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Keywords = dental fear and anxiety (DFA)

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10 pages, 212 KiB  
Article
Reliability and Validity of the Modified Dental Anxiety Scale Among Children Aged 9 to 12 Years
by Satu Lahti, Mika Kajita, Vesa Pohjola and Auli Suominen
Dent. J. 2025, 13(6), 248; https://doi.org/10.3390/dj13060248 - 30 May 2025
Viewed by 588
Abstract
Objectives: Our aim was to study whether the Modified Dental Anxiety Scale (MDAS) is reliable and valid for use in children aged 9 to 12 years. Methods: The study population was a convenient sample of Finnish comprehensive school pupils in the third and [...] Read more.
Objectives: Our aim was to study whether the Modified Dental Anxiety Scale (MDAS) is reliable and valid for use in children aged 9 to 12 years. Methods: The study population was a convenient sample of Finnish comprehensive school pupils in the third and sixth grades (N = 57 and N = 69, respectively). Dental fear and anxiety (DFA) were measured with the Finnish validated adult version of MDAS, the modified Child Fear Survey Schedule—Dental Subscale (CFSS-DS-M), and a single question. Reliability was evaluated using Cronbach’s alpha. The criterion validity of MDAS was assessed using Spearman rank correlation coefficients against CFSS-DS-M and the single question. Construct validity was assessed by examining the ability of MDAS to find differences according to gender and treatment procedures using the chi-square test for categorized and the Mann–Whitney and Jonckheere–Terpstra tests for continuous variables. Results: The Cronbach alphas were 0.841, 0.708, and 0.778 for MDAS total, anticipatory, and treatment-related DFA, respectively. Correlations between MDAS and CFSS-DS-M total and subscale scores were moderate to strong (ρ = 0.559–0.794), supporting criterion validity. Girls in third grade had lower mean MDAS anticipatory DFA (3.4, SD = 1.44) than boys (4.5, SD = 2.21, p = 0.051). In sixth graders, girls had higher mean MDAS treatment-related DFA (8.4, SD = 3.17) than boys (6.9, SD = 2.61, p = 0.067). Children reporting orthodontic treatment had lower anticipatory DFA (mean = 3.4, SD = 2.13) than children not reporting (mean = 4.0, SD = 1.83; p = 0.009), supporting construct validity. Conclusions: The Finnish version of the MDAS showed good reliability, good criterion validity, and acceptable construct validity, supporting its use in children aged 9–12 years. Full article
(This article belongs to the Special Issue Current Advances in Pediatric Odontology)
11 pages, 240 KiB  
Review
Recent Developments in the Non-Pharmacological Management of Children’s Behavior Based on Distraction Techniques: A Concise Review
by Jieyi Chen, Ke Deng, Dikuan Yu, Cancan Fan, Limin Liu, Haijing Gu, Fang Huang and Yongbiao Huo
Healthcare 2024, 12(19), 1940; https://doi.org/10.3390/healthcare12191940 - 27 Sep 2024
Cited by 3 | Viewed by 3244
Abstract
Oral diseases and conditions affect children’s oral health and negatively influence their overall health. Early detection and intervention are important in mitigating these negative consequences. However, dental fear and anxiety (DFA) regarding dental procedures often hinder children from seeking necessary dental care. Non-pharmacological [...] Read more.
Oral diseases and conditions affect children’s oral health and negatively influence their overall health. Early detection and intervention are important in mitigating these negative consequences. However, dental fear and anxiety (DFA) regarding dental procedures often hinder children from seeking necessary dental care. Non-pharmacological behavior management strategies, such as distraction techniques, are commonly adopted to manage children’s behaviors. Distraction techniques have been developed rapidly in recent years and are widely accepted by both health professionals and parents due to their noninvasive and low-cost nature. This concise review aims to summarize current distraction techniques applied during dental treatments, especially for children. The most commonly reported techniques for children are audio distraction, audio-visual distraction, tactile distraction, olfactory distraction, and gustatory distraction. Audio distraction techniques involving music and storytelling help children relax. Audio-visual distraction techniques help to divert children’s attention from the dental treatment. Tactile stimuli can reduce the transmission of pain signals. Olfactory stimuli can help children feel comfortable and relaxed. Gustatory distraction involving sweet substances can create a positive environment. These distraction techniques effectively reduce DFA in children and improve their satisfaction with dental procedures. As technology continues to develop, further research is needed to provide more robust, evidence-based guidance for dentists using distraction techniques. Full article
(This article belongs to the Special Issue Prevention and Management of Oral Diseases Among Children)
16 pages, 1399 KiB  
Article
Do Subjects from Different Occupational Groups Experience Dental Fear and Anxiety Equally?
by Eglė Slabšinskienė, Karolina Radlinskaitė, Aistė Kavaliauskienė, Ingrida Vasiliauskienė, Jūratė Zūbienė, Kristina Saldūnaitė-Mikučionienė and Apolinaras Zaborskis
Medicina 2024, 60(4), 674; https://doi.org/10.3390/medicina60040674 - 21 Apr 2024
Viewed by 1522
Abstract
Background and Objectives: Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. Materials and Methods: A [...] Read more.
Background and Objectives: Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. Materials and Methods: A cross-sectional study with 422 respondents from four occupational groups (physicians, teachers, industry workers, and artists) was carried out. A questionnaire on previous dental experience using the Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and Self-Esteem Scale was self-administered electronically. The data analysis involved descriptive statistics and structural equation modeling (SEM). Results: The DFA levels differed significantly across the occupational groups, with the lowest mean scores among physicians (DAS = 9.29 (SE 0.39); DFS-1 = 14.67 (0.63); DFS-2 = 33.94 (1.69)) and the highest mean scores among artists (DAS = 10.74 (0.38); DFS-1 = 17.19 (0.71); DFS-2 = 41.34 (1.92)). A significant impact of self-esteem on DFA was observed among physicians, teachers, and artists, but not among industry workers. Multi-group analysis with SEM revealed differences in the variable association (Chi-squared = 53.75; df = 21; p < 0.001), thus rejecting the hypothesis of the same mechanism underlying DFA across occupational groups. Conclusions: Individuals from various occupations experience DFA at different levels, and there are different mechanisms underlying their DFA. These findings can provide valuable insights for dental practitioners in developing tailored approaches to reduce the feeling of DFA of their patients. Full article
(This article belongs to the Section Dentistry and Oral Health)
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30 pages, 4228 KiB  
Systematic Review
Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis
by Sarrah S. F. S. Almarzouq, Helene Chua, Cynthia K. Y. Yiu and Phoebe P. Y. Lam
Healthcare 2024, 12(5), 537; https://doi.org/10.3390/healthcare12050537 - 23 Feb 2024
Cited by 8 | Viewed by 4682
Abstract
Background: Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children [...] Read more.
Background: Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12. Method: A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses. Result: A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell–show–do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell–show–do and other NPBIs in reducing DFA among children. Conclusions: The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA. Full article
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11 pages, 248 KiB  
Review
The Impact of Molar Incisor Hypomineralisation on Children and Adolescents: A Narrative Review
by Stephanie Shields, Tong Chen, Felicity Crombie, David J. Manton and Mihiri Silva
Healthcare 2024, 12(3), 370; https://doi.org/10.3390/healthcare12030370 - 1 Feb 2024
Cited by 10 | Viewed by 3909
Abstract
Molar incisor hypomineralisation (MIH) is a qualitative developmental enamel defect with a prevalence of 13% worldwide. This review aims to outline the current evidence regarding the impact of MIH on children’s oral health and, more broadly, their day-to-day activities. MIH is associated with [...] Read more.
Molar incisor hypomineralisation (MIH) is a qualitative developmental enamel defect with a prevalence of 13% worldwide. This review aims to outline the current evidence regarding the impact of MIH on children’s oral health and, more broadly, their day-to-day activities. MIH is associated with negative sequelae, including hypersensitivity, post-eruptive breakdown, the rapid development of carious lesions and poor aesthetics. Other concerns pertain to the clinical management of MIH and include difficulty in achieving local anaesthesia, increased dental fear and anxiety (DFA) and increased behaviour management problems. Oral health-related quality of life (OHRQoL) is the most standardised measure of patient impact; however, no instruments have been validated for use in MIH populations. The few existing observational studies investigating the impact of MIH on OHRQoL in children have produced conflicting results. Interventions to alleviate hypersensitivity and improve aesthetics had a positive impact on the OHRQoL of MIH-affected children. Multiple methodological issues make it difficult to measure the impact of MIH, including heterogeneity in the MIH severity classification, an overlap in the indices used to diagnose dental caries and MIH as well as the subjectivity of outcome measures for hypersensitivity and DFA. Full article
(This article belongs to the Special Issue Oral Health Status of Children and Adolescents)
13 pages, 736 KiB  
Article
Possible Risk Factors for Dental Fear and Anxiety in Children Who Suffered Traumatic Dental Injury
by Anka Jurišić Kvesić, Miroslav Hrelja, Željka Lovrić, Luka Šimunović, Bruno Špiljak, Nika Supina, Lara Vranić and Dubravka Negovetić Vranić
Dent. J. 2023, 11(8), 190; https://doi.org/10.3390/dj11080190 - 9 Aug 2023
Cited by 13 | Viewed by 4669
Abstract
Background: Children who undergo painful experiences such as traumatic dental injury (TDI) during their early years are more likely to be at an increased risk of developing dental fear and anxiety (DFA). The purpose of this study was to identify potential risk factors [...] Read more.
Background: Children who undergo painful experiences such as traumatic dental injury (TDI) during their early years are more likely to be at an increased risk of developing dental fear and anxiety (DFA). The purpose of this study was to identify potential risk factors for DFA of these children. Methods: The study participants were 220 parents/caregivers and their children who experienced TDI. Their socio-demographic backgrounds were investigated with the modified WHO Oral Health Questionnaire for Children that included questions about parents’ knowledge and attitudes, while the DFA level was determined using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and the Simplified Oral Hygiene Index (OHI-S Index) was used to assess oral hygiene status. Results: The confirmed risk factors are parental knowledge, female gender, and degree of oral hygiene and pain in the last three months, while age, type of TDI, presence of soft-tissue injury, and number of subjective complaints were not confirmed. The overall model predicted approximately 54% of variance in DFA, R2 = 0.545, F (4.215) = 64.28 p < 0.001. Conclusions: These findings emphasise the importance of addressing pain management, improving oral hygiene, and enhancing parental knowledge to mitigate DFA in children with TDIs. Full article
(This article belongs to the Special Issue Dentistry Journal: 10th Anniversary)
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10 pages, 2671 KiB  
Article
Dental Fear and Anxiety of Chinese Preschool Children in a School-Based Outreach Service Using Silver Diamine Fluoride for Caries Control: A Cross-Sectional Study
by Ivy Guofang Sun, Hollis Haotian Chai, Edward Chin Man Lo, Chun Hung Chu and Duangporn Duangthip
Int. J. Environ. Res. Public Health 2023, 20(5), 4467; https://doi.org/10.3390/ijerph20054467 - 2 Mar 2023
Cited by 9 | Viewed by 2582
Abstract
Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA) of preschool children after participating in a school-based outreach service using SDF to arrest early childhood caries [...] Read more.
Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA) of preschool children after participating in a school-based outreach service using SDF to arrest early childhood caries (ECC). The study recruited 3- to 5-year-old children with untreated ECC. A trained dentist performed a dental examination and applied SDF therapy to the carious lesions. ECC experience was measured using the dmft index. Questionnaires for parents were used to collect the children’s demographic information and their dental treatment experiences. The children’s DFA before and immediately after SDF therapy was assessed using the self-reported Facial Image Scale (FIS) on a Likert scale of 1 (very happy) to 5 (very distressed). The association between the children’s DFA after SDF therapy and the potentially related factors, including demographic background, caries experience, and DFA before SDF therapy, were analysed using bivariate analysis. Three hundred and forty children (187 boys, 55%) joined this study. Their mean (SD) age and dmft scores were 4.8 (0.9) and 4.6 (3.6), respectively. Most of them (269/340, 79%) never had a dental visit. After SDF therapy, 86% (294/340) of the children exhibited no or low DFA (FIS ≤ 3), whereas 14% (46/340) reported high DFA (FIS > 3). No factor was associated with children’s DFA after SDF therapy (p > 0.05). This study showed most preschool children with ECC exhibited no or low DFA after SDF therapy in a school setting. Full article
(This article belongs to the Special Issue Oral Health and Dental Caries)
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14 pages, 448 KiB  
Article
Children’s Perceptions of Dental Experiences and Ways to Improve Them
by Melika Modabber, Karen M. Campbell, C. Meghan McMurtry, Anna Taddio and Laura J. Dempster
Children 2022, 9(11), 1657; https://doi.org/10.3390/children9111657 - 29 Oct 2022
Cited by 4 | Viewed by 2549
Abstract
This qualitative study explored children’s perceptions of their dental experiences and their acceptability of the CARD™ (Comfort, Ask, Relax, Distract) system, adapted for the dental setting as a means to mitigate dental fear and anxiety (DFA). A purposive sample of 12 participants (7 [...] Read more.
This qualitative study explored children’s perceptions of their dental experiences and their acceptability of the CARD™ (Comfort, Ask, Relax, Distract) system, adapted for the dental setting as a means to mitigate dental fear and anxiety (DFA). A purposive sample of 12 participants (7 males) aged 8-12 years receiving dental care at the Paediatric Dental Clinic, University of Toronto, was recruited. Virtual one-on-one interviews were augmented with visual aids. Participants were oriented to and asked about their perceptions of various dental procedures. Data were deductively analyzed, according to the Person-Centered Care framework (PCC). Four themes were identified: establishing a therapeutic relationship, shared power and responsibility, getting to know the person and empowering the person. Children emphasized the importance of clinic staff attributes and communication skills. They expressed a desire to engage more actively in their own care and highlighted the positive influence of pre-operative education and preparation. Participants found the CARD™ system to facilitate opportunities for self-advocacy in their dental care. Full article
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19 pages, 1413 KiB  
Review
The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model
by Leah I. Stein Duker, Mollianne Grager, Willa Giffin, Natasha Hikita and José C. Polido
Int. J. Environ. Res. Public Health 2022, 19(4), 2380; https://doi.org/10.3390/ijerph19042380 - 18 Feb 2022
Cited by 36 | Viewed by 10986
Abstract
Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or [...] Read more.
Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA. Full article
(This article belongs to the Special Issue Approach to Promoting Oral Health)
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9 pages, 958 KiB  
Article
Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years
by Andreas Dahlander, Fernanda Soares, Margaret Grindefjord and Göran Dahllöf
Dent. J. 2019, 7(3), 68; https://doi.org/10.3390/dj7030068 - 1 Jul 2019
Cited by 71 | Viewed by 10341
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Psychosocial Impacts of Dental Conditions in Childhood, Volume Ⅱ)
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