Can Birth Order Affect Temperament, Anxiety and Behavior in 5 to 7-year-old Children in the Dental Setting?

Abstract

Aim The aim of this study was to evaluate the relationships between birth order and child's temperament, anxiety and behavior in the dental setting. Materials and methods A total of 200 healthy children aged 5 to 7 years, were included in this double-blind randomized controlled trial. The study consisted of two sessions. In the initial appointment, parents were provided with instructions and asked to complete children's behavior questionnaire (CBQ). In the second appointment, identical dental treatments were rendered to all subjects. During treatment, Frankl scale for child's behavior, facial Image scale (FIS) for situational anxiety, and clinical anxiety rating scale for clinical anxiety were utilized. Analysis of data was done using U Mann-Whitney and Kruskal-Wallis tests. Results Only children had higher clinical (p = 0.041) and situational (p < 0.001) anxiety, and more negative behavior (p = 0.013) compared to children with siblings. In children with siblings, first-born child was in increased risk of developing negative behavior (p = 0.008), clinical anxiety (p < 0.001) and situational anxiety (p = 0.006). With an exception (sadness, p < 0.001), no significant differences in temperament scale were observed among children with different birth orders. Conclusion According to the results, only children and laterborns are at higher risk of developing worse outcomes in the dental setting. Clinical significance The role of birth order has been ignored as a possible factor of behavior during routine dental treatment and these findings may shed light on our understanding of behavior management strategies in the dental setting. Considering the increasing pattern of family with an only child both in modern and developing countries, this is more likely that the dental team will face children with negative outcome during dental treatment. How to cite this article Aminabadi NA, Sohrabi A, Erfanparast L, Oskouei SG, Ajami BA. Can Birth Order Affect Temperament, Anxiety and Behavior in 5 to 7-year-old Children in the Dental Setting? J Contemp Dent Pract 2011;12(4):225-231.

Children’s dental fear and anxiety: exploring family related factors

“…On the other hand, there was an alternative theory describing personality of single-born children as more self-centered, demanding, shy, dependent and moody [ 40 ]. While the former lends support to our findings, the latter points to the possibility of higher DFA in single children, which was a finding of some other studies [ 21 , 22 ]. There were also research studies suggesting no difference in the personalities of single child and their peers with siblings when judged by parents, teachers, and themselves [ 41 ] .…”

“…It has been reported that children’s birth order partially determines their ability to cope with stresses in medical situations [ 20 ]. In the dental setting, only born children and first-born children were found to have a higher clinical situational DFA and were less cooperative than others [ 21 , 22 ]. A study involving children of various age showed that more children reported to have DFA if their siblings reported DFA [ 23 ].…”

Behavior of Children Submitted to Tooth Extraction: Influence of Maternal and Child Psychosocial Characteristics

“…This result corroborates numerous studies that observed a trend of non-cooperative behavior in children whose mothers present high levels of dental anxiety [1,3,10,13,18,25].…”

“…It is expected that the child's behavior improves with advancing age, once older children tend to have a wider coping repertoire and therefore, positive skills to cope with stressful events such as dental treatment [1][2][3]17,18]. With maturity, there is an increase in the positive perception regarding dental treatment and, therefore, a trend of collaborate during dental treatment [18]. In addition, children develop mentally, emotionally, socially and cognitively over the years.…”

Association of Dental Anxiety with Psychosocial Characteristics among Children Aged 7-13 Years

“…In the same line, only children have demonstrated being more anxious than the other children [14]. Only children are at the core center of attention and care and tend to be more vulnerable to stressful situations such as dental treatment [15].…”