Oral health self-perception, dental caries, and pain: the role of dental fear underlying this association

Abstract

Background: Oral health perception has multidimensional nature and can be influenced not only by clinical conditions but also by psychosocial characteristics.

Hypothesis: Dental fear could modify the association between dental caries and dental pain and the perception of negative impact.

Design: A cross-sectional study was conducted with (n = 1,196) children aged 8-12 years attending public and private schools in Pelotas/Brazil. Children were interviewed and examined. Oral health perception was assessed using a global oral health impact item. Crude and adjusted multivariable regression models were built and effect modification of dental fear in the association between clinical indicators and perception of impact was tested.

Results: Compared with children without fear and caries, children with fear and dental caries presented a 1.45 higher prevalence of negative impact (95% CI: 1.18-1.79) while those without fear and with dental caries had a 1.31 higher prevalence (95% CI: 1.11-1.54) after adjustments. Also, the prevalence of negative perception was higher for children with fear and dental pain (PR: 2.95; 95% CI: 1.59-2.39) and for children without fear and with pain (PR: 1.53; 95% CI: 1.29-1.80), compared to children without fear and pain.

Conclusion: The presence of fear increased the effect of pain and caries on children's oral health perception.