The possible influence of fear of death and attitude toward death were studied related to dental anxiety in Hungarian elementary and secondary school subjects (n = 277; 114 males, 163 females; age between 8 and 18 years). Dental fear and anxiety scores were DAS: 10.8 +/- 3.6; DFS: 40.6 +/- 15.6; STAI-S: 38.0 +/- 11.0; STAI-T: 40.3 +/- 10.0. Lester's Attitude Toward Death Scale scores were 6.3 +/- 1.3. Girls scored higher on DAS, STAI-S, and STAI-T scales (P < or = 0.05). Age influenced STAI-S, STAI-T, and Lester's Scale scores (P < or = 0.05). Lester's Scale scores influenced the expectations of the subjects about the dental fear of their surrounding people (parents, brother, sister, friends) (P < or = 0.05). A percentage of 7.22 of the subjects indicated a rather strong connection between dental fear and fear of death. These subjects had significantly higher dental fear and anxiety scores as compared to others (P < or = 0.01). Death-related content was found in 4.3% of drawings and in 10.5% of free associations (couplings) related to teeth (in 12.6% either in drawings or in couplings). The appearance of death-related content was higher with higher age, and higher expected dental fear of surrounding people (P < or = 0.01). Our data indicate a detectable influence of fear of death on dental fear, especially in subjects with higher dental fear scores.
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