Changes in children's dental fear: a longitudinal study

Abstract

Aim: The study aimed to evaluate the development of dental fear in a low fear group and a fearful group of children aged between 8 and 13 years of age and to assess the differences between these groups over time taking into account general variables, such as gender, and treatment variables, such as restorations. Furthermore it was evaluated to what extent general variables and treatment variables predict the change in dental fear or dental fear at later age.

Study design: A three-year longitudinal study.

Methods: 401 parents completed the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), 218 of them repeating this after a 3-year interval. Dental records were used to collect the clinical data, starting from the children's first dental appointment and the CFSS-DS was used to assess the child's dental fear.

Results/statistics: Analysis of variance for repeated measures showed an interaction effect between fear level and mean total CFSS-DS score. Regression analyses applied to the mean total CFSS-DS score at the second measurement moment and the change in total CFSS-DS score between both measurement moments revealed that little variance could be explained by the treatment variables over the various periods, such as extractions in the first period, and that child-characteristic variables could not predict much variance. Independent-samples t-tests showed a significant difference in means for extractions over the whole period between the fearful group (mean=1.73, SD+/-1.18) and low fear group (mean= 0.68, SD+/-2.01) (t=-4.05, p<0.001, n=218). Also the frequency of Behavioural Management Problems (BMP) over the whole period differed between these groups (fearful group: mean=1.40, SD+/-1.90 and low fearful group: mean= 0.40, SD+/-0.93) (t= -4.58, p<0.001, n=218).

Conclusion: The effect of treatment variables and subjective experiences on child dental fear seems to diminish over time. Findings support the theoretical framework of conditioning and gradual exposure in children to prevent dental fear.