Dental caries is associated with dental fear in childhood: findings from a birth cohort study

Abstract

OBJECTIVE: This study aimed to investigate the prevalence of dental fear in preschool children and to estimate its association with maternal and children characteristics. METHODS: 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. RESULTS: 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. CONCLUSIONS: Presence of dental caries and dental pain were associated with dental fear regardless of socioeconomic origin and lack of dental service use in childhood.