Dental anxiety in schoolchildren with molar incisor hypomineralization—A population‐based cross‐sectional study

Abstract

Background Identifying patients with high levels of DA helps to define the most adequate oral healthcare strategy, especially for pediatric patients. Aim To investigate the association between parental reports of dental anxiety (DA) and molar incisor hypomineralization (MIH) in schoolchildren. Design A cross‐sectional study was conducted in a representative sample of 731 8‐year‐old schoolchildren from the city of Curitiba, Brazil, who were clinically examined (k ≥ 0.75) for the diagnosis of MIH and dental caries using the EAPD criteria and dmft/DMFT index, respectively. Parents/guardians reported children's DA using the Dental Anxiety Question (DAQ) and answered a self‐administered structured questionnaire addressing socioeconomic and demographic characteristics. Associations were evaluated using Poisson regression analysis with robust variance (P < 0.05). Results A significant association was found between DA and MIH (PR = 1.20; 95%CI: 1.01‐1.42; P = 0.038), but this association lost its significance when adjusted for the other characteristics (PR = 1.13; 95%CI: 0.93‐1.38; P = 0.215). Caries experience in primary teeth was associated with lower levels of DA (PR = 0.83; 95%CI: 0.71‐0.96; P = 0.0013). The most recent visit to the dentist due to pain increased the levels of DA (PR = 1.18; 95%CI: 1.07‐1.30; P = 0.001). Conclusions The presence of MIH in schoolchildren was not associated with parental reports of DA.

Dental Fear in Children: Association with Dental Caries and Molar Incisor Hypomineralization

“…It is recognized that socioeconomic status is considered an indirect influence on dental fear (5,8). The factors experienced by the child are considered direct influences (5), such as caries (6) and dental pain (5,11), as well as previous history of dental treatment (5,8,24). In this research, significant association between dental fear and monthly family income was found, but some other studies have found no association (4,11).…”

“…This indicates that CFSS-DS is a reliable instrument for measuring dental fear in children. It is a self-report or parental report questionnaire, and in this research, it was applied directly to children, since it was observed that when using the parental version of the questionnaire, less anxious parents tend to underestimate their children's dental fear, and more anxious parents tend to overestimate it (11). In Brazil, as far as we know, this is the first research that associates dental fear with dental caries and MIH using CFSS-DS.…”

“…Data collection was performed between March and May 2019. The questionnaire developed by researchers contained questions regarding guardians (nuclear family structure when child lived with biological parents who were married or in a stable union, and non-nuclear family structure when the child lived with only one biological parent who was single, divorced or widowed (11), schooling, monthly family income and participation in assistance programs) and children (sex, age, mental retardation or developmental disorders, and neuropsychiatric disorders), in addition to data about their oral health habits (if they visited dentist in life, type of dental health service consulted, dental pain and dental sensitivity in the last 6 months).…”

“…Dental fear is multifactorial (1) and can be triggered by pain experience (2,5), dental caries (6), negative experiences during dental treatment (7), socioeconomic, psychological (8) and cultural aspects, as well as by the profile of visits to dental services and previous visits to the dentist (5,8). In children with molar incisor hypomineralization (MIH), the risk of developing fear, anxiety and behavioral problems may be increased (9,10), because MIH is associated with many dental problems such as dentin hypersensitivity, rapid development of carious lesions and need for recurrent dental treatment (9,10), as well as dental pain (10,11) and difficulties in obtaining adequate anesthesia (9).…”

“…Few studies have analyzed the relation between dental fear and dental caries in patients with MIH (9)(10)(11)14) and some limitations can be observed regarding the use of the parental version of questionnaires (9,11), and regarding the collection of children's dental data from records retrieved from the service responsible for care (9,10). Therefore, the aim of this study was to investigate the prevalence of dental fear and to evaluate its association with dental caries and MIH in schoolchildren aged 8-10 years.…”