Assessing children's dental anxiety: A systematic review of current measures
Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, S10 2TA, UK. Community Dentistry And Oral Epidemiology
(Impact Factor: 2.03).
09/2012; 41(2). DOI: 10.1111/j.1600-0528.2012.00740.x
The reliable assessment of children's dental anxiety can have many benefits for the dental team, service providers and dental public health practitioners. This study aimed to identify and evaluate self-report measures, which are available to assess children's dental anxiety. Systematic searches of the literature between 1998 and 2011 were conducted to identify relevant studies. The properties of each measure (reliability and validity) were assessed, and measures were evaluated against a theoretical framework of dental anxiety. Executing the search strategy generated 498 articles and of these 60 studies met all of the inclusion criteria. Seven 'trait' and two 'state' measures of dental anxiety had been employed to assess children's dental anxiety over the past decade. Reliability and validity estimates for the most widely used measures were good; however, many questionnaires had a limited focus in the aspects of anxiety they assessed. The paper summarizes the measures of children's dental anxiety which may be most useful for a number of different purposes and populations.
Available from: Katarzyna Emerich
- "ograniczenie się do jednej tylko pozycji, na podstawie której dokonuje się oceny (tzw. single-item measure), jest jej niewątpliwą wadą, utrudniającą identyfikację lęku stomatologicznego jako zespołu różnych czynników  i uniemożliwiającą ocenę rzetelności metody . Test jest łatwy i szybki do przeprowadzenia (zajmuje mniej niż 1 minutę), a jego wynik jest odzwierciedleniem wskazanej twarzy, dzięki temu więc zapewnia natychmiastową ocenę stanu emocjonalnego młodego pacjenta, co może być przydatne dla lekarza stomatologa przy doborze odpowiedniego leczenia. "
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The objectives of this article are to approach the problem of dental fear in children and adolescents, which is met by dentists in dental practices and to describe the methods of its evaluation. There are objective and subjective methods for the assessment of the intensity of dental anxiety. These methods can be useful for treatment planning in anxious patients.
The dental fear and anxiety of a child patient which is associated with a dental appointment may take many different forms. An adequate evaluation of the behaviour of a child patient in the dental treatment is very important at the very first contact with the dentist, as it allows the dental team to choose the right method. In dental practices especially those, who do not specialize in pediatric dentistry, may barely have skills sufficient to properly evaluate the behaviour of a young patient. This results in the selection of inappropriate methods of conduct with a child, during the first appointment, the consequence of which is a lack of cooperation during treatments, present and future.
Dentists lacking abilities and experience to assess patients’ behaviour, should considering a wider variety of evaluation methods for dental anxiety in children and adolescents. A proper relationship between dentist and patient will have a positive influence on children's attitudes in dental treatment and will improve the comfort of work and increase the effectiveness of the treatment.
- ", instruments used to evaluate dental fear [Klingberg and Broberg, 2007; Themessl- Huber et al., 2010], methodological issues, sampling methods [Themessl-Huber et al., 2010] and cut-off scores [Ten Berge et al., 2002]. Among the several dental fear or dental anxiety measurements available [Porritt et al., 2013], the DAQ employed in this study is considered a simple method of evaluating dental fear in children, with only one item presenting validity and reliability [Neverlien, 1990; Armfield et al., 2009]. Similar to other studies [Armfield et al., 2009; Luoto et al., 2009, 2010], the children whose mothers answered the question with the response 'a little' were categorized as 'without fear', considering that low levels of this feeling (fear) are compatible with the normal development of children [Klingberg and Broberg, 2007] and may be insufficient to interfere with dental treatment [Ten Berge et al., 2002; Nuttall et al., 2008]. "
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This study aimed to investigate the prevalence of dental fear in preschool children and to estimate its association with maternal and children characteristics.
The study was nested in a population-based birth cohort from Pelotas, Brazil, started in 2004. A sample of 1,129 children aged 5 years was dentally examined, and their mothers were interviewed. Dental fear was investigated using a validated instrument through the question ‘Do you think that your child is afraid of going to the dentist?'. The possible answers were (1) ‘no', (2) ‘yes, a little', (3) ‘yes' and (4) ‘yes, a lot'. The outcome was dichotomized as ‘children without dental fear' (answers 1 and 2) and ‘children with dental fear' (answers 3 and 4). Exploratory variables included demographic characteristics, socioeconomic status, maternal oral health status and maternal behaviors. The main explanatory variables were caries and dental pain. Data were analyzed using multivariable Poisson regression.
The prevalence of dental fear was 16.8% (95% confidence interval 14.6-19.0). Multivariate analysis showed that the lower the family income at birth and the higher the severity of dental caries, the higher the prevalence of dental fear. Children who never visited the dentist and those who frequently experienced dental pain were positively associated with higher dental fear prevalence.
Presence of dental caries and dental pain were associated with dental fear regardless of socioeconomic origin and lack of dental service use in childhood.
- "ograniczenie się do jednej tylko pozycji, na podstawie której dokonuje się oceny (tzw. single-item measure), jest jej niewątpliwą wadą, utrudniającą identyfikację lęku stomatologicznego jako zespołu różnych czynnikówi uniemożliwiającą ocenę rzetelności metody. Test jest łatwy i szybki do przeprowadzenia (zajmuje mniej niż 1 minutę), a jego wynik jest odzwierciedleniem wskazanej twarzy, dzięki temu więc zapewnia natychmiastową ocenę stanu emocjonalnego młodego pacjenta, co może być przydatne dla lekarza stomatologa przy doborze odpowiedniego leczenia. "
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ABSTRACT: The aim of this study is to present objective measures of assessing dental anxiety in children and adolescents and possibilities of their use for dental practice. Early and reliable evaluation of child's anxiety and its level is very important and should be an essential part of dental examination. Proper management of an anxious child in the dental office has a positive effect on young patient's cooperation, reduces the levels of fear, improves the comfort of dentist's work and increases the effectiveness of treatment. Objective methods of assessing anxiety are based on physiological responses to fear-producing situations. Although they play an important role in psychophysiology, they are not commonly used in everyday dental practice. It is mainly because they require financial outlays, specialized equipment and extra time spent in the dental office.
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