Aim: Dental fear (DF) in children is a multifactorial problem that may affect the child\'s dental treatment and behavior at the dental office. This study aimed to evaluate the familial characteristics affecting DF among Arabic-speaking 12- to 15-year-old children in Jeddah, Saudi Arabia.
Materials and methods: A cross-sectional study assessing 16 middle schools in Jeddah, Saudi Arabia, was performed through multistage stratified random sampling. DF among children was measured using the children fear survey schedule-dental subscale (CFSS-DS) questionnaire. A parental questionnaire was used to collect information regarding familial socioeconomic status, parental DF, and DF among siblings and friends. The data were analyzed using the t test, one-way analysis of variance (ANOVA), and multiple linear regression analysis.
Results: A total of 1,522 children were included. Socioeconomic variables were not associated with DF among children. Parental DF, parental dental experiences, siblings’ DF, and friends’ DF were significantly associated with DF in children. In the regression analysis, mothers’ anxiety at the last dental visit, siblings’ DF, and friends’ DF were significant predictors of DF among children.
Conclusion: DF in children is associated with mothers’ anxiety during their last dental visit and DF in siblings or friends.
Clinical significance: Obtaining comprehensive dental, family, and social history from patients is as essential as asking about medical history for pediatric dentists to plan the most appropriate and effective behavioral management techniques for their pediatric patients. Understanding the etiology of DF assists clinicians to provide better oral health services for their fearful patients.
Gordon SM, Dionne RA, et al. Dental fear and anxiety as a barrier to accessing oral health care among patients with special health care needs. Spec Care Dentist 1988;18(2):88–92.
Nigam AG, Marwah N, et al. Correlation of general anxiety and dental anxiety in children aged 3 to 5 years: a clinical survey. J Int Oral Health 2013;5(6):18–24.
Johnsen DC. Managing the patient and parents in dental practice. In: Pediatric Dentistry: Total Patient Care. Wei SHY. ed. Philadelphia: Lea & Febiger, 1988, vol. 1, pp. 140–155.
Corah NL, Gale EN, et al. Assessment of a dental anxiety scale. J Am Dent Assoc 1978;97(5):816–819.
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.
Oba AA, Dulgergil CT, et al. Prevalence of dental anxiety in 7 to 11 year-old children and its relationship to dental caries. Med Princ Pract 2009;18(6):453–457. DOI: 10.1159/000235894.
Locker D, Liddell A, et al. Age of onset of dental anxiety. J Dent Res 1999;78(3):790–796. DOI: 10.1177/00220345990780031201.
Moore R, Brodsgaard I, et al. The contribution of embarrassment to phobic dental anxiety: a qualitative research study. BMC Psychiatry 2004;4:10. DOI: 10.1186/1471-244X-4-10.
Alshoraim MA, El-Housseiny AA, et al. Effects of child characteristics and dental history on dental fear: cross-sectional study. BMC Oral Health 2018;18(1):33. DOI: 10.1186/s12903-018-0496-4.
Silveira ERd, Goettems ML, et al. Clinical and individual variables in children's dental fear: a school-based investigation. Braz Dent J 2017;28(3):398–404. DOI: 10.1590/0103-6440201601265.
Nuttall NM, Steele JG, et al. The reported impact of oral condition on children in the United Kingdom, 2003. Br Dent J 2006;200(10):551–556. DOI: 10.1038/sj.bdj.4813586.
Coric A, Banozic A, et al. Dental fear and anxiety in older children: an association with parental dental anxiety and effective pain coping strategies. J Pain Res 2014;7:515. DOI: 10.2147/JPR.S67692.
Rachman S. The conditioning theory of fear acquisition: a critical examination. Behav Res Ther 1977;15(5):375–387.
Assuncao CM, Losso EM, et al. The relationship between dental anxiety in children, adolescents and their parents at dental environment. J Indian Soc Pedod Prev Dent 2013;31(3):175–179. DOI: 10.4103/0970-4388.117977.
Majstorovic M, Morse DE, et al. Indicators of dental anxiety in children just prior to treatment. J Clin Pediatr Dent 2014;39(1):12–17.
Milsom KM, Tickle M, et al. The relationship between anxiety and dental treatment experience in 5 year-old children. Br Dent J 2003;194(9):503–506. DOI: 10.1038/sj.bdj.4810070.
Goettems ML, Ardenghi TM, et al. Children's use of dental services: influence of maternal dental anxiety, attendance pattern, and perception of children's quality of life. Community Dent Oral Epidemiol 2012;40(5):451–458. DOI: 10.1111/j.1600-0528.2012.00694.x.
Wu L, Gao X. Children's dental fear and anxiety: exploring family related factors. BMC Oral Health 2018;18(1):100. DOI: 10.1186/s12903- 018-0553-z.
Paryab M, Hosseinbor M. Dental anxiety and behavioral problems: a study of prevalence and related factors among a group of Iranian children aged 6 to 12. J Indian Soc Pedod Prev Dent 2013;31(2):82. DOI: 10.4103/0970-4388.115699.
Bedi R, Sutcliffe P, et al. The prevalence of dental anxiety in a group of 13 and 14 year old Scottish children. Int J Paediatr Dent 1992;2(1): 17–24.
Vandenbroucke JP, von Elm E, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Epidemiology 2007;18(6):805–835. DOI: 10.1097/EDE.0b013e3181577511.
Jaakkola S, Rautava P, et al. Dental fear: one single clinical question for measurement. Open Dent J 2009;3:161–166. DOI: 10.2174/1874210600903010161.
El-Housseiny AA, Alamoudi NM, et al. Characteristics of dental fear among Arabic-speaking children: a descriptive study. BMC Oral Health 2014;14(1):118. DOI: 10.1186/1472-6831-14-118.
Al-Namankany A, De Souza M, et al. Evidence-based dentistry: analysis of dental anxiety scales for children. Br Dent J 2012;212(5):219–222. DOI: 10.1038/sj.bdj.2012.174.
El-Housseiny AA, Alsadat FA, 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;16:49. DOI: 10.1186/s12903-016-0205-0.
El-Housseiny AA, Farsi NM, et al. Assessment for the children's fear survey schedule-dental subscale. J Clin Pediatr Dent 2014;39(1):40–46.
Ingman KA, Ollendick TH, et al. Cross-cultural aspects of fears in African children and adolescents. Behav Res Ther 1999;37(4):337–345.
Taani DQ. Dental attendance and anxiety among public and private school children in Jordan. Int Dent J 2002;52(1):25–29.
Ten Berge M, Veerkamp JSJ, et al. The etiology of childhood dental fear: the role of dental and conditioning experiences. J Anxiety Disord 2002;16(3):321–329.
Armfield JM, Spencer AJ, et al. Dental fear in Australia: who's afraid of the dentist? Aust Dent J 2006;51(1):78–85.
Rantavuori K, Lahti S, et al. Dental fear and oral health and family characteristics of Finnish children. Acta Odontol Scand 2004;62(4):207–213. DOI: 10.1080/00016350410001586.
El-Housseiny AA, Merdad LA, et al. Effect of child and parent characteristics on child dental fear ratings: analysis of short and full versions of the children fear survey schedule-dental subscale. OHDM 2015;14(1):9–16.
Milgrom P, Mancl L, et al. Origins of childhood dental fear. Behav Res Ther 1995;33(3):313–319.
Colares V, Franca C, et al. Dental anxiety and dental pain in 5 to 12 yearold children in Recife, Brazil. Eur Arch Paediatr Dent 2013;14(1):15–19. DOI: 10.1007/s40368-012-0001-8.
Klaassen MA, Veerkamp JSJ, et al. Changes in children's dental fear: a longitudinal study. Eur Arch Paediatr Dent 2008;9(1):29–35.
Tickle M, Jones C, et al. A prospective study of dental anxiety in a cohort of children followed from 5 to 9 years of age. Int J Paediatr Dent 2009;19(4):225–232. DOI: 10.1111/j.1365-263X.2009.00976.x.
Alaki S, Alotaibi A, et al. Dental anxiety in middle school children and their caregivers: prevalence and severity. J Dent Oral Hygiene 2012;4(1):6–11.
Smith PA, Freeman R. Remembering and repeating childhood dental treatment experiences: parents, their children, and barriers to dental care. Int J Paediatr Dent 2010;20(1):50–58. DOI: 10.1111/j.1365- 263X.2009.01004.x.
Proffit WR, Fields HW, et al. Contemporary orthodontics, 5th edn. St. Louis, MO: Mosby Elsevier; 2014.
Suprabha BS, Rao A, et al. Child dental fear and behavior: the role of environmental factors in a hospital cohort. J Indian Soc Pedod Prev Dent 2011;29(2):95. DOI: 10.4103/0970-4388.84679.