer TA, Robinson PG. The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age. BMC Oral Health 2009;9(1):20. DOI: 10.1186/1472-6831-9-20.
Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai-Pareekh's scale updated for 2019. J Family Med Prim Care 2019;8(6):1846–1849. DOI: 10.4103/jfmpc.jfmpc_288_19.
Kumar BP, Dudala SR, Rao AR. Kuppuswamy's Socio-economic status scale – a revision of economic parameter for 2012. Int J Res Develop Health 2013;1(1):2–4.
Raj S, Agarwal M, Aradhya K, et al. Evaluation of dental fear in children during dental visit using children's fear survey schedule-dental Subscale. Int J Clin Pediatr Dent 2013;6(1):12–15. DOI: 10.5005/jp-journals-10005-1178.
Folayan MO, Idehen EE, Ojo OO. The modulating effect of culture on the expression of dental anxiety in children: a literature review. Int J Paediatr Dent 2004;14(4):241–245. DOI: 10.1111/j.1365-263X.2004.00563.x.
Rachman S. The conditioning theory of fear-acquisition: a critical examination. Behav Res Ther 1977;15(5):375–387. DOI: 10.1016/0005-7967(77)90041-9.
Townend E, Dimigen G, Fung D. A clinical study of child dental anxiety. Behav Res Ther 2000;38(1):31–46. DOI: 10.1016/s0005-7967(98) 00205-8.
Cardoso CL, Loureiro SR, Nelson-Filho P. Paediatric dental treatment: manifestations of stress in patients, mothers and dental students. Braz Oral Res 2004;18(2):150–155. DOI: 10.1590/s1806-83242004000200011.
Brightfutures.aap.org. 2019 [cited 20 March 2020]. Available from: https://brightfutures.aap.org/Bright%20Futures%20Documents/BF4_MiddleChildhoodVisits.pdf.
Holtzman JM, Berg RG, Mann J, et al. The relationship of age and gender to fear and anxiety in response to dental care. Spec Care Dentist 1997;17(3):82–87. DOI: 10.1111/j.1754-4505.1997.tb00873.x.
Peretz B, Efrat J. Dental anxiety among young adolescent patients in Israel. Int J Paediatr Dent 2000;10(2):126–132. DOI: 10.1046/j.1365-263x.2000.00181.x.
Leal AM, Serra KG, Queiroz RC, et al. Fear and/or anxiety of children and parents associated with the dental environment. Eur J Paediatr Dent 2013;14(4):269–272.
Milgrom P, Mancl L, King B, et al. Origins of childhood dental fear. Behav Res Ther 1995;33(3):313–319. DOI: 10.1016/0005-7967(94) 00042-i.
Olak J, Saag M, Honkala S, et al. Children's dental fear in relation to dental health and parental dental fear. Stomatologija 2013;15(1): 26–31.
Boman UW, Lundgren J, Elfström ML, et al. Common use of a fear survey schedule for assessment of dental fear among children and adults. Int J Paediatr Dent 2008;18(1):70–76. DOI: 10.1111/j.1365-263X.2007.00863.x.
Ripa LW. Maternal influence on children's behavior in the dental situation. In: Ripa LW, Barnie JT. Management of Dental Behavior in Children. Littleton, MA: PSG Publishing; 1979. pp. 15–76.
Soares FC, Lima RA, Barros MVG, et al. Development of dental anxiety in schoolchildren: a 2-year prospective study. Community Dent Oral Epidemiol 2017;45(3):281–288. DOI: 10.1111/cdoe.12290.
Klaassen M, Veerkamp J, Hoogstraten J. Predicting dental anxiety. the clinical value of anxiety questionnaires: an explorative study. Eur J Paediatr Dent 2003;4(4):171–176.
El-Housseiny AA, Alsadat FA, Alamoudi NM, et al. Reliability and validity of the children's fear survey schedule-dental Subscale for arabic-speaking children: a cross-sectional study. BMC Oral Health 2016;16(1):49. DOI: 10.1186/s12903-016-0205-0.
Fotedar S, Bhardwaj V, Fotedar V. Dental anxiety levels and factors associated with it among patients attending a dental teaching institute in Himachal Pradesh. SRM J Res Dent Sci 2016;7(3):153–157. DOI: 10.4103/0976-433X.188799.
Ratson T, Blumer S, Peretz B. Dental anxiety of parents in an Israeli Kibbutz population and their prediction of their children's behavior in the dental office. J Clin Pediatr Dent 2016;40(4):306–311. DOI: 10.17796/1053-4628-40.4.306.