Morgan, Annie G; Rodd, Helen D; Porritt, Jenny M; Baker, Sarah R; Creswell, Cathy; Newton, Tim; Williams, Chris; Marshman, Zoe
Dental anxiety is common among children. Although there is a wealth of research investigating childhood dental anxiety, little consideration has been given to the child's perspective. This qualitative study sought to explore with children their own experiences of dental anxiety using a cognitive behavioural therapy assessment model. Face-to-face, semi-structured interviews were conducted with dentally anxious children aged 11-16 years. The Five Areas model was used to inform the topic guide and analysis. Data were analysed using a framework approach. In total, 13 children were interviewed. Participants described their experiences of dental anxiety across multiple dimensions (situational factors and altered thoughts, feelings, physical symptoms, and behaviours). Participants placed considerable value on communication by dental professionals, with poor communication having a negative influence on dental anxiety and the dentist-patient relationship. This study confirms the Five Areas model as an applicable theoretical model for the assessment of childhood dental anxiety. Children provided insights about their own dental anxiety experiences that have not previously been described. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Shinde, Swapnali Dilip; Hegde, Rahul J
Identifying anxiety levels of parents accompanying their children can help the clinician in designing the behavior management strategies for the child. In addition, continued dental experience can improve the child's response, indicating desensitization to dental stress. To evaluate the influence of parental anxiety on children's behavior and understanding children's dental anxiety after sequential dental visits. A total of 175 children of age 6-12 years, 98 were boys and 77 were girls, were randomly selected from various schools of Navi Mumbai. Parental dental anxiety was assessed using the Corah's dental anxiety scale (DAS), and child anxiety level was measured using children fear survey schedule-dental subscale (CFSS-DS). Pearson's correlation coefficient analysis, ANOVA, and Friedman test. There is a significant positive correlation (P < 0.0001) between DAS scores and CFSS-DS scores at all three dental visits. The mean ± standard deviation, CFSS-DS scores at the first, second, and third dental visits are (34.07 ± 11.97), (31.04 ± 10.94), and (27.26 ± 9.39), respectively, showing the score is more during the first dental visit than the second and third visits. The dental anxiety levels in parents may influence the anxiety levels of children and also all children exhibited an improvement in the levels of dental anxiety from the first dental visit to the subsequent dental visits.
POPESCU, SANDA MIHAELA; DASCĂLU, IONELA TEODORA; SCRIECIU, MONICA; MERCUŢ, VERONICA; MORARU, IREN; ŢUCULINĂ, MIHAELA JANA
Background: Dental anxiety is a condition that causes a decrease in population addressability to the dentist with adverse consequences for long-term oral health. Assessment of behavioral factors that correlate with dental anxiety is important for accurate evaluation of dental fear. Its diagnosis in childhood is important for establishing therapeutic management strategies to reduce anxiety and promote oral health. Objective: To determine the prevalence of dental anxiety in a group of Romanian schoolchildren, and assess its correlation with behavioral factors. Methods: This cross-sectional survey included a number of 650 schoolchildren attending public schools, randomly chosen. Data were collected from September 2013 to October 2013. 485 children aged 6–12 years responded the questionnaires and were included in the study (248 female, 237 male). Each subject was asked to independently complete a questionnaire including Dental Anxiety Scale (DAS) and other questions about children behavior towards dental health education and practice. Children having a score of 13 and above were included in the anxious group while those scoring under 13 were placed in the non anxious group. The data collected was processed and analyzed using the SPSS statistical software. Results: The overall prevalence of dental anxiety was 22.68% amongst subjects included in the study. No significant differences in dental anxiety scores between boys and girls were found in this study. Dental anxiety scores decreased with increasing age. Dental anxiety correlated positively with chewing gum use and sweet consumption frequency and negatively with age and dental health education. Conclusions: Prevalence of dental anxiety in the 6–12 year old children of this study was 22.68%. Factors like chewing gum use, sweet consumption frequency, age and dental health education were correlated with dental anxiety. PMID:26788356
Popescu, Sanda Mihaela; Dascălu, Ionela Teodora; Scrieciu, Monica; Mercuţ, Veronica; Moraru, Iren; Ţuculină, Mihaela Jana
Dental anxiety is a condition that causes a decrease in population addressability to the dentist with adverse consequences for long-term oral health. Assessment of behavioral factors that correlate with dental anxiety is important for accurate evaluation of dental fear. Its diagnosis in childhood is important for establishing therapeutic management strategies to reduce anxiety and promote oral health. To determine the prevalence of dental anxiety in a group of Romanian schoolchildren, and assess its correlation with behavioral factors. This cross-sectional survey included a number of 650 schoolchildren attending public schools, randomly chosen. Data were collected from September 2013 to October 2013. 485 children aged 6-12 years responded the questionnaires and were included in the study (248 female, 237 male). Each subject was asked to independently complete a questionnaire including Dental Anxiety Scale (DAS) and other questions about children behavior towards dental health education and practice. Children having a score of 13 and above were included in the anxious group while those scoring under 13 were placed in the non anxious group. The data collected was processed and analyzed using the SPSS statistical software. The overall prevalence of dental anxiety was 22.68% amongst subjects included in the study. No significant differences in dental anxiety scores between boys and girls were found in this study. Dental anxiety scores decreased with increasing age. Dental anxiety correlated positively with chewing gum use and sweet consumption frequency and negatively with age and dental health education. Prevalence of dental anxiety in the 6-12 year old children of this study was 22.68%. Factors like chewing gum use, sweet consumption frequency, age and dental health education were correlated with dental anxiety.
Carson, P; Freeman, R
The aim of the study was to examine how physical (dental caries) and psychosocial (age, dental anxiety and dental health behaviour) factors, associated with child and parent, influenced dentists' sedation choice when a child presents in pain. 600 parents whose children were aged between 5 and 11 years took part: 200 attended for routine dental care (RDC); the remaining 400 attended as emergency patients and were offered either dental general anaesthesia (DGA) or relative analgesia (RA). The subjects were approached and invited to take part. The researcher was blind as to the child's pattern of dental attendance and the type of sedation offered. All parents and children completed self-reported ratings of dental anxiety. The children's teeth were examined to determine past and present dental caries experience. The results showed that children who were offered DGA had greater experience of dentinal caries, were younger and dentally anxious. The children offered RA were older, had a higher frequency of brushing their teeth with fluoride toothpaste and were also dentally anxious. Discriminant analysis showed that 2 canonical functions provided clear categorisation of the three treatment groups. Function 1 was a physical (dental caries) factor, which was related to the child's experience of dentinal caries. Function 2 was a psychosocial factor, which was related to the child's age, dental anxiety and frequency of tooth brushing. A greater proportion of the variance in the treatment offered was explained by Function 1, suggesting that the most important factor in the decision to offer DGA was dentinal caries. Function 2 was of lesser importance. The findings have implications for the type of sedation offered to children presenting for emergency care. These children may not otherwise receive treatment and the need to provide less anxiety provoking forms of sedation must be promoted. By doing so, parents who have only brought their children when in pain may take advantage
Majstorovic, M; Morse, D E; Do, D; Lim, L l; Herman, N G; Moursi, A M
We evaluated the relationship between child dental anxiety and selected child and parental characteristics. Children and their parents were interviewed at the New York University, College of Dentistry, Pediatric Dentistry Clinic. The Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) evaluated child self-reported anxiety; the Modified Dental Anxiety Scale (MDAS) measured self-reported parental anxiety when the parent received dental treatment. Ninety-three children and their parents completed the questionnaires. Mean CFSS-DS scores were higher for girls than boys (32.5 vs. 26.3, p=0.003) and for children whose accompanying parents had MDAS scores of 11+ vs. ≥ 11 (32.8 vs. 26.6, p=0.001). There was little difference in mean CFSS-DS scores among those aged 6-10 yrs. vs. 11-14 yrs. (30.1 vs. 29.3). Significant correlations were found between CFSS-DS and both gender (Spearman's rho, rs=0.31) and MDAS scores (rs=0.33), but not between CFSS-DS and child age (rs=-0.05). Controlling simultaneously for gender, MDAS score and child age, a high CFSS-DS score (38+ vs. ≥ 38) was positively associated with girls (ORadj=3.76, 95% CI: 1.13-12.54) and an MDAS score of ≤ 15 vs. ≥ 11 (ORadj=2.50, 0.73-8.54), but weakly and inversely associated with age (ORadj=0.80, 0.25-2.52). Child gender and parental anxiety are indicators of child dental anxiety.
Kilinç, Gulser; Akay, Aynur; Eden, Ece; Sevinç, Nilgün; Ellidokuz, Hülya
This study evaluated the dental anxiety levels of preschool children at a kindergarten and at a dental clinic. The anxiety levels of ninety 4-6-year-old (4.99 ± 0.81) preschool children were evaluated according to pulse rates, the facial image scale (FIS), the Venham picture test (VPT), and the Frankl behavior rating scale. The children's mothers were asked to complete the state-trait anxiety inventory (STAI) forms 1 and 2 (STAI 2 and STAI 2). The sample t-test, Mann-Whitney U test, and Pearson's correlation test were used. A statistically significant difference was observed between the children's pulse rates when measured at the dental clinic and those when measured at the kindergarten (p < 0.001). Although the results were not statistically significant, more negative facial expressions were observed in the children at the dental clinic than in those at the kindergarten when assessed using FIS and VPT (p = 0.090 and p = 0.108, respectively). There was a statistically significant correlation between the transient anxiety levels (STAI 1) of mothers and the VPT scores of their children evaluated at the dental clinic (r = 0.506, p < 0.001). The continuous anxiety level of the mothers of males was found to be significantly higher (p = 0.033) than that of the mothers of females (STAI 2). Although the children had been informed about dentistry and were introduced to a dentist at the kindergarten, their anxiety levels seemingly increased as they arrived at the dental clinic. The significant increase observed in the children's pulse rates was a physical indicator that their anxiety levels had increased. It can be concluded that the children felt more anxious at the dental clinic that at the kindergarten.
Asl, Aminabadi Naser; Shokravi, Marzieh; Jamali, Zahra; Shirazi, Sajjad
Dental anxiety, fear and phobia have different etiology, response patterns, time courses, and intensities that justify a clear distinction between these constructs. Differentiation of dental anxiety, fear or phobia in practice is a critical prerequisite for developing and implementing effective treatment for children. The aim of this study was to investigate whether current researches in the pediatric dentistry appropriately discriminate the central construct of dental anxiety, fear and phobia. We also highlighted the specific methodological issues in the assessment of these issues in pediatric dentistry. A systematic search was conducted in Pubmed/medline and Scopus for articles which assessed dental anxiety, fear or phobia in children. 104 research papers were included in the review that had made a distinction between dental anxiety, fear and phobia and had not used them interchangeably. Only five studies used different clinical measures or cut-offs to discriminate between dental anxiety, fear and phobia. The dental literature appears unable to capture and also measure the multi-sided construct of dental anxiety, fear and phobia and, therefore, there was a tendency to use them interchangeably.
Wu, Lingli; Gao, Xiaoli
Dental fear and anxiety (DFA) is a major issue affecting children's oral health and clinical management. This study investigates the association between children's DFA and family related factors, including parents' DFA, parenting styles, family structure (nuclear or single-parent family), and presence of siblings. A total of 405 children (9-13 years old) and their parents were recruited from 3 elementary schools in Hong Kong. Child's demographic and family-related information was collected through a questionnaire. Parents' and child's DFA were measured by using the Corah Dental Anxiety Scale (CDAS) and Children Fear Survey Schedule-Dental Subscale (CFSS-DS), respectively. Parenting styles were gauged by using the Parent Authority Questionnaire (PAQ). DFA was reported by 33.1% of children. The mean (SD) CFSS-DS score was 29.1 (11.0). Children with siblings tended to report DFA (37.0% vs. 24.1%; p = 0.034) and had a higher CFSS-DS score (29.9 vs. 27.4; p = 0.025) as compared with their counterpart. Children from single-parent families had lower CFSS-DS score as compared with children from nuclear families (β = - 9.177; p = 0.029). Subgroup analysis showed a higher CFSS-DS score among boys with siblings (β = 7.130; p = 0.010) as compared with their counterpart; girls' from single-parent families had a lower CFSS-DS score (β = - 13.933; p = 0.015) as compared with girls from nuclear families. Children's DFA was not associated with parents' DFA or parenting styles (p > 0.05). Family structure (nuclear or single-parent family) and presence of siblings are significant determinants for children's DFA. Parental DFA and parenting style do not affect children's DFA significantly.
Goettems, Marília L; Ardenghi, Thiago M; Demarco, Flávio F; Romano, Ana R; Torriani, Dione D
The purpose of the study was to investigate the influence of a child's clinical condition; maternal characteristics such as dental anxiety and dental visit pattern; socioeconomic conditions; and maternal perception of the child's oral health-related quality of life (OHRQoL) on a child's use of dental care services. A cross-sectional study of 608 mother-child dyads was conducted during the Children's Immunization Campaign in Pelotas, Brazil. Mothers answered a questionnaire regarding their use of dental services, dental anxiety (Dental Anxiety Scale), socioeconomic status, and perception of their children's OHRQoL (the Early Childhood Oral Health Impact Scale). Clinical examination of the children was performed to assess dental caries (dmf-t). Associations between the above-mentioned factors and child use of dental services were assessed using Poisson regression models (prevalence ratio [PR]; 95% CI; P ≤ 0.05). The majority of children (79.3%) had never had a dental appointment and of the children who had visited a dentist, 55 (43.65%) presented with untreated dental caries at the time of examination. More than half the mothers (60.2%) did not visit a dentist regularly. In the final model, low schooling level of mothers (PR, 0.64) and irregular visits to a dentist by the mother (PR, 0.48) were factors because of which a child did not have a dental appointment. Children who had experienced pain (PR, 1.56), those who had poor OHRQoL (PR, 1.49), and older children (PR, 2.14) visited a dentist with higher frequency. Use of dental care services by preschool children was low, and treatment was neglected even among children who had visited a dentist. Children of mothers with low schooling level who do not visit a dentist regularly were at greater risk of not receiving dental care. Maternal perception of their child's oral health motivated visits to the dentist. © 2012 John Wiley & Sons A/S.
Tong, H J; Khong, J; Ong, C; Ng, A; Lin, Y; Ng, J J; Hong, C H L
To evaluate child and parental attitudes towards dentists' appearance, subsequently related to a child's dental experience and their association with child's anxiety levels. 402 parent-child pairs were surveyed using interviewer-administered questionnaires at the School Dental Service, Health Promotion Board, Singapore. Standardised pictures of models with different attires, ages, genders and ethnicities were shown to the parent-child pairs. Information on each child's dental experience was obtained. Parental proxy was used to evaluate the children's dental fear levels based on the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Personal protective equipment (PPE) was the attire of choice for both parents and children, followed by the paediatric coat. Formal and informal attire was least preferred by children and parents, respectively. Parents preferred female dentists to treat their child, whereas children preferred a dentist of the same gender (p < 0.001). Parent's and child's preferences for the child's dentist's appearance were shown to be significantly different (p < 0.001). CFSS-DS scores were also significantly associated with the number of previous dental visits (p = 0.002) as well as a history of extractions (p = 0.02), but not with child's demographics, dmft or preference for dentist's appearance (p > 0.05). Regardless of child anxiety levels, the PPE followed by paediatric coats were preferred over other choices of dentists' attire. Children tended to choose a dentist who was of a younger age, and of the same gender and ethnicity as themselves. Parents tended to choose younger, female dentists of the same ethnicity as themselves. Subjective experience of extractions, as well as multiple dental visits appeared to play a more significant role in the development of dental fear than dental caries experience per se.
Folayan, M O; Idehen, E E
To establish the effect of information received about dental care on the anxiety level of the child prior to receiving any form of dental treatment and on their behaviour during dental treatment. Eighty-four healthy child patients at their first dental visit, between the ages of 8 and 13 years attending a paediatric dental clinic in Nigeria participated in the study. Information on their dental anxiety level was collected using the Dental Subscale of the Child Fear Survey Schedule. The children were asked to identify their source and type of dental information received. The information given was later categorised into positive or negative for analysis purposes. The children's behaviour during dental treatment was assessed using Venham's clinical ratings of anxiety and cooperative behaviour. The mean dental anxiety scores, as well as the mean Venham behavioural ratings, of those that had received information on dental treatment were compared with those that had never received any information. Previously received information did not appear to have any significant impact on the measures of the dental anxiety level of these children neither was there a statistically significant association between information received and behaviour of the child in the dental chair. Past information may play only a minor role in affecting dental anxiety levels and behaviour of the child during dental treatment.
Pop-Jordanova, Nadica; Sarakinova, Olivera; Pop-Stefanova-Trposka, Maja; Zabokova-Bilbilova, Efka; Kostadinovska, Emilija
Fear of the dentist and dental treatment is a common problem. It can cause treatment difficulties for the practitioner, as well as severe consequences for the patient. As is known, the level of stress can be evaluated thought electrodermal activity, cortisol measure in saliva, or indirectly by psychometric tests. The present study examined the psychological influence of dental interventions on the child as well as coping patterns used for stress diminution. We examined two matched groups of patients: a) children with orthodontic problems (anomalies in shape, position and function of dentomaxillofacial structures) (N = 31, mean age 10.3 ± 2.02) years; and b) children with ordinary dental problems (N = 31, mean age 10.3 ± 2.4 years). As psychometric instruments, we used: 45 items Sarason's scale for anxiety, 20 items simple Stress - test adapted for children, as well as A - cope test for evaluation coping patterns. Obtained scores confirmed the presence of moderate anxiety in both groups as well as moderate stress level. For Sarason's test obtained scores for the group with dental problems are 20.63 ± 8.37 (from max 45); and for Stress test 7.63 ± 3.45 (from max 20); for the orthodontic group obtained scores are 18.66 ± 6.85 for Sarason's test, while for the Stress test were 7.76 ± 3.78. One way ANOVA confirmed a significant difference in values of obtained scores related to the age and gender. Calculated Student t - test shows non-significant differences in obtained test results for both groups of examinees. Coping mechanisms evaluated by A - cope test shows that in both groups the most important patterns used for stress relief are: developing self-reliance and optimism; avoiding problems and engaging in demanding activity. This study confirmed that moderate stress level and anxiety are present in both groups of patients (orthodontic and dental). Obtained scores are depending on gender and age. As more used coping patterns in both groups are developing self
Leal, A M; Serra, K G; Queiroz, R C; Araújo, M A; Maia Filho, E M
To assess levels of anxiety in children concerning different dental instruments and equipment and to relate them with parents' anxiety levels moments before the appointment. Fifty children from 4 to 12 years of age (average of 10±3.07) and their respective parents were evaluated. A facial scale was used to assess children's anxiety levels, while the Dental Anxiety Scale (DAS) was used to assess parents. Friedman test was applied to check any differences in children's anxiety levels relative to the equipment/instruments, and this was complemented by the use of the Wilcoxon test for two-by-two comparison. In order to assess correlation between parents' and their children's anxiety levels, the study used Spearman correlation coefficient. With regard to parents' anxiety levels, 4% resulted as null, 18% were low, 56% were moderate, and 22% were exacerbated; children's anxiety level results were: 52% light, 44% intermediate, and 4% intense. Anxiety levels related to instruments/equipment were, in descending order: carpule syringe > paediatric forceps > dental explorer > x-ray machine > rubber dam punch > high speed handpiece > rubber dam forceps > mouth mirror > clinical tweezers > dental chair. No correlation was found between parents' anxiety levels and those of their children (p=0.546). The instruments/equipment used in the assessment generated different anxiety levels in the children. No correlation was found between parents' anxiety levels and those of their children.
Zhang, Hong-mei; Xia, Bin; Wang, Jian-hong; Chen, Xiao-xian; Ge, Li-hong
To compare the level of dental anxiety and dental behavior between dental fear children with dental treatment under general anaesthesia (GA) and those under restraint. The GA group included 31 dental fear children aged 4-6-year-old who received dental treatment under the GA. The restraint group included 31 dental fear children aged 4-6-year-old who received dental treatment under the restraint. Age, gender, parent's education level, decayed-missing-filled-tooth (dmft) and face version of the Modified Child Dental Anxiety Scale (MCDASf) score before treatment were matched between the two groups. The Chinese version of MCDASf was used to evaluate the level of dental anxiety in each child before treatment, right after treatment and before examination at recall visit 2-3 weeks after treatment. And the Chinese version of Venham Clinical Anxiety and Cooperative Behavior Scale was used to evaluate children's dental behavior in each child before treatment and before examination at recall visit 2-3 weeks after treatment. The average scores of MCDASf in GA group right after treatment and before recall were lower than that before treatment. The difference was statistically significant (P<0.05). Furthermore, the average score of MCDASf before recall was lower than those after treatment, and the difference was statistically significant (P<0.05). The average scores of MCDASf in restraint group right after treatment and 2-3 weeks after treatment were higher than those before treatment, but the difference was not statistically significant (P>0.05). Children's dental behavior was significantly improved at recall visit in both groups (P<0.01). Dental fear could be reduced by treatment under GA. The children's dental behavior was improved after GA. Restraint did not result in the significant elevation of dental anxiety level, but dental behavior was improved after restraint during the short-term recall.
Porritt, J; Rodd, H; Morgan, A; Williams, C; Gupta, E; Kirby, J; Creswell, C; Newton, T; Stevens, K; Baker, S; Prasad, S; Marshman, Z
Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for dental anxiety; however, access to therapy is limited. The current study aimed to develop a self-help CBT resource for reducing dental anxiety in children, and to assess the feasibility of conducting a trial to evaluate the treatment efficacy and cost-effectiveness of such an intervention. A mixed methods design was employed. Within phase 1, a qualitative "person-based" approach informed the development of the self-help CBT resource. This also employed guidelines for the development and evaluation of complex interventions. Within phase 2, children, aged between 9 and 16 y, who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital, were invited to use the CBT resource. Children completed questionnaires, which assessed their dental anxiety and health-related quality of life (HRQoL) prior to and following their use of the resource. Recruitment and completion rates were recorded. Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/carers and dental professionals. For this analysis, the authors adhered to the Mixed Methods Appraisal Tool criteria. There were 24 families and 25 dental professionals participating in the development and qualitative evaluation of the CBT resource for children with dental anxiety. A total of 56 children agreed to trial the CBT resource (66% response rate) and 48 of these children completed the study (86% completion rate). There was a significant reduction in dental anxiety (mean score difference = 7.7, t = 7.9, df = 45, P < 0.001, Cohen's d ES = 1.2) and an increase in HRQoL following the use of the CBT resource (mean score difference = -0.03, t = 2.14, df = 46, P < 0.05, Cohen's d ES = 0.3). The self-help approach had high levels of acceptability to stakeholders. These findings provide preliminary evidence for the effectiveness and acceptability of the resource in
Krikken, J B; van Wijk, A J; ten Cate, J M; Veerkamp, J S J
Treating children can be difficult for both dentist and child. In some cases treatment fails and those children are referred to a specialist paediatric dentist. Different factors can be put forward for referral of children, such as factors relating to the child, dentist and parent. Possible child-related factors can be dental anxiety and the child's temperament. A possible parental factor is the parental rearing style. The objective of this study was to assess the possible associations between dental anxiety, parental rearing style and referral status of children. Parents of 120 non-referred and 335 referred paediatric dental patients were asked to fill out the Child Rearing Practices Report (CRPR) and the Child Fear Survey Schedule Dental Subscale (CFSS-DS) on behalf of their children. The questionnaires were filled out by 115 (96%) parents of primary schoolchildren and by 331 (99%) parents of referred children. Referred children were younger than non-referred children, t(442) = 6.9, p < 0.01, and had significantly more dental anxiety, t(430) = -8.7, p < 0.01. No differences existed between parents of referred children and parents of non-referred children on parental rearing-style. No differences existed between fearful and non-fearful children on parental rearing-style and also no correlation existed between children's dental anxiety and their parent's rearing style. However, non-referred children with parents using an authoritarian parenting style were more anxious than the other non-referred children. In the present study, referral status and dental anxiety of 4-12 year old children were not associated with parental rearing style.
Simon, Arun K.; Bhumika, T. V.; Nair, N. Sreekumaran
Dental anxiety is one of the major problems affecting children, which impairs the rendering of dental care, leading to impaired quality of life. It often leads to occupational stress in dental personnel and conflict between parents/caregivers. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials done in children, to synthesize evidence of the effectiveness of atraumatic restorative treatment (ART) in reducing dental anxiety in children compared to conventional restorative treatments. The databases searched included PubMed, Google Scholar and The Cochrane Oral Health Group's Trials Register. Eligible studies reporting dental anxiety by a variety of psychometric scales were tabulated. The review was conducted and reported in accordance with the guidelines provided by the Cochrane Collaboration. Among 416 studies retrieved through literature search, six studies matched the inclusion criteria. Due to lack of data, only three studies were included for meta-analysis using RevMan software (Review Manager, Version 5.3;The Cochrane Collaboration, Copenhagen, 2014). The pooled meta-analysis data, (standardized mean difference − 2.12 [95% confidence interval: −4.52, 0.27]) failed to show any difference between ART group and the conventional treatment group. In conclusion, ART was not more beneficial in reducing dental anxiety among pediatric dental patients. The findings are relevant in the field of clinical practice in dentistry in the management of the anxious pediatric dental patient. PMID:26038668
Gao, Xiaoli; Hamzah, S H; Yiu, Cynthia Kar Yung; McGrath, Colman; King, Nigel M
Dental fear and anxiety (DFA) refers to the fear of and anxiety towards going to the dentist. It exists in a considerable proportion of children and adolescents and is a major dilemma in pediatric dental practice. As an Internet social medium with increasing popularity, the video-sharing website YouTube offers a useful data source for understanding health behaviors and perceptions of the public. Using YouTube as a platform, this qualitative study aimed to examine the manifestations, impacts, and origins of DFA in children and adolescents from the public's perspective. To retrieve relevant information, we searched YouTube using the keywords "dental fear", "dental anxiety", and "dental phobia". Videos in English expressing a layperson's views or experience on children's or adolescent's DFA were selected for this study. A video was excluded if it had poor audiovisual quality, was irrelevant, was pure advertisement or entertainment, or contained only the views of professionals. After the screen, we transcribed 27 videos involving 32 children and adolescents, which were reviewed by a panel of 3 investigators, including a layperson with no formal dental training. Inductive thematic analysis was applied for coding and interpreting the data. The videos revealed multiple manifestations and impacts of DFA, including immediate physical reactions (eg, crying, screaming, and shivering), psychological responses (eg, worry, upset, panic, helplessness, insecurity, resentment, and hatred), and uncooperativeness in dental treatment. Testimonials from children, adolescents, and their parents suggested diverse origins of DFA, namely personal experience (eg, irregular dental visits and influence of parents or peers), dentists and dental auxiliaries (eg, bad manner, lack of clinical skills, and improper work ethic), dental settings (eg, dental chair and sounds), and dental procedures (eg, injections, pain, discomfort, and aesthetic concerns). This qualitative study suggests that DFA in
Shahnavaz, S; Hedman, E; Grindefjord, M; Reuterskiöld, L; Dahllöf, G
Dental anxiety affects approximately 9% of children and is associated with poor oral health, pain, and psychosocial problems. The objective of this study was to investigate the efficacy of cognitive behavioral therapy (CBT) for children with dental anxiety in specialist pediatric dentistry. The study used a parallel-group superiority randomized controlled trial design. The primary outcome measure was the behavioral avoidance test; assessors were blind to treatment allocation. Participants were 8 boys and 22 girls 7 to 18 y old (mean ± SD, 10 ± 3.1). Children fulfilling the diagnostic criteria for dental anxiety were randomized to CBT (n = 13) or treatment as usual (n = 17), such as various sedation methods. Psychologists provided 10 h of CBT based on a treatment manual. Treatments were conducted in a naturalistic real-world clinical setting. Assessments were conducted before the treatment, 3 mo after the start of treatment, and at 1-y follow-up. The analyses of the primary outcome measure by repeated-measures analysis of variance and independent t test showed that children receiving CBT made superior, statistically significant improvements at follow-up (16.8 ± 2.4) compared with treatment as usual (11.4 ± 3.1, P < 0.01). A large between-group effect size (Cohen's d = 1.9) was found. Following treatment, 73% of those in the CBT group managed all stages of the dental procedures included in the behavioral avoidance test compared with 13% in the treatment-as-usual group. Furthermore, 91% in the CBT group compared with 25% in the treatment-as-usual group no longer met the diagnostic criteria for dental anxiety at the 1-y follow-up according to the secondary outcome measure. Measures of dental anxiety and self-efficacy showed larger improvements in the CBT group compared with controls. We conclude that CBT is an efficacious treatment for children and adolescents with dental anxiety and should be made accessible in pediatric dentistry (ClinicalTrials.gov: NCT01798355
Chikkala, Jayanth; Chandrabhatla, Srinivas Kumar; Vanga, Narasimha Rao V
It is essential to understand the factors influencing the level of anxiety to dental treatment among different children as it can influence seeking dental care. Here, we assessed the impact of parental loss on dental anxiety among 6-13-year-old children. A total of 444 children within the age group 6-13 years were selected. Group 1 consisted of orphan children living in government-run orphanages, Group 2 consisted of orphan children taken care by a person with a motherly relationship, Group 3 consisted of abandoned children living in private organization and Group 4 consisted of children living with their parents. Dental anxiety was measured using children's fear survey schedule-dental subscale and modified faces version of modified child dental anxiety scale. The highest number of anxious children were observed in Group 4 and the difference in the anxiety levels among the four groups was found to be highly statistically significant. Children living in government-run orphanages had least dental anxiety. All the orphans may not have the same anxiety levels and the environment of upbringing the orphans plays a significant role in the development of the anxiety.
Cantekin, Kenan; Yildirim, Mustafa Denizhan; Cantekin, Isin
This study's purpose was to investigate how young children's and parent/caregivers' oral health-related quality of life and children's dental fears were affected by dental rehabilitation under general anesthesia (DRGA). A consecutive clinical sample of dyads of parents/caregivers and their four- to six-year-old children who received DRGA were surveyed before and after DRGA. Parents/caregivers responded through a self-administered questionnaire [Early Childhood Oral Health Impact Scale (ECOHIS)], and children received a dentist-administered questionnaire [children's fear survey schedule-dental subscale (CFSS-DS)]. The final sample consisted of 311 children/caregiver dyads. One to six teeth were extracted in 91 percent of children. There was a 44 percent decrease in total ECOHIS scores following treatment (P<.001). Overall child impact section scores decreased 34 percent following treatment (P<.001), and family impact section scores decreased 65 percent (P<.001). CFSS-DS anxiety scores after dental treatment were significantly higher for 14 of 15 situations/conditions assessed (P<.001). There was a trend of higher CFSS-DS scores in children who received increasing numbers of extractions. Children's and parent/caregivers' quality of life improved after the children received dental rehabilitation under general anesthesia, and children's fears increased for all situations tested. The number of extractions the children received was associated with increased levels of fear.
Shahnavaz, Shervin; Rutley, Sara; Larsson, Karin; Dahllöf, Göran
There is a high prevalence of dental anxiety in children and adolescents. Cognitive behavioral therapy is emerging as a treatment option. The purpose of this study is to explore how children with dental anxiety and their parents experience cognitive behavioral therapy (CBT) in dentistry. We interviewed 12 children and one of their parents and conducted a thematic analysis of the transcribed interviews. Perspective shift emerged as overarching theme in our thematic analysis. This theme consisted of three main themes, which were mastery, safety, and reduced fear. Six subthemes were also identified according to our analyses. Mastery includes two subthemes, gradual exposure and autonomy and control. Subthemes and sources for safety feeling were therapeutic alliance and changed appraisal. The theme reduced fear also consisted of two subthemes; reduced anticipatory anxiety and coping. The results show that parents and children had positive experiences of CBT and its outcome and were able to benefit from this psychological treatment when dealing with dental anxiety. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Hamzah, SH; Yiu, Cynthia Kar Yung; McGrath, Colman; King, Nigel M
Background Dental fear and anxiety (DFA) refers to the fear of and anxiety towards going to the dentist. It exists in a considerable proportion of children and adolescents and is a major dilemma in pediatric dental practice. As an Internet social medium with increasing popularity, the video-sharing website YouTube offers a useful data source for understanding health behaviors and perceptions of the public. Objective Using YouTube as a platform, this qualitative study aimed to examine the manifestations, impacts, and origins of DFA in children and adolescents from the public’s perspective. Methods To retrieve relevant information, we searched YouTube using the keywords “dental fear”, “dental anxiety”, and “dental phobia”. Videos in English expressing a layperson’s views or experience on children’s or adolescent’s DFA were selected for this study. A video was excluded if it had poor audiovisual quality, was irrelevant, was pure advertisement or entertainment, or contained only the views of professionals. After the screen, we transcribed 27 videos involving 32 children and adolescents, which were reviewed by a panel of 3 investigators, including a layperson with no formal dental training. Inductive thematic analysis was applied for coding and interpreting the data. Results The videos revealed multiple manifestations and impacts of DFA, including immediate physical reactions (eg, crying, screaming, and shivering), psychological responses (eg, worry, upset, panic, helplessness, insecurity, resentment, and hatred), and uncooperativeness in dental treatment. Testimonials from children, adolescents, and their parents suggested diverse origins of DFA, namely personal experience (eg, irregular dental visits and influence of parents or peers), dentists and dental auxiliaries (eg, bad manner, lack of clinical skills, and improper work ethic), dental settings (eg, dental chair and sounds), and dental procedures (eg, injections, pain, discomfort, and
Restrepo, Claudia C; Medina, Isabel; Patiño, Isabel
To evaluate the effectiveness of occlusal splints to reduce the signs and symptoms of temporomandibular disorders (TMD), dental wear and anxiety in a group of bruxist children. All of the subjects were 3 to 6 years old, had complete primary dentition, class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, anxiety was evaluated with the Conners' Parent Rating Scales (CPRS). The TMD were evaluated using the RDC/TMD. The dental wear was processed in digital format with Mat Lab® and Lab view® software to determine its size and form. The children were randomized into an experimental (n=19) and a control (n=17) group. The children in the experimental group used rigid bite plates for a two-year period, until mixed dentition. Afterwards, the CPRS and the RDC/TMD were applied again and dental casts were taken. Comparisons of the variables regarding dental wear, signs and symptoms of TMD and anxiety before and after treatment among the groups were analyzed using the t-test, the Wilcoxon rank sum test and the Mann-Whitney test. The subjects in the experimental group showed no statistically significant difference regarding anxiety levels and dental wear when compared with the control group. The signs and symptoms of TMD were not reduced except for the deviation in mouth opening. The use of rigid occlusal bite plates was not efficient in reducing the signs of bruxism as a whole but did reduce the deviation in mouth opening.
Chhabra, N; Chhabra, A; Walia, G
Dental anxiety and fear pose a considerable challenge for the practice of clinical dentistry as these are problematic entities in the management of child patients and present a potential barrier to the utilization of oral health care services. The aim of this study was to estimate the prevalence of dental anxiety and fear among the 5-10 years aged Indian child population. A total of 523 children aged 5-10 years and their parents, visiting Krishna Dental College, Ghaziabad, India were finally recruited in this study. Dental Fear/anxiety distribution in the children was studied using the Indian parent's version of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Total fear scores were calculated separately for boys and girls and at different age levels. The collected data was statistically analyzed using a SPSS statistical program. The estimated prevalence of dental anxiety among 5 to 10 year old children in the study population was 6.3%. The overall median CFSS-DS score was 23 and the overall mean value of CFSS-DS score was 24. The prevalence of dental anxiety in children aged 5 years was 7.9%, 7.1% for 6 years old, 6.6% in 7 years old, 6.5% in 8 years old, 6.3% for 9 year old children and 5.8% in children aged 10 years. No statistically significant gender differences were found in the dental anxiety scores. The most fear provoking situations were the sight of injections, the drilling procedures by the dentist, touch of a stranger and noise of drilling by the dentist. The results of this study indicate the need for preventive health education and intervention programmes in India to prevent and reduce dental anxiety/fear and to promote children's oral health.
Shahnavaz, Shervin; Hedman-Lagerlöf, Erik; Hasselblad, Tove; Reuterskiöld, Lena; Kaldo, Viktor; Dahllöf, Göran
Cognitive behavioral therapy (CBT) is an evidence-based method for treating specific phobias, but access to treatment is difficult, especially for children and adolescents with dental anxiety. Psychologist-guided Internet-based CBT (ICBT) may be an effective way of increasing accessibility while maintaining treatment effects. The aim of this study was to test the hypothesis that psychologist-guided ICBT improves school-aged children's and adolescents' ability to manage dental anxiety by (1) decreasing avoidance and affecting the phobia diagnosis and (2) decreasing the dental fear and increasing the target groups' self-efficacy. The study also aimed to examine the feasibility and acceptability of this novel treatment. This was an open, uncontrolled trial with assessments at baseline, posttreatment, and the 1-year follow-up. The study enrolled and treated 18 participants. The primary outcome was level of avoidance behaviors, as measured by the picture-guided behavioral avoidance test (PG-BAT). The secondary outcome was a diagnostic evaluation with the parents conducted by a psychologist. The specific phobia section of the structured interview Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) was used. Other outcome measures included level of dental anxiety and self-efficacy. The ICBT, which employed exposure therapy, comprised 12 modules of texts, animations, dentistry-related video clips, and an exercise package (including dental instruments). Participants accessed the treatment through an Internet-based treatment platform and received Web-based guidance from a psychologist. Treatment also included training at dental clinics. Feasibility and acceptability were assessed by measures of engagement, adherence, compliance, completed measures, patient and parent satisfaction scale, and staff acceptability. The level of avoidance (according to the primary outcome measure PG-BAT) and dental anxiety decreased
Majstorovic, M; Veerkamp, J S; Skrinjaric, I
The aim of the study was to evaluate reliability and validity of different questionnaires and predict related causes, as concomitant factors in assessing different aspects of children's dental anxiety. Children were interviewed on dental anxiety, dispositional risk factors and satisfaction with the dentist after dental treatment had been accomplished. Parents were interviewed on dental anxiety as well. The study population included 165 children (91 boys) aged 5 to 15 years, referred to a university dental clinic by general dental practitioners because of a history of fear and uncooperative behaviour during previous dental visits. Children were treated by two dentists, both experienced in treating fearful children. Statistical analysis was performed in Statistics for Windows, Release 5.5 and Release 7.5. Pearson's correlation coefficients were calculated for validity and Cronbach alpha for reliability of the measures. Spearman Brown prophecy formula was used for correction of the alpha scores. Results The children's total average CFSS-DS score was 27.02, with no significant difference with respect to gender. The highest Cronbach alpha scores regarding reliability were obtained for the S-DAI, the CFSS-DS and the PDAS. Pearson's correlations regarding validity presented significant correlations between the CMFQ, the CDAS and the S-DAI, between the OAS, the CDAS and the S-DAI, as well as between the OAS and the DVSS-SV. Previous negative medical experience had significant influence on children's dental anxiety, supporting Rachman's conditioning theory. Anxious children were more likely to show behaviour problems (aggression) and more introvert in expressing their judgement regarding the dentist. Both the S-DAI and the CFSS-DS, which were standardized in the Croatian population sample, showed the highest reliability in assessment of children's dental anxiety.
Aminabadi, Naser Asl; Sohrabi, Azin; Erfanparast, Leila K; Oskouei, Sina Ghertasi; Ajami, Behjat Almolook
The aim of this study was to evaluate the relationships between birth order and child's temperament, anxiety and behavior in the dental setting. 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. 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. According to the results, only children and laterborns are at higher risk of developing worse outcomes in the dental setting. 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.
Guinot Jimeno, F; Mercadé Bellido, M; Cuadros Fernández, C; Lorente Rodríguez, A I; Llopis Pérez, J; Boj Quesada, J R
To evaluate whether the parental perception of the patient's anxiety, children's anxiety, pain, behaviour and heart rate of paediatric patients improves when an audiovisual technique is used as a distraction method during dental treatment. This non-randomised crossover trial was performed with 34 patients aged 6-8 years, who required a minimum of two treatment visits for restorative therapy. During the last visit, the patient was shown a cartoon film. There was a significant improvement in the global behaviour when children were shown a cartoon film (P < 0.001). A significant increase in heart rate was recorded in both visits (P = 0.0001) when the anaesthetic was injected. A 97% of the sample would like to continue seeing their chosen film during subsequent visits. No statistically significant differences were found (P > 0.05) between the visits in terms of parental perception of the patient's anxiety, or the patient's self-reported anxiety, pain and heart rate. The use of the audiovisual material used as a method of distraction produces a global improvement in patient behaviour, but not in parental perception of the patient's anxiety, self-reported anxiety, pain or heart rate according to the measurement scales used. This material is also highly accepted by paediatric patients.
Muppa, Radhika; Bhupatiraju, Prameela; Duddu, Mahesh; Penumatsa, Narendra Varma; Dandempally, Arthi; Panthula, Priyanka
Fear or anxiety due to noise produced in the dental clinic is rated third among the reasons to avoid dental visits. The aim of the present study was to determine anxiety levels associated with noise in a dental clinic. The study was done using a survey questionnaire containing 10 questions and was divided into two parts. The first part included demographic information such as name, age, gender, and school; the second half included questions regarding patient's feelings toward noise in the dental clinic and its possible link to dental anxiety. Two-hundred and fifty children and adolescents of age group 6-15 years participated in the study. Results of the study showed that 50% of females, 29% males avoided a visit to the dentist because of anxiety and fear, 38% subjects of age group 6-11 years reported that sound of the drill makes them uncomfortable, followed by having to wait in the reception area. Gender gap was also observed with more females feeling annoyed than males on the 1-10 annoyance level scale. More than 60% felt "annoyed" to "extremely annoyed" by noise in the dental clinic. 45% of subjects preferred watching television to cope with such noise. This study concludes that the noise produced in dental clinic is anxiety provoking and significantly contributes to avoidance of dental treatment and the best way opted by the majority of subjects to overcome this anxiety was audiovisual distraction method.
Costa, Vanessa Polina Pereira; Correa, Marcos Britto; Goettems, Marília Leão; Pinheiro, Ricardo Tavares; Demarco, Flávio Fernando
Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers' children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads) to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p < 0.05). At data collection, the prevalence of maternal depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children's dental fear was positively associated with mothers' presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child's perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.
Morse, Zac; Takau, Aleva F
Despite the technological advances in dentistry, anxiety about dental treatment and the fear of pain associated with dentistry remains globally widespread and is considered a major barrier to dental treatment. This can have detrimental consequences to people's oral health and pose a serious epidemiological challenge to oral health care professionals. Dental anxiety is well described in the Western world however there is little literature on the situation in the developing world. The purpose of the study was to evaluate the levels of dental anxiety in Fijians using Corah's DentalAnxiety Scale (DAS). 120 adults, aged 18-45 years were randomly selected from the capital city of Suva until there were 60 Indigenous and 60 IndoFijians, with 30 males and 30 females from each group responding to questions from Corah's Dental Anxiety Scale. The average DAS for all the participants was 8.8. The average DAS for IndoFijians was 9.8 and was significantly higher than for Indigenous Fijians ie 78. IndoFijians only reported less anxiety with increasing age as the Indigenous Fijians generally displayed low levels of anxiety. There was no significant difference in DAS between the genders. A considerable proportion of IndoFijians (28%) were anxious with 13% being highly anxious. Young IndoFijian adults are more likely to possess dental anxiety and should be managed appropriately which may include behavioural and/or pharmacological therapy. This may require referral to dental specialists or involve a multidisciplinary approach to the management of these people.
Zhang, Cai; Qin, Dan; Shen, Lu; Ji, Ping; Wang, Jinhua
To perform a systematic review and meta-analysis on the effects of audiovisual distraction on reducing dental anxiety in children during dental treatment under local anesthesia. The authors identified eligible reports published through August 2017 by searching PubMed, EMBASE, and Cochrane Central Register of Controlled Trials. Clinical trials that reported the effects of audiovisual distraction on children's physiological measures, self-reports and behavior rating scales during dental treatment met the minimum inclusion requirements. The authors extracted data and performed a meta-analysis of appropriate articles. Nine eligible trials were included and qualitatively analyzed; some of these trials were also quantitatively analyzed. Among the physiological measures, heart rate or pulse rate was significantly lower (p=0.01) in children subjected to audiovisual distraction during dental treatment under local anesthesia than in those who were not; a significant difference in oxygen saturation was not observed. The majority of the studies using self-reports and behavior rating scales suggested that audiovisual distraction was beneficial in reducing anxiety perception and improving children's cooperation during dental treatment. The audiovisual distraction approach effectively reduces dental anxiety among children. Therefore, we suggest the use of audiovisual distraction when children need dental treatment under local anesthesia. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Mathur, Jyoti; Diwanji, Amish; Sarvaiya, Bhumi; Sharma, Dipal
To develop a simple method to assess the level of anxiety by using children's drawings and correlating them with Frankl's behavior rating scale. A total of 178 patients aged of 3 to 14 years were handed out two-page forms which contained three sections on coloring and drawing, along with general information, and Frankl's behavior rating scale for the visit. The three types of drawing exercises given to the patients were geometric copy drawings, coloring a nonthreatening figure, and an empty sheet for freehand drawing. Out of 178 patients, 60 showed definitely positive behavior, 73 exhibited positive behavior, 37 showed negative behavior, and 8 were definitely negative on Frankl's behavior rating scale; 133 children had none or, 1 stress marker and 45 exhibited 2 or 3 stress markers in their drawings. Chi-square (χ 2 ) analysis was done with a 2 × 2 contingency table. Observed χ 2 value was 46.166, which at 1 degree of freedom was much greater than that at 0.995 percentile. Therefore, the result was highly significant. Children requiring specialized behavioral techniques can be identified by the presence of stress markers in their drawings. This nonverbal activity by itself can have an overall positive effect on the behavior displayed in the dental clinic. Mathur J, Diwanji A, Sarvaiya B, Sharma D. Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale. Int J Clin Pediatr Dent 2017;10(1):24-28.
Roshan, N M; Sakeenabi, B
To evaluate the anxiety in children during occlusal atraumatic restorative treatment (ART) in the primary molars of children; and compare the anxiety for ART procedure performed in school environment and in hospital dental setup. A randomized controlled trial where one dentist placed 120 ART restorations in 60 five- to seven year-olds who had bilateral matched pairs of occlusal carious primary molars. A split-mouth design was used to place restorations in school and in hospital dental setup, which were assigned randomly to contralateral sides. Anxiety was evaluated by Modified Venhem score and the heart rate of the children at five fixed moments during dental treatment. At the entrance of the children into the treatment room, statistically significant difference between treatment in school environment and treatment in hospital dental setup for venham score and heart rate could be found (P = 0.023 and P = 0.037 respectively). At the start of the treatment procedure higher venham score and heart rate was observed in children treated in hospital dental setup in comparison with the children treated in school environment, finding was statistically significant (P = 0.011 and P = 0.029 respectively). During all other three points of treatment, the Venham scores of the children treated in school were lower than those of the children treated in hospital dental setup but statistically not significant (P > 0.05). Positive co-relation between Venham scores and Heart rate was established. No statistically significant relation could be established between boys and girls. Overall anxiety in children for ART treatment was found to be less and the procedure was well accepted irrespective of environment where treatment was performed Hospital dental setup by itself made children anxious during entrance and starting of the treatment when compared to children treated in school environment.
Diercke, Katja; Ollinger, Isabelle; Bermejo, Justo Lorenzo; Stucke, Kathrin; Lux, Christopher J; Brunner, Monika
BACKGROUND. About 11% of children and adolescents suffer from dental fear. These young people run an increasing risk of undergoing more invasive treatments. AIM. We researched the management of dental anxiety in young patients by general and paediatric dentists as well as by trained and untrained dentists. DESIGN. Eight hundred dentists in Germany were interviewed via e-mail regarding their experience, treatment techniques, information material and complications during the treatment of fearful children. We also examined how difficult dentists judge the treatment of anxious children and how often they participate in continuing education courses. RESULTS. Paediatric dentists applied a greater spectrum of management techniques than general dentists. They used more often psychotherapeutic interventions and anxiety assessment questionnaires. Dentists who frequently attend in continuing education courses judged the treatment to be less difficult and also used psychotherapeutic interventions more often. CONCLUSIONS. German paediatric dentists and dentists who take continuing education courses utilise a broader range of techniques to manage dental anxiety. They may be eminently suited to treat children with severe forms of anxiety. Therefore, dentists who treat young patients should participate in education programmes so as to reduce both the anxiety of their patients and their own anxiety. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.
Al-Namankany, A; de Souza, M; Ashley, P
To review paediatric dental anxiety measures (DAMs) and assess the statistical methods used for validation and their clinical implications. A search of four computerised databases between 1960 and January 2011 associated with DAMs, using pre-specified search terms, to assess the method of validation including the reliability as intra-observer agreement 'repeatability or stability' and inter-observer agreement 'reproducibility' and all types of validity. Fourteen paediatric DAMs were predominantly validated in schools and not in the clinical setting while five of the DAMs were not validated at all. The DAMs that were validated were done so against other paediatric DAMs which may not have been validated previously. Reliability was not assessed in four of the DAMs. However, all of the validated studies assessed reliability which was usually 'good' or 'acceptable'. None of the current DAMs used a formal sample size technique. Diversity was seen between the studies ranging from a few simple pictograms to lists of questions reported by either the individual or an observer. To date there is no scale that can be considered as a gold standard, and there is a need to further develop an anxiety scale with a cognitive component for children and adolescents.
Asl Aminabadi, Naser; Erfanparast, Leila; Sohrabi, Azin; Ghertasi Oskouei, Sina; Naghili, Armaghan
Dental practitioners have numerous methods to control anxiety and pain in children, and distracting the child appears to be the most common technique used for behavior management during dental procedures. The aim of the present study was to evaluate the influence of using virtual reality eyeglasses on severity of pain and anxiety during dental procedures in pediatric patients. This study included 120 healthy children aged 4-6 years. Children with no previous anxiety disorder were randomly divided into two groups, each consisting of 60 children. The study consisted of 3 consecutive treatment sessions. During the first visit fluoride therapy was carried out in both groups. In the next sessions, the groups received restorative treatment with and without virtual reality eyeglasses in a randomized single-blind-controlled crossover fashion. Then at the end of each session the subjects' pain severity was assessed using Wong Baker FACES Pain Rating Scale and state anxiety was measured by Faces version of the Modified Child Dental Anxiety Scale [MCDAS (f)]. There was a significant decrease in pain perception (P < 0.001) and state anxiety scores (P < 0.001) with the use of virtual reality eyeglasses during dental treatment. Results of this study showed that virtual reality eyeglasses can successfully decrease pain perception and state anxiety during dental treatment. 201103126036N1.
Elmore, Jessica L; Bruhn, Ann M; Bobzien, Jonna L
Autism Spectrum Disorder (ASD) can greatly inhibit a child's communication and social interaction skills, impacting their comfort during dental hygiene treatment and services. Children with ASD may exhibit sensory sensitivities, fear of the unfamiliar and lack of socio-cognitive understanding, leading to anxiety and corresponding behavioral deficits. Since the prevalence rates for ASD have risen significantly in the past decade, increased emphasis has been placed on educational and behavior guidance techniques, which can be helpful for children with ASD because of their increased capabilities in visual-processing. The purpose of this literature review is to summarize the interventions available to reduce dental anxiety in children with ASD, and to determine which strategies are best suited for implementation by the dental hygienist. Advancements in technology and socio-behavioral interventions were assessed for appropriate use, efficacy and engagement in the target population. Interventions were categorized into the following groups: picture cards, video technologies and mobile applications. Copyright © 2016 The American Dental Hygienists’ Association.
El Batawi, Hisham Yehia
Aim: To investigate the possible effects of preoperative oral Midazolam on parental separation anxiety, emergence delirium, and post-anesthesia care unit time on children undergoing dental rehabilitation under general anesthesia. Methods: Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/kg, while children of the control group were premedicated with a placebo. Scores for parental separation, mask acceptance, postoperative emergence delirium, and time spent in the post-anesthesia care unit were compared statistically. Results: The test group showed significantly lower parental separation scores and high acceptance rate for anesthetic mask. There was no significant difference between the two groups regarding emergence delirium and time spent in post-anesthesia care unit. Conclusions: Preoperative oral Midazolam could be a useful adjunct in anxiety management for children suffering dental anxiety. The drug may not reduce the incidence of postoperative emergence delirium. The suggested dose does not seem to affect the post-anesthesia care unit time. PMID:25992332
El Batawi, Hisham Yehia
To investigate the possible effects of preoperative oral Midazolam on parental separation anxiety, emergence delirium, and post-anesthesia care unit time on children undergoing dental rehabilitation under general anesthesia. Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/kg, while children of the control group were premedicated with a placebo. Scores for parental separation, mask acceptance, postoperative emergence delirium, and time spent in the post-anesthesia care unit were compared statistically. The test group showed significantly lower parental separation scores and high acceptance rate for anesthetic mask. There was no significant difference between the two groups regarding emergence delirium and time spent in post-anesthesia care unit. Preoperative oral Midazolam could be a useful adjunct in anxiety management for children suffering dental anxiety. The drug may not reduce the incidence of postoperative emergence delirium. The suggested dose does not seem to affect the post-anesthesia care unit time.
Busato, Paloma; Garbín, Raíssa Rigo; Santos, Catielma Nascimento; Paranhos, Luiz Renato; Rigo, Lilian
Anxiety is usually classified as a disorder of neurotic nature and is often related to contexts of stress, which may include worries, motor tension and autonomic hyperactivity. The aim of this study was to assess the influence of mothers' anxiety on their children's anxiety during dental care. Analytical cross-sectional study conducted at in a private dentistry school in the south of Brazil. Convenience sampling was used. All mothers of children undergoing treatment were invited to participate in this study. Data to investigate anxiety related to dental treatment among the children were collected through applying the Venham Picture Test (VPT) scale. For the mothers, the Corah scale was applied. A self-administered sociodemographic questionnaire with questions about demographic, behavioral, oral health and dental service variables was also used. 40 mother-child pairs were included in the study. The results showed that 40% of the children were anxious and 60% of the mothers were slightly anxious. Local anesthesia was the procedure that caused most anxiety among the mothers, making them somewhat uncomfortable and anxious (60%). Family income higher than R$ 1,577.00 had an influence on maternal anxiety (75.6%). Maternal anxiety had an influence on child anxiety (81.3%). Most of the children showed the presence of anxiety, which ranged from fear of dental care to panic, inferring that maternal anxiety has an influence on children's anxiety. Dental procedures did not interfere with the mothers' anxiety, but caused positive feelings, whereas they affected the children more.
Yahaya, Wan Ahmad Jaafar Wan; Salam, Sobihatun Nur Abdul
This paper presents an example of how usability design strategies for children can be designed into educational material using CD-ROM based multimedia application for assisting parents and teachers to develop children's learning and knowledge in decreasing as well as motivate children aged 7-9 years old to reduce their anxious feelings towards…
Krikken, J B; Vanwijk, A J; Tencate, J M; Veerkamp, J S
To examine the relationship between self-reported parental rearing style, parent's assessment of their child's dental anxiety and the dental history of children. Parents of primary school children were asked to complete questionnaires about their parenting style, using four different questionnaires. Parents also completed the Child Fear Survey Schedule Dental Subscale (CFSS-DS) on behalf of their child and a questionnaire about the dental history of their child. 454 interview forms were available for analysis. Minor associations were found between dental anxiety and parenting style. Anxious parents were more permissive and less restrictive in their parenting style. Parents of children who did not visit their dentist for regular check-ups reported more laxness and less restrictiveness. Children who had a cavity at the time of investigation, children who had suffered from toothache in the past and children who did not have a nice and friendly dentist reported more dental anxiety. No clear associations between parenting style and dental anxiety were found. Known causes of dental anxiety were confirmed.
Nuvvula, S; Alahari, S; Kamatham, R; Challa, R R
To determine the effect of three-dimensional (3D) audiovisual (AV) distraction in reducing dental anxiety of children. A randomised clinical trial with a parallel design carried out on 90 children (49 boys and 41 girls) aged between 7 and 10 years (mean age of 8.4 years) to ascertain the comparative efficacy of audio (music) and AV (3D video glasses) distraction in reducing the dental anxiety of children during local analgesia (LA) administration. Ninety children were randomly divided into three groups; control (basic behaviour guidance techniques without distraction), audio (basic techniques plus music) and AV (basic techniques plus 3D AV) distraction groups. All the children experienced LA administration with/without distraction and the anxiety was assessed using a combination of measures: MCDAS(f) (self-report), pulse rate (physiological), behaviour (using Wright's modification of Frankl behaviour rating scale and Houpt scale) and preferences of children. All 90 children completed the study. A highly significant reduction in the anxiety of audiovisual group as reported by the MCDAS(f) values (p<0.001) and Houpt scale (p=0.003); whereas pulse rate showed statistically significant increase (p<0.001) in all the three groups irrespective of distraction. The child preferences also affirmed the usage of 3D video glasses. LA administration with music or 3D video glasses distraction had an added advantage in a majority of children with 3D video glasses being superior to music. High levels of satisfaction from children who experienced treatment with 3D video glasses were also observed.
Seligman, Laura D; Hovey, Joseph D; Chacon, Karina; Ollendick, Thomas H
Dental anxiety and dental phobia typically emerge during childhood; the associated avoidance of dental care can result in oral health problems and is associated with lower quality of life. In this review, we discuss the definition of dental phobia and dental anxiety and issues related to their differentiation. We then review the literature on dental anxiety and dental phobia, including its prevalence, assessment, and sequalae. Moreover, we provide a synthesis of findings on the etiology and maintenance of dental phobia and propose a comprehensive cognitive behavioral model to guide further study. We also present a systematic qualitative and a quantitative review of the treatment literature, concluding that although we have made strides in learning how to prevent dental anxiety in youth, the methods effective in preventing anxiety may not be equally effective in treating youth with dental phobia. We propose a multidisciplinary approach, including those with expertise in pediatric anxiety as well as pediatric dentistry, is likely required to move forward. Copyright © 2017 Elsevier Ltd. All rights reserved.
Quteish Taani, D S M
Dental anxiety constitutes a major problem for patients and dental care providers alike. The aim of this study was to examine the relationship between dental anxiety and regularity of dental attendance among young adults. A random sample of 15 course directors (1:50) was asked to participate in the study. Of these, only 10 course-directors agreed to handout the 500 questionnaires. All undergraduate students who participated in this study were asked to complete a questionnaire modified from Dental Fear Survey (DFS) questionnaire and 368 (73.6%) filled forms were returned for statistical analysis. The results showed that only 20.9% were regular dental attendee while the majority (79.1%) were irregular attendee. The reasons given for irregular attendance were 'lack of time' (36%), 'treatment not needed' (34.1%), 'fear from dentist' (13.3%) and 'cost' (16.6%). The sight and sensation of the injection and sight, sound, and sensation of the drill were the most common fear-eliciting stimuli. Increased heart rate was the commonest reported physiological response. Females had higher mean ratings, therefore tended to be more anxious than males. Dental anxiety represented by the mean responses to the items, was found to be higher in irregular dental attendee than regular attendee. In conclusion, this suggests that dental anxiety may affect the seeking of dental care, therefore to be taken into account when training dental care providers.
... to 1 year. The American Academy of Pediatric Dentistry and the American Dental Association recommend scheduling a ... children and adolescents. The American Academy of Pediatric Dentistry recommends scheduling regular dental checkups, with the most ...
D'Alessandro, Giovanni; Alkhamis, Nadia; Mattarozzi, Katia; Mazzetti, Michela; Piana, Gabriela
Dental anxiety could impede dental treatment in children. Evidence shows that parents' fear of dentists contributes to children's anxiety towards dentists. The aim of the present study was to determine whether and to what extent: a) parents' anxiety and depression personality traits, b) parent's dental fear, and c) child personality traits can predict children's dental anxiety in an Italian population. One hundred and four children (5-14 years old) and one of their parents participated in the study. Well-known and validated questionnaires were administered to children (MCDASf, CFSS-DS, TAD) and parents (FDPQ, STAI Y1, Y2, and BDI-II). Dental anxiety is significantly associated with the anxiety personality trait and depression of the child and with parental fear of dental pain. A hierarchical regression analysis showed that, regardless of age and gender, the best predictor of child dental anxiety is parent's fear of dental pain, rather than relatively stable temperaments of the child. In line with the literature concerning adults, these findings highlight the children dental anxiety as a complex phenomena consisting of different components, including the child's personality traits (anxiety trait and depression) and parents' dental fear. Clinical implications of this evidence are discussed. © 2015 American Association of Public Health Dentistry.
Woodmansey, Karl F.
Dental anxiety remains a pervasive barrier to dental treatment for many individuals, including college-age patients. In this article, the author reviews dental anxiety and examines the usefulness of assessment instruments for identifying dental anxiety. Using 2 unique assessment instruments, he examines the prevalence of dental anxiety in his…
Economou, George C
This study investigated whether personality plays a role in a condition called dental anxiety. Specifically, the study examined the relationship between dental anxiety (the negative response to the stress elicited from a dental interaction) and self-consciousness (the tendency to evaluate aspects of oneself that are subject to private and public display). The purpose of this study was to identify the characteristics possessed by dentally anxious individuals who face potential health risks because of their avoidance. Sixty York University undergraduate students were recruited by convenience sampling to participate. These subjects completed Corah's Dental Anxiety Scale and the Self-Consciousness Scale. The Self-Consciousness Scale consists of three subscales, including private self-consciousness, public self-consciousness, and social anxiety. Results indicated an 0.54 significant correlation between dental anxiety and self-consciousness. The public self-consciousness and social anxiety subscales correlated the most with dental anxiety. Furthermore, the data did not indicate a significant moderating relationship for gender between the two aforementioned variables. These results contribute to the establishment of personality characteristics as one of the dimensions determining dental anxiety.
Arrow, P; Klobas, E
To compare changes in child dental anxiety after treatment for early childhood caries (ECC) using two treatment approaches. Children with ECC were randomized to test (atraumatic restorative treatment (ART)-based approach) or control (standard care approach) groups. Children aged 3 years or older completed a dental anxiety scale at baseline and follow up. Changes in child dental anxiety from baseline to follow up were tested using the chi-squared statistic, Wilcoxon rank sum test, McNemar's test and multinomial logistic regression. Two hundred and fifty-four children were randomized (N = 127 test, N = 127 control). At baseline, 193 children completed the dental anxiety scale, 211 at follow up and 170 completed the scale on both occasions. Children who were anxious at baseline (11%) were no longer anxious at follow up, and 11% non-anxious children became anxious. Multinomial logistic regression found each increment in the number of visits increased the odds of worsening dental anxiety (odds ratio (OR), 2.2; P < 0.05), whereas each increment in the number of treatments lowered the odds of worsening anxiety (OR, 0.50; P = 0.05). The ART-based approach to managing ECC resulted in similar levels of dental anxiety to the standard treatment approach and provides a valuable alternative approach to the management of ECC in a primary dental care setting. © 2016 Australian Dental Association.
Karibe, Hiroyuki; Aoyagi-Naka, Kyoko; Koda, Arisa
The purpose of this study was to assess the levels of dental fear, state anxiety, and physiological distress in children and their mothers during pediatric dental procedures and to investigate the associations between these variables. Forty children and their mothers who visited six pediatric dental clinics in Tokyo, Japan, participated in this study. Dental fear was assessed using the dental subscale of the Children's Fear Survey Schedule (CFSS-DS) and the Dental Fear Survey. Children completed the pre- and post-treatment State-Trait Anxiety Inventory for Children-State (STAIC-S), and mothers completed the State-Trait Anxiety Inventory-State (STAI-S). Pre- and post-treatment salivary alpha amylase (sAA) levels were measured to assess physiological distress. Paired t tests and Pearson's correlation coefficients were used for statistical analyses. State anxiety scores and sAA levels significantly differed between pre- and post-treatment in mothers (P=.007 and P<.02, respectively) but not in children. Pretreatment STAI-S scores in mothers were correlated with CFSS-DS scores in children (r=.348, P<.03), but pretreatment STAI-S and STAIC-S scores were not. Maternal anxiety before children's dental treatment was significantly associated with children's dental fear.
Klein, Ulrich; Manangkil, Rochelle; DeWitt, Peter
To investigate parents' ability to assess dental anxiety of their six- to 10-year-old children and to determine how parents' and children's fear assessments correlate with patient behavior during dental treatment. From a continuous convenience sample, 184 child/parent dyads were recruited to complete the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire prior to dental treatment. One provider treated all children, assessed their behavior, and assigned a Frankl score rating to them. Parent/child anxiety scores were compared to each other and to the behavior children presented during dental treatment. The mean dental anxiety score reported by the children was 30.30; the score reported by their parents was 2.94 points higher (P=.0016). There was poor consistency within parent/child pairs when precisely assessing dental anxiety. Parental assessments of their children's dental anxiety were a poor to fair predictor for observed behavior, whereas the children's self-assessments were fair to good. Child age was not associated with ability to assess anxiety. Parents of children with low anxiety overestimated their children's anxiety, whereas parents of children with high anxiety underestimated their children's anxiety. Parents and children showed moderate agreement assessing dental anxiety measured by the CFSS-DS. The child's score is preferable for predicting behavior.
Krikken, J B; Veerkamp, J S J
This was to explore the relation between children's dental anxiety, their behaviour during treatment and their parent's rearing style. Also the parents' preparation of the child for dental treatment was related to behaviour and parental rearing style. The parents of 100 children, referred to a secondary dental care clinic were asked to fill out the Child Rearing Practices Report (CRPR), the Child Fear Survey Schedule (CFSS) on behalf of their children and an additional questionnaire on child preparation prior to dental treatment. Four rearing styles were constructed by using the results of the Nurturance and the Restrictiveness domain of the CRPR. Dentists were asked to assess the behaviour of the child during dental habituation and dental treatment using the Venham scale. The dentists were unaware of the child's CFSS score. Parents were not present during actual dental treatment. Each child's dental anxiety was related to their behaviour displayed during dental treatment. Highly anxious children showed more disruptive behaviour than their low anxious counterparts did, especially during familiarisation. Parental rearing style was neither related to child dental anxiety prior to or to behaviour during dental treatment. Parents who use a permissive rearing style were less likely to tell their children that the dentist will not hurt them compared with authoritarian parents. Parents with an authoritative rearing style were more convinced that the behaviour of their child could be managed by the dentist than parents with a permissive and neglectful rearing style. After their children's dental rehabilitation parents were less inclined to accompany their child during treatment. Dental anxiety correlated positively with the behaviour displayed during treatment. No relation was found between parenting style and dental anxiety and behaviour during treatment. Parents showed more confidence in the child-dentist dyad after the rehabilitation of their child's teeth.
Ujaoney, S; Mamtani, M; Thakre, T; Tote, J; Hazarey, V; Hazarey, P; Kulkarni, H
Dental fear and anxiety in early childhood are widely prevalent and contribute to dental problems and behaviour in adulthood. Novel ways to reduce dental fear and anxiety in children are needed. Our aim was to conduct an efficacy trial of a novel Camouflage Syringe to reduce dental fear and anxiety in children. randomised controlled trial of efficacy of the Camouflage Syringe. We designed a Camouflage Syringe with a toy-like appearance that veils the conventional syringe to permit topical application and injection of local anaesthesia and ensure more involvement of the patient in the treatment process. We conducted a concurrent parallel, randomised controlled trial (NCT01398007) on the efficacy of this Camouflage Syringe to reduce the dental fear and anxiety in children seeking dental treatment who required the use of local anaesthesia. Using Venham's clinical rating scale, Venham's picture test, parental stress questionnaire and recall questionnaire, the efficacy of the Camouflage Syringe to reduce dental fear and anxiety ranged from 82% to 97% for various outcomes and from 60% to 100% for prevention of related adverse outcomes. For all outcomes, the number needed to treat was close to unity. Our results strongly favour the use of Camouflage Syringe to reduce dental fear and anxiety in children.
Ekanayake, L; Dharmawardena, D
The purpose of the study was to determine the prevalence and factors affecting dental anxiety in patients seeking dental care. A cross sectional study. 503 first visit patients attending the University Dental Hospital in Peradeniya, Sri Lanka. Corah's dental anxiety scale was used to assess the dental anxiety in these patients. The prevalence of dental anxiety was 32% (DAS score > or = 12) while 12% were considered to be extremely anxious (DAS score > or = 15). Females were found to be more dentally anxious than males. Level of education was associated with dental anxiety. Problem oriented attenders had a significantly higher mean DAS score than regular attenders. Those who had an extraction at the last dental visit were significantly more dentally anxious than those who had a restoration/scaling. Negative dental experience was not associated with dental anxiety. The logistic regression model revealed that gender, level of education and 'fear' which was cited as the reason for the delay in seeking care for the presenting complaint were significant predictors of dental anxiety. However, only 4% of the variation in dental anxiety could be explained by these independent variables. Socio-demographic factors and variables related to past dental experiences had a limited influence in explaining dental anxiety in this sample of dental patients.
Porritt, J.; Rodd, H.; Morgan, A.; Williams, C.; Gupta, E.; Kirby, J.; Creswell, C.; Newton, T.; Stevens, K.; Baker, S.; Prasad, S.; Marshman, Z.
Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for dental anxiety; however, access to therapy is limited. The current study aimed to develop a self-help CBT resource for reducing dental anxiety in children, and to assess the feasibility of conducting a trial to evaluate the treatment efficacy and cost-effectiveness of such an intervention. A mixed methods design was employed. Within phase 1, a qualitative “person-based” approach informed the development of the self-help CBT resource. This also employed guidelines for the development and evaluation of complex interventions. Within phase 2, children, aged between 9 and 16 y, who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital, were invited to use the CBT resource. Children completed questionnaires, which assessed their dental anxiety and health-related quality of life (HRQoL) prior to and following their use of the resource. Recruitment and completion rates were recorded. Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/carers and dental professionals. For this analysis, the authors adhered to the Mixed Methods Appraisal Tool criteria. There were 24 families and 25 dental professionals participating in the development and qualitative evaluation of the CBT resource for children with dental anxiety. A total of 56 children agreed to trial the CBT resource (66% response rate) and 48 of these children completed the study (86% completion rate). There was a significant reduction in dental anxiety (mean score difference = 7.7, t = 7.9, df = 45, P < 0.001, Cohen’s d ES = 1.2) and an increase in HRQoL following the use of the CBT resource (mean score difference = -0.03, t = 2.14, df = 46, P < 0.05, Cohen’s d ES = 0.3). The self-help approach had high levels of acceptability to stakeholders. These findings provide preliminary evidence for the effectiveness and acceptability of the resource
Ofori, Marian A.; Adu-Ababio, F.; Nyako, E. A.; Ndanu, Tom A.
Objective: To find out the prevalence of dental anxiety and fear amongst patients in various selected dental clinics in Accra, Ghana. Study design: Dental patients (n = 279) who had either been exposed to dental treatments or had no prior dental exposure, attending four selected dental clinics in Accra were randomly sampled. They were interviewed…
Binanzan, Najla; Alhassan, Aseel
Objectives To measure the occurrence and levels of depression, anxiety and stress in undergraduate dental students using the Depression, Anxiety and Stress Scale (DASS-21). Methods This cross-sectional study was conducted in November and December of 2014. A total of 289 dental students were invited to participate, and 277 responded, resulting in a response rate of 96%. The final sample included 247 participants. Eligible participants were surveyed via a self-reported questionnaire that included the validated DASS-21 scale as the assessment tool and questions about demographic characteristics and methods for managing stress. Results Abnormal levels of depression, anxiety and stress were identified in 55.9%, 66.8% and 54.7% of the study participants, respectively. A multiple linear regression analysis revealed multiple predictors: gender (for anxiety b=-3.589, p=.016 and stress b=-4.099, p=.008), satisfaction with faculty relationships (for depression b=-2.318, p=.007; anxiety b=-2.213, p=.004; and stress b=-2.854, p<.001), satisfaction with peer relationships (for depression b=-3.527, p<.001; anxiety b=-2.213, p=.004; and stress b=-2.854, p<.001), and dentistry as the first choice for field of study (for stress b=-2.648, p=.045). The standardized coefficients demonstrated the relationship and strength of the predictors for each subscale. To cope with stress, students engaged in various activities such as reading, watching television and seeking emotional support from others. Conclusions The high occurrence of depression, anxiety and stress among dental students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions. PMID:28553831
Basudan, Sumaya; Binanzan, Najla; Alhassan, Aseel
To measure the occurrence and levels of depression, anxiety and stress in undergraduate dental students using the Depression, Anxiety and Stress Scale (DASS-21). This cross-sectional study was conducted in November and December of 2014. A total of 289 dental students were invited to participate, and 277 responded, resulting in a response rate of 96%. The final sample included 247 participants. Eligible participants were surveyed via a self-reported questionnaire that included the validated DASS-21 scale as the assessment tool and questions about demographic characteristics and methods for managing stress. Abnormal levels of depression, anxiety and stress were identified in 55.9%, 66.8% and 54.7% of the study participants, respectively. A multiple linear regression analysis revealed multiple predictors: gender (for anxiety b=-3.589, p=.016 and stress b=-4.099, p=.008), satisfaction with faculty relationships (for depression b=-2.318, p=.007; anxiety b=-2.213, p=.004; and stress b=-2.854, p<.001), satisfaction with peer relationships (for depression b=-3.527, p<.001; anxiety b=-2.213, p=.004; and stress b=-2.854, p<.001), and dentistry as the first choice for field of study (for stress b=-2.648, p=.045). The standardized coefficients demonstrated the relationship and strength of the predictors for each subscale. To cope with stress, students engaged in various activities such as reading, watching television and seeking emotional support from others. The high occurrence of depression, anxiety and stress among dental students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions.
Gunjal, Shilpa; Pateel, Deepak Gowda Sadashivappa; Parkar, Sujal
Aim . To assess the dental anxiety level among dental, medical, and pharmacy students of MAHSA University, Malaysia. Materials and Methods . A cross-sectional questionnaire study was conducted among 1500 undergraduate students of MAHSA University. The Modified Dental Anxiety Scale (MDAS) was used to measure dental anxiety among the study population. The responses were assessed by 5-point likert scale ranging from 1 to 5. The level of anxiety was categorized into lowly anxious (5-11), moderately anxious (12-18), and severely anxious ≥19. Out of 1500 students enrolled, 1024 students (342 males and 682 females) completed and returned the questionnaire having response rate of 68.26%. Results . There was a statistically significant difference ( P < 0.001) when the mean dental anxiety scores were compared among the three faculties and dental students had lowest mean score (11.95 ± 4.21). The fifth year (senior) dental students scored significantly ( P = 0.02) lower mean anxiety score as compared to the first dental students (junior). The students were anxious mostly about tooth drilling and local anesthetic injection. Conclusions . Dental students have a significantly low level of dental anxiety as compared with medical and pharmacy students. Incorporation of dental health education in preuniversity and other nondental university curriculums may reduce dental anxiety among the students.
Dahllöf, Göran; Bejerot, Susanne
Dental anxiety is associated with previous distressing dental experiences, such as lack of understanding of the dentist intentions, perceptions of uncontrollability and experiences of pain during dental treatment. People with autism spectrum disorder (ASD) are impaired in building flexible predictions and expectations, which is very much needed during a dental visit. The aims of the study were to investigate if people with ASD have more negative dental experiences and a higher level of dental anxiety compared to a matched control group. Forty-seven adults with ASD and of normal intellectual performance, and 69 age- and sex-matched typically developing controls completed questionnaires on previous dental experiences and dental anxiety, the Dental Anxiety Scale, and the Dental Beliefs Survey. The ASD group experienced pain during dental treatments more often than the controls and 22% had repeatedly experienced being forced to dental treatment they were not prepared for, compared to 3% of the controls. A higher level of dental anxiety was reported by the ASD group. Dental treatment and methods for supporting the communication with patients with ASD need to be developed, in order to reduce the negative dental experiences and dental anxiety in people with ASD. PMID:25530879
Doganer, Yusuf Cetin; Aydogan, Umit; Yesil, Hande Ucler; Rohrer, James Edwin; Williams, Mark Douglas; Agerter, David Charles
The aims of the present study were to evaluate possible associations between trait anxiety, dental fear and the predictors of these interactions including demographic characteristics and dental history of patients applied to the dental care center in Ankara, Turkey. A sample of 607 participants (mean age: 21.02 ± 2.32) responded to a Turkish version of the Modified Dental Fear Survey (MDFS), the State-Trait Anxiety Inventory (STAI-T) and a questionnaire regarding previous negative dental experience. Multiple logistic regression analysis was used to identify the association between dental fear and the independent variables including trait anxiety, age groups, education level, dental visit frequency, experience and the source of dental knowledge. There was a trend for increasing in trait anxiety scores with greater levels of dental fear in a medium level of the dental fear group (OR = 1.055, 95%CI [1.025-1.086]; p < 0.001) and in a high level of the dental fear group (OR = 1.090 [1.057-1.124]; p < 0.001). Comparing to the low level of dental fear group; participants of medium dental fear level intended more likely to go to the dentist when they have a complaint instead of regularly going (odds ratio; OR = 3.177, 95%CI [1.304-7.741]; p = 0.011). Participants of high dental fear level tended to be less likely to have experienced no problem (OR = 0.476, 95%CI [0.284-0.795]; p = 0.005) than the low level of the dental fear group. We strongly indicate that higher dental fear scores have a predisposition of having high trait anxiety scores. Unpleasant dental experiences increased the risk for high dental fear levels. Patients with dental fear tended only to visit a dentist when necessary, avoiding regular visits.
Kebriaee, F; Sarraf Shirazi, A; Fani, K; Moharreri, F; Soltanifar, A; Khaksar, Y; Mazhari, F
To compare the effectiveness of inhalation sedation with nitrous oxide/oxygen (N2O/O2) and cognitive behavioural therapy (CBT) in reducing dental anxiety in preschool children. Randomised controlled clinical trial. This study was conducted on 45 preschoolers with moderate to severe dental anxiety (determined by the Children's Fear Survey Schedule Dental Subscale), who required pulp treatment of at least one primary mandibular molar. Baseline anxiety and cooperation levels were determined using Venham Clinical Anxiety and Cooperation Scales (VCAS and VCCS) and Venham Picture Test (VPT) at the first dental visit (dental prophylaxis and fluoride treatment). Before the second dental visit (pulp treatment), the children were randomly assigned to one of three groups--1: control, 2: N(2)O/O(2) and 3: CBT. In group 1, the usual behaviour management techniques were used, in group 2, nitrous oxide/oxygen gas was used and in group 3, unrelated play, Benson's breathing and positive self-talk and modelling were used. Anxiety and cooperation levels were determined at three periods: injection, rubber dam placement and the application of a high-speed handpiece with VCAS and VCCS and VPT. Finally, anxiety and cooperation differences between the two dental visits were compared within the three groups. Chi square, ANOVA and Kruskal-Wallis and Mann-Whitney U tests were used. N(2)O/O(2) and CBT significantly resulted in lower anxiety and higher cooperation in the second visit (at all three periods) compared to the control, although there was no significant difference between these two treatment methods. Both test methods were effective in reducing dental anxiety in preschoolers. Considering the adverse effects and necessity of equipment and trained personnel when using nitrous oxide and oxygen inhalation sedation, cognitive behavioural therapy is preferable because of its better applicability.
Boka, Vasiliki; Arapostathis, Konstantinos; Kotsanos, Nikolaos; Karagiannis, Vassilis; van Loveren, Cor; Veerkamp, Jaap
The aims of this study were to determine: 1) the relationship between children's psychological functioning, dental anxiety and cooperative behavior before and during local anesthesia, 2) the relationship of parental dental anxiety with all the above child characteristics. There was a convenient sample of 100 children (4-12 years). Child dental anxiety and psychological functioning were measured using the "Children's Fear Survey Schedule" (CFSS-DS) and the "Strengths and Difficulties Questionnaire" (SDQ) respectively. Parental dental anxiety was measured using the "Modified Dental Anxiety Scale" (MDAS). All questionnaires were completed by parents. Before and during local anesthesia, the child behavior was scored by one experienced examiner, using the Venham scale. Non-parametric tests and correlations (Mann-Whitney, Spearman's rho) were used for the analysis. The mean SDQ score was 10±5.6 for boys (n=60) and 8.3±4.8 for girls (n=40) (p=0.038), but there was no correlation with children's age. The mean CFSS-DS score was 33.1±11.86 and there was no correlation with age or gender. Children with higher levels in the pro-social subscale of the SDQ had significantly less anxiety and better behavior before local anesthesia. Higher mean CFSS-DS scores were significantly associated with uncooperative behavior during local anesthesia (p=0.04). There was no correlation between parents' and their children's dental anxiety, psychological functioning and behavior. 46% of the children had previous dental experience in the last 6 months. As time since the last dental treatment increased, an improvement was found in children's behavior during local anesthesia. Child psychological functioning was related to dental anxiety and behavior during dental appointment involving local anesthesia.
Bergdahl, Maud; Bergdahl, Jan
The aim of the present study was to investigate character and temperament dimensions of personality in six men and 31 women (aged 20-57 yr) with severe dental anxiety, and to evaluate whether these dimensions were associated with the level of dental anxiety. The Dental Anxiety Scale (DAS) and the Temperament and Character Inventory (TCI) were used. High ratings in novelty seeking and female gender predicted high DAS scores. Compared with controls, the patients scored significantly higher on the temperament dimension, novelty seeking. For character dimensions, the patients scored lower on cooperativeness and higher on self-transcendence than controls. Our results indicated that patients with dental anxiety are neurotic extravert (i.e. novelty seekers who experience brief dissociative periods and magical thinking). Furthermore, the combination of the inherited temperament dimension novelty seeking and the social learned character dimension cooperativeness and self-transcendence seem to form a vulnerable personality to develop dental anxiety.
Peretz, B; Mann, J
The aims of the present study were (a) to evaluate students' estimation of their parents' dental anxiety; (b) to measure students' dental anxiety and to study their ranking of the most fear provoking stimuli in the dental situation during their pre-clinical and clinical years; (c) to investigate gender differences among students with regard to dental anxiety. 30 3rd-year students (15 male and 15 female) who completed a 4-section questionnaire which requested sociodemographic information, evaluation of parents' dental anxiety, dental anxiety scale (DAS) and dental fear scale (DFS), completed the DAS and DFS in their 5th and 6th years. Both male and female students estimated their mothers' dental anxiety as significantly higher than their fathers'. Female students ranked their parents higher than males. DAS scores were significantly higher among female students than among males in the 3rd year. However, DAS scores were reduced from the 3rd to the 6th year among the total class and significantly among females, while males' levels of anxiety remained within close range throughout the years. The dental anxiety scores of all students who experienced a dental procedure in the past were higher than the scores of the students who did not. The most fearful stimulus was 'feeling the needle'. Our findings may suggest that the change in the reported dental anxiety of the students during the years of dental studies in the present study may be explained by the increased professional education and clinical experience that the students acquire throughout their studies in the dental school. Being exposed to basic trivial dental procedures (such as local anaesthetic injection) may help students either to be habituated or to use rational coping strategies when dealing with personal dental experience.
Al-Namankany, A; Petrie, A; Ashley, P
This study was part of a successfully completed PhD and was presented at the IADR/AADR General Session (2013) in Seattle, Washington, USA. The report of this clinical trial conforms to the CONSORT statement. A randomised controlled trial to investigate if video modelling can influence a child's anxiety before the administration of local anaesthesia (LA). A sample of 180 (6- to 12-year-old) children due to have dental treatments under LA were randomly allocated to the modelling video or the control video (oral hygiene instruction). The level of anxiety was recorded before and after watching the video on the Abeer Children Dental Anxiety Scale (ACDAS) and the child's ability to cope with the subsequent procedure was assessed on the visual analogue scale (VAS). A two group chi-square test was used as the basis for the sample size calculation; a significance level of 0.025 was chosen rather than the conventional 0.05 to avoid spurious results arising from multiple testing. Children in the test group had significantly less anxiety after watching the video than children in the control group throughout the subsequent dental procedure; in particular at the time of the LA administration (p <0.001). Video modelling appeared to be effective at reducing dental anxiety and has a significant impact on needle phobia in children.
Hamzah, Hajar S; Gao, Xiaoli; Yung Yiu, Cynthia K; McGrath, Colman; King, Nigel M
Internet social media offers a rich source for soliciting the public's views on health issues. This qualitative research, using You-Tube as a platform, aimed to explore the public's perspectives on management of dental fear and anxiety (DFA) in pediatric patients. Using three keywords ("dental fear," "dental phobia," and "dental anxiety"), YouTube videos were searched. Twenty-seven videos related to DFA in children and adolescents were reviewed by three investigators, including a nondental layperson. Inductive thematic analysis was adopted for interpreting the data. Several strategies were considered useful for controlling DFA in pediatric patients, including: verbal and nonverbal communication to establish closeness and effective guidance (explanation, permission-seeking, reassurance, and negotiation); desensitization to dental settings and procedures; tell-show-do; positive reinforcement; distraction by imagination and thoughtful designs of clinic; and parental presence and support. Some self-coping strategies adopted by patients alleviated their DFA, such as self-reasoning and trust-building through long-term connection. Dentists' clinical competence, favorable treatment outcomes, and state-of-the-art devices and technologies (dental lasers, intraoral camera, and adapted anaesthesia method) contributed to reducing DFA. Authentic testimonials in YouTube videos endorsed and interpreted a variety of strategies adoptable by patients, parents, and dental professionals for managing children's and adolescents' dental fears and anxieties.
Sadi, Hana; Finkelman, Matthew; Rosenberg, Morton
The aim of this study was to investigate the correlation between dental anxiety, salivary cortisol, and salivary alpha amylase (sAA) levels. Furthermore, the aim was to look into individual differences such as age, race, gender, any existing pain, or traumatic dental experience and their effect on dental anxiety. This study followed a cross-sectional design and included a convenience sample of 46. Every patient was asked to complete the Dental Anxiety Scale (DAS) and a basic demographic/dental history questionnaire. A saliva sample, utilizing the method of passive drooling, was then collected in 2-mL cryovials. Samples were analyzed for salivary cortisol and sAA levels by Salimetrics. Significant associations were observed between DAS scores and presence of pain and history of traumatic dental experience. However, no significant correlations were observed between DAS, cortisol, and sAA levels. Our study reconfirms that dental anxiety is associated with presence of pain and a history of traumatic dental experience. On the other hand, our study was the first to our knowledge to test the correlation between the DAS and sAA; nevertheless, our results failed to show any significant correlation between dental anxiety, cortisol, and sAA levels. PMID:23763559
Erfanparast, Leila; Vafaei, Ali; Sohrabi, Azin; Ranjkesh, Bahram; Bahadori, Zahra; Pourkazemi, Maryam; Dadashi, Shabnam; Shirazi, Sajjad
Background and aims. Different factors affect children’s behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child’s anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child’s anxiety and child’s behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman’s correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P < 0.001), and a moderate correlation between the self-concept and child’s behavior scores (r = 0.491, P < 0.001). A strong inverse relation was also found between the anxiety and behavior scores (r = -0.91, P < 0.001). Conclusion. Children with higher self-concept had lower anxiety level and better behavioral feedback during dental treatment. PMID:26697152
Prangnell, Simon J.; Green, Karen
Dental anxiety is a common form of anxiety problem, and research suggests that more people with learning disabilities experience dental anxiety than in the general population. Very little work has been done to investigate effective non-medical approaches for supporting people with a learning disability and dental anxiety to access dental care.…
Armfield, Jason M; Ketting, Manon
It has been proposed that avoidance of dental visits might be the main determinant of poor oral health outcomes in people with high dental anxiety (HDA). This study aimed to determine the predictors of dental avoidance among people with HDA and also whether these predictors differed from those found in people with lower dental anxiety (LDA). Study participants (n = 596; response rate = 41.1%) comprised a random cross-sectional sample of the Australian adult population who completed a mailed self-complete questionnaire containing items relating to the use and accessibility of dental services, trust in dental professionals, dental anxiety, dental experiences, self-perceived oral health, vulnerability-related perceptions of visiting the dentist, and psychological health. Multiple imputation was used to replace missing values and statistically significant variables in bivariate analyses were entered into a multivariable logistic generalized linear model. More than two-thirds of participants with HDA were currently avoiding or delaying a dental visit. Among people with HDA, dental avoidance was independently and significantly predicted by difficulty paying a $300 dental bill, having no or only little trust in the last-visited dentist, perceived treatment need and dental anxiety. Among people with LDA, only perceived treatment need and dental anxiety predicted avoidance. In addition to their high anxiety, a number of additional barriers to dental visiting were found for people with HDA. These barriers, especially cost and communication issues with dentists, need to be addressed to assist people with HDA obtain necessary, regular dental care. (c) 2015 APA, all rights reserved).
Negovetić Vranić, Dubravka; Ivančić Jokić, Nataša; Bakarčić, Danko; Carek, Andreja; Rotim, Željko; Verzak, Željko
Tooth injuries are serious clinical conditions. Some children experience dental trauma only once, while others are more prone to repeated tooth injuries. Repeated dental trauma occurs in 19.4% to 30% of patients. Pain and dental trauma are the most common reasons for fear and anxiety. The main objective of this study was to investigate how dental trauma, as well as repeated dental trauma affects the occurrence and development of dental fear in children. The study was conducted on a random sample of 147 subjects (88 boys and 59 girls) aged 5-8 and 9-12 years. Subjects in both age groups were divided into subroups without dental trauma, with one dental trauma and with repeated dental trauma. The validated Children’s Fear Survey Schedule – Dental Subscale was used on fear assessment. Results showed that only 12.2% of children without trauma, 33.3% with one trauma and 51.7% with repeated trauma were not afraid of injection. Older children had a significantly lower fear of injections, touch of an unknown person, choking, going to the hospital and people in white uniforms. Dentist was not the cause of fear in 65.5% of patients with repeated trauma. With each repeated injury of teeth, the degree of their fear of dental treatment was lower.
Goettems, Marília Leão; Schuch, Helena Silveira; Demarco, Flávio Fernando; Ardenghi, Thiago Machado; Torriani, Dione Dias
This study investigated the relationship between dental anxiety and fear, demographic and socioeconomic characteristics, and dental attendance patterns in a sample of women in Brazil. A cross-sectional study of women in healthcare centers was conducted during an immunization campaign in the city of Pelotas in southern Brazil. Interviews were conducted to assess dental anxiety and fear, education level, family income, marital status, and the use of dental services. Data were analyzed by Poisson regression models, with estimation of the prevalence ratio and the rate ratio (RR). A total of 608 women aged 16-50 years (mean age 29.3 ± 7.2 years) were included in the study. Dental anxiety and fear scores (according to Corah's Dental Anxiety Scale) ranged from 4 to 20. Of the 608 participants, 59.5 percent displayed low dental fear, 18.1 percent had moderate dental fear, and 22.4 percent displayed high dental fear. A total of 60.2 percent of the women exhibited irregular dental attendance patterns, characterized by never visiting a dentist, or only visiting when experiencing pain. After adjustments, the presence of at least moderate dental anxiety and fear was associated with low education levels (RR 1.43; 95 percent CI 1.11-1.84), low family income (RR 1.33; 95 percent CI 1.06-1.68), and irregular dental attendance patterns (RR 1.83; 95 percent CI 1.41-2.37). In this sample of Brazilian women, dental anxiety and fear were strongly associated with socioeconomic characteristics and dental attendance patterns. © 2014 American Association of Public Health Dentistry.
Singh, Preet Bano; Young, Alix; Lind, Synnøve; Leegaard, Marie Cathinka; Capuozzo, Alessandra; Parma, Valentina
Despite the fact that human body odors can transfer anxiety-related signals, the impact of such signals in real-life situations is scant. In this study, the effects of anxiety chemosignals on the performance of dental students operating on simulation units, wearing t-shirts imbued with human sweat and masked with eugenol were tested. Twenty-four 4th year dental students (17F) donated their body odors in two sessions (Anxiety and Rest). Twenty-four normosmic, sex- and age-matched test subjects who were3rd year dental students performed three dental procedures while smelling masked anxiety body odors, masked rest body odors or masker alone. The intensity and pleasantness ratings showed that the test subjects could not report perceptual differences between the odor conditions. When exposed to masked anxiety body odors the test subject's dental performance was significantly worse than when they were exposed to masked rest body odors and masker alone, indicating that their performance was modulated by exposure to the emotional tone of the odor. These findings call for a careful evaluation of the anxiety-inducing effects of body odors in performance-related tasks and provide the first ecological evaluation of human anxiety chemosignal communication.
Lazea, Andreea; Todea, Carmen
Objectives: To evaluate the dental anxiety level and the degree of acceptance of laser assisted pedodontic treatments from the children part. Also, we want to underline the advantages of laser use in pediatric dentistry, to make this technology widely used in treating dental problems of our children patients. Methods: Thirty pediatric dental patients presented in the Department of Pedodontics, University of Medicine and Pharmacy "Victor Babeş", Timişoara were evaluated using the Wong-Baker pain rating scale, wich was administered postoperatory to all patients, to assess their level of laser therapy acceptance. Results: Wong-Baker faces pain rating scale (WBFPS) has good validity and high specificity; generally it's easy for children to use, easy to compare and has good feasibility. Laser treatment has been accepted and tolerated by pediatric patients for its ability to reduce or eliminate pain. Around 70% of the total sample showed an excellent acceptance of laser dental treatment. Conclusions: Laser technology is useful and effective in many clinical situations encountered in pediatric dentistry and a good level of pacient acceptance is reported during all laser procedures on hard and soft tissues.
Huet, Adeline; Lucas-Polomeni, Marie-Madeleine; Robert, Jean-Claude; Sixou, Jean-Louis; Wodey, Eric
The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.
... Living Listen Español Text Size Email Print Share Dental Health & Hygiene for Young Children Page Content Article ... and lead to future dental problems. Teaching Good Dental Habits The best way to protect your child's ...
Haworth, S.; Dudding, T.; Waylen, A.; Thomas, S. J.; Timpson, N. J.
Objectives To identify whether dental general anaesthesia (DGA) status is informative in assessing risk of caries or dental anxiety by (a) describing long-term oral health and dental anxiety for people who underwent DGA in childhood and (b) testing whether DGA status in childhood is associated with incident future dental caries or anxiety independently of preconceived risk factors. Design Analysis of prospectively obtained data. Setting An established population based cohort in the UK, the Avon Longitudinal Study of Parents and Children. Participants and methods In total 1,695 participants with dental data in childhood and adolescence were included in analysis. DGA status by age 7 and oral health measures at age 17 were identified from questionnaire data. Main outcome measures Filled or extracted permanent teeth at age 17, Corah Dental Anxiety Scale. Results One hundred and twenty-eight (7.6%) participants underwent DGA in childhood. Individuals who underwent DGA had higher measures of filled or extracted permanent teeth in adolescence (0.36 more affected teeth in fully-adjusted model [95% confidence interval: 0.27, 0.55; P <0.001]). Conclusions DGA in childhood predicts burden of treated caries in adolescence, independently of other risk factors. DGA status may be a clinically useful adjunct in identifying young people at high risk of further disease. PMID:28232699
Haworth, S; Dudding, T; Waylen, A; Thomas, S J; Timpson, N J
Objectives To identify whether dental general anaesthesia (DGA) status is informative in assessing risk of caries or dental anxiety by (a) describing long-term oral health and dental anxiety for people who underwent DGA in childhood and (b) testing whether DGA status in childhood is associated with incident future dental caries or anxiety independently of preconceived risk factors.Design Analysis of prospectively obtained data.Setting An established population based cohort in the UK, the Avon Longitudinal Study of Parents and Children.Participants and methods In total 1,695 participants with dental data in childhood and adolescence were included in analysis. DGA status by age 7 and oral health measures at age 17 were identified from questionnaire data.Main outcome measures Filled or extracted permanent teeth at age 17, Corah Dental Anxiety Scale.Results One hundred and twenty-eight (7.6%) participants underwent DGA in childhood. Individuals who underwent DGA had higher measures of filled or extracted permanent teeth in adolescence (0.36 more affected teeth in fully-adjusted model [95% confidence interval: 0.27, 0.55; P <0.001]).Conclusions DGA in childhood predicts burden of treated caries in adolescence, independently of other risk factors. DGA status may be a clinically useful adjunct in identifying young people at high risk of further disease.
Sullivan, C; Schneider, P E; Musselman, R J; Dummett, C O; Gardiner, D
Virtual reality, a three-dimensional computer generated world, has been shown to relax adults during dental treatment. The purpose of this study was to investigate the effect of virtual reality on the behavior and anxiety of children during dental treatment. The behavior, anxiety and heart rate of twenty-six children, ages five to seven years were evaluated for the first five minutes of two restorative treatment visits. Thirteen children viewed virtual reality at their first restorative visit and not the second, and thirteen children viewed virtual reality at the second restorative visit and not the first. Before and immediately following the restorative visits, each child was instructed to draw a human figure. The restorative appointments were video recorded and heart rate monitored. The drawings and videotapes were rated independently by two examiners. The Koppitz method of evaluating drawings was used to measure anxiety. The Frankl behavior rating scale was used to evaluate behavior. Differences (ANOVA) in behavior (p < or = 0.50) and anxiety (p < or = 0.65) were not significant. The overall pulse rate was significantly lower (ANOVA p < or = 0.001) when the child was wearing glasses and viewing virtual reality. In conclusion, virtual reality during dental treatment had no significant effect on the behavior or anxiety but significantly reduced the pulse.
Asserts that parent education is vital to good dental hygiene for the whole family. Discusses what Head Start staffers can do to ensure that children's dental needs are being met, particularly in assisting parents with taking responsibility for children's dental hygiene. Covers dental care tips for parents, questions and answers about dental…
Al-Harasi, Sharifa; Ashley, Paul F; Moles, David R; Parekh, Susan; Walters, Val
Managing children is a challenge that many dentists face. Many non-pharmacological techniques have been developed to manage anxiety and behavioural problems in children, such us: 'tell, show & do', positive reinforcement, modelling and hypnosis. The use of hypnosis is generally an overlooked area, hence the need for this review. This systematic review attempted to answer the question: What is the effectiveness of hypnosis (with or without sedation) for behaviour management of children who are receiving dental care in order to allow successful completion of treatment?Null hypothesis: Hypnosis has no effect on the outcome of dental treatment of children. We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE (OVID), EMBASE (OVID), and PsycINFO. Electronic and manual searches were performed using controlled vocabulary and free text terms with no language restrictions. Date of last search: 11th June 2010. All children and adolescents aged up to 16 years of age. Children having any dental treatment, such as: simple restorative treatment with or without local anaesthetic, simple extractions or management of dental trauma. Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two review authors. Authors of trials were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The methodological quality of randomised controlled trials (RCTs) was assessed using the criteria described in the Cochrane Handbook for Systematic Reviews of Interventions 5.0.2. Only three RCTs (with 69 participants) fulfilled the inclusion criteria. Statistical analysis and meta-analysis were not possible due to insufficient number of studies. Although there are a considerable number of anecdotal accounts indicating the benefits of using hypnosis in paediatric dentistry, on the basis of the three studies meeting the inclusion criteria for this review there
Wigen, Tove I; Skaret, Erik; Wang, Nina J
The aim of this study was to explore associations between avoidance behaviour and dental anxiety in both parents and children and caries experience in 5-year-old children. It was hypothesised that parents' dental avoidance behaviour and dental anxiety were related to dental caries in 5-year-old children. Data were collected from dental records and by clinical and radiographic examination of 523 children. The parents completed a questionnaire regarding education, national background, dental anxiety, dental attendance, and behaviour management problems. Bivariate and multivariate logistic regression was conducted. Children having one or more missed dental appointments (OR = 4.7), child behaviour management problems (OR = 3.3), child dental anxiety (OR = 3.1), and parents avoiding dental care (OR = 2.1) were bivariately associated with caries experience at the age of 5 years. In multivariate logistic regression, having one or more missed dental appointments (OR = 4.0) and child behaviour management problems (OR = 2.4) were indicators for dental caries in 5-year-old children, when controlling for parents education and national origin. Parents that avoid bringing their child to scheduled dental appointments and previous experiences of behaviour management problems for the child indicated risk for dental caries in 5-year-old children.
Background So far, there are few studies considering the development of dental anxiety and dental attendance patterns across time in the general population of Norwegian adults. This study aimed to 1) determine the frequency of dental anxiety and regular dental attendance among 25-year-olds in Norway in 1997 and 2007, 2) to study the development (time trend) of dental anxiety and the socio-behavioral distribution of dental anxiety from 1997 to 2007. Method Random samples of 1,190 and 8,000 25-yr-olds were drawn from the populations of three counties in Western Norway in 1997 and 2007, respectively. The eligible participants received questionnaires by mail including questions on socio-demographics, dental anxiety (DAS) and dental attendance. Results In 1997, 11.5% males versus 23% females reported high dental anxiety (DAS ≥ 13). Corresponding figures in 2007 were 11.3% and 19.8%. The proportions who had attended yearly for a dental check-up during the past 5 years fell from 62% in 1997 (men 56.9% and women 66.4%) to 44.6% (men 38.1% and women 48.6%) in 2007. After controlling for potential confounding factors, the 25-year-olds were 1.4 times more likely to report dental anxiety in 1997 compared to 2007. The decrease was largely attributable to a lower mean DAS score among higher educated females in 2007 than in 1997. The discrepancy in dental anxiety between regular and non-regular dental attendees had decreased, largely attributable to a decline in dental anxiety among irregular dental attendees. Conclusion The study showed reduced dental anxiety and dental attendance among 25 year-olds in Norway from 1997 to 2007. This study points to the importance of controlling for possible changes in socio-demographic distributions when different cohorts are compared. PMID:21426538
Thomson, W. M.; Broadbent, J. M.; Locker, D.; Poulton, R.
Objective To examine predictors of dental anxiety trajectories in a longitudinal study of New Zealanders. Methods Prospective study of a complete birth cohort born in 1972/73 in Dunedin, New Zealand, with dental anxiety scale (DAS) scores and dental utilization determined at ages 15, 18, 26 and 32 years. Personality traits were assessed at a superfactor and (more fine-grained) subscale level via the Multidimensional Personality Questionnaire at age 18 years. Group-based trajectory analysis was used to identify dental anxiety trajectories. Results DAS scores from at least three assessments were available for 828 participants. Six dental anxiety trajectories were observed: stable nonanxious low (39.6%); stable nonanxious medium (37.9%); recovery (1.6%); adult-onset anxious (7.7%); stable anxious (7.2%) and adolescent-onset anxious (5.9%). Multivariate analysis showed that males and those with higher DMFS at age 15 years were more likely to be in the stable nonanxious low trajectory group. Membership of the stable nonanxious medium group was predicted by the dental caries experience at age 15 years. Participants who had lost one or more teeth between ages 26 and 32 years had almost twice the relative risk for membership of the adult-onset anxious group. Personality traits predicted group membership. Specifically, high scorers (via median split) on the ‘stress reaction’ subscale had over twice the risk of being in the stable anxious group; low scorers on the traditionalism subscale were more likely to be members of the recovery trajectory group; and high scorers on the ‘social closeness’ subscale had half the risk of being in the stable anxious group. Dental caries experience at age 5 years was also a predictor for the stable anxious group. Membership of the late-adolescent-onset anxious group was predicted by higher dental caries experience by age 15 years, but none of the other predictors was significant. Conclusion Six discrete trajectories of dental anxiety
Lourenço-Matharu, L; Papineni McIntosh, A; Lo, J W
The primary aim of this study was to assess whether parents' own anxiety and their perception of their child's dental fear and child's general fear can predict preoperatively their child's behaviour during dental treatment under oral sedation. The secondary aim was to assess whether the child's age, gender and ASA classification grade are associated with a child's behaviour under oral sedation. Cross-sectional prospective study. The Corah's Dental Anxiety Scale (DAS), Children's Fear Survey Schedule Dental-Subscale (CFSS-DS) and Children's Fear Survey Schedule Short-Form (CFSS-SF) questionnaires were completed by parents of children undergoing dental treatment with oral midazolam. Behaviour was rated by a single clinician using the overall behaviour section of the Houpt-Scale and scores dichotomised into acceptable or unacceptable behaviour. Data were analysed using χ (2), t test and logistic regression analysis. In total 404 children (215 girls, 53 %) were included, with the mean age of 4.57 years, SD = 1.9. Behaviour was scored as acceptable in 336 (83 %) and unacceptable in 68 (17 %) children. The level of a child's dental fear, as perceived by their parent, was significantly associated with the behaviour outcome (p = 0.001). Logistic regression analysis revealed that if the parentally perceived child's dental fear (CFSS-DS) rating was high, the odds of the child exhibiting unacceptable behaviour under oral sedation was two times greater than if their parents scored them a low dental fear rating (OR 2.27, 95 % CI 1.33-3.88, p = 0.003). CFSS-DS may be used preoperatively to help predict behaviour outcome when children are treated under oral sedation and facilitate treatment planning.
Chaiklin, Harris; Mosher, Barbara
There is a relationship between maternal anxiety and lead levels in children. Data were collected from the mothers of 15 children with "normal" lead levels and 15 children with elevated blood levels. Anxiety was measured by the Taylor Manifest Anxiety Scale. All families lived in areas with poor housing. Treatment of lead poisoning tends…
Oosterink, F M D; de Jongh, A; Aartman, I H A
The purpose of the present study was to assess which types of experiences are most closely associated with pathological forms of dental anxiety. Data came from a sample of dental patients (n=1462). Pathological dental anxiety was operationalized in two ways: (1) a score of > or =36 on the Short form of the Dental Anxiety Inventory (S-DAI; high dental anxiety, HDA), or (2) fulfilling the screening criteria of specific phobia (DSM-IV-TR; dental phobia, DP). A wide variety of dental experiences appeared to be significantly related with both HDA and DP, while general traumatic experiences were not. No differences were found between women and men. Retrospective accounts of dental experiences involving helplessness were most strongly associated with having HDA [OR=8.2] and positive screens of DP [OR=16.2]. The results suggest that disruptive emotional and interoceptive reactions during dental treatment (particularly helplessness) have the greatest potential risk of precipitating pathological forms of dental anxiety.
Al-Omari, Wael Mousa; Al-Omiri, Mahmoud Khalid
This study was designed to investigate the subjective ratings of dental anxiety levels among university students enrolled at Jordan University of Science and Technology. In addition, the present study aimed to explore the sources of dental anxiety and the impact of gender on the perceived dental anxiety and the correlation between field of study and dental anxiety level. The Modified Corah Dental Anxiety Scale was used to measure dental anxiety among the study population. Six hundred subjects were recruited into the study from Jordanian undergraduate students from the faculties of Medicine, Engineering, and Dentistry. Five hundred and thirty five complete questionnaires were returned, which accounts for a response rate of 89.2%. The totals of the mean anxiety scores were the following: Medical students, 13.58%; Engineering students, 13.27% and dental students, 11.22%. About 32% of the study population has scored 15 or more. Dental students had the lowest percentage of those who scored 15 or more. Surprisingly, the medical students were responsible for the highest percentage of those who scored 15 or above. Although women demonstrated statistically higher total dental anxiety scores than men (p= 0.03), the difference between both genders was small and could be clinically insignificant. The students were anxious mostly about tooth drilling and local anesthetic injection. Lack of adequate dental health education may result in a high level of dental anxiety among non-dental university students in Jordan. Further studies are required to identify the correlates of dental anxiety among university students.
Jälevik, Birgitta; Klingberg, Gunilla
In a previous study, 9-year-old children with severe Molar Incisor Hypomineralization (MIH) had undergone dental treatment of their first molars nearly ten times as often as children in a control group. They also showed more management problems (BMP) and fear and anxiety (DFA). To assess the long-term outcomes of dental treatments, dental anxiety, and patients' satisfaction in adolescents with MIH. Sixty-seven patients, identical with those in the baseline study, were studied at age 18-years. The participants answered the Children's Fear Survey Schedule - Dental Subscale the Dental Visit Satisfaction Scale (DVSS). Data were compiled from the dental records concerning dental health, number of restorative treatments and BMP. Molar Incisor Hypomineralization group had a significantly higher DMFT, and had undergone treatment of their permanent first molars 4.2 times as often as the controls. BMP was still significantly more common in the MIH group. However, DFS was reduced in MIH group and increased in the control groups. The DVSS scores did not differ between the groups. Conclusions. Patients with severe MIH had a poorer dental health and were still more treatment consuming at age 18-years. However, their dental fear was now at the same level as the controls. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.
Panda, A; Garg, I; Shah, M
Despite many advances in paediatric dentistry, the greatest challenge for any paediatric dentist is to remove the anxiety related to a dental visit and have a child patient to accept dental treatment readily. Minor changes made in the waiting room design can have a major effect on the way any child perceives the upcoming dental experience. This study was carried out to determine children's preferences regarding the dental waiting area so as to improve their waiting experience and reduce their preoperative anxiety before a dental appointment. This was a cross-sectional descriptive study using survey methodology. A questionnaire designed to evaluate children's preferences regarding the waiting room was distributed to new paediatric patients, aged between 6 and 11 years of age, attending an outpatient dental facility and was completed by 212 children (127 males, 85 females). The analyses were carried out on cross-tables using Phi (for 2×2 tables) or Cramer's V (for larger than 2×2 tables) to assess responses to the questionnaire items across age groups and gender. A majority of children preferred music and the ability to play in a waiting room. They also preferred natural light and walls with pictures. They preferred looking at an aquarium or a television and sitting on beanbags and chairs and also preferred plants and oral hygiene posters Repetious. The results obtained from this study may help the dental team decide on an appropriate design of their paediatric waiting room so as to make children comfortable in the dental environment and improve delivery of health care.
Appukuttan, Deva Priya
Dental anxiety and phobia result in avoidance of dental care. It is a frequently encountered problem in dental offices. Formulating acceptable evidence-based therapies for such patients is essential, or else they can be a considerable source of stress for the dentist. These patients need to be identified at the earliest opportunity and their concerns addressed. The initial interaction between the dentist and the patient can reveal the presence of anxiety, fear, and phobia. In such situations, subjective evaluation by interviews and self-reporting on fear and anxiety scales and objective assessment of blood pressure, pulse rate, pulse oximetry, finger temperature, and galvanic skin response can greatly enhance the diagnosis and enable categorization of these individuals as mildly, moderately, or highly anxious or dental phobics. Broadly, dental anxiety can be managed by psychotherapeutic interventions, pharmacological interventions, or a combination of both, depending on the level of dental anxiety, patient characteristics, and clinical situations. Psychotherapeutic interventions are either behaviorally or cognitively oriented. Pharmacologically, these patients can be managed using either sedation or general anesthesia. Behavior-modification therapies aim to change unacceptable behaviors through learning, and involve muscle relaxation and relaxation breathing, along with guided imagery and physiological monitoring using biofeedback, hypnosis, acupuncture, distraction, positive reinforcement, stop-signaling, and exposure-based treatments, such as systematic desensitization, “tell-show-do”, and modeling. Cognitive strategies aim to alter and restructure the content of negative cognitions and enhance control over the negative thoughts. Cognitive behavior therapy is a combination of behavior therapy and cognitive therapy, and is currently the most accepted and successful psychological treatment for anxiety and phobia. In certain situations, where the patient is not
Sitheeque, Mohaideen; Massoud, Moustafa; Yahya, Suzana; Humphris, Gerry
The aims of the present study were to evaluate the reliability and validity of the Malay version of the Modified Dental Anxiety Scale (MDAS), and to determine the prevalence of dental anxiety and associated factors in a Malaysian population. A Malay-language questionnaire with questions to elicit demographic and dental care-related information, and the Malay version of the MDAS, were administered to 455 patients at the dental outpatient clinics of the Hospital Universiti Sains Malaysia. Factor analysis and internal consistency statistics were generated. A test-retest of the questionnaire was performed with 30 participants. Cronbach's alpha was 0.854, indicating good internal consistency. Factor analysis yielded results showing good validity. Approximately 3.5% of the participants expressed the highest levels of anxiety. Dental anxiety was significantly higher among females than males. Age correlated inversely with dental anxiety. Individuals seeking dental care only if a problem appeared had significantly more anxiety than regular attendees. Patients who postponed treatment because of fear had significantly higher anxiety levels than those who delayed treatment for other reasons. Past adverse dental experience exacerbated dental anxiety. The Malay version of the MDAS had good reliability and validity. Anxiety levels found in the Malaysians studied were comparable to participants from other countries. © 2014 Wiley Publishing Asia Pty Ltd.
Humphris, G M; Freeman, R; Campbell, J; Tuutti, H; D'Souza, V
To gain further evidence of the psychometric properties of the Modified Dental Anxiety Scale. Dental admission clinics. Consecutive sampling, cross-sectional survey. Patients (n = 800) in four cities (Belfast, Northern Ireland; Helsinki, Finland; Jyväskylä, Finland and Dubai, UAE). Questionnaire booklet handed to patients, attending clinics, for completion following an invitation by the researcher to be included in the study. Modified Dental Anxiety Scale (MDAS), together with further questions concerning dental attendance and nervousness about dental procedures. Overall 9.3 per cent of patients indicated high dental anxiety. MDAS showed high levels of internal consistency, and good construct validity. The relationship of dental anxiety with age was similar to previous reports and showed lowered anxiety levels in older patients. Data from three countries has supported the psychometric properties of this modified and brief dental anxiety scale.
Dhamo, Brunilda; Elezi, Besiana; Kragt, Lea; Wolvius, Eppo B; Ongkosuwito, Edwin M
Although a link between dietary changes, caries, and dental development has been observed, the literature provides little insight about this relationship. The aim of our study was to investigate the association between dental caries and dental development in a clinical sample of Albanian children and adolescents. In total, 118 children and adolescents, born between 1995 and 2004 and aged 6–15 years, were included. Dental caries in the deciduous dentition was assessed using the Decayed, Filled Teeth (dft) index and dental caries in the permanent dentition was assessed using the Decayed, Missing, Filled Teeth (DMFT) index. Dental development during the permanent dentition was determined using the Demirjian method. Linear and ordinal regression models were applied to analyze the associations of dental caries with dental age and developmental stages of each left mandibular tooth. Dental caries in the deciduous dentition, estimated as a median dft of 2.0 (90% range, 0.0–9.1), was significantly associated with lower dental age (β = -0.21; 90% CI: -0.29, -0.12) and with delayed development of the canine, both premolars, and the second molar. Untreated dental caries (dt) was associated with lower dental age (β = -0.19; 90% CI: -0.28, -0.10). Dental caries in the permanent dentition, estimated as a median DMFT of 1.0 (90% range, 0.0–8.0), was not significantly associated with dental age (β = 0.05; 90% CI: -0.04, 0.14). However, the DMFT was associated with the advanced stages of development of both premolars and the second molar. The untreated dental caries in the deciduous dentition delays the development of permanent teeth. PMID:29659350
Chi, Donald L.; Momany, Elizabeth T.; Mancl, Lloyd A.; Lindgren, Scott D.; Zinner, Samuel H.; Steinman, Kyle J.
Introduction Medicaid-enrolled children with autism spectrum disorder (ASD) encounter significant barriers to dental care. Iowa’s I-Smile Program was implemented in 2006 to improve dental use for all children in Medicaid. This study compared dental home and preventive dental utilization rates for Medicaid-enrolled children by ASD status and within three time periods (pre-implementation, initial implementation, maturation) and determined I-Smile’s longitudinal influence on ASD-related dental use disparities. Methods Data from 2002–2011 were analyzed for newly Medicaid-enrolled children aged 3–17 years (N=30,059), identified each child’s ASD status, and assessed whether the child had a dental home or utilized preventive dental care. Log-linear regression models were used to generate rate ratios. Analyses were conducted in 2015. Results In 2003–2011, 9.8% of children with ASD had dental homes compared with 8% of children without ASD; 36.3% of children with ASD utilized preventive care compared to 45.7% of children without ASD. There were no significant differences in dental home rates by ASD status during pre-implementation, initial implementation, or maturation. There were no significant differences in preventive dental utilization by ASD status during pre-implementation or initial implementation, but children with ASD were significantly less likely to utilize preventive care during maturation (rate ratio=0.79, p<0.001). Longitudinal trends in dental home and preventive dental utilization rates were not significant (p=0.54 and p=0.71, respectively). Conclusions Among newly Medicaid-enrolled children in Iowa’s I-Smile Program, those with ASDs were not less likely than those without ASD to have dental homes but were significantly less likely to utilize preventive dental care. PMID:26514624
Aitken, Jennifer Creem; Wilson, Stephen; Coury, Daniel; Moursi, Amr M
The purpose of this study was to determine if audio distraction could decrease patient anxiety, pain and disruptive behavior during pediatric dental procedures. Forty-five children between the ages of 4 to 6 years had two visits each involving restorative dentistry with local anesthesia in a mandibular quadrant. Visit #1 was a baseline session for all patients. During visit #2, the children were assigned to either an upbeat music group, a relaxing music group or a no music group. Variables measured were: (1) parent-reported anxiety via the Modified Corah Anxiety Scale, (2) self-reported anxiety via the Venham picture scale, (3) heart rate, (4) behavior via the North Carolina Behavior Rating Scale and (5) pain via a visual analogue scale. No significant differences were found among the three groups during experimental visit #2 across any variables. A majority of patients (90%) stated that they enjoyed the music and would like to listen to it during their next visit. Audio distraction was not an effective means of reducing anxiety, pain or uncooperative behavior during pediatric restorative dental procedures. However, patients did enjoy listening to the music during their visits.
Simon, Ellin; Bögels, Susan Maria
Anxiety disorders are highly prevalent and have negative consequences on individual and societal level. This study examined the usefulness of screening for anxiety disorders in primary school children. More specifically, the value of the screening method to discriminate between and to predict anxiety disorders was studied. Children and their parents were selected if the children had self-reported scores on the screening questionnaire Screen for Child Anxiety Related Emotional Disorders-71 (SCARED-71) within the top-15% (High-anxious) or from two points below to two points above the median (Median-anxious). Of the selected children, 183 high-anxious children and their parents, and 80 median-anxious children and their parents took part in a diagnostic interview, the Anxiety Disorder Interview Schedule (ADIS). Of the high-anxious children, 60% had an anxiety disorder versus 23% of the median-anxious children, whereas groups did not differ on rates of dysthymia/depression and attention deficit hyperactivity disorder. The diagnoses separation anxiety disorder, social phobia and specific phobia were specifically predicted by the corresponding subscales of the screening questionnaire, while the diagnosis generalised anxiety disorder was not predicted by any of the subscales. The screening method has proven its utility for discriminating between children with and without anxiety disorders when applying the top-15% cut-off. Moreover, separation anxiety disorder, social phobia, and specific phobia, all known to be prevalent and debilitating childhood anxiety disorders, can be predicted by the corresponding subscale of the screening instrument.
Bernabé, Eduardo; Humphris, Gerry; Freeman, Ruth
To evaluate the contribution of dental anxiety to social gradients in different oral health outcomes and whether social gradients in oral health persist once dental anxiety is removed from the population examined. Data from 9035 British adults were analysed. Participants' socioeconomic position (SEP) was measured through education and household income. Dental anxiety was measured with the Modified Dental Anxiety Scale. Poor subjective oral health, oral impacts on quality of life and edentulism among all adults and the number of teeth, the number of decayed, missing and filled surfaces (DMFS) and sextants with pocketing among dentate adults were the oral health outcomes. The contribution of dental anxiety to absolute and relative social inequalities in each oral health outcome (measured with the Slope and Relative Index of Inequality [SII and RII], respectively) was estimated from regression models without and with adjustment for dental anxiety and quantified with the percentage attenuation. Interactions between each SEP indicator and dental anxiety were used to test what would happen if dental anxiety were removed from the whole population. The largest contribution of dental anxiety to explaining oral health inequalities was found for education gradients in perceived outcomes (11%-13%), but dental anxiety explained <4% of social gradients in edentulism. Among dentate adults, dental anxiety accounted for <5% and <7% of education and income gradients, respectively. Only four of the 24 interactions tested were statistically significant. Hence, the education- and income-based SII and RII for oral impacts were nonsignificant among anxiety-free adults but were significant at higher levels of dental anxiety. Little support was found for the role of dental anxiety in explaining social inequalities in various perceived and clinical oral health measures. Oral health inequalities were found among both nondentally anxious and anxious participants. © 2017 John Wiley & Sons A
Boka, V; Arapostathis, K; Vretos, N; Kotsanos, N
The aim of this study was to examine the acceptance by Greek parents of nine behaviour-management techniques and its association with several possible confounding factors. Following ethical approval, 106 parents whose 3- to 12-year-old children had been receiving treatment in a university postgraduate paediatric dental clinic, and 123 parents of children from a private paediatric dental practice agreed to participate. After being shown a video with nine behaviour-management techniques, parents rated the acceptance of each technique on a 0-10 scale. They were then asked to complete a questionnaire about demographics, their previous dental experience and dental anxiety (modified Corah dental anxiety scale). The best accepted technique was tell-show-do (9.76 ± 0.69), followed by parental presence/absence (PPA) technique (7.83 ± 3.06) and nitrous oxide inhalation sedation (7.09 ± 3.02). The least accepted techniques were passive restraint (4.21 ± 3.84) and general anaesthesia (4.21 ± 4.02). No correlations were found between acceptance of any individual management technique and parental age, gender, income, education, dental experience and dental anxiety or the child's age, gender and dental experience. Parents whose children had been treated at the University clinic had lower income and educational levels, and rated passive restraint, oral sedation and general anaesthesia higher than those from the private practice. When the parents were specifically asked to choose between general anaesthesia over any of the active or passive restraint, hand-over-mouth and voice control techniques, 10% preferred general anaesthesia, and these parents reported statistically significant more negative dental experience but not higher dental anxiety. Statistical significance of differences was explored using the Tukey-Kramer method. There was no correlation between parental dental experience and dental anxiety and the acceptance of any specific behaviour-management technique
Marion, Ian W; Nelson, Travis M; Sheller, Barbara; McKinney, Christy M; Scott, JoAnna M
To investigate caregivers' preference regarding dental stories to prepare children with autism for dental visits. Caregivers of children with autism were allowed use of dental stories available via different media (paper, tablet computer, computer) and image types (comics or drawings, photographs, video). Caregivers completed pre- and postintervention surveys. Fisher's exact tests were used to determine associations between predictive factors and preferences. Forty initial and 16 follow-up surveys were completed. Subjects were primarily male (85%). Mean child age was 6.7 years. Nine (64%) caregivers found the dental story useful for themselves and their child. Two (14%) caregivers found the aid only helpful for themselves. Preferred media type was associated with language understanding (p = .038) and home media preference (p = .002). Practitioners should consider using dental stories to help prepare families and children for dental visits. Individual preferences for dental stories vary; using prior history can aid in selection. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.
Krikken, Janneke B; de Jongh, Ad; Veerkamp, Jaap S J; Vogels, Wilma; Cate, Jacob M Ten; van Wijk, Arjen J
To determine changes in dental anxiety levels of cleft lip and/or palate (CL/P) children and to explore the role of coping strategies in the development of their dental anxiety. Prospective study. Free University Medical Center Amsterdam. A sample of CL/P children (at T1: n = 153, 4 to 18 years, 67 girls; at T2: n = 113, 7 to 21 years, 51 girls). Data were available at both time points for 102 children. Dental anxiety and coping strategies were assessed at the start of the study (T1; mean age: 9.8 years, standard deviation 4.1) and 3 years later (T2; mean age: 13.4 years, standard deviation 3.8). These scores were compared to a normative group of Dutch children. The severity of dental anxiety was indexed using the Parental Version of the Dental Subscale of the Children's Fear Survey Schedule. Dental coping strategies were assessed with the Dental Cope Questionnaire. Overall, dental anxiety decreased to a level equal to normative scores of Dutch children. However, 5% of the children became more anxious. At T2, children used significantly fewer coping strategies. Children whose level of dental anxiety increased significantly used more destructive coping strategies than children whose level of dental anxiety decreased significantly or remained stable. Results suggest that dental anxiety levels of most CL/P children gradually decline over time. Whereas some coping strategies have the potential to be protective, more destructive coping strategies may put children at greater risk for developing and maintaining their dental anxiety.
Wadhwa, Puneet; Yu, Qingzhao; Zhu, Han; Townsend, Janice A
The purpose of this study was to determine if changes in dental development are associated with Attention Deficit Hyperactivity Disorder (ADHD) or ADHD medications. This retrospective chart review evaluated the dental age of 128 patients between 6 and 16 years of age using the Demirjian method from the following two groups a) children with ADHD b) unaffected children. The ADHD group was further stratified into four groups according to the medication type. The impact of ADHD on dental age difference (the difference between dental age and chronologic age) was analyzed using T-test and the association between medication type and dental age difference was analyzed through one way ANOVA. The mean difference between estimated dental age and chronologic age (dental age difference) for all subjects was 0.80 years. There was no significant dental age difference in subjects with ADHD and the control group (0.78±1.28vs. 0.84 ±1.09 years respectively; P=0.75) and there was no significant difference in dental age difference and type of medication (P=0.84). No significant difference was found between children with ADHD and unaffected children with respect to dental age difference. No significant differences were found in dental age difference in the four medication groups.
Beaudette, Jennifer R.; Fritz, Peter C.; Sullivan, Philip J.; Ward, Wendy E.
Oral health is an integral part of overall health. Poor oral health can lead to an increased risk of chronic diseases including diabetes mellitus, cardiovascular disease, and some types of cancer. The etiology of these diseases could be linked to the individual’s inability to eat a healthy diet when their dentition is compromised. While periodontal or implant surgery may be necessary to reconstruct tissue around natural teeth or replace missing teeth, respectively, some individuals avoid such interventions because of their associated fear and anxiety. Thus, while the relationship between poor oral health, compromised nutritional choices and fear and anxiety regarding periodontal procedures is not entirely new, this review provides an up-to-date summary of literature addressing aspects of this complex relationship. This review also identifies potential strategies for clinicians to help their patients overcome their fear and anxiety associated with dental treatment, and allow them to seek the care they need. PMID:29563414
Eli, I; Uziel, N; Blumensohn, R; Baht, R
To evaluate factors affecting modulation of dental anxiety among adults. A total of 183 adult members of a closed communal society (Kibbutz), who have been treated since childhood only by the dentists employed in their community, were investigated concerning their past and present dental anxiety, evaluation of their past and present dentists, psychopathologic symptoms and individual pattern of attachment. The best predictor of subjects' evaluation of their present dental anxiety was the scale of anxiety as recorded by the SCL-90R questionnaire. The best predictors of the decrease in subjects' dental anxiety over time were the evaluation of their past and present dentists and the secure and avoidant patterns of attachment. Patterns of attachment (avoidant and ambivalent) were the best predictors of subjects' evaluation of their present dentist. While psychopathologic traits are involved in subjects' present dental anxiety, pattern of attachment may have a dominant affect as to whether anxiety persists throughout life or can be modulated through a corrective emotional experience.
Weinstein, P; Raadal, M; Naidu, S; Yoshida, T; Kvale, G; Milgrom, P
While the psychological literature shows that perceptions of uncontrollability contribute to anxiety and other pathologies, interventions that enhance perceived control have been shown to reduce anxiety. This study attempted to assess a brief videotape to enhance child perceived control in a dental setting. 101 children aged 7-9 years completed warm-up procedures and viewed either: a) the experimental intervention, a 2 minutes video of a dentist explaining what an injection will feel like and proposing hand raising as a signal mechanism; or b) the control condition, a 2 minutes video of Disneyland. Fear of dental injections was assessed on a 10 cm visual analogue scale before and after the intervention. In the experimental group there was a significant fear reduction from pre- to post-intervention, while this was not the case in the control group. Children with higher pre-existing levels of fear benefited more from the intervention than children with lower levels of fear. The results of this pilot study suggest that intervention packages that impact child control have promise in lowering anxiety.
Aminabadi, Naser-Asl; Pourkazemi, Maryam; Babapour, Jalil; Oskouei, Sina-Ghertasi
The present study investigated the correlations between maternal emotional intelligence (EQ), parenting style, child trait anxiety and child behavior in the dental setting. One-hundred seventeen children, aged 4-6 years old (mean 5.24 years), and their mothers participated in the study. The BarOn Emotional Quotient Inventory and Bumrind's parenting style questionnaire were used to quantify maternal emotional intelligence and parenting style. Children's anxiety and behavior was evaluated using the Spence Children's Anxiety Scale (SCAS) and Frankl behavior scale. Significant correlation was found between maternal EQ and child behavior (r=0.330; p<0.01); but not between parenting style and child behavior. There was no significant correlation between mother's total EQ and child's total anxiety; however, some subscales of EQ and anxiety showed significant correlations. There were significant correlations between authoritarian parenting style and separation anxiety (r=0.186; p<0.05) as well as authoritative parenting style and mother's EQ (r=0.286; p<0.01). There was no significant correlation between child anxiety and behavior (r = -0.81). Regression analysis revealed maternal EQ is effective in predicting child behavior (β=0.340; p<0.01). This study provides preliminary evidence that the child's behavior in the dental setting is correlated to mother's emotional intelligence. Emotionally intelligent mothers were found to have predominantly authoritative parenting style.
Gurunathan, Deepa; Shanmugaavel, Arunachalam Karthikeyan
Child dental neglect is the failure of a parent or guardian to meet the child's basic oral health needs such that the child enjoys adequate function and freedom from pain and infection, where reasonable resources are available to family or caregiver. The aim of the study is to evaluate the phenomenon of dental neglect among children in Chennai and to associate dental neglect with oral health status of children aged 3-12 years. This is a cross-sectional study involving 478 pairs of parents and children. Dental neglect scale and a questionnaire were used to assess the dental neglect score among parents of the children involved in the study. Oral health status of children was clinically assessed using oral hygiene index, decayed, extracted, filled teeth (def(t)), pulp, ulcers, fistula, abscess (pufa), decayed, missing, filled teeth (DMFT), PUFA as per the World Health Organization criteria and pufa/PUFA index. Student's t-test and one-way ANOVA were used appropriately for statistical analysis using SPSS software version 20.0. A significant higher dental neglect score was reported among the parents who reside in the suburban location (P < 0.001), whose educational qualification was secondary (P < 0.001) and who have not availed any dental service for >3 years (P = 0.001). A significant higher DMFT (P = 0.003), deft (P = 0 < 0.001), pufa (P = 0.011), and debris index (P = 0.002) scores were seen in the higher dental neglect group. Child dental neglect is seen among the parents whose educational qualification was secondary, who reside in the suburban location, and who have not utilized the dental services for more than 3 years in Chennai. This dental neglect results in poorer oral health of children.
Maulina, Tantry; Djustiana, Nina; Shahib, M Nurhalim
In order to minimize the possibility of unsuccessful dental extraction procedure due to dental anxiety, there are several approaches that can be used, including music intervention. The objective of this research was to investigate the effectiveness of classical and religious Islamic music on reducing dental anxiety. Two hundred and twenty-five muslim participants (105 males, 120 females) were recruited for this study and randomly assigned to three groups: classical music group, religious Islamic music group, and the group with no music intervention, equally in numbers. Participant's blood pressure (BP) and blood sample were taken prior to and after dental extraction to evaluate systolic and diastolic BP as well as nor-adrenaline plasma (NAP) level. All data were then analyzed by using t-test, ANOVA test, Mann-Whitney and Kruskawallis test. There was a decrease in NAP level in the religious music group (0.110 ng/mL) and the control group (0.013 ng/mL) when initial NAP level was compared to post extraction NAP level, whilst the classical music group showed an increase of 0.053 ng/mL. There were significant differences found between the religious Islamic music group and the classical music group ( p = 0.041) as well as the control group ( p = 0.028) for the difference between pre and post NAP level, of which the NAP level of the religious Islamic group participants were lower. Religious Islamic music was proven to be effective in reducing dental anxiety in Muslim participants compared to classical music. Despite, further evaluation in a more heterogenous population with various religious and cultural background is needed.
Malvania, Ekta A; Ajithkrishnan, C G
Anxiety is a subjective state of feelings. Dental anxiety is often reported as a cause of irregular dental attendance, delay in seeking dental care or even avoidance of dental care, resulting in poor oral health related quality of life. To assess the prevalence and socio-demographic correlates of dental anxiety among a group of adult patients attending a dental institution in Vadodara, Gujarat. A total of 150 adult patients waiting in the out-patient Department of Oral Diagnosis of K.M. Shah Dental College and Hospital were included in the study. Subjects were selected by convenience sampling. Dental anxiety was assessed by using Modified Dental Anxiety Scale (MDAS) and self-designed, semi-structured questionnaire incorporating various demographic variables, type and nature of dental treatment. Statistical analysis was done using SPSS version 16. Descriptive analysis, unpaired t-test, one-way analysis of variance (ANOVA) test and multiple logistic regression were applied for statistical analysis. 46% of the participants were dentally anxious. Females were found to be significantly more anxious than males. Subjects residing in villages had significantly more score than those residing in city. Relative influence of age, education, type of dental treatment, and previous dental visit were not significantly associated with dental anxiety. However, those subjects who had past negative dental experience were found to be significantly more anxious. The study shows that dental anxiety was high among study subjects. It is recommended that this issue should be given due importance and addressed in a practical and meaningful manner.
Verduin, Timothy L.; Kendall, Philip C.
Examined three aspects of childhood anxiety and peer liking: (1) whether or not children can detect anxiety in age-mates, (2) the degree to which peer-reported anxiety, self-reported anxiety, and presence of anxiety disorders are associated with peer liking, and (3) whether or not self-reported anxiety and presence of anxiety disorders are…
Lara, America; Crego, Antonio; Romero-Maroto, Martin
Dental fear is considered to be one of the most frequent problems in paediatric dentistry. According to literature, parents' levels of dental fear play a key role in the development of child's dental anxiety. HYPOTHESIS OR AIM: We have tried to identify the presence of emotional transmission of dental fear among family members and to analyse the different roles that mothers and fathers might play concerning the contagion of dental fear to children. We have hypothesized a key role of the father in the transfer of dental fear from mother to child. A questionnaire-based survey (Children's Fear Survey Schedule-Dental Subscale) has been distributed among 183 schoolchildren and their parents in Madrid (Spain). Inferential statistical analyses, i.e. correlation and hierarchical multiple regression, were carried out and possible mediating effects between variables have been tested. Our results support the hypothesis that family members' levels of dental fear are significantly correlated, and they also allow us to affirm that fathers' dental fear is a mediating variable in the relationship between mothers and children's fear scores. Together with the presence of emotional transmission of dental fear among family members, we identified the relevant role that fathers play as regards the transfer of dental fear from parents to children. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.
Crawley, Esther; Hunt, Linda; Stallard, Paul
Anxiety symptoms are commonly described in children with chronic fatigue syndrome or myalgic encephalopathy (CFS/ME) but to date there has been little information on the type of anxiety children experience or the relationship between anxiety and school attendance, disability or fatigue. The aim of this study was to first describe the prevalence and type of anxiety symptoms in children with CFS/ME compared with a normal European population, and secondly to investigate the association of anxiety symptoms with age, gender, school attendance, fatigue, and physical function in paediatric CFS/ME. Data were prospectively collected on children and young people with CFS/ME referred to a large specialist CFS/ME service. One hundred and sixty-four children with CFS/ME had complete data for the Spence Children's Anxiety Scale. Teenage girls had the highest rates of total anxiety symptoms with 38% (95% CI 27-49) over the cut off (top 10% of normal European population) and significantly higher rates of symptoms in each subscale. Younger girls were more likely to score over the cut off in separation anxiety (37%, 19-40) and social phobia (39%, 25-47). There was no evidence of association between total anxiety symptoms and: time at school, time to assessment, pain or age. Associations with fatigue and physical function were attenuated when adjusted for other variables. Although anxiety symptoms are high in CFS/ME, particularly in teenage girls, it does not appear to be associated with school attendance or other measures of disability. Separation anxiety and social phobia were the most clearly elevated in paediatric CFS/ME.
Wong, Hai Ming; Mak, Cheuk Ming; Xu, Ying Feng
This paper reports the results of a four-part questionnaire survey to assess the effects of the sound of dental equipment on people's perceptions and dental anxiety levels. The convenience sample for the survey comprised 230 dental students and 230 gender and age matched non-dental university students. The subjects were requested to complete the questionnaires themselves. The results show that the sound of dental equipment has a great influence on dental anxiety. Dental students, who are more familiar with the operation of this equipment, are less prone to anxiety when they hear its sound than their non-dental counterparts.
Marshman, Zoe; Morgan, Annie; Porritt, Jenny; Gupta, Ekta; Baker, Sarah; Creswell, Cathy; Newton, Tim; Stevens, Katherine; Williams, Christopher; Prasad, Suneeta; Kirby, Jennifer; Rodd, Helen
Childhood dental anxiety is very common, with 10-20 % of children and young people reporting high levels of dental anxiety. It is distressing and has a negative impact on the quality of life of young people and their parents as well as being associated with poor oral health. Affected individuals may develop a lifelong reliance on general anaesthetic or sedation for necessary dental treatment thus requiring the support of specialist dental services. Children and young people with dental anxiety therefore require additional clinical time and can be costly to treat in the long term. The reduction of dental anxiety through the use of effective psychological techniques is, therefore, of high importance. However, there is a lack of high-quality research investigating the impact of cognitive behavioural therapy (CBT) approaches when applied to young people's dental anxiety. The first part of the study will develop a profile of dentally anxious young people using a prospective questionnaire sent to a consecutive sample of 100 young people referred to the Paediatric Dentistry Department, Charles Clifford Dental Hospital, in Sheffield. The second part will involve interviewing a purposive sample of 15-20 dental team members on their perceptions of a CBT self-help resource for dental anxiety, their opinions on whether they might use such a resource with patients, and their willingness to recruit participants to a future randomised controlled trial (RCT) to evaluate the resource. The third part of the study will investigate the most appropriate outcome measures to include in a trial, the acceptability of the resource, and retention and completion rates of treatment with a sample of 60 dentally anxious young people using the CBT resource. This study will provide information on the profile of dentally anxious young people who could potentially be helped by a guided self-help CBT resource. It will gain the perceptions of dental care team members of guided self-help CBT for
Levy, Karyn; Hunt, Caroline; Heriot, Sandra
Objective: The aim of the study was to evaluate the effectiveness of an intervention that targeted both anxious and aggressive behaviors in children with anxiety disorders and comorbid aggression by parent report. Method: The effects of a cognitive-behavioral therapy intervention targeting comorbid anxiety and aggression problems were compared…
SUHANI, RALUCA DIANA; SUHANI, MIHAI FLAVIU; BADEA, MÎNDRA EUGENIA
Background and aim Dental fear and anxiety is a major barrier for dental care provision. Identifying anxious patients can help dental professionals manage them appropriately. The study aimed at assessing dental fear and anxiety among a deaf population in Cluj-Napoca, Romania and their associated and contributing factors. Method In this cross sectional study 165 deaf participants were invited to complete a questionnaire comprising three sections. The first section contained questions about social and economical status, the second comprised a Romanian version of the Modified Dental Anxiety Scale (MDAS) while part three was the Dental Fear Survey (DFS). Data was introduced and analyzed with the Statistical Package for Social Sciences (SPSS) program, version 20.0 (SPSS Inc., Chicago, Illinois, USA). Results Thirty four point nine percent (34.9%) of respondents were found to be insignificantly anxious, 59.7% were moderately or extremely anxious with 5.3% being identified with dental phobia based on the MDAS scores. Mean total score for dental anxiety on the MDAS scale was 13.7. Patients suffering from a prior negative experience were found to be more anxious (p<0.05). Conclusions Dental fear and anxiety is widespread in the deaf communities. Higher percentages were observed among women and people with a previous traumatic dental experience. PMID:27004038
Children's movies bear so many significant features that it should be studied from many aspects. In fact, one of the issues very often encountered in researches and analyses done so far, is the element of terror exposed in children's movies. Nevertheless, first how the basic feelings such as fear and anxiety are produced and formed in children's…
Aminabadi, N A; Vafaei, A; Erfanparast, L; Oskouei, S G; Jamali, Z
The present study evaluated the effect of listening to a pictorial story about going to the dentist on pain perception, situational anxiety and behavioral feedback during dental treatment in pediatric dental patients. Eighty, 6-7-year-old children were included The childhood anxiety-related disorders using Screen for Child Anxiety Related Disorders (SCARED) Parent Version scale and intelligence quotient using Raven's Progressive Matrices were evaluated The subjects were randomly assigned to two groups, listening to a pictorial story about going to a dentist (test), or listening to a pictorial story about going to a barbershop (control). A dental treatment was performed on each subject, during which, behavior was assessed using Sound, Eye, and Motor Scale. Pain perception and situational anxiety were then assessed using Wong-Baker Fasces Pain Rating Scale and Faces version of the Modified Child Dental Anxiety Scale, respectively. There was a significant decrease in pain perception (P=0.02) and situational anxiety (P<0.001) in the test group. In addition, the test intervention significantly improved children behavioral feedback during dental treatment (P<0.001). Preparation of children with pictorial story can be effective in decreasing pain perception and situational anxiety as well as improving behavior during dental treatment.
Welch, Paul S; Jacks, Mary E; Smiley, Lynn A; Walden, Carolyn E; Clark, William D; Nguyen, Carol A
In light of increased emphasis on evidence-based practice in the profession of dental hygiene, it is important that today's dental hygienist comprehend statistical measures to fully understand research articles, and thereby apply scientific evidence to practice. Therefore, the purpose of this study was to investigate statistics anxiety among graduate dental hygiene students in the U.S. A web-based self-report, anonymous survey was emailed to directors of 17 MSDH programs in the U.S. with a request to distribute to graduate students. The survey collected data on statistics anxiety, sociodemographic characteristics and evidence-based practice. Statistic anxiety was assessed using the Statistical Anxiety Rating Scale. Study significance level was α=0.05. Only 8 of the 17 invited programs participated in the study. Statistical Anxiety Rating Scale data revealed graduate dental hygiene students experience low to moderate levels of statistics anxiety. Specifically, the level of anxiety on the Interpretation Anxiety factor indicated this population could struggle with making sense of scientific research. A decisive majority (92%) of students indicated statistics is essential for evidence-based practice and should be a required course for all dental hygienists. This study served to identify statistics anxiety in a previously unexplored population. The findings should be useful in both theory building and in practical applications. Furthermore, the results can be used to direct future research. Copyright © 2015 The American Dental Hygienists’ Association.
Ishan; Shivlingesh, K K; Agarwal, Vartika; Gupta, Bhuvan Deep; Anand, Richa; Sharma, Abhinav; Kushwaha, Sumedha; Khan, Khateeb
Atraumatic Restorative Treatment (ART) involves manually excavating the carious part of the tooth and restoring the prepared cavity with chemically adhesive restorative material [Glass Ionomer Cement (GIC)] and it may induce and/or impact the dental anxiety in children. It is well established that ART procedure is less anxiety producing when compared with other restorative procedures using dental drill. The aim of this study was to evaluate the anxiety levels among five-year-old children undergoing ART restoration in I.T.S. Dental College, Greater Noida, India. A sample of 50, five-year-old children visiting the Outpatient Department (OPD) of ITS Dental College, Greater Noida was selected for ART treatment using Fuji IX GIC. Modified Venham Anxiety Scale based on their behaviour and heart rate of the children were measured and recorded before, during and after the ART procedure. Heart rate was measured using Radial Pulse examination method. Chi-square test was used and tests were conducted using IBM SPSS software (ver.20.0; IBM, Chicago, IL, USA). Before the ART treatment, heart rates and Modified Venham Anxiety Scores of majority of children were higher than that after the treatment. A p-value was statistically significant (0.028 and 0.048 respectively) for association of gender with heart rate and Modified Venham's score before the ART treatment. No statistically significant relation was found between the variables during and after the ART treatment. The level of anxiety for ART treatment in children was higher before the treatment than that during and after the treatment. There is a correlation between the gender of children and their level of anxiety for ART treatment.
Hoge, Elizabeth; Bickham, David; Cantor, Joanne
There are growing concerns about the impact of digital technologies on children's emotional well-being, particularly regarding fear, anxiety, and depression. The 2 mental health categories of anxiety and depression will be discussed together because there is significant symptom overlap and comorbidity. Early research has explored the impact of traditional media (eg, television, movies) on children's acute fears, which can result in anxieties and related sleep disturbances that are difficult to remedy. More recent research deals with the interactive nature of newer media, especially social media, and their impacts on anxiety and depression. Key topics of inquiry include the following: anxiety and depression associated with technology-based negative social comparison, anxiety resulting from lack of emotion-regulation skills because of substituted digital media use, social anxiety from avoidance of social interaction because of substituted digital media use, anxiety because of worries about being inadequately connected, and anxiety, depression, and suicide as the result of cyberbullying and related behavior. A growing body of research confirms the relationship between digital media and depression. Although there is evidence that greater electronic media use is associated with depressive symptoms, there is also evidence that the social nature of digital communication may be harnessed in some situations to improve mood and to promote health-enhancing strategies. Much more research is needed to explore these possibilities. Copyright © 2017 by the American Academy of Pediatrics.
Klingberg, G; Sillén, R; Norén, J G
The etiologies of dental fear and dental behavior management problems in children were investigated in a database of information on 2,257 Swedish children 4-6 and 9-11 years old. The analyses were performed using computerized inductive techniques within the field of artificial intelligence. The database held information regarding dental fear levels and behavior management problems, which were defined as outcomes, i.e. dependent variables. The attributes, i.e. independent variables, included data on dental health and dental treatments, information about parental dental fear, general anxiety, socioeconomic variables, etc. The data contained both numerical and discrete variables. The analyses were performed using an inductive analysis program (XpertRule Analyser, Attar Software Ltd, Lancashire, UK) that presents the results in a hierarchic diagram called a knowledge tree. The importance of the different attributes is represented by their position in this diagram. The results show that inductive methods are well suited for analyzing multifactorial and complex relationships in large data sets, and are thus a useful complement to multivariate statistical techniques. The knowledge trees for the two outcomes, dental fear and behavior management problems, were very different from each other, suggesting that the two phenomena are not equivalent. Dental fear was found to be more related to non-dental variables, whereas dental behavior management problems seemed connected to dental variables.
Jan, Basil M.; Jan, Mohammed M.
Cerebral palsy (CP) is a common chronic motor disorder with associated cognitive, communicative, and seizure disorders. Children with CP have a higher risk of dental problems creating significant morbidity that can further affect their wellbeing and negatively impact their quality of life. Screening for dental disease should be part of the initial assessment of any child with CP. The objective of this article is to present an updated overview of dental health issues in children with CP and outline important preventative and practical strategies to the management of this common comorbidity. Providing adequate oral care requires adaptation of special dental skills to help families manage the ongoing health issues that may arise. As oral health is increasingly recognized as a foundation for general wellbeing, caregivers for CP patients should be considered an important component of the oral health team and must become knowledgeable and competent in home oral health practices. PMID:27744459
Heaton, Lisa J.; Hyatt, Halee A.; Huggins, Kimberly Hanson; Milgrom, Peter
Dental fear is a barrier to receiving dental care, particularly for those patients who also suffer from mental illnesses. The current study examined United States dental professionals’ perceptions of dental fear experienced by patients with mental illness, and frequency of sedation of patients with and without mental illness. Dentists and dental staff members (n = 187) completed a survey about their experiences in treating patients with mental illness. More participants agreed (79.8%) than disagreed (20.2%) that patients with mental illness have more anxiety regarding dental treatment (p < .001) than dental patients without mental illness. Further, significantly more participants reported mentally ill patients’ anxiety is “possibly” or “definitely” a barrier to both receiving (96.8%; p < .001) and providing (76.9%; p < .01) dental treatment. Despite reporting more fear in these patients, there were no significant differences in frequency of sedation procedures between those with and without mental illness, regardless of type of sedation (p’s > .05). This lack of difference in sedation for mentally ill patients suggests hesitancy on the part of dental providers to sedate patients with mental illness and highlights a lack of clinical guidelines for this population in the US. Suggestions are given for the assessment and clinical management of patients with mental illness. PMID:24876662
Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H
To investigate the impact of experimentally manipulated state anxiety and the influence of anxiety-related variables on children's memories for pain. A total of 110 children (60 boys) between the ages of 8 and 12 years were randomly assigned to complete a state anxiety induction task or a control task. Following experimental manipulation, children completed a laboratory pain task, pain ratings, and questionnaire measures of anxiety-related variables. 2 weeks later, children provided pain ratings based on their memories of the pain task. The experimental manipulation effectively induced state anxiety; however, pain memories did not differ between groups. Irrespective of group assignment, children with higher state anxiety had more negative pain memories. State anxiety uniquely predicted children's pain memories over and above other well established factors. Anxiety sensitivity and trait anxiety were significant predictors of recalled pain-related fear. These data highlight the importance of anxiety in the development of children's memories for pain.
Hughes, Alicia A.; Furr, Jami M.; Sood, Erica D.; Barmish, Andrea J.; Kendall, Philip C.
Examined the prevalence of anxiety, mood, and substance use disorders in the parents of anxiety disordered (AD) children relative to children with no psychological disorder (NPD). The specificity of relationships between child and parent anxiety disorders was also investigated. Results revealed higher prevalence rates of anxiety disorders in…
Mishra, Gyanendra; Thakur, Seema; Singhal, Parul; Ghosh, Shiv Nath; Chauhan, Deepak; Jayam, Cheranjeevi
Children and adolescents comprise a group of individuals representing a large variation in size, competence, maturity, personality, temperament and emotions experience, oral health, family background, culture, etc. Furthermore, a growing child is in a constant state of flux as he grows up and actively interacts with the environment. Many factors contribute to the dental behavior of the child. The aim of this study was to evaluate the effect of sociodemographic factors, general anxiety, body mass index (BMI), and role of multimedia on the child behavior (CB) in the dental operatory. Three hundred and one children aged 3-14 years and their parents participated in the study. In the first visit, the questionnaire was filled by the parent and general examination was done. During the second visit, the required dental procedure was rendered, and the behavior was recorded by a single examiner. Among sociodemographic factors, increasing age is directly related to child's positive behavior, whereas other factors such as gender and socioeconomic status (SES) are not significantly related. General anxiety significantly affects the child's behavior. BMI of the child is not related to child's behavior in dental operatory. Multimedia was not found to be significantly affecting the behavior of the child in dental operatory. Interpretations and Conclusion: The principle conclusion of this study is that there is a significant association of age and treatment procedure rendered with the CB in the dental operatory whereas gender, SES, general anxiety, BMI, and multimedia do not show any significant association with the CB in the dental operatory.
Prins, Pier J.
Utilizes two different experiments to test the effectiveness of a variety self-instructional training methods to reduce the dental fears of groups of 8- to 12-year-old children. Results indicate that high levels of anxiety impair the effectiveness of self-instruction. (FMW)
This study examined the level of test anxiety of adolescent children of divorced parents. It suggests such anxiety is a possible explanation of the lower scholastic achievement of such children. Results indicated children of divorced parents had significantly higher anxiety scores than did children of intact families. (Author/BSR)
Restrepo, C; Peláez, A; Alvarez, E; Paucar, C; Abad, P
The aim of this study was to evaluate and compare the area, perimeter, and form (D factor and fractal dimension) of the dental wear among bruxist and nonbruxist children with mixed dentition in order to determine if the dental wear may be used as criteria to diagnose bruxism. The children were 8 to 11 years old and were classified as bruxist or nonbruxist, according to anxiety level and temporomandibular disorders. Dental casts of the upper arch were obtained for the bruxist (n = 24) and the control (n = 29) group. The dental wear was measured in digital format and processed automatically. The complete and pathological dental wear was compared between the two groups, using the Student's t-test and Mann-Whitney test. Statistically significant differences were observed between the two groups, with a higher area, perimeter, and more irregular form of the pathological dental wear among the bruxist group. Regarding complete dental wear, differences were only significant for the D factor (an un-dimensional quantitative parameter which produces a relation between the area and the perimeter of an object). Digital imaging of dental wear may be used as criteria to diagnose bruxism in children with mixed dentition after making an analysis of the area, perimeter, and irregularity of the form of pathological dental wear.
Glaesmer, Heide; Geupel, Hendrik; Haak, Rainer
Empirical evidence concerning the efficacy of hypnosis to reduce anxiety in dental patients is limited. Hence we conducted a controlled trial in patients undergoing tooth removal. The study aims at assessing patient's attitude toward hypnosis and comparing the course of dental anxiety before, during and subsequent to tooth removal in patients with treatment as usual (TAU) and patients with treatment as usual and hypnosis (TAU+HYP). 102 patients in a dental practice were assigned to TAU or TAU+HYP. Dental anxiety was assessed before, during and after treatment. All patients were asked about their experiences and attitudes toward hypnosis. More than 90% of patients had positive attitudes toward hypnosis. Dental anxiety was highest before treatment, and was decreasing across the three assessment points in both groups. The TAU+HYP group reported significantly lower levels of anxiety during treatment, but not after treatment compared with TAU group. Our findings confirm that hypnosis is beneficial as an adjunct intervention to reduce anxiety in patients undergoing tooth removal, particularly with regard to its no-invasive nature. The findings underline that hypnosis is not only beneficial, but also highly accepted by the patients. Implementation of hypnosis in routine dental care should be forwarded. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Sayed, Abrar; Ranna, Vinisha; Padawe, Dimple; Takate, Vilas
Adapting a child to the alien settings of a dental operatory is a major challenge to the dentist. Fear of the unknown and preconceived notions of dental pain causes anxiety in the pediatric patient. This often leads to disruptive and uncooperative behavior in the dental operatory. Many methods of behavior management have been described, of which the Tell-Show-Do (TSD) is an established and time-tested technique of behavior management. To determine if a live visual output of the dental operating microscope (DOM) could be used as an adjunct to the TSD technique, to involve the child more completely in the procedure and reduce the fear of the unknown. The study was a randomized, controlled, crossover, and cross-sectional clinical trial. Data were obtained from two visits. 90 children having carious lesions on both lower first molars, in the 7-9 years age group were selected and divided randomly into two groups. Restorative procedures were performed on one tooth per visit, with visits 1 week apart. Live display of the procedure was shown to the patient using video output of the DOM displayed on a 72 inch LCD monitor, angled for best visibility of the child. Anxiety levels were evaluated using Venhams picture selection test and pulse oximetry. Student's t-test was used to compare the anxiety scores obtained from the two groups. The results showed there was a decrease in the anxiety from the first visit to the second visit. (P = 0.05 for Group A and P = 0.003 for Group B). The patients preferred the visit in which the DOM was used. The operator reported an increased patient compliance and reduced patient movement in the visits in which the DOM was used. There is a reduction in anxiety from the first visit to the second visit for restorative treatment when the DOM is used.
Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R.
Objectives We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Methods Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. Results The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). Conclusion A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals. PMID:22547875
de Jongh, Ad; Fransen, Jolanda; Oosterink-Wubbe, Floor; Aartman, Irene
This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent.
Bhola, Rahul; Malhotra, Reema
Objectives The study aims to determine the degree of anxiety pertaining to dental procedures and various oral hygiene practices among college teenagers. Methods Corah's Modified Dental Anxiety Scale was administered on a randomly chosen sample of 100 Indian college students (50 males and 50 females) of Delhi University, belonging to the age group of 17–20 years. Results Descriptive statistical computations revealed 12.14 years as the mean age of first dental visit, with moderately high levels of anxiety (60.75%) for various dental procedures among the Indian teenagers and 5% lying in the “phobic or extremely anxious” category. With merely 4.16% people going for regular consultations, general check-ups evoked 78.3% anxiety and having an injection or a tooth removed was perceived as the most threatening. The sample subgroup not using mouthwash and mouthspray, smokers, and alcohol drinkers with improper oral hygiene practices experienced much higher anxiety towards routine dental procedures. Conclusion The majority of the Indian youngsters had an evasive attitude of delaying dental treatment. The core problems lay in deficient health care knowledge, lack of patient-sensitive pedagogy to train dental professionals, inaccessibility of services, and a dismissive attitude towards medical help. The feelings of fear and anxiety prevalent among the Indian youth offer significant insights into causes and preventive measures for future research and practice. Methods of education and motivation could be developed to dissipate the anxiety amongst Indian teenagers that prevent routine dental visits and maintenance of adequate oral hygiene. PMID:25379373
Romero-Maroto, M; Santos-Puerta, N; González Olmo, M J; Peñacoba-Puente, C
To analyse the relationship between different dimensions of dental appearance impact and self-esteem in adult patients undergoing orthodontic treatment, with special attention to the possible mediating role of anxiety. A quasi-experimental design was used with a matched control group (without orthodontic treatment). In each group (experimental and control), there were 85 patients. The impact of dental appearance was measured using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). State anxiety was assessed with the State Anxiety Inventory (STAI-S) and self-esteem with Rosenberg's self-esteem scale. In both groups (experimental and control), self-esteem correlates negatively, ranging between 0.26 and 0.43, with all dimensions of dental appearance impact (except for the positive dental self-confidence dimension, where all correlations were positive). Anxiety correlates positively, ranges between 0.35 and 0.44, with social impact, psychological impact and aesthetic concern, although it maintains no significant correlations with dental self-confidence. Nevertheless, in patients undergoing orthodontic treatment, anxiety plays a mediating role between dental impact dimensions and self-esteem, whilst for the control group anxiety only plays a mediator role between psychological impact and self-esteem. Anxiety plays a fundamental role in the effect of perceived dental impact on self-esteem in adult patients undergoing orthodontic treatment. These results have important practical implications for the design of bio-psycho-social intervention programs that contemplate cognitive-affective variables as an essential part of orthodontic treatment in adults. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Nissan, Sagit; Yochman, Aviva; Blumer, Sigalit; Kharouba, Johnny; Peretz, Benjamin
To evaluate children's behavior during dental examinations, their reactions to various selected sensory stimuli and the association between them. Sixty-three children (28 boys and 35 girls) aged 5-12 years (mean age 7.9 ± 1.6 years) participated in the study. Their parents were asked to complete a questionnaire while in the dentist's waiting room. The dentists evaluated the children's behavior in the dental office using Frankl's behavioral scale and noted the children's reactions to the sensory stimuli of touch, noise, smell and backward tilting of the examination chair. Most of the children cooperated during the dental examination. Lack of cooperation was associated with adverse reactions to all selected sensory stimuli. There was also an association between resistance to brushing teeth and adverse reaction to touch. Children who reacted negatively to sensory stimuli during dental examinations were more likely to have needed advanced management techniques during past dental treatment. Children's behavior during dental examinations is known to be affected by many factors, including age, previous experiences, anxiety and fear and others. This investigation demonstrates that it is also associated with their reactions to various sensory stimuli.
Alshammasi, Hussain; Buchanan, Heather; Ashley, Paul
Assessing anxiety is an important part of the assessment of a child presenting for dental treatment; however, the use of dental anxiety scales in practice is not well-documented. To introduce child dental anxiety scales, and to monitor the extent to which dentists used them; to explore the experience and views of dentists regarding anxiety assessment. A mixed-methods design was employed. A protocol for child anxiety assessment was introduced to paediatric dentists in Eastman Dental Hospital. After 6 months, 100 patient files were audited to examine compliance with the protocol. Fourteen dentists were interviewed to explore their experience and views regarding anxiety assessment. Only five patients were assessed using the scales. Thematic analysis of the dentist interviews revealed three themes: 'Clinical observations and experience: The gold standard'; 'Scales as an estimate or adjunct'; and 'Shortcomings and barriers to using scales'. The dentists in our study did not use anxiety scales, instead they rely on their own experience/judgement. Therefore, scales should be recommended as an adjunct to judgement. Brief scales are recommended as clinicians lack time and expertise in administering anxiety questionnaires. Advantages of using scales and hands-on experience could be incorporated more in undergraduate training. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Pourkazemi, Maryam; Babapour, Jalil; Oskouei, Sina-Ghertasi
Objective. The present study investigated the correlations between maternal emotional intelligence (EQ), parenting style, child trait anxiety and child behavior in the dental setting. Study design. One-hundred seventeen children, aged 4-6 years old (mean 5.24 years), and their mothers participated in the study. The BarOn Emotional Quotient Inventory and Bumrind�s parenting style questionnaire were used to quantify maternal emotional intelligence and parenting style. Children�s anxiety and behavior was evaluated using the Spence Children�s Anxiety Scale (SCAS) and Frankl behavior scale. Results. Significant correlation was found between maternal EQ and child behavior (r=0.330; p<0.01); but not between parenting style and child behavior. There was no significant correlation between mother�s total EQ and child�s total anxiety; however, some subscales of EQ and anxiety showed significant correlations. There were significant correlations between authoritarian parenting style and separation anxiety (r=0.186; p<0.05) as well as authoritative parenting style and mother�s EQ (r=0.286; p<0.01). There was no significant correlation between child anxiety and behavior (r = -0.81). Regression analysis revealed maternal EQ is effective in predicting child behavior (?=0.340; p<0.01). Conclusion. This study provides preliminary evidence that the child�s behavior in the dental setting is correlated to mother�s emotional intelligence. Emotionally intelligent mothers were found to have predominantly authoritative parenting style. Key words:Anxiety, child behavior, parenting, pediatric dentistry. PMID:22926462
Davies, E Bethan; Buchanan, Heather
Behaviour management techniques (BMTs) are utilised by dentists to aid children's dental anxiety (DA). Children's perceptions of these have been underexplored, and their feedback could help inform paediatric dentistry. To explore children's acceptability and perceptions of dental communication and BMTs and to compare these by age, gender, and DA. A total of sixty-two 9- to 11-year-old school children participated in the study. Children's acceptability of BMTs was quantified using a newly developed Likert scale, alongside exploration of children's experiences and perceptions through interviews. anova and t-tests explored BMT acceptability ratings by age, gender, and DA. Thematic analysis was used to analyse interviews. Statistical analyses showed no effect of age, gender, or DA upon BMT acceptability. Children generally perceived the BMTs as acceptable or neutral; stop signals were the most acceptable, and voice control the least acceptable BMT. Beneficial experiences of distraction and positive reinforcement were common. Children described the positive nature of their dentist's communication and BMT utilisation. Dental anxiety did not affect children's perceptions of BMTs. Children were generally positive about dentist's communication and established BMTs. Children's coping styles may impact perceptions and effectiveness of BMTs and should be explored in future investigations. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.
Kazancioglu, H-O; Dahhan, A-S; Acar, A-H
To evaluate the effects of different patient education techniques on patients' anxiety levels before and after dental implant surgery. Sixty patients were randomized into three groups; each contained 20 patients; [group 1, basic information given verbally, with details of operation and recovery; group 2 (study group), basic information given verbally with details of operative procedures and recovery, and by watching a movie on single implant surgery]; and a control group [basic information given verbally "but it was devoid of the details of the operative procedures and recovery"]. Anxiety levels were assessed using the Spielberger's State-Trait Anxiety Inventory (STAI) and Modified Dental Anxiety Scale (MDAS). Pain was assessed with a visual analog scale (VAS). The most significant changes were observed in the movie group (P < 0.05). Patients who were more anxious also used more analgesic medication. Linear regression analysis showed that female patients had higher levels of anxiety (P < 0.05). Preoperative multimedia information increases anxiety level.
Carlsson, Viktor; Hakeberg, Magnus; Blomkvist, Klas; Wide Boman, Ulla
Severe dental anxiety (DA) is associated with both oral health and psychosocial consequences in what has been described as a vicious circle of DA. The aim of this study was to investigate self-rated orofacial esthetics in patients with DA and its relationship to psychological and oral health. A consecutive sample of 152 adult patients who were referred or self-referred to a specialized dental anxiety clinic filled out the Orofacial Esthetic Scale (OES) as well as measurements on DA, self-rated oral health and general anxiety and depression. Clinical measures of dental status were also obtained. Compared with the general population, patients with DA had lower ratings of satisfaction on all aspects of their orofacial esthetics, which included the teeth, gingiva, mouth and face, as well as a global orofacial assessment. Furthermore, the perception of the orofacial appearance was related both to dental status and self-rated oral health, as well as to general anxiety and depression. The level of dissatisfaction with the orofacial appearance was similar for both genders, but women reported more regular dental care and better dental status. The results of this study clearly show less satisfaction with dental and facial appearance in patients with DA, and that the self-rating of orofacial esthetics is related to both oral and psychological health. The OES can be used to assess orofacial esthetics in patients with DA.
Halldorsson, Brynjar; Draisey, Jenny; Cooper, Peter; Creswell, Cathy
It has been suggested that elevated maternal social anxiety may play a disorder-specific role in maintaining childhood social anxiety disorder (SAD), but few studies have examined whether mothers of children with SAD are more socially anxious than mothers of children with other anxiety disorders (ANX). This study set out to examine whether symptoms of social anxiety were more severe amongst mothers of 7-12 year old children presenting for treatment with SAD (n = 260) compared to those presenting with ANX (n = 138). In addition, we examined whether there were differences between these two groups in terms of maternal and paternal general anxiety, depression, and stress. Parents of 7-12 year old children referred for treatment of SAD or ANX completed self-report questionnaire measures of emotional symptoms. Compared to mothers of children with ANX, mothers of children with SAD reported significantly higher levels of social anxiety, general anxiety, and depression. In addition, fathers of children with SAD reported significantly higher levels of anxiety, stress, and depression than fathers of children with ANX. This study is one of the few existing studies that have examined mothers' and fathers' psychopathology across different childhood anxiety disorders. Compared to parents of children with ANX, parents of children with SAD may have poorer mental health which may inhibit optimum child treatment outcomes for children with SAD. Thus, targeting parental psychopathology may be particularly important in the treatment of childhood SAD. Consideration of parental psychopathology may be particularly important in the treatment of childhood social anxiety disorder. Mothers of children with social anxiety disorder are more socially anxious than mothers of children with other anxiety disorders Fathers of children with social anxiety disorder are more anxious and depressed than fathers of children with other anxiety disorders Participants were predominantly of high
Donate-Bartfield, Evelyn; Spellecy, Ryan; Shane, Nicholas J
This article examines advantages associated with nonpharmacological behavioral management techniques and suggests that there are benefits to their use (such as achieving a more lasting solution to the problem of dental anxiety) that are not realized with medication-based interventions. Analyses that use Kantian and existential viewpoints for exploring the use of medication versus behavioral interventions for managing life problems yield parallel conclusions: there are advantages gained by using behavioral interventions that are not always associated with medication-based interventions. These analyses, taken together with an understanding of the psychology of dental anxiety management, suggest that using nonpharmacological techniques for the management of dental anxiety can maximize adherence to the ethical principles of beneficence and patient autonomy. The authors discuss the barriers that make nonpharmacological interventions for anxiety management difficult for dentists to routinely use, and suggest that additional training in these methods and increased collaboration with mental health professionals are needed for dentists.
Mejía-Rubalcava, Cynthia; Alanís-Tavira, Jorge; Mendieta-Zerón, Hugo; Sánchez-Pérez, Leonor
The aim of this study was to determine the effect of music therapy on patients suffering dental anxiety. In addition, a second objective was to determine the correlation between salivary cortisol and other physiologic parameters. 34 patients were randomly assigned to the control group and the experimental group. For each patient was measured for salivary cortisol, stimulate salivary flow, blood pressure, heart rate, oxygen saturation and body temperature. Student t-test and Chi2 were applied to analyze significant differences between the studied variables before and after the unpleasant stimulation causes anxiety for dental treatment. Initially, both groups registered the same level of anxiety. In the second measurement, significant differences were registered in the salivary cortisol concentration, systolic and diastolic pressure, heart rate, body temperature and stimulated salivary flow for treated group with music therapy. Music therapy has a positive effect in control of dental anxiety. Copyright © 2015. Published by Elsevier Ltd.
Background A recent UK population survey of oral health included questions to assess dental anxiety to provide mean and prevalence estimates of this important psychological construct. Methods A two-stage cluster sample was used for the survey across England, Wales, and Northern Ireland. The survey took place between October-December 2009, and January-April 2010. All interviewers were trained on survey procedures. Within the 7,233 households sampled there were 13,509 adults who were asked to participate in the survey and 11,382 participated (84%). Results The scale was reliable and showed some evidence of unidimensionality. Estimated proportion of participants with high dental anxiety (cut-off score = 19) was 11.6%. Percentiles and confidence intervals were presented and can be estimated for individual patients across various age ranges and gender using an on-line tool. Conclusions The largest reported data set on the MDAS from a representative UK sample was presented. The scale’s psychometrics is supportive for the routine assessment of patient dental anxiety to compare against a number of major demographic groups categorised by age and sex. Practitioners within the UK have a resource to estimate the rarity of a particular patient’s level of dental anxiety, with confidence intervals, when using the on-line percentile calculator. PMID:23799962
Ghaderi, Faezeh; Fijan, Soleiman; Hamedani, Shahram
Prediction of child cooperation level in dental setting is an important issue for a dentist to select the proper behavior management method. Many psychological studies have emphasized the effect of birth order on patient behavior and personality; however, only a few researches evaluated the effect of birth order on child's behavior in dental setting. This study was designed to evaluate the influence of children ordinal position on their behavior in dental setting. A total of 158 children with at least one primary mandibular molar needing class I restoration were selected. Children were classified based on the ordinal position; first, middle, or last child as well as single child. A blinded examiner recorded the pain perception of children during injection based on Visual Analogue Scale (VAS) and Sound, Eye and Movement (SEM) scale. To assess the child's anxiety, the questionnaire known as "Dental Subscale of the Children's Fear Survey Schedule" (CFSS-DS) was employed. The results showed that single children were significantly less cooperative and more anxious than the other children (p<0.001). The middle children were significantly more cooperative in comparison with the other child's position (p< 0.001). Single child may behave less cooperatively in dental setting. The order of child birth must also be considered in prediction of child's behavior for behavioral management.
Ghaderi, Faezeh; Fijan, Soleiman; Hamedani, Shahram
Statement of the Problem Prediction of child cooperation level in dental setting is an important issue for a dentist to select the proper behavior management method. Many psychological studies have emphasized the effect of birth order on patient behavior and personality; however, only a few researches evaluated the effect of birth order on child’s behavior in dental setting. Purpose This study was designed to evaluate the influence of children ordinal position on their behavior in dental setting. Materials and Method A total of 158 children with at least one primary mandibular molar needing class I restoration were selected. Children were classified based on the ordinal position; first, middle, or last child as well as single child. A blinded examiner recorded the pain perception of children during injection based on Visual Analogue Scale (VAS) and Sound, Eye and Movement (SEM) scale. To assess the child's anxiety, the questionnaire known as “Dental Subscale of the Children's Fear Survey Schedule” (CFSS-DS) was employed. Results The results showed that single children were significantly less cooperative and more anxious than the other children (p<0.001). The middle children were significantly more cooperative in comparison with the other child's position (p< 0.001). Conclusion Single child may behave less cooperatively in dental setting. The order of child birth must also be considered in prediction of child’s behavior for behavioral management. PMID:26636121
Rajwar, Anju Singh; Goswami, Mridula
There is a great need for identifying fearful children, who often present problems in patient management, thus affecting the quality of dental care rendered to them. This study is unique in the way that dental fear was assessed through three fear scales as research has suggested the use of more than one scale because each scale has its own restrictions and is open to criticism. The aim of this study was to evaluate dental fear and anxiety (DFA) among children aged 3-14 years using three fear measurement scales. The study was conducted on children (3-14 years) who visited the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences, New Delhi. The DFA levels were measured using three fear measurement scales, i.e., facial image scale (FIS), dental fear scale (DFS), and children's fear survey schedule-dental subscale (CFSS-DS). The dental behavior was estimated using the Frankl's behavior rating scale (FBRS). The prevalence of dental fear according to FIS was 14.3%, according to DFS was 22.6%, and according to CFSS-DS was 7.4%. In assessment of the behavior of children in the clinics through FBRS, it was observed that he maximum number of respondents (69.8%) showed Frankl's Rating 3 i.e. positive. In the DFS and CFSS-DS, the factor which caused most fear was "feeling the needle injected" and "injections," respectively. Assessment of dental fear is an extremely useful tool for the dental practitioner, who can use it to customize the behavioral treatment and management for child patients.
Wallace, Ann; Rogers, Helen J; Zaitoun, Halla; Rodd, Helen D; Gilchrist, Fiona; Marshman, Zoe
It is widely acknowledged that children should participate in healthcare decisions, service development and even setting research agendas. Dental traumatology is a major component of paediatric dentistry practice and research. However, little is known about young patients' contribution to new knowledge in this field. The aim of the study was to establish the extent to which children are involved in contemporary dental trauma research and to evaluate the quality of the related literature. A systematic review of the dental trauma literature was conducted from 2006 to 2014. The electronic databases, MEDLINE and Scopus, were used to identify relevant studies. The selected papers were independently examined by five calibrated reviewers. Studies were categorized by the degree of children's involvement and appraised using a validated quality assessment tool. The initial search yielded 4374 papers. After application of the inclusion and exclusion criteria, only 96 studies remained. Research on children accounted for 87.5% of papers, and a proxy was involved in 4.2%. Children were engaged to some degree in only 8.3% of studies, and there were no studies where children were active research participants. In the quality assessment exercise, papers scored, on average, 57% (range = 14-86%). There is scope to encourage more active participation of children in dental trauma research in the future. Furthermore, there are some areas where the quality of research could be improved overall. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Background Math anxiety, defined as a negative affective response to mathematics, is known to have deleterious effects on math performance in the general population. However, the assumption that math anxiety is directly related to math performance, has not yet been validated. Thus, our primary objective was to investigate the effects of math anxiety on numerical processing in children with specific deficits in the acquisition of math skills (Developmental Dyscalculia; DD) by using a novel affective priming task as an indirect measure. Methods Participants (12 children with DD and 11 typically-developing peers) completed a novel priming task in which an arithmetic equation was preceded by one of four types of priming words (positive, neutral, negative or related to mathematics). Children were required to indicate whether the equation (simple math facts based on addition, subtraction, multiplication or division) was true or false. Typically, people respond to target stimuli more quickly after presentation of an affectively-related prime than after one that is unrelated affectively. Result Participants with DD responded faster to targets that were preceded by both negative primes and math-related primes. A reversed pattern was present in the control group. Conclusion These results reveal a direct link between emotions, arithmetic and low achievement in math. It is also suggested that arithmetic-affective priming might be used as an indirect measure of math anxiety. PMID:20633269
Rubinsten, Orly; Tannock, Rosemary
Math anxiety, defined as a negative affective response to mathematics, is known to have deleterious effects on math performance in the general population. However, the assumption that math anxiety is directly related to math performance, has not yet been validated. Thus, our primary objective was to investigate the effects of math anxiety on numerical processing in children with specific deficits in the acquisition of math skills (Developmental Dyscalculia; DD) by using a novel affective priming task as an indirect measure. Participants (12 children with DD and 11 typically-developing peers) completed a novel priming task in which an arithmetic equation was preceded by one of four types of priming words (positive, neutral, negative or related to mathematics). Children were required to indicate whether the equation (simple math facts based on addition, subtraction, multiplication or division) was true or false. Typically, people respond to target stimuli more quickly after presentation of an affectively-related prime than after one that is unrelated affectively. Participants with DD responded faster to targets that were preceded by both negative primes and math-related primes. A reversed pattern was present in the control group. These results reveal a direct link between emotions, arithmetic and low achievement in math. It is also suggested that arithmetic-affective priming might be used as an indirect measure of math anxiety.
Li, Yong; Ji, Cheng-Ye; Qin, Jiong; Zhang, Zhi-Xiang
To investigate the prevalence of parental anxiety associated with epileptic children, and to explore whether and how this specific condition affects children's quality of life (QOL), and what are the significant determinants for parental anxiety. Three hundred and forty parents whose children were affected with known epilepsy were enrolled in the study. Questionnaires for quality of life in childhood epilepsy (QOLCE), and hospital anxiety and depression (HAD) of parents were used to collect demographic data of both children and their parents, as well as clinical manifestations of epilepsy and family status. Parental anxiety (of any severity) was observed in 191 subjects at interview, giving a prevalence rate of 56.2%. Of the 191 subjects, 18.5% reported mild anxiety, 24.4% moderate anxiety, and 13.2% severe anxiety. Factors associated with parental anxiety included frequency of seizure in children, average monthly income per person and parents' knowledge about epilepsy (P < 0.05). Parental anxiety significantly (P = 0.000) correlated with quality of life of children with epilepsy. Parents of children with epilepsy are at high risk of having anxiety. Factors associated with parental anxiety originate both from children and from parents. Parental anxiety is significantly related with children's QOL. It is important for experts concerned to recognize such a relationship to improve the QOL of children and their parents.
Khojastepour, L; Zareifar, S; Ebrahimi, M
This cross sectional study was performed to evaluate dental ages and incidence of dental anomalies in children treated for acute lymphoblastic leukemia (ALL). A total of 25 ALL patient who passed at least 2 years of chemotherapy and 25 healthy sex and age matched children were evaluated. Dental age as well as dental anomalies in shape, size, number, and structure was recorded based on their panoramic radiographies which were taken for dental purposes. The number of dental anomalies significantly increased in ALL treated children. Seven ALL cases (28%) in compression to only one (4%) in control group had at least one dental anomaly. However, there was neither statistically significant differences between the mean of dental (p=0.32) and chronologic age (p=0.12) in both groups, nor between dental age of cases and control group (p=0.62).The age at the onset of treatment as well as treatment durations has not affected dental age and the incidence of dental anomalies significantly (p<0.05). Chemotherapy in children results in emergence of dental anomaly. Dental age, maturity, and development process however seems to be independent from chemotherapy.
Pakpour, Amir H; Gellert, Paul; Asefzadeh, Saeed; Sniehotta, Falko F
The aim of this study was to investigate whether planning a dental appointment is a predictor of actual dental visits over a one-year period when controlling for past attendance, demographic factors, and dental health beliefs. In addition, the planning-attendance association was explored to determine whether dental anxiety and educational status moderated this relationship. A total of N = 1,422 adults with a mean age of M = 44.4 (SD = 11.0) years and resident in Iran participated in a prospective study over a one-year period. The primary outcome was self-reported dental appointment attendance at one-year follow-up, which was validated using clinical records. Action planning, coping planning, health beliefs, age, dental insurance, income, dental health status, dental anxiety, and years of education were assessed at baseline by self-report questionnaire. Data were analysed using multivariate logistic regression. Action planning and coping planning were significantly associated with dental appointment attendance at one-year follow-up. Planning a dental appointment was more predictive of dental appointment attendance for people with higher levels of education and lower dental anxiety. The findings of this study suggest that implementation of the behaviour change technique planning into routine dental practice may have the potential to increase dental appointment attendance rates. © 2014 The International Association of Applied Psychology.
Karim, Zarina Abdul; Musa, Normaizura; Noor, Siti Noor Fazliah Mohd
Dental treatment under general anaesthesia may be needed for some children and adolescents due to medical or behaviour problem. The objective of the study is to identify the type of treatment that has been carried out under GA in Hospital Universiti Sains Malaysia (HUSM). A retrospective record review study from hospital records of dental patients (under 18 years old) receiving dental treatment under GA from 2003 until 2007 were retrieved from the database. Information such as the reason for GA, and the type of treatment provided was recorded in data sheet. The data were analyzed using SPSS 12.0.1 for Windows. It was checked and verified for errors. A total of 349 cases were treated of which 43.6% had medical problems. Patients were mostly diagnosed to have rampant caries (77.1%) and some of them have behavioural problems (34.4%). Treatment pattern in deciduous dentition revealed more extraction (97.8%) as compared to restoration (75.7%) whereas in permanent dentition more restoration was done (24.3%) as compared to extraction (2.2%). Majority of the restorations were done using Glass Ionomer Cements (47.5%). Biopsy (4.3%) contributed mainly to the surgery (24.1%) done during GA. General anesthesia is necessary when dental disease is interfering with health and general well-being of patient and it can facilitated dental treatment allowing dentists to benefit from improved treatment conditions and provide a higher quality of care. PMID:22570587
Gao, Kenneth; Wiederhold, Brenda K.
Abstract Virtual reality (VR) has been used by clinicians to manage pain in clinical populations. This study examines the use of VR as a form of distraction for dental patients using both subjective and objective measures to determine how a VR system affects patients' reported anxiety level, pain level, and physiological factors. As predicted, results of self-evaluation questionnaires showed that patients experienced less anxiety and pain after undergoing VR treatment. Physiological data reported similar trends in decreased anxiety. Overall, the favorable subjective and objective responses suggest that VR distraction systems can reduce discomfort and pain for patients with mild to moderate fear and anxiety. PMID:24892198
Wiederhold, Mark D; Gao, Kenneth; Wiederhold, Brenda K
Virtual reality (VR) has been used by clinicians to manage pain in clinical populations. This study examines the use of VR as a form of distraction for dental patients using both subjective and objective measures to determine how a VR system affects patients' reported anxiety level, pain level, and physiological factors. As predicted, results of self-evaluation questionnaires showed that patients experienced less anxiety and pain after undergoing VR treatment. Physiological data reported similar trends in decreased anxiety. Overall, the favorable subjective and objective responses suggest that VR distraction systems can reduce discomfort and pain for patients with mild to moderate fear and anxiety.
Shamir-Essakow, Galia; Ungerer, Judy A.; Rapee, Ronald M.
This study examined the association between insecure attachment, behavioral inhibition, and anxiety in an at risk sample of preschool children. The relationship between maternal anxiety and child anxiety was also assessed. Participants were 104 children aged 3-4 years who were assessed for behavioral inhibition and mother-child attachment (using…
Ghasemi, Mahmood; Lotfollahzadeh, Hana; Kermani-Ranjbar, Tahereh; Kharazifard, Mohammad Javad
The practice of dentistry has long been associated with high levels of occupational stress and anxiety and music has been shown as a method of reducing stress. Considering the reportedly high level of stress among dental students and its consequences and also considering the positive effect of music therapy, the aim of this study was to evaluate the relationship between music practice and level of stress in dental students. In this analytical, cross-sectional study, 88 students, including 44 with a history of music practice and 44 matched controls without music practice who met the defined inclusion criteria, participated. Upon obtaining written informed consent, all volunteers filled the Beck anxiety inventory (BAI) and Beck depression inventory (BDI) questionnaires. Data were analyzed using the Kolmogorov-Smirnov test, and multiple linear regression test with backward method was used to evaluate the effect of demographic factors on anxiety and depression scores. The level of anxiety was higher in students who did not have music practice and this difference was significant (P<0.001). The same was observed for depression (P=0.027). Other factors including age, gender, and being far from family had no significant effect on depression and anxiety (P>0.05). But level of anxiety and depression was higher in students of universities with tuition fee compared to free public institutes (P<0.05). It may be concluded that music practice can reduce anxiety and depression of dental students.
Lotfollahzadeh, Hana; Kermani-Ranjbar, Tahereh; Kharazifard, Mohammad Javad
Objectives: The practice of dentistry has long been associated with high levels of occupational stress and anxiety and music has been shown as a method of reducing stress. Considering the reportedly high level of stress among dental students and its consequences and also considering the positive effect of music therapy, the aim of this study was to evaluate the relationship between music practice and level of stress in dental students. Materials and Methods: In this analytical, cross-sectional study, 88 students, including 44 with a history of music practice and 44 matched controls without music practice who met the defined inclusion criteria, participated. Upon obtaining written informed consent, all volunteers filled the Beck anxiety inventory (BAI) and Beck depression inventory (BDI) questionnaires. Data were analyzed using the Kolmogorov-Smirnov test, and multiple linear regression test with backward method was used to evaluate the effect of demographic factors on anxiety and depression scores. Results: The level of anxiety was higher in students who did not have music practice and this difference was significant (P<0.001). The same was observed for depression (P=0.027). Other factors including age, gender, and being far from family had no significant effect on depression and anxiety (P>0.05). But level of anxiety and depression was higher in students of universities with tuition fee compared to free public institutes (P<0.05). Conclusions: It may be concluded that music practice can reduce anxiety and depression of dental students. PMID:29167685
Levin, A; Zini, A
The objective of the study was to evaluate the difference in the level of self dental assessment between different groups of soldiers: 115 combats and 115 non-combats. All the solders in this study where male, Jewish, with a service record of 12-48 months, ages 18-22 and born in Israel. The data was summarized, evaluated and tested by x2 - chi square and logistic regressions analysis. In the following parameters no significant differences were found regarding time past from last visit to the dentist, self assessment of dental condition, self assessment of need of dental treatment and the frequency of tooth brushing and sugar consumption. Significant differences were found in the percentage of smokers (59.1% among non-combat vs. 31.9% among combat), and in the dental anxiety level (55.3% among non-combat vs. 38% among combat). The main difference between these two groups is the nature of the social support and society surrounding them, a society that strengthens them and gives the feeling they can deal with fears and difficulties. An additional study should be done in which the soldiers self assessment should be compared to clinical examination. The importance of this study is that the non-combat group should be defined as a high risk population regarding dental anxiety.
Poole, Kristie L; Van Lieshout, Ryan J; McHolm, Angela E; Cunningham, Charles E; Schmidt, Louis A
Few studies have examined the interactive effect of intra- and extra-individual vulnerability factors on the trajectory of social anxiety in children. In this study, we examined the joint influence of familial vulnerability (i.e., parental social anxiety) and child biological stress vulnerability (i.e., cortisol reactivity) on trajectories of social anxiety. Children (N = 112 (57 males), M age = 8.14 years, S.D. = 2.25) were followed over three visits spanning approximately three years. Parental social anxiety was assessed using the Social Phobia and Anxiety Inventory, children's behavior and salivary cortisol reactivity were measured in response to a speech task, and children's social anxiety was assessed at all three visits using the Screen for Child Related Emotional Disorders (SCARED; Parent-report). A growth curve analysis was used to examine trajectories of child social anxiety as predicted by children's cortisol reactivity and parental social anxiety, adjusting for covariates. We found a significant interaction between parental social anxiety and child cortisol reactivity in predicting child social anxiety across time. Having a socially anxious parent coupled with heightened cortisol reactivity predicted the highest levels of child social anxiety, with scores that remained above clinically significant levels for social anxiety across all visits. Children with familial risk for social anxiety and who also exhibit high stress-reactivity appear to be at risk for persistent, clinically significant social anxiety. This highlights the importance of considering the interaction between both biological and contextual factors when considering the development, maintenance, and treatment of social anxiety in children across time.
Isong, Inyang A; Rao, Sowmya R; Holifield, Chloe; Iannuzzi, Dorothea; Hanson, Ellen; Ware, Janice; Nelson, Linda P
Dental care is a significant unmet health care need for children with autism spectrum disorders (ASD). Many children with ASD do not receive dental care because of fear associated with dental procedures; oftentimes they require general anesthesia for regular dental procedures, placing them at risk of associated complications. Many children with ASD have a strong preference for visual stimuli, particularly electronic screen media. The use of visual teaching materials is a fundamental principle in designing educational programs for children with ASD. To determine if an innovative strategy using 2 types of electronic screen media was feasible and beneficial in reducing fear and uncooperative behaviors in children with ASD undergoing dental visits. We conducted a randomized controlled trial at Boston Children's Hospital dental clinic. Eighty (80) children aged 7 to 17 years with a known diagnosis of ASD and history of dental fear were enrolled in the study. Each child completed 2 preventive dental visits that were scheduled 6 months apart (visit 1 and visit 2). After visit 1, subjects were randomly assigned to 1 of 4 groups: (1) group A, control (usual care); (2) group B, treatment (video peer modeling that involved watching a DVD recording of a typically developing child undergoing a dental visit); (3) group C, treatment (video goggles that involved watching a favorite movie during the dental visit using sunglass-style video eyewear); and (4) group D, treatment (video peer modeling plus video goggles). Subjects who refused or were unable to wear the goggles watched the movie using a handheld portable DVD player. During both visits, the subject's level of anxiety and behavior were measured using the Venham Anxiety and Behavior Scales. Analyses of variance and Fisher's exact tests compared baseline characteristics across groups. Using intention to treat approach, repeated measures analyses were employed to test whether the outcomes differed significantly: (1) between
Waters, Allison M.; Schilpzand, Elizabeth; Bell, Clare; Walker, Lynn S.; Baber, Kari
This study examined the incidence and correlates of functional gastrointestinal symptoms in children with anxiety disorders. Participants were 6-13 year old children diagnosed with one or more anxiety disorders (n = 54) and non-clinical control children (n = 51). Telephone diagnostic interviews were performed with parents to determine the presence…
van Steensel, Francisca J. A.; Bogels, Susan M.; Wood, Jeffrey J.
The aim of this study was to examine ASD traits in children with clinical anxiety in early development, as well as current manifestations. Parents of 42 children with an anxiety disorder (but no known diagnosis of ASD) and 42 typically developing children were interviewed using the Autism Diagnostic Interview (ADI-R). They also completed…
Hu, Yu-Hsuan; Tsai, Aileen; Ou-Yang, Li-Wei; Chuang, Li-Chuan; Chang, Pei-Ching
General anesthesia has been widely used in pediatric dentistry in recent years. However, there remain concerns about potential postoperative dental morbidity. The goal of this study was to identify the frequency of postoperative dental morbidity and factors associated with such morbidity in children. From March 2012 to February 2013, physically and mentally healthy children receiving dental treatment under general anesthesia at the Department of Pediatric Dentistry of the Chang Gung Memorial Hospital in Taiwan were recruited. This was a prospective and observational study with different time evaluations based on structured questionnaires and interviews. Information on the patient demographics, anesthesia and dental treatment performed, and postoperative dental morbidity was collected and analyzed. Correlations between the study variables and postoperative morbidity were analyzed based on the Pearson's chi-square test. Correlations between the study variables and the scale of postoperative dental pain were analyzed using the Mann-Whitney U test. Fifty-six pediatric patients participated in this study, with an average age of 3.34 ± 1.66 years (ranging from 1 to 8 years). Eighty-two percent of study participants reported postoperative dental pain, and 23% experienced postoperative dental bleeding. Both dental pain and bleeding subsided 3 days after the surgery. Dental pain was significantly associated with the total number of teeth treated, while dental bleeding, with the presence of teeth extracted. Patients' gender, age, preoperative dental pain, ASA classification, anesthesia time, and duration of the operation were not associated with postoperative dental morbidity. Dental pain was a more common postoperative dental morbidity than bleeding. The periods when parents reported more pain in their children were the day of the operation (immediately after the procedure) followed by 1 day and 3 days after the treatment.
Annamary, Kattakayam; Prathima, Gajula Shivashankarappa; Sajeev, Renganathan; Kayalvizhi, Gurusamy; Ramesh, Venkatesan; Ezhumalai, Govindasamy
Dental setting plays an important role in child's behavior and cooperation to the planned dental treatment. Adding attractive colours to the dental environment and by incorporating colourful equipments can make the child feel good and be at ease. This study tries to convey the relationship between colours and dental anxiety among children. To evaluate the colour preference to emotions in relation to children's age, gender and anxiety level. A total of 382 children aged 6-12 years were randomly selected from schools in and around Puducherry. Modified dental anxiety scale was recorded by a calibrated examiner. Each question was scored from one (not anxious) to five (extremely anxious); such that the total score ranges from 5 to 25, wherein a score of 15 or more was considered to be anxious. Based on this, children were divided into anxious and non-anxious groups. All the children were provided with eight different coloured crayon pencils and were asked to shade two cartoon emoticons indicating happiness and sadness with their preferred colour. Values were tabulated and statistically analyzed to evaluate the association between the variables using Z test, Chi-square, Chi-square goodness of fit and odds ratio. (p≤0.05 was considered statistically significant). Among 382 children, 77% (294) were graded as anxious and 23% (88) as non- anxious. For positive emotion (happiness), 31.2% (119) children preferred blue followed by pink 29.3% (112). For negative emotion (sadness), 52.1% (199) of children preferred black and 46.9% (179) preferred red. Association between colour and emotion was highly significant (p= 0.005). From the colours preferred by the children in our study, it can be concluded that colours like blue and pink in the dental set-up could enhance a positive attitude while black and red could develop a negative outlook in their mind.
Lau, Gar-Yen; Patel, Nisha; Umasunthar, Thisanayagam; Gore, Claudia; Warner, John O; Hanna, Heather; Phillips, Katherine; Zaki, Amirah Mohd; Hodes, Matthew; Boyle, Robert J
Previous reports suggest that parents especially mothers of food-allergic children may have increased anxiety. Studies with an appropriate control group have not been undertaken, and the determinants of such anxiety are not known. We compared measures of anxiety and stress in mothers of food-allergic children and atopic non-food-allergic children, with anxiety and stress in mothers of children with no chronic illness. Cross-sectional study of mothers attending a hospital appointment for their 8- to 16-year-old child. Mothers of children with food allergy, asthma but no food allergy or no chronic illness completed questionnaires including State-Trait Anxiety Inventory, Perceived Stress Scale and measures of anxiety and psychologic adjustment in their child. Forty mothers of food-allergic children, 18 mothers of asthmatic children without food allergy and 38 mothers of children with no chronic illness (controls) were recruited. Mothers of food-allergic children showed increased state anxiety – median anxiety score 38.0 (IQR 30.0, 44.0) food allergy, 27.0 (22.0, 40.0) control p = 0.012; and increased stress – median stress score 18.5 (12.0, 22.0) food allergy, 14.0 (7.5, 19.5)control p = 0.035. No significant differences were seen between mothers in the asthmatic group and controls. In multivariate analysis, previous food anaphylaxis(p = 0.008) and poorly controlled asthma (p = 0.004) were associated with increased maternal anxiety. Child anxiety and adjustment did not differ between food-allergic and control groups. Mothers of food-allergic children have increased anxiety and stress compared with mothers of children with no chronic illness. Anaphylaxis and poorly controlled asthma are associated with maternal anxiety.
Lau, Gar-Yen; Patel, Nisha; Umasunthar, Thisanayagam; Gore, Claudia; Warner, John O; Hanna, Heather; Phillips, Katherine; Mohd Zaki, Amirah; Hodes, Matthew; Boyle, Robert J
Previous reports suggest that parents especially mothers of food-allergic children may have increased anxiety. Studies with an appropriate control group have not been undertaken, and the determinants of such anxiety are not known. We compared measures of anxiety and stress in mothers of food-allergic children and atopic non-food-allergic children, with anxiety and stress in mothers of children with no chronic illness. Cross-sectional study of mothers attending a hospital appointment for their 8- to 16-year-old child. Mothers of children with food allergy, asthma but no food allergy or no chronic illness completed questionnaires including State-Trait Anxiety Inventory, Perceived Stress Scale and measures of anxiety and psychologic adjustment in their child. Forty mothers of food-allergic children, 18 mothers of asthmatic children without food allergy and 38 mothers of children with no chronic illness (controls) were recruited. Mothers of food-allergic children showed increased state anxiety - median anxiety score 38.0 (IQR 30.0, 44.0) food allergy, 27.0 (22.0, 40.0) control p = 0.012; and increased stress - median stress score 18.5 (12.0, 22.0) food allergy, 14.0 (7.5, 19.5) control p = 0.035. No significant differences were seen between mothers in the asthmatic group and controls. In multivariate analysis, previous food anaphylaxis (p = 0.008) and poorly controlled asthma (p = 0.004) were associated with increased maternal anxiety. Child anxiety and adjustment did not differ between food-allergic and control groups. Mothers of food-allergic children have increased anxiety and stress compared with mothers of children with no chronic illness. Anaphylaxis and poorly controlled asthma are associated with maternal anxiety. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Sciberras, Emma; Lycett, Kate; Efron, Daryl; Mensah, Fiona; Gerner, Bibi; Hiscock, Harriet
Although anxiety is common in children with attention-deficit/hyperactivity disorder (ADHD), it is unclear how anxiety influences the lives of these children. This study examined the association between anxiety comorbidities and functioning by comparing children with ADHD and no, 1, or ≥2 anxiety comorbidities. Differential associations were examined by current ADHD presentation (subtype). Children with diagnostically confirmed ADHD (N = 392; 5-13 years) were recruited via 21 pediatrician practices across Victoria, Australia. Anxiety was assessed by using the Anxiety Disorders Interview Schedule for Children-IV. Functional measures included parent-reported: quality of life (QoL; Pediatric Quality of Life Inventory 4.0), behavior and peer problems (Strengths and Difficulties Questionnaire), daily functioning (Daily Parent Rating of Evening and Morning Behavior), and school attendance. Teacher-reported behavior and peer problems (Strengths and Difficulties Questionnaire) were also examined. Linear and logistic regression controlled for ADHD severity, medication use, comorbidities, and demographic factors. Children with ≥2 anxiety comorbidities (n = 143; 39%) had poorer QoL (effect size: -0.8) and more difficulties with behavior (effect size: 0.4) and daily functioning (effect size: 0.3) than children without anxiety (n = 132; 36%). Poorer functioning was not observed for children with 1 anxiety comorbidity (n = 95; 26%). Two or more anxiety comorbidities were associated with poorer functioning for children with both ADHD-Inattentive and ADHD-Combined presentation. Children with ADHD demonstrate poorer QoL, daily functioning and behavior when ≥2 anxiety comorbidities are present. Future research should examine whether treating anxiety in children with ADHD improves functional outcomes. Copyright © 2014 by the American Academy of Pediatrics.
Luscre, Deanna M.; Center, David B.
This study of the outcomes of treatment of three children with autism, to reduce fear of dental examinations, found that the children could be trained through a combined desensitization, symbolic modeling, and reinforcement treatment package to undergo a dental exam in an analog setting, and the training could generalize somewhat to a clinical…
Mifflin, Katherine A; Hackmann, Thomas; Chorney, Jill Maclaren
Anesthesia induction in children is frequently achieved by inhalation of nitrous oxide and sevoflurane. Pediatric anesthesiologists commonly use distraction techniques such as humor or nonprocedural talk to reduce anxiety and facilitate a smooth transition at this critical phase. There is a large body of successful distraction research that explores the use of video and television distraction methods for minor medical and dental procedures, but little research on the use of this method for ambulatory surgery. In this randomized control trial study we examined whether video distraction is effective in reducing the anxiety of children undergoing inhaled induction before ambulatory surgery. Children (control = 47, video = 42) between 2 and 10 years old undergoing ambulatory surgery were randomly assigned to a video distraction or control group. In the video distraction group a video clip of the child's preference was played during induction, and the control group received traditional distraction methods during induction. The modified Yale Preoperative Anxiety Scale was used to assess the children's anxiety before and during the process of receiving inhalation anesthetics. All subjects were similar in their age and anxiety scores before entering the operating rooms. Children in the video distraction group were significantly less anxious at induction and showed a significantly smaller change in anxiety from holding to induction than did children in the control group. Playing video clips during the inhaled induction of children undergoing ambulatory surgery is an effective method of reducing anxiety. Therefore, pediatric anesthesiologists may consider using video distraction as a useful, valid, alternative strategy for achieving a smooth transition to the anesthetized state.
Downer, M C; Drugan, C S; Blinkhorn, A S
To document data on current and past levels of dental decay in British children and compare trends with those in other countries, in Europe in particular. Data were abstracted from multiple sources and collated and tabulated. The dental health of the majority of British children has improved dramatically since the early 1970s. Twelve-year-old children now have on average less than one decayed, missing (extracted) or filled tooth. Levels of dental decay in UK children at 5 and 12 years are among the lowest in the world. There are still marked inequalities in the dental decay experience of children between the territorial regions of the UK, high and low socio-economic groups, and regular and symptomatic dental attenders. Many children in areas of deprivation are either not motivated to seek dental treatment or experience barriers in obtaining it. In parallel with improvements in the dental health of the majority of children, the proportion of UK adults who have no natural teeth has fallen from 37% to 12% over the past four decades. Total tooth loss is now confined almost entirely to individuals over 45 years of age. Most of the improvements in children's dental health are attributable to environmental factors, in particular the widespread availability of fluoride containing toothpastes since the 1970s. There are clear benefits from fluoridation of public water supplies over and above those attributable to other factors. The findings suggest initiatives should be directed to bringing children from deprived backgrounds under the umbrella of dental care. To help alleviate the inequalities in dental health, water fluoridation should be implemented, in urban industrial areas in particular, where levels of dental decay are still unacceptably high.
Sari, M E; Ozmen, B; Koyuturk, A E; Tokay, U; Kasap, P; Guler, D
The purpose of this study was to analyze traumatic dental injuries in children visiting the dental hospital emergency department in Samsun of Turkey, in the period from 2007 to 2011. Data of age, gender, causes of dental trauma, injured teeth, type of dental injuries, the application period, the dental treatments, and traumatic dental injuries according to the seasons were obtained from the records at dental hospital. Of all 320 patients with traumatic dental injury, 205 were boys and 115 were girls with a boys/girls ratio 1.78:1. Traumatic dental injury was observed more frequently in the 7-12 age groups: 52.5% in girls and 67.8% in boys. Falls are the major cause of traumatic dental injury in the age group 6-12 (51.4%). Sport activities are a common cause of traumatic dental injury in the 7-12 age group (34.2%). Patients visited a dentist within approximately 2 h (57.1%). The upper anterior teeth were subjected to trauma more frequently than the lower anterior teeth. The maxillary central incisors were the most commonly affected teeth, and the mandibular canins were the least affected teeth. In primary teeth, avulsion was the most common type of dental injury (23%); on the other hand, enamel fractures were the most common type of dental injury (30.6%) observed in permanent teeth. In the primary dentition, the most commonly performed treatments were dental examination and prescribing (70%). The most common treatment choices in permanent teeth were restoration and dental examination (49.7 and 15.8%, respectively). The results of the study show that the emergency intervention to traumatized teeth is important for good prognosis of teeth and oral tissues. Therefore, the parents should be informed about dental trauma in schools, and dental hospital physicians should be subjected to postgraduate training.
Roohafza, Hamidreza; Pirnia, Afsaneh; Sadeghi, Masoumeh; Toghianifar, Nafiseh; Talaei, Mohammad; Ashrafi, Mahmood
To investigate anxiety levels in two groups of children exposed to nurses with white vs. coloured clothing in a university hospital in Iran. Hospitalisation causes anxiety in children and it is documented that nurses have an important role in alleviating children's distress and anxiety. Nurses characteristics, including their clothing is a factor that affects quality of care through child-nurse relationship. Clinical trial. Children (n = 92) aged 7-15 years old hospitalised for 3-5 days in paediatric surgery ward were exposed to nurses in white or coloured clothing. Children's anxiety was assessed on admission and at discharge using Revised Children's Manifest Anxiety Scale. Children exposed to white nursing uniforms showed higher anxiety levels compared with children exposed to coloured nursing clothing (p < or = 0.05). Besides coloured nursing clothing, female sex, age >11 years old (guidance school) and living in families with more than four members were predictors of lower global anxiety scores. Providing a child-friendly environment through colourful nursing clothing can promote nurses' relationship with hospitalised children. This can satisfy children's expectations of the nursing care and alleviates the need for meeting ideals of nursing care through wearing a white nursing uniform provided that standards of nursing care are favoured. Using colourful nursing clothing in paediatric wards reduces anxiety as a psychological parameter which delays improvement and provides a child-friendly environment that helps promotion of quality of nursing care.
Wright, Kristi D.; Stewart, Sherry H.; Finley, G. Allen; Buffett-Jerrott, Susan E.
Preoperative anxiety (anxiety regarding impending surgical experience) in children is a common phenomenon that has been associated with a number of negative behaviors during the surgery experience (e.g., agitation, crying, spontaneous urination, and the need for physical restraint during anesthetic induction). Preoperative anxiety has also been…
van Beek, N.; Perna, G.; Schruers, K.; Muris, P.; Griez, E.
Anxiety sensitivity (AS), which refers to the tendency to interpret anxiety-related bodily sensations as having potentially harmful somatic, psychological or social consequences, has been proposed as a vulnerability factor for the development of panic disorder (PD). The current study examined the anxiety sensitivity levels in children of parents…
Moore, Rod; Brødsgaard, Inger; Rosenberg, Nicole
Background Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Methods Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20–65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Results Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were
Moore, Rod; Brødsgaard, Inger; Rosenberg, Nicole
Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20-65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of
Bathla, Manish; Singh, Manpreet; Kulhara, Paramanand; Chandna, Shalu; Aneja, Jitender
There is an increasing amount of stress in undergraduate dental students leading to anxiety, depression, and suicidal attempts/suicide. This study aims to evaluate anxiety, depression and suicidal intent in undergraduate dental students and to find out the various areas of stress. A cross-sectional study was conducted using a semi-structured questionnaire (to assess academic and nonacademic areas of stress) and three scales-Hamilton scale for anxiety (HAM-A); Hamilton depression rating scale (HDRS) and Beck's Suicide Intent Scale (BSI). Descriptive statistics; Pearson's Chi-square test; Multiple ANOVA; Kruskal-Wallis test and Mann-Whitney test were used to analyze the data at the significant level of P ≤ 0.05. In a total of 258 dental undergraduate students, academic areas of stress that were found to be statistically significant were long teaching hours (P = 0.002); high workload (P ≤ 0.001); frequency of tests (P ≤ 0.001) and competition/fear of failure (P = 0.009). Lack of interest in the profession was a statistically significant nonacademic area for stress (P ≤ 0.001). The students of first and final year reported higher anxiety (HAM-A 13.93 ± 6.908 and 16.44 ± 7.637 respectively) and depression (HDRS 14.29 ± 6.302 and 14.22 ± 5.422); whereas suicidal intent was reported almost the same throughout the study sample (BSI 5.65 ± 5.465). An increasing level of anxiety, depression and suicidal intent due to various stressors in undergraduate dental students indicate a need to modify current education system and timely help to have psychological healthy dental professionals in future.
Isik, B K; Esen, A; Büyükerkmen, B; Kilinç, A; Menziletoglu, D
Binaural beats are an auditory illusion perceived when two different pure-tone sine waves are presented one to each ear at a steady intensity and frequency. We evaluated their effectiveness in reducing preoperative anxiety in dentistry. Sixty patients (30 in each group) who were to have impacted third molars removed were studied (experimental group: 20 women and 10 men, mean (range) age 24 (18-35) years, and control group: 22 women and 8 men, mean (range) age 28 (15-47) years). All patients were fully informed about the operation preoperatively, and their anxiety recorded on a visual analogue scale (VAS). The local anaesthetic was given and the patients waited for 10minutes, during which those in the experimental group were asked to listen to binaural beats through stereo earphones (200Hz for the left ear and 209.3Hz for the right ear). No special treatment was given to the control group. In both groups anxiety was then recorded again, and the tooth removed in the usual way. The paired t test and t test were used to assess the significance of differences between groups. The degree of anxiety in the control group was unchanged after the second measurement (p=0.625), while that in the experimental group showed a significant reduction in anxiety (p=0.001). We conclude that binaural beats may be useful in reducing preoperative anxiety in dentistry. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
De Oliveira, Patricia Alves Drummond; Paiva, Saul Martins; De Abreu, Mauro Henrique Nogueira Guimarães; Auad, Sheyla Márcia
The purpose of this study was to investigate the impact of gastroesophageal reflux disease (GERD) on dental erosion (DE) in children and analyze the association between dental erosion and diet, oral hygiene, and sociodemographic characteristics. This case-control study encompassed 43 two- to 14-year-olds diagnosed positive for GERD by the 24-hour pH monitoring, paired by age group with 136 healthy controls, in Belo Horizonte, Minas Gerais, Brazil. DE was assessed by one calibrated examiner using the O'Sullivan index. A questionnaire was self-administered by parents collecting information regarding sociodemographics, oral hygiene, and dietary habits. Dental erosion experience was compared between the groups, and a stratified analysis was performed (P<0.05). Dental erosion was diagnosed in 10.6 percent (N equals 19) of all the children; 25.6 percent (N equals 11) of GERD children and 5.9 percent (N equals eight) of children without GERD, P=0.001). Dental erosion was not associated with dietary consumption or sociodemographic characteristics in both groups (P≥0.05). Children who used adult toothpaste had a 5.79 higher chance of having dental erosion in the group with GERD. Children diagnosed with gastroesophageal reflux disease were at an increased risk of having dental erosion when compared to healthy subjects; among the GERD children, dental erosion was associated with the use of adult toothpaste.
Habib, Mariam; Hottel, Timothy L; Hong, Liang
The purpose of this study was to assess the prevalence and characteristics of dental erosion in children aged 2-4 years old and 12 years old. 243 subjects were recruited from daycare centers, preschools, and grade schools; they received dental examinations assessing their condition of dental erosion, including both depth and area of tooth surface loss on four maxillary incisors. Questionnaires were given to the subjects to obtain socio-demographic, oral health behaviors at home, and access to dental care. Dental erosion was analyzed and risk factors were assessed using Chi-Square and logistic regression analysis. The subjects were 60% Caucasians, 31% Black, 7% Hispanic and others were 2%. 34% of children could not get the dental care they needed within the past 12 months and 61% of all children brushed their teeth twice or more daily. Overall, 12% of study children had dental erosion with 13% for 2-4 years old and 10% for 12 years old, with the majority of erosive lesions within enamel. Family income (OR 3.98, p = 0.021) and acidic fruit juice consumption (OR 2.38, p = 0.038) were significant risk factors for dental erosion, even after controlling for other factors, such as source of drinking water and oral hygiene using logistic regression analysis. Dental erosion is a relatively common problem among the children in this study and it is seen as a multi-factorial process.
Borelli, Jessica L; Smiley, Patricia; Bond, D Kyle; Buttitta, Katherine V; DeMeules, Madeleine; Perrone, Laura; Welindt, Nicole; Rasmussen, Hannah F; West, Jessica L
Parental anxiety confers risk for the development of an anxiety disorder in children, and this risk may be transmitted through children's stress reactivity. Further, some children may be more vulnerable to reactivity in the presence of parent factors such as anxiety. In this study, we examined whether parents' anxiety symptoms prospectively predict school-aged children's physiological reactivity following stress, assessed through their electrodermal activity (galvanic skin response) during recovery from a performance challenge task, and whether this varies as a function of children's temperamental fearfulness. Parents and their children (N = 68) reported on their anxiety symptoms at Time 1 of data collection, and parents characterized the extent to which their children had fearful temperaments. At Time 2 children completed the performance challenge and two recovery tasks. Greater parental anxiety symptom severity at Time 1 predicted children's higher electrodermal response during both recovery tasks following the failure task. Further, these effects are specific to children with medium and high fearful temperament, whereas for children low in fearfulness, the association between parent anxiety and child reactivity is not significant. Findings provide additional evidence for the diathesis-stress hypothesis and are discussed in terms of their contribution to the literature on developmental psychopathology.
Herren, Chantal; In-Albon, Tina; Schneider, Silvia
Despite the fact that numerous developmental models have highlighted the role of parental cognitive processes in connection with anxiety disorders in children and adolescents, the role of parents' beliefs about their children and parenting remains largely unexplored. This study investigated the specific association between parental beliefs and child separation anxiety. Parents of children with a diagnosis of Separation Anxiety Disorder (SAD) reported on beliefs and expectations related to their child's fears and own parenting competence. To study the potential specificity of relationships, a clinical control group of mothers of children with social phobia (SoP) and a group of mothers of children without a mental disorder (healthy controls, HC) were included. Results indicated that parents of anxious children had significantly higher levels of dysfunctional beliefs than the parents in the HC group. Mothers of children with SAD showed lower levels of parenting self-efficacy than mothers of children with SoP. They also demonstrated lower parenting self-efficacy and satisfaction compared to mothers of healthy children. Parental dysfunctional beliefs about child anxiety and paternal parenting self-efficacy were significantly positively associated with child anxiety. The effects remained significant after controlling for parental anxiety and depression. Due to the cross-sectional design of the study, causality of the found effects cannot be inferred. Data suggest that children's anxiety and parents' beliefs about their child's anxiety, coping skills and parenting are strongly associated. Further research is needed to investigate whether addressing parental cognitions in addition to parents' anxiety may improve prevention and intervention of child anxiety. Copyright © 2012 Elsevier Ltd. All rights reserved.
Chu, C H; Fung, D S; Lo, E C
To describe the dental caries status of preschool children in Hong Kong and factors which affect their caries status. 658 preschool children aged 4 to 6 years from six randomly selected kindergartens in Hong Kong were surveyed in December 1997. A questionnaire to investigate possible explanatory variables for caries status was completed by their parents. Dental caries was diagnosed according to the criteria recommended by the World Health Organization (1997). Caries experience as measured by the mean number of decayed, missing and filled primary teeth (dmft) of the 4-, 5-, and 6-year-old children were found to be 0.9, 1.8, and 3.3 respectively. Overall, 61% of the children had a zero dmft score. Children born in Mainland China had a higher mean dmft score (4.6) than those born in Hong Kong (1.4). Statistically significant correlations were found between the children's dental caries status and their oral health practices as well as their socio-economic background. Parents' education level, dental knowledge and attitudes were also associated with the children's dental caries experience. In general, the caries status of Hong Kong Chinese preschool children was similar to that of children in industrialised countries and was better than that of children in the nearby areas. However, special dental programmes should be made available to children from lower socio-economic classes and new immigrants from Mainland China because they are the high risk groups for caries in Hong Kong.
Vélez, A L; Restrepo, C C; Peláez-Vargas, A; Gallego, G J; Alvarez, E; Tamayo, V; Tamayo, M
The aim of the present study was to compare the head position and dental wear of bruxist and non-bruxist children with primary dentition. All the subjects had complete primary dentition, dental and skeletal class I occlusion and were classified as bruxist or non-bruxist according to their anxiety level, bruxism described by their parents and signs of temporomandibular disorders. The dental wear was drawn in dental casts and processed in digital format. Physiotherapeutic evaluation and a cephalometric radiograph with natural head position were also performed for each child to evaluate the cranio-cervical position for the bruxist group (n = 33) and the control group (n = 20). The variables of the two groups were compared, using the Student t-test and Mann-Whitney U-test. A more anterior and downward head tilt was found in the bruxist group, with statistically significant differences compared with the controls. More significant dental wear was observed in the bruxist children. Bruxism seems to be related to altered natural head posture and more intense dental wear. Further studies are necessary to explore bruxism mechanisms.
Hopkins, Joyce; Gouze, Karen R.; Bryant, Fred B.
Anxiety and depression tend to co-occur in children. Studies indicate that higher levels of anxiety are associated with subsequent higher levels of depression, while depression may inhibit subsequent anxiety. It is important to increase our understanding of the temporal sequencing of these disorders and, particularly, to determine if suppression effects account for the inhibitory association. In addition, further information about these relationships in young children is needed. Participants were a diverse (20.4 % Hispanic, 16.7 % African American; 49.1 % boys) community sample of 796 children with data available at ages 4, 5, and 6–7 years. Anxiety and depression symptoms were assessed using the Child Symptom Inventory and symptom count measures from the Diagnostic Interview Schedule for Children-Parent Scale-Young Child version. The results indicated: (a) anxiety and depression were relatively stable over time; (b) anxiety at age 4 and 5 was a significant positive predictor of subsequent depression; (c) while an inhibitory effect of depression on subsequent anxiety was found, that inhibitory effect was due to negative suppression, and higher levels of depression were actually associated with subsequent anxiety; (e) consistent with a significant suppression effect, when depression was included as a predictor, the association between anxiety at ages 4 and 5 and anxiety one year later increases in magnitude. Both anxiety and depression are associated with higher levels of one another in the subsequent year. Implications for prevention are discussed. PMID:24934567
Poirier, Catherine Serra; Brendgen, Mara; Girard, Alain; Vitaro, Frank; Dionne, Ginette; Boivin, Michel
This study examined (a) whether, in line with a gene-environment correlation (rGE), a genetic disposition for anxiety puts children at risk of having anxious friends or having no reciprocal friends; (b) to what extent these friendship experiences are related to anxiety symptoms, when controlling for sex and genetic disposition for this trait; and (c) the additive and interactive predictive links of the reciprocal best friend's anxiety symptoms and of friendship quality with children's anxiety symptoms. Using a genetically informed design based on 521 monozygotic and ic twins (264 girls; 87% of European descent) assessed in Grade 4 (M age = 10.04 years, SD = .26), anxiety symptoms and perceived friendship quality were measured with self-report questionnaires. Results indicated that, in line with rGE, children with a strong genetic disposition for anxiety were more likely to have anxious friends than nonanxious friends. Moreover, controlling for their genetic risk for anxiety, children with anxious friends showed higher levels of anxiety symptoms than children with nonanxious friends but did not differ from those without reciprocal friends. Additional analyses suggested a possible contagion of anxiety symptoms between reciprocal best friends when perceived negative features of friendship were high. These results underline the importance of teaching strategies such as problem solving that enhance friendship quality to limit the potential social contagion of anxiety symptoms.
MacNeil, Bonnie M.; Lopes, Vicki A.; Minnes, Patricia M.
Anxiety symptoms and disorders are highly prevalent in children and adolescents with Autism Spectrum Disorder (ASD), although they are often unrecognized or misdiagnosed. The purpose of the present review is to (1) provide clinicians with practical information on assessment and diagnosis of co-morbid anxiety in children and adolescents with ASD,…
Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Poli, Paola; Bertini, Nicoletta; Milantoni, Luca
Objective: There are insufficient data on generalized anxiety disorder in children and adolescents. Symptoms and comorbidity of generalized anxiety disorder are described as a function of age, gender, and comorbidity in a consecutive series of referred children and adolescents. Method: One hundred fifty-seven outpatients (97 males and 60 females,…
Ale, Chelsea M.; Chorney, Daniel B.; Brice, Chad S.; Morris, Tracy L.
Research relating anxiety and facial affect recognition has focused mostly on school-aged children and adults and has yielded mixed results. The current study sought to demonstrate an association among behavioural inhibition and parent-reported social anxiety, shyness, social withdrawal and facial affect recognition performance in 30 children,…
To assess whether children's dental health behavior differs between family compositions of either natural parents or birth mothers together with stepfathers. We use data from the German Health Interview and Examination Survey Children and Adolescents (KiGGS) public use file. This is the first nationally r ep resentative sample on child health in Germany and particularly contains variables for dental attendance, tooth care, and eating behavior of 13,904 children below 14 years of age. A series of zero-inflated Poisson, ordinary least squares, binary, and ordered logistic regression models was set up in order to identify whether family composition is a significant explanatory variable for children's dental health behavior. Family composition turned out as a significant parameter for some aspects of children's dental health behavior. Specifically, children who grow up in families with a birth mother and a stepfather have only half the probability to access dental services but, once seeking treatment, the number of visits is significantly higher in comparison with children raised by their natural parents. Moreover, children growing up in such a patchwork family setting consume a higher amount of sugary foods and drinks. This appears mainly attributable to differential consumption habits for juices, cookies, and chocolate. Children who grow up in settings other than the nuclear family may develop different dental health behaviors than children who grow up with both natural parents, albeit more research is needed to identify the extent to which such behavioral changes lead to variations in caries occurrence.
Chen, Hsin-Yung; Yang, Hsiang; Chi, Huang-Ju; Chen, Hsin-Ming
Anxiety induced by dental treatment can become a serious problem, especially for patients with special needs. Application of deep touch pressure, which is a sensory adaptation technique, may ameliorate anxiety in disabled patients. However, few empiric studies have investigated the possible links between the clinical effects of deep touch pressure and its behavioral and physiologic aspects. Equally little progress has been made concerning theoretical development. The current study is a crossover intervention trial to investigate the behavioral and physiological effects of deep touch pressure for participants receiving dental treatment. Nineteen disabled participants, who were retrospectively subclassified for positive trend or negative trend, were recruited to receive the papoose board as an application of deep touch pressure. Quantitative analyses of behavioral assessments and physiological measurements, including electrodermal activity and heart rate variability, were conducted. We sought to understand the modulation of the autonomic nervous system and the orchestration of sympathetic and parasympathetic (PsNS) nervous systems. Behavioral assessments reported that higher levels of anxiety were induced by the dental treatment for participants with both groups of positive and negative trends. Although no significant differences were found in the SNS activity, physiologic responses indicated that significantly changes of PsNS activity were observed under the stress condition (dental treatment) when deep touch pressure intervention was applied, especially for participants in the group of positive trend. Our results suggest that the PsNS activation plays a critical role in the process of ANS modulation. This study provides not only physiologic evidence for the modulation effects of deep touch pressure on stressful conditions in dental environments but also the evidence that the application of papoose board, as a sensory adaptation technique, is not harmful for dental
Cermak, Sharon A.; Stein Duker, Leah I.; Williams, Marian E.; Dawson, Michael E.; Lane, Christianne J.; Polido, José C.
This pilot and feasibility study examined the impact of a sensory adapted dental environment (SADE) to reduce distress, sensory discomfort, and perception of pain during oral prophylaxis for children with autism spectrum disorder (ASD). Participants were 44 children ages 6-12 (n=22 typical, n=22 ASD). In an experimental crossover design, each participant underwent two professional dental cleanings, one in a regular dental environment (RDE) and one in a SADE, administered in a randomized and counterbalanced order three to four months apart. Outcomes included measures of physiological anxiety, behavioral distress, pain intensity, and sensory discomfort. Both groups exhibited decreased physiological anxiety and reported lower pain and sensory discomfort in the SADE condition compared to RDE, indicating a beneficial effect of the SADE. PMID:25931290
Leroy, Roos; Bogaerts, Kris; Hoppenbrouwers, Karel; Martens, Luc C; Declerck, Dominique
At present, our understanding of the use of dental care services is incomplete, certainly where preschool children are concerned. To investigate what proportion of 3- and 5-year-olds living in Flanders (Belgium) have already visited the dentist, to describe parents' experience about their child's dental visit, and to explore factors that may have an impact on children's early dental visit. Data were collected from 1057 children; validated questionnaires were completed, and children were examined by trained dentist at ages 3 and 5. Logistic regression analyses were performed to explain dental attendance. At the age of 3, 62% and by 5 years, 21% had never visited the dentist. The first dental visit was considered a pleasant experience for the majority of children. Multivariable regression analyses revealed that children who were not first born, whose mothers had a higher educational level and whose parents had recently visited the dentist, had significantly higher odds for having visited the dentist at young age. Parents of young children need to be informed about and motivated for an early dental visit. Promotion campaigns should focus on firstborn children, children from less educated parents, and parents who do not regularly see a dentist. © 2012 The Authors. International Journal of Paediatric Dentistry © 2012 BSPD, IAPD and Blackwell Publishing Ltd.
Maloney, Erin A; Ramirez, Gerardo; Gunderson, Elizabeth A; Levine, Susan C; Beilock, Sian L
A large field study of children in first and second grade explored how parents' anxiety about math relates to their children's math achievement. The goal of the study was to better understand why some students perform worse in math than others. We tested whether parents' math anxiety predicts their children's math achievement across the school year. We found that when parents are more math anxious, their children learn significantly less math over the school year and have more math anxiety by the school year's end-but only if math-anxious parents report providing frequent help with math homework. Notably, when parents reported helping with math homework less often, children's math achievement and attitudes were not related to parents' math anxiety. Parents' math anxiety did not predict children's reading achievement, which suggests that the effects of parents' math anxiety are specific to children's math achievement. These findings provide evidence of a mechanism for intergenerational transmission of low math achievement and high math anxiety. © The Author(s) 2015.
Fahlvik-Planefeldt, C; Herrström, P
Children with an autistic disorder may need more dental care and may also be more difficult to treat than healthy children. This study compared oral health in autistic and healthy children. Also explored was the dental management of autistic children within the non-specialized Public Dental Service. The study was designed as a case-control study with all cases of autistic disorders aged 3-19 years identified within a primary care area in southwest Sweden. One dentist did a clinical investigation of cases and one control per case. The patients, or their parents, answered a questionnaire. 28 patients were identified and 20 (71%) agreed to participate in the study. Cases and controls had a similar prevalence of fillings, caries, gingivitis and degree of oral hygiene. However, the need of orthodontic treatment seemed to be greater among the autistic children. According to a standardised assessment, autistic children were less able to cooperate in the dental treatment. Approximately 30% of the cases had occasionally been subjected to specialized dental care. The results of this study indicate that the care provided to autistic children within the non-specialized Public Dental Service is satisfactory, provided that there is access to a paediatric dentist when necessary.
Wild, Yvette K.; Heyman, Melvin B.; Vittinghoff, Eric; Dalal, Deepal H.; Wojcicki, Janet M.; Clark, Ann L.; Rechmann, Beate; Rechmann, Peter
Background & Aims Dental erosion is a complication of gastroesophageal reflux (GER) in adults; in children, it is not clear if GER has a role in dental pathologic conditions. Dietary intake, oral hygiene, high bacterial load, and decreased salivary flow might contribute independently to GER development or dental erosion, but their potential involvement in dental erosion from GER is not understood. We investigated the prevalence of dental erosion among children with and without GER symptoms, and whether salivary flow rate or bacterial load contribute to location-specific dental erosion. Methods We performed a cross-sectional study of 59 children (ages 9–17 y) with symptoms of GER and 20 asymptomatic children (controls); all completed a questionnaire on dietary exposure. Permanent teeth were examined for erosion into dentin, erosion locations, and affected surfaces. The dentist was not aware of GER status, nor was the gastroenterologist aware of dental status. Stimulated salivary flow was measured and salivary bacterial load was calculated for total bacteria, Streptococcus mutans and Lactobacilli. Results Controlling for age, dietary intake, and oral hygiene, there was no association between GER symptoms and dental erosion, by tooth location or affected surface. Salivary flow did not correlate with GER symptoms or erosion. Erosion location and surface were independent of total bacteria and levels of Streptococcus mutans and Lactobacilli. Conclusions Location-specific dental erosion is not associated with GER, salivary flow, or bacterial load. Prospective studies are required to determine the pathogenesis of GER-associated dental erosion and the relationship between dental caries to GER and dental erosion. PMID:21820389
Wild, Yvette K; Heyman, Melvin B; Vittinghoff, Eric; Dalal, Deepal H; Wojcicki, Janet M; Clark, Ann L; Rechmann, Beate; Rechmann, Peter
Dental erosion is a complication of gastroesophageal reflux (GER) in adults; in children, it is not clear if GER has a role in dental pathologic conditions. Dietary intake, oral hygiene, high bacterial load, and decreased salivary flow might contribute independently to GER development or dental erosion, but their potential involvement in dental erosion from GER is not understood. We investigated the prevalence of dental erosion among children with and without GER symptoms, and whether salivary flow rate or bacterial load contribute to location-specific dental erosion. We performed a cross-sectional study of 59 children (ages, 9-17 y) with symptoms of GER and 20 asymptomatic children (controls); all completed a questionnaire on dietary exposure. Permanent teeth were examined for erosion into dentin, erosion locations, and affected surfaces. The dentist was not aware of GER status, and the gastroenterologist was not aware of dental status. Stimulated salivary flow was measured and salivary bacterial load was calculated for total bacteria, Streptococcus mutans, and Lactobacilli. Controlling for age, dietary intake, and oral hygiene, there was no association between GER symptoms and dental erosion by tooth location or affected surface. Salivary flow did not correlate with GER symptoms or erosion. Erosion location and surface were independent of total bacteria and levels of Streptococcus mutans and Lactobacilli. Location-specific dental erosion is not associated with GER, salivary flow, or bacterial load. Prospective studies are required to determine the pathogenesis of GER-associated dental erosion and the relationship between dental caries to GER and dental erosion. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
Mian, Nicholas D.; Carter, Alice S.; Pine, Daniel S.; Wakschlag, Lauren S.; Briggs-Gowan, Margaret J.
Background Identifying anxiety disorders in preschool-age children represents an important clinical challenge. Observation is essential to clinical assessment and can help differentiate normative variation from clinically significant anxiety. Yet, most anxiety assessment methods for young children rely on parent-reports. The goal of this article is to present and preliminarily test the reliability and validity of a novel observational paradigm for assessing a range of fearful and anxious behaviors in young children, the Anxiety Dimensional Observation Schedule (Anx-DOS). Methods A diverse sample of 403 children, aged 3 to 6 years, and their mothers was studied. Reliability and validity in relation to parent reports (Preschool Age Psychiatric Assessment) and known risk factors, including indicators of behavioral inhibition (latency to touch novel objects) and attention bias to threat (in the dot-probe task) were investigated. Results The Anx-DOS demonstrated good inter-rater reliability and internal consistency. Evidence for convergent validity was demonstrated relative to mother-reported separation anxiety, social anxiety, phobic avoidance, trauma symptoms, and past service use. Finally, fearfulness was associated with observed latency and attention bias toward threat. Conclusions Findings support the Anx-DOS as a method for capturing early manifestations of fearfulness and anxiety in young children. Multimethod assessments incorporating standardized methods for assessing discrete, observable manifestations of anxiety may be beneficial for early identification and clinical intervention efforts. PMID:25773515
dos Santos, Márcio José Possari; Bernabé, Daniel Galera; Nakamune, Ana Cláudia de Melo Stevanato; Perri, Silvia Helena Venturoli; de Aguiar, Sandra Maria Herondina Coelho Ávila; de Oliveira, Sandra Helena Penha
The purpose of this study was to analyze the alpha-amylase (sAA) and cortisol levels in children with Global developmental delay (GDD) before and after dental treatment and its association with the children's behavior during treatment. The morning salivary cortisol levels and activity of sAA of 33 children with GDD were evaluated before and after dental treatment and were compared to 19 healthy children. The behavior of children with GDD during dental care was assessed by the Frankl scale. Children with GDD showed lower levels of sAA activity than healthy children, but this result was not significant. The salivary cortisol levels were similar between GDD and healthy children. GDD children showed increased levels of sAA (but not cortisol) prior to the dental treatment as compared to the post-treatment phase. GDD children who showed less favorable behavior during dental care had higher levels of sAA and salivary cortisol than GDD children with more favorable behavior, but only the sAA results were significant. In conclusion, GDD children show hyperactivity of the SNS-axis in anticipation of dental treatment which indicates the need for strategies to reduce their anxiety levels before and during dental care. Copyright © 2011 Elsevier Ltd. All rights reserved.
Le, S H; Tonami, K; Umemori, S; Nguyen, L T-B; Ngo, L T-Q; Mataki, S
An objective method to recognize patient psychology using heart rate variability (HRV) has recently been developed and is increasingly being used in medical practice. This study compared the potential of this new method with the use of conventional surveys measuring anxiety levels in patients undergoing impacted third molar (ITM) surgery. Patient anxiety was examined before treatment in 64 adults who required ITM surgery, using two methods: measurement of HRV and conventional questionnaire surveys (state section of the State-Trait Anxiety Inventory (STAI-S) and Dental Fear Survey (DFS)). Both methods were assessed for their respective abilities to determine the impact of personal background, the amount of information provided, and the surgical procedure on patient psychology. Questionnaires and HRV yielded the same finding: dental experience was the single background factor that correlated with patient anxiety; the other factors remain unclear. The STAI-S showed a significant relationship between the information provided to the patient and their anxiety level, while the DFS and HRV did not. In addition, HRV demonstrated its ability to assess the effects of the surgical procedure on patient psychology. HRV demonstrated great potential as an objective method for evaluating patient stress, especially for providing real-time information on the patient's status. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Renno, Patricia; Wood, Jeffrey J.
Despite reports of high anxiety in children with autism spectrum disorders (ASD), there is controversy regarding differential diagnosis of ASD symptoms and anxiety symptoms. This study examined 88 children, aged 7-11 years, with ASD referred for concerns about anxiety. A multitrait-(social anxiety, separation anxiety, overall anxiety severity, and…
Waszczuk, M.A.; Zavos, H.M.S.; Eley, T.C.
Anxiety sensitivity, a belief that symptoms of anxiety are harmful, has been proposed to influence development of panic disorder. Recent research suggests it may be a vulnerability factor for many anxiety subtypes. Moderate genetic influences have been implicated for both anxiety sensitivity and anxiety, however, little is known about the aetiology of the relationship between these traits in children. Self-reports of anxiety sensitivity and anxiety symptoms were collected from approximately 300 twin pairs at two time points. Partial correlations indicated that anxiety sensitivity at age 8 was broadly associated with most anxiety subtypes at age 10 (r = 0.11–0.17, p < 0.05). The associations were largely unidirectional, underpinned by stable genetic influences. Non-shared environment had unique influences on variables. Phenotypic results showed that anxiety sensitivity is a broad predictor of anxiety symptoms in childhood. Genetic results suggest that childhood is a developmental period characterised by genetic stability and time-specific environmental influences on anxiety-related traits. PMID:23872507
Beil, Heather A; Rozier, R Gary
In this study we estimated factors associated with children being advised to see the dentist by a doctor or other health provider; tested for an association between the advisement on the likelihood that the child would visit the dentist; and estimated the effect of the advisement on dental costs. We identified a sample of 5268 children aged 2 to 11 years in the 2004 Medical Expenditures Panel Survey. A cross-sectional analysis with logistic regression models was conducted to estimate the likelihood of the child receiving a recommendation for a dental checkup, and to determine its effect on the likelihood of having a dental visit. Differences in cost for children who received a recommendation were assessed by using a linear regression model. All analyses were conducted separately on children aged 2 to 5 (n = 2031) and aged 6 to 11 (n = 3237) years. Forty-seven percent of 2- to 5-year-olds and 37% of 6- to 11-year-olds had been advised to see the dentist. Children aged 2 to 5 who received a recommendation were more likely to have a dental visit (odds ratio: 2.89 [95% confidence interval: 2.16-3.87]), but no difference was observed among older children. Advice had no effect on dental costs in either age group. Health providers' recommendation that pediatric patients visit the dentist was associated with an increase in dental visits among young children. Providers have the potential to play an important role in establishing a dental home for children at an early age. Future research should examine potential interventions to increase effective dental referrals by health providers.
Jouriles, Ernest N; Rancher, Caitlin; Vu, Nicole L; McDonald, Renee
This study examined whether police involvement in intimate partner violence (IPV) is associated with children's anxiety symptoms and threat appraisals. Participants were 117 mothers and their children (7-10 years) recruited from domestic violence shelters and followed for 6 months. Mothers reported on IPV and police involvement in the past 6 months; children reported their own anxiety symptoms and threat appraisals. Police involvement in IPV incidents at Time 1 was positively related to children's anxiety symptoms at both the Time 1 and Time 2 assessments, even after controlling for the severity of the IPV. Police involvement was not associated with children's threat appraisals. Police involvement in IPV may inadvertently contribute to an increase in children's anxiety symptoms. Efforts to mitigate adverse outcomes should be investigated.
Wei, Chiaying; Hoff, Alexandra; Villabø, Marianne A.; Peterman, Jeremy; Kendall, Philip C.; Piacentini, John; McCracken, James; Walkup, John T.; Albano, Anne Marie; Rynn, Moira; Sherrill, Joel; Sakolsky, Dara; Birmaher, Boris; Ginsburg, Golda; Keaton, Courtney; Gosch, Elizabeth; Compton, Scott N.; March, John
The present study examined the psychometric properties, including discriminant validity and clinical utility, of the youth self-report and parent-report forms of the Multidimensional Anxiety Scale for Children (MASC) among youth with anxiety disorders. The sample included parents and youth (N= 488, 49.6% male) ages 7 – 17 who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). Although the typical low agreement between parent and youth self-reports was found, the MASC evidenced good internal reliability across MASC subscales and informants. The main MASC subscales (i.e., Physical Symptoms, Harm Avoidance, Social Anxiety, and Separation/Panic) were examined. The Social Anxiety and Separation/Panic subscales were found to be significantly predictive of the presence and severity of social phobia and separation anxiety disorder, respectively. Using multiple informants improved the accuracy of prediction. The MASC subscales demonstrated good psychometric properties and clinical utilities in identifying youth with anxiety disorders. PMID:23845036
Mouradian, W E; Wehr, E; Crall, J J
Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professionally applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental care is the most prevalent unmet health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they are eligible. Children from low income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children. Childhood oral disease has significant medical and financial consequences that may not be appreciated because of the separation of medicine and dentistry. The infectious nature of dental caries, its early onset, and the potential of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, many pediatricians lack critical knowledge to promote oral health. We recommend financial incentives for prioritizing Medicaid Early and Periodic Screening, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical care, and research; and national leadership. JAMA. 2000;284:2625-2631.
Lai, Bien; Milano, Michael; Roberts, Michael W; Hooper, Stephen R
Mail-in pilot-tested questionnaires were sent to a stratified random sample of 1,500 families from the North Carolina Autism Registry. Multivariate logistic regression analysis was used to determine the significance of unmet dental needs and other predictors. Of 568 surveys returned (Response Rate = 38%), 555 were complete and usable. Sixty-five (12%) children had unmet dental needs. Of 516 children (93%) who had been to a dentist, 11% still reported unmet needs. The main barriers were child's behavior, cost, and lack of insurance. The significant predictor variables of unmet needs were child's behavior (p = 0.01), child's dental health (p < 0.001), and caregiver's last dental visit greater than 6 months (p = 0.002). Type of ASD did not have an effect on having unmet dental needs.
Hudson, C J; Leeper, J D; Strickland, M P; Jessee, P
This study investigates the use of storytelling as a method of measuring children's anxiety during hospitalization. Sixty-seven hospitalized children were asked to create stories about pictures they were shown. The stories were categorized as negative or positive in tone and, hence, the children were categorized as anxious or not anxious. Children who told negative stories displayed significantly more negative behaviors and showed significantly higher anxiety levels and poorer adjustment to hospitalization as measured by observational methods. The most anxious children were male, black, and rural. Implications for practitioners who work with children in medical settings are discussed.
Orchard, Faith; Cooper, Peter J; Phil, D; Creswell, Cathy
Models of the development and maintenance of childhood anxiety suggest an important role for parent cognitions: that is, negative expectations of children's coping abilities lead to parenting behaviors that maintain child anxiety. The primary aims of the current study were to (1) compare expectations of child vulnerability and coping among mothers of children with anxiety disorders on the basis of whether or not mothers also had a current anxiety disorder, and (2) examine the degree to which the association between maternal anxiety disorder status and child coping expectations was mediated by how mothers interpreted ambiguous material that referred to their own experience. The association between interpretations of threat, negative emotion, and control was assessed using hypothetical ambiguous scenarios in a sample of 271 anxious and nonanxious mothers of 7- to 12-year-old children with an anxiety disorder. Mothers also rated their expectations when presented with real life challenge tasks. There was a significant association between maternal anxiety disorder status and negative expectations of child coping behaviors. Mothers’ self-referent interpretations were found to mediate this relationship. Responses to ambiguous hypothetical scenarios correlated significantly with responses to real life challenge tasks. Treatments for childhood anxiety disorders in the context of parental anxiety disorders may benefit from the inclusion of a component to directly address parental cognitions. Some inconsistencies were found when comparing maternal expectations in response to hypothetical scenarios with real life challenges. This should be addressed in future research.
Orchard, Faith; Cooper, Peter J; Creswell, Cathy
Background Models of the development and maintenance of childhood anxiety suggest an important role for parent cognitions: that is, negative expectations of children's coping abilities lead to parenting behaviors that maintain child anxiety. The primary aims of the current study were to (1) compare expectations of child vulnerability and coping among mothers of children with anxiety disorders on the basis of whether or not mothers also had a current anxiety disorder, and (2) examine the degree to which the association between maternal anxiety disorder status and child coping expectations was mediated by how mothers interpreted ambiguous material that referred to their own experience. Methods The association between interpretations of threat, negative emotion, and control was assessed using hypothetical ambiguous scenarios in a sample of 271 anxious and nonanxious mothers of 7- to 12-year-old children with an anxiety disorder. Mothers also rated their expectations when presented with real life challenge tasks. Results There was a significant association between maternal anxiety disorder status and negative expectations of child coping behaviors. Mothers’ self-referent interpretations were found to mediate this relationship. Responses to ambiguous hypothetical scenarios correlated significantly with responses to real life challenge tasks. Conclusions Treatments for childhood anxiety disorders in the context of parental anxiety disorders may benefit from the inclusion of a component to directly address parental cognitions. Some inconsistencies were found when comparing maternal expectations in response to hypothetical scenarios with real life challenges. This should be addressed in future research. PMID:25763427
Plaka, Kavita; Ravindra, Khaiwal; Mor, Suman; Gauba, Krishan
The aim of the study was to assess the prevalence of dental fluorosis, dental caries, and associated risk factors in the school children of district Fatehgarh Sahib, Punjab, India, using a cross-sectional study design. Oral health status of children aged between 8 and 15 years was assessed using World Health Organization (WHO) 2013 criteria. Dental fluorosis was assessed using Dean's index, and dental caries were recorded using decayed, missing, filled/decayed, extracted, filled (DMF/def) indices. Four hundred school children were examined, of which 207 were in the 8-11-year-old group and 193 were in the 12-15-year-old group. The overall prevalence of dental fluorosis was 4.1%, which might be linked to a high concentration of fluoride in drinking water at certain locations of rural Punjab. The prevalence of dental caries was 36.5% with a mean DMF score of 0.3 and def score of 0.6. Risk factors for dental caries include oral hygiene behavior and sugar consumption patterns. The study highlights the need to increase awareness about the oral health and hygiene among the school children in India.
In April 2008, the Arctic Investigations Program (AIP) of CDC was informed by the Alaska Department of Health and Social Services (DHSS) of a large number of Alaska Native (AN) children living in a remote region of Alaska who required full mouth dental rehabilitations (FMDRs), including extractions and/or restorations of multiple carious teeth performed under general anesthesia. In this remote region, approximately 400 FMDRs were performed in AN children aged <6 years in 2007; the region has approximately 600 births per year. Dental caries can cause pain, which can affect children's normal growth and development. AIP and Alaska DHSS conducted an investigation of dental caries and associated risk factors among children in the remote region. A convenience sample of children aged 4-15 years in five villages (two with fluoridated water and three without) was examined to estimate dental caries prevalence and severity. Risk factor information was obtained by interviewing parents. Among children aged 4-5 years and 12-15 years who were evaluated, 87% and 91%, respectively, had dental caries, compared with 35% and 51% of U.S. children in those age groups. Among children from the Alaska villages, those aged 4-5 years had a mean of 7.3 dental caries, and those aged 12-15 years had a mean of 5.0, compared with 1.6 and 1.8 dental caries in same-aged U.S. children. Of the multiple factors assessed, lack of water fluoridation and soda pop consumption were significantly associated with dental caries severity. Collaborations between tribal, state, and federal agencies to provide effective preventive interventions, such as water fluoridation of villages with suitable water systems and provision of fluoride varnishes, should be encouraged.
Armfield, Jason M.
The measurement of dental fear is important due to its high prevalence and appreciable individual, clinical, and public health consequences. However, existing measures of dental anxiety and fear (DAF) have theoretical or practical limitations. This study describes the development and subsequent assessment of the reliability and validity of test…
Shapiro, Michele; Melmed, Raphael N; Sgan-Cohen, Harold D; Parush, Shula
The aim of this study was to evaluate the effect of a sensory-adapted dental environment (SADE) on anxiety, relaxation, and cooperation of children with developmental disabilities (CDDs). Pharmacological treatment has been widely used to reduce anxiety, but nonpharmacological methods may be similarly effective. The standardized clinical situation chosen was a dental hygiene cleaning. A SADE was structured. Sixteen CDDs participated in an open cross-over intervention trial measuring behavioral and psychophysiological variables. There was a substantial increase in relaxation and cooperation in the SADE as opposed to the regular dental environment (RDE). This was reflected by: mean duration of anxious behaviors (SADE = 9.04 minutes vs. RDE = 23.44 minutes; P < .01); mean magnitude of anxious behaviors (SADE = 8.49 vs. RDE = 15.50; P < .01); cooperation levels (SADE = 331 vs. RDE = 1.94; P < .01); mean electrodermal activity (EDA; SADE = 1230 vs. RDE = 446; P < .001); and difference in degree of relaxation by EDA (SADE=2014 vs. RDE=763; P < .004). The findings indicate the potential importance of considering the sensory-adapted environment as a preferable dental environment for this population.
Thorgaard, Mette Viller
Excessive health anxiety, still designated as hypochondriasis in ICD-10, refers to worries and anxiety about harbouring serious illness. It is common in both primary and secondary health care with prevalence rates up to 9% and causes great suffering for the individual as well as high health care costs when untreated. Growing research suggests that health anxiety may originate in childhood, and studies have demonstrated that cognitive and behavioural features similar to those described for health anxiety in adults may be present. The development of health anxiety probably has a complex nature involving a number of interacting factors such as genetics and environmental factors. A few studies have highlighted a possible transmission of health anxiety symptoms from a parent to a child and found significant associations between child and parental self-reported health anxiety symptoms. Theoretical perspectives also assume an association between childhood experiences and family factors and a later development of health anxiety. This dissertation is based on a systematic review and a family case-control study and aims to answer the following questions: 1) What is the empirical evidence for the influence of childhood and family factors for the development of health anxiety? 2) Does exposure to severe maternal health anxiety contribute to health anxiety symptoms in their children or perhaps more broadly affect the children emotionally? 3) Do mothers with severe health anxiety express more health anxiety on behalf of their child, more maladaptive illness perceptions and behaviours compared to mothers with rheumatoid arthritis and healthy mothers? The first part, the systematic review, was performed in accordance with the PRISMA statement and focused on the current empirical evidence for childhood and family factors involved in the development of health anxiety. In total 25 papers were examined emanating from 23 studies. The results, based on this limited research, suggested
Carroll, M K; Ryan-Wenger, N A
The purpose of this study was to identify the fears of school-age children and determine the relationship between fear and anxiety. A descriptive, correlational, secondary analysis study was conducted using a convenience sample of 90 children between the ages of 8 and 12 years. Each child was instructed to complete the Revised Children's Anxiety Scale and then answer questions from a structured interview. On completion, each child was instructed to draw a human figure drawing. Frequency charts and correlational statistics were used to analyze the data. Findings indicated that the most significant fears of the boys were in the categories of animals, safety, school, and supernatural phenomena, whereas girls were more fearful of natural phenomena. High correlations existed between anxiety scores and the number of fears and emotional indicators on human figure drawings. Because human figure drawings are reliable tools for assessing anxiety and fears in children, practitioners should incorporate these drawings as part of their routine assessments of fearful children.
Arrieta Vergara, Katherine; Cárdenas, Shyrley Díaz; Martínez, Farith González
To estimate the relationship between depressive symptoms, anxiety and stress and socio-demographic, academic and social factors among dental students. A cross-sectional study was carried out on dental students from a university in Cartagena, selected by simple random sampling. Students answered a self-report anonymous questionnaire of 20 questions that included demographic characteristics, depression, anxiety and stress symptoms (DASS scale 21), family function (APGAR family) and other factors associated with the academic, economic and social context. Data were analyzed computing odds ratios by binomial logistic regression. The prevalence of symptoms of anxiety, depression and stress were 37.4%, 56.6% and 45.4%, respectively. Factors associated with depressive symptoms were lack of support from friends (OR=6.2; 95%CI, 2.6-14.5), family dysfunction (OR=3.6; 95%CI, 1.9-6.6) and economic hardship (OR=2.2; 95%CI, 1.2-3.9). The anxiety symptoms were associated with family dysfunction (OR=3.1; 95%CI, 1.8-5.3) and lack of support from friends (OR=2.1; 95%CI, 1.1-5.8). Also for symptoms of stress factors family dysfunction (OR=2.3; 95%CI, 1.4-4.1), income (OR=2.4; 95%CI, 1.2-4.9) and time to rest (OR=2.3; 95%CI, 1.4-4.0). Dental students report a high prevalence of symptoms of anxiety, depression and stress. Associated factors are economic resources, family function, lack of time for rest, and social support. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Ramírez-Carrasco, A; Butrón-Téllez Girón, C; Sanchez-Armass, O; Pierdant-Pérez, M
Background and Objective . Anxiety/pain are experiences that make dental treatment difficult for children, especially during the time of anesthesia. Hypnosis is used in pediatric clinical situations to modify thinking, behavior, and perception as well as, recently, in dentistry; therefore the aim of this study was to evaluate the effectiveness of hypnosis combined with conventional behavior management techniques during infiltration anesthetic. Methods . Anxiety/pain were assessed with the FLACC scale during the anesthetic moment, as well as heart rate variability and skin conductance before and during the anesthetic moment, between the control and experimental group. Results . A marginal statistical difference ( p = 0.05) was found in the heart rate between baseline and anesthetic moment, being lower in the hypnosis group. No statistically significant differences were found with the FLACC scale or in the skin conductance ( p > 0.05). Conclusion . Hypnosis combined with conventional behavior management techniques decreases heart rate during anesthetic infiltration showing that there may be an improvement in anxiety/pain control through hypnotic therapy.
Ramírez-Carrasco, A.; Butrón-Téllez Girón, C.; Sanchez-Armass, O.
Background and Objective. Anxiety/pain are experiences that make dental treatment difficult for children, especially during the time of anesthesia. Hypnosis is used in pediatric clinical situations to modify thinking, behavior, and perception as well as, recently, in dentistry; therefore the aim of this study was to evaluate the effectiveness of hypnosis combined with conventional behavior management techniques during infiltration anesthetic. Methods. Anxiety/pain were assessed with the FLACC scale during the anesthetic moment, as well as heart rate variability and skin conductance before and during the anesthetic moment, between the control and experimental group. Results. A marginal statistical difference (p = 0.05) was found in the heart rate between baseline and anesthetic moment, being lower in the hypnosis group. No statistically significant differences were found with the FLACC scale or in the skin conductance (p > 0.05). Conclusion. Hypnosis combined with conventional behavior management techniques decreases heart rate during anesthetic infiltration showing that there may be an improvement in anxiety/pain control through hypnotic therapy. PMID:28490941
Shaghaghian, Soheila; Abolvardi, Masoud; Akhlaghian, Marzieh
Statement of the Problem: Dental caries, the most common infectious disease, can lead to several consequences, including inflammation and bleeding of the gum, abscess formation, tooth loss, and subsequently loss of available space in the arch. Purpose: This study was designed to determine dental caries status of Shiraz preschool children and its related factors. Materials and Method: This cross-sectional study was conducted on the children registered in Shiraz kindergartens in 2014. The study recruited 453 children by randomized cluster sampling. We evaluated the children’s demographic and oral hygiene factors, and their dental caries status using decayed, missed, and filled tooth (dmft) index and prevalence of the children with untreated dental caries. Relationship between the children’s characteristics and their dental caries status was evaluated. Results: Only 119 children (30.1%) were caries-free. The children’s mean dmft index was 3.88(±3.9). After controlling the effect of confounding factors, the children’s dental caries status was significantly associated with variables indicating their socioeconomic status such as fathers’ job, mothers’ education, and number of children in the family. Furthermore, there was a significant association between the children’s dental caries status and their oral hygiene habits such as frequency of tooth brushing. Conclusion: The dental caries status of the studied preschool children was not desirable which could be indicative of the inadequacy of the current preventive programs. To improve this issue, interventional preventive programs such as tooth brushing are recommended. The programs are more necessary for the children of low socioeconomic families and those with poor oral hygiene habits. PMID:29854883
Lee, Jeongwoo; Lee, Jihye; Lim, Hyungsun; Son, Ji-Seon; Lee, Jun-Rae; Kim, Dong-Chan; Ko, Seonghoon
We performed this study to determine the beneficial effects of viewing an animated cartoon and playing with a favorite toy on preoperative anxiety in children aged 3 to 7 years in the operating room before anesthesia induction. One hundred thirty children aged 3 to 7 years with ASA physical status I or II were enrolled. Subjects were randomly assigned to 1 of 3 groups: group 1 (control), group 2 (toy), and group 3 (animated cartoon). The children in group 2 were asked to bring their favorite toy and were allowed to play with it until anesthesia induction. The children in group 3 watched their selected animated cartoon until anesthesia induction. Children's preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) and parent-recorded anxiety Visual Analog Scale (VAS) the night before surgery, in the preanesthetic holding room, and just before anesthesia induction. In the preanesthetic holding room, the group 2 mYPAS and parent-recorded anxiety VAS scores were significantly lower than those of groups 1 and 3 (mYPAS: P = 0.007; parent-recorded anxiety VAS: P = 0.02). In the operating room, the children in group 3 had the lowest mYPAS and parent-recorded anxiety VAS scores among the 3 groups (mYPAS: P < 0.001; parent-recorded anxiety VAS: P < 0.001). In group 3, the mYPAS and parent-recorded anxiety VAS scores of only 3 and 5 children were increased in the operating room compared with their scores in the preanesthetic holding room, whereas the anxiety scores of 32 and 34 children in group 1 and 25 and 32 children in group 2 had increased (P < 0.001). The number of children whose scores indicated no anxiety (mYPAS score <30) in the operating room was 3 (7%), 9 (23%), and 18 (43%) in groups 1, 2, and 3, respectively (P < 0.001). Allowing the viewing of animated cartoons by pediatric surgical patients is a very effective method to alleviate preoperative anxiety. Our study suggests that this intervention is an inexpensive, easy to
Sicouri, Gemma; Sharpe, Louise; Hudson, Jennifer L; Dudeney, Joanne; Jaffe, Adam; Selvadurai, Hiran; Hunt, Caroline
Anxiety disorders are highly prevalent in children with asthma yet very little is known about the parenting factors that may underlie this relationship. The aim of the current study was to examine observed parenting behaviours - involvement and negativity - associated with asthma and anxiety in children using the tangram task and the Five Minute Speech Sample (FMSS). Eighty-nine parent-child dyads were included across four groups of children (8-13 years old): asthma and anxiety, anxiety only, asthma only and healthy controls. Overall, results from both tasks showed that parenting behaviours of children with and without asthma did not differ significantly. Results from a subcomponent of the FMSS indicated that parents of children with asthma were more overprotective, or self-sacrificing, or non-objective than parents of children without asthma, and this difference was greater in the non-anxious groups. The results suggest that some parenting strategies developed for parents of children with anxiety may be useful for parents of children with asthma and anxiety (e.g. strategies targeting involvement), however, others may not be necessary (e.g. those targeting negativity). Copyright © 2017 Elsevier Ltd. All rights reserved.
Prathima, Vedati; Anjum, M Shakeel; Reddy, P Parthasarathi; Jayakumar, A; Mounica, M
To assess the levels of dental anxiety among patients anticipating dental treatments in dental clinics/hospitals of Ranga Reddy district. A cross-sectional study was conducted among a representative sample of 1200 subjects (at least 18 years old) in dental clinics/hospitals which were selected from a list obtained through systematic random sampling. The data were collected using a pre-tested and calibrated questionnaire consisting of the Modified Corah Dental Anxiety Scale (MDAS) to assess anxiety levels. The majority (52.4%) of subjects showed a low level of anxiety. Females (11.44 ± 4.41) were found to have higher mean MDAS scores than males, and the highest mean MDAS scores were found among 18- to 34-year-olds (11.28 ± 4.67) (P < 0.05). Significant differences were found among subjects anticipating different treatments, with higher MDAS scores for extraction (11.25 ± 5.4), followed by examination, root canal treatment, gum surgery, scaling, restoration and others, e.g. orthodontic treatment, restoration with crowns, bridges and dentures (7.79 ± 3.80). The highest mean MDAS scores were found among subjects who were apprehensive due to 'past difficult experience in dental treatments', followed by 'drill' and 'injection', with the lowest scores among subjects indicating 'other reasons' (7.82 ± 3.84). The present data show that anxiety levels are higher in patients who have to undergo extractions than those who must be fitted with dentures. Thus, dental health care providers should pay more attention to patients' anxiety levels associated with different types of treatment.
Padrino-Barrios, Carmelo; McCombs, Gayle; Diawara, Norou; De Leo, Gianluca
The purpose of this study was to evaluate the effects of Immersive Visualization (IV) eyewear on anxious, adult patients during oral debridement. Thirty adult volunteers (n=23 females; n=7 males) were enrolled in the study. Participants were required to be 18 years or older, exhibit at least moderate anxiety (score 9 or higher) on the Corah's Dental Anxiety Scale-Revised (DAS-R), and be generally healthy. Individuals were excluded from participation if they presented with severe dental calculus, periodontal disease, or dental caries, were taking psychotropic drugs, had a history of convulsive disorders, vertigo, or equilibrium disorders, or required antibiotic pre-medication. Subjects received a full mouth oral prophylaxis (supra- and subgingival scaling and selective polishing) by a single experienced dental hygienist. A split mouth design was utilized whereby each subject served as their own control. Subjects were randomly divided into 2 groups: Group A used IV eyewear during the first one-half of the appointment (right side of the mouth) and Group B used IV eyewear during the second one-half of the appointment (left side of the mouth). At screening, medical and dental histories were obtained, full mouth oral examinations were performed, and DAS-R was scored to determine eligibility. At baseline, the DAS-R was re-scored to validate anxiety levels. The Calmness Scale was scored pre- and post-IV treatment on a Likert scale ranging from 1 (very calm) to 7 (less calm). At the end of the study, subjects completed a Post IV Opinion survey. Data were entered into Microsoft Excel for Mac 2011 (Microsoft Corporation Version 14.3.5) and analyzed using SAS® 9.3 statistical software. Thirty subjects with a mean age of 29.9 years completed the study. Data analysis indicated no statistically significant difference between Group A and B with regard to mean DAS-R anxiety levels at baseline (3.15 and 2.40, respectively), with a p-value of 0.07. Data showed a significant
Gupta, Sarika; Arya, Astha
Background: Dental caries and periodontal disease are the most prevalent dental disease among mentally retarded children worldwide. Aims and Objectives: A study was carried out in Jodhpur city of Rajasthan state of India to assess the Dental caries and periodontal Status of Mentally handicapped attending special schools children in Jodhpur city. Materials and Methods: A cross-sectional descriptive survey was conducted in 80 mentally handicapped subjects, attending a Special Needs school in Jodhpur City. Dental caries and Periodontal Status were recorded following the WHO basic oral health survey. Results: None of the subject had healthy periodontal status, dental caries was found in 79.2% of the subjects, Lymphadenopathy was observed in highest number of subjects 55 (76.3%). Conclusion: Health professionals should therefore be aware of the impact of mental illness and its treatment on oral health, Health personnel should receive training to support and provide all possible services to this population. PMID:25177632
Varela, R Enrique; Niditch, Laura A; Hensley-Maloney, Lauren; Moore, Kathryn W; Creveling, C Christiane
A number of factors are believed to confer risk for anxiety development in children; however, cultural variation of purported risk factors remains unclear. We examined relations between controlling and rejecting parenting styles, parental modeling of anxious behaviors, child interpretive biases, and child anxiety in a mixed clinically anxious (n=27) and non-clinical (n=20) sample of Latino children and at least one of their parents. Families completed discussion-based tasks and questionnaires in a lab setting. Results indicated that child anxiety was: linked with parental control and child interpretative biases, associated with parental modeling of anxious behaviors at a trend level, and not associated with low parental acceptance. Findings that controlling parenting and child interpretive biases were associated with anxiety extend current theories of anxiety development to the Latino population. We speculate that strong family ties may buffer Latino children from detrimental effects of perceived low parental acceptance. Copyright © 2013 Elsevier Ltd. All rights reserved.
Cowden, Peter A.
Humans experience social anxiety to different degrees and in different areas. In school settings, this can be a barrier to learning. The school is a social place and to experience anxiety around peers can be challenging, especially if the student also has a learning disability. Social anxiety problems are often associated with learning…
Ciesla, David; Kerins, Carolyn A; Seale, N Sue; Casamassimo, Paul S
This study's purpose was to describe the workforce, patient, and service characteristics of dental clinics affiliated with US children's hospitals belonging to the National Association of Children's Hospital and Related Institutions (NACHRI). A 2-stage survey mechanism using ad hoc questionnaires sought responses from hospital administrators and dental clinic administrators. Questionnaires asked about: (1) clinic purpose; (2) workforce; (3) patient population; (4) dental services provided; (5) community professional relations; and (5) relationships with medical services. Of the 222 NACHRI-affiliated hospitals, 87 reported comprehensive dental clinics (CDCs) and 64 (74%) of CDCs provided data. Provision of tertiary medical services was significantly related to presence of a CDC. Most CDCs were clustered east of the Mississippi River. Size, workload, and patient characteristics were variable across CDCs. Most were not profitable. Medical diagnosis was the primary criterion for eligibility, with all but 1 clinic treating special needs children. Most clinics (74%) had dental residencies. Over 75% reported providing dental care prior to major medical care (cardiac, oncology, transplantation), but follow-up care was variable. Many children's hospitals reported comprehensive dental clinics, but the characteristics were highly variable, suggesting this element of the pediatric oral health care safety net may be fragile.
Facco, Enrico; Zanette, Gastone
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness. Basic emotions are related to survival functions in an inseparable psychosomatic unity that enable an immediate response to critical situations rather than generating knowledge, which is why many anxious patients are unaware of the cause of their anxiety. Archeological findings suggest that humans have been surprisingly skillful and knowledgeable since prehistory. Neanderthals used medicinal plants; and relics of dental tools bear witness to a kind of Neolithic proto-dentistry. In the two millennia BC, Egyptian and Greek physicians used both plants (such as papaver somniferum ) and incubation (a forerunner of modern hypnosis, e.g., in the sleep temples dedicated to Asclepius) in the attempt to provide some form of therapy and painless surgery, whereas modern scientific medicine strongly understated the role of subjectivity and mind-body approaches until recently. DA has a wide range of causes and its management is far from being a matter of identifying the ideal sedative drug. A patient's proper management must include assessing his/her dental anxiety, ensuring good communications, and providing information (iatrosedation), effective local anesthesia, hypnosis, and/or a wise use of sedative drugs where necessary. Any weak link in this chain can cause avoidable suffering, mistrust, and emergencies, as well as having lifelong psychological consequences. Iatrosedation and hypnosis are no
Facco, Enrico; Zanette, Gastone
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness. Basic emotions are related to survival functions in an inseparable psychosomatic unity that enable an immediate response to critical situations rather than generating knowledge, which is why many anxious patients are unaware of the cause of their anxiety. Archeological findings suggest that humans have been surprisingly skillful and knowledgeable since prehistory. Neanderthals used medicinal plants; and relics of dental tools bear witness to a kind of Neolithic proto-dentistry. In the two millennia BC, Egyptian and Greek physicians used both plants (such as papaver somniferum) and incubation (a forerunner of modern hypnosis, e.g., in the sleep temples dedicated to Asclepius) in the attempt to provide some form of therapy and painless surgery, whereas modern scientific medicine strongly understated the role of subjectivity and mind-body approaches until recently. DA has a wide range of causes and its management is far from being a matter of identifying the ideal sedative drug. A patient's proper management must include assessing his/her dental anxiety, ensuring good communications, and providing information (iatrosedation), effective local anesthesia, hypnosis, and/or a wise use of sedative drugs where necessary. Any weak link in this chain can cause avoidable suffering, mistrust, and emergencies, as well as having lifelong psychological consequences. Iatrosedation and hypnosis are no
Kvist, T; Zedrén-Sunemo, J; Graca, E; Dahllöf, G
To study if treatment under general anaesthesia (GA) is associated with dental neglect or dental disability. This was a retrospective study. Dental records of all children in the age 0-6 years who underwent GA at a specialist paediatric dentistry clinic during 2006-2011 were studied with regard to decayed-missed-filled teeth, traumatic injuries, emergency visits, behaviour management problems and the history of attendance. The final sample consisted of 134 children. Matched controls were selected among recall patients who had not received treatment under GA. Fishers exact test or Pearson Chi-square test analysed response distribution and comparisons between groups, and for multivariate analyses, logistic regression was used. The results show that children treated under GA had significantly higher caries prevalence, apical periodontitis and infections due to pulpal necrosis. Dental neglect as well as dental disability was significantly more prevalent in the GA group compared to the control group. In a multivariate analysis with dental neglect as independent factor, dental disability was the only significant factor (p = 0.006). Children treated under general anaesthesia were significantly more often diagnosed with both dental neglect and dental disability. Dental disability was the only factor significantly related to dental neglect. There is a need for improved documentation in the dental records to better identify dental neglect and dental disability, and also a continued training of dentists regarding child protection.
The purpose of this study is to study anxieties of mothers related to their children's future. Qualitative method was used in order to study anxieties of mothers from different socio-economic levels. Sample of the study participants are 129 mothers living in Istanbul. 32 of those mothers are from upper socio-economic level, 57, from middle…
Roome, John R.; Romney, David M.
Thirty gifted children (grades six to eight) were allocated to either progressive muscle relaxation or biofeedback treatment groups or to a no-treament, control group. Biofeedback Ss evinced a significant decrease in anxiety and both groups moved towards more internal locus of control compared with controls. There was no change in trait anxiety.…
Ginsburg, Golda S.; Riddle, Mark A.; Davies, Mark
Objective: To evaluate the prevalence of somatic symptoms (SSs) in children and adolescents with anxiety disorders; the relationship between SSs and anxiety severity, impairment, and child global functioning; and the impact of fluvoxamine (FLV) versus pill placebo (PBO) on reducing SSs. Method: As part of a double-blind, placebo-controlled trial,…
Margalit, Malka; Zak, Itai
One hundred learning disabled (LD) and 118 nondisabled children (six-13 years old) participated in the study which demonstrated significantly higher anxiety and lower self-concept in the first group. The differences emphasized the self-dissatisfaction of the LD group and their pawning related anxiety. (Author/CL)
Hearn, Cate S; Donovan, Caroline L; Spence, Susan H; March, Sonja; Holmes, Monique C
Social anxiety disorder (SAD) in children is often comorbid with generalized anxiety disorder (GAD). We investigated whether worry, intolerance of uncertainty, beliefs about worry, negative problem orientation and cognitive avoidance, that are typically associated with GAD, are present in children with SAD. Participants included 60 children (8-12 years), matched on age and gender. Groups included children: with primary GAD and without SAD (GAD); with primary SAD and without GAD (SAD); and without an anxiety disorder (NAD). GAD and SAD groups scored significantly higher than the NAD group on worry, intolerance of uncertainty, negative beliefs about worry and negative problem orientation, however, they did not score differently from each other. Only the GAD group scored significantly higher than the NAD group on cognitive avoidance. These findings further understanding of the structure of SAD and suggest that the high comorbidity between SAD and GAD may be due to similar underlying processes within the disorders.
Morou-Bermudez, Evangelia; Rodriguez, Selena; Bello, Angel S; Dominguez-Bello, Maria G
Urease enzymes produced by oral bacteria generate ammonia, which can have a significant impact on the oral ecology and, consequently, on oral health. To evaluate the relationship of urease with dental plaque microbial profiles in children as it relates to dental caries, and to identify the main contributors to this activity. 82 supragingival plaque samples were collected from 44 children at baseline and one year later, as part of a longitudinal study on urease and caries in children. DNA was extracted; the V3-V5 region of the 16S rRNA gene was amplified and sequenced using 454 pyrosequencing. Urease activity was measured using a spectrophotometric assay. Data were analyzed with Qiime. Plaque urease activity was significantly associated with the composition of the microbial communities of the dental plaque (Baseline P = 0.027, One Year P = 0.012). The bacterial taxa whose proportion in dental plaque exhibited significant variation by plaque urease levels in both visits were the family Pasteurellaceae (Baseline P<0.001; One Year P = 0.0148), especially Haemophilus parainfluenzae. No association was observed between these bacteria and dental caries. Bacteria in the genus Leptotrichia were negatively associated with urease and positively associated with dental caries (Bonferroni P<0.001). Alkali production by urease enzymes primarily from species in the family Pasteurellaceae can be an important ecological determinant in children's dental plaque. Further studies are needed to establish the role of urease-associated bacteria in the acid/base homeostasis of the dental plaque, and in the development and prediction of dental caries in children.
Cianetti, S; Lombardo, G; Lupatelli, E; Rossi, G; Abraha, I; Pagano, S; Paglia, L
The aim of this study was to verify whether socioeconomic determinants, such as parents' educational level, family income and dental service attendance by children, are associated with the presence of caries among an Italian population of children. An observational retrospective study was carried out in a population of children aged 4-14 years who visited the Paediatric Dentistry Department of the University of Perugia, Italy. Children were stratified according to familial socioeconomic level (father's and mother's educational level, family income) and dental service attendance of children. Age- and sex- adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated by means of multivariate logistic regression models. A sample of 231 children (mean age 8.1 yrs, SD 2.6; 127 males, 104 females) was recruited. One hundred and sixty three (70.46%) children in the study had caries. Caries presence in children was higher in children where the mothers' educational level was lower (OR =6.1; 95% CI = 3.1 to 12.7), in children where the fathers' educational level was lower (OR =2.9; 95% CI =1.6 to 5.5) and in children with lower family income (OR = 9.9; 95% 95% CI = 5.1 to 20.1). No statistically significant difference were observed in terms of caries presence between the children who were visited at least once by a dentist and children who were not previously seen by a dental practitioner (OR = 0.8; 95% CI = 0.4 to 1.6). Socioeconomic level was an important predictor of caries presence among children. Both low income and low parental educational level were related to an increased presence of caries, whereas previous dental visits experience did not affect caries presence in children.
Kumar, Dipanshu; Anand, Ashish; Mittal, Vipula; Singh, Aparna; Aggarwal, Nidhi
Aim The aim of the present study was to identify the various background variables and its influence on behavior management problems (BMP) in children. Materials and methods The study included 165 children aged 2 to 8 years. During the initial dental visit, an experienced operator obtained each child’s background variables from accompanying guardians using a standardized questionnaire. Children’s dental behavior was rated by Frankel behavior rating scale. The behavior was then analyzed in relation to the answers of the questionnaire, and a logistic regression model was used to determine the power of the variables, separately or combined, to predict BMP. Results The logistic regression analysis considering differences in background variables between children with negative or positive behavior. Four variables turned out to be as predictors: Age, the guardian’s expectation of the child’s behavior at the dental examination, the child’s anxiety when meeting unfamiliar people, and the presence and absence of toothache. Conclusion The present study concluded that by means of simple questionnaire BMP in children may be expected if one of these attributes is found. Clinical significance Information on the origin of dental fear and uncooperative behavior in a child patient prior to treatment process may help the pediatric dentist plan appropriate behavior management and treatment strategy. How to cite this article Sharma A, Kumar D, Anand A, Mittal V, Singh A, Aggarwal N. Factors predicting Behavior Management Problems during Initial Dental Examination in Children Aged 2 to 8 Years. Int J Clin Pediatr Dent 2017;10(1):5-9. PMID:28377646
Torriani, D D; Goettems, M L; Cademartori, M G; Fernandez, R R; Bussoletti, D M
Paediatric dentistry requires knowledge of preventive measures, restorative skills and an understanding of child development. This exploratory, descriptive and qualitative study has analysed children's drawings regarding their perception of dental treatment and oral health. Children aged from six to ten years attending a dental school for treatment were randomly invited to create a drawing about 'dental treatment' and 'oral health'. Verbal expressions made by the children whilst drawing were also recorded and attached to the drawings. These representations were analysed and categorised using Vygotsky postulations for context reading. During the drawing analysis different themes emerged. Five categories regarding perceptions of dental treatment were identified: personal relationship; power relation; trauma; childhood resistance; and contextualisation of dental care in the child's life. Three categories relating to oral health were determined: dichotomy of health/sickness; ludic representation of health; and sickness seen as a process. Drawing can be used to understand children's emotions and expectations about dental treatment. Besides possessing technical skills and scientific knowledge, dentists have an obligation to pay attention to children's feelings.
Milgrom, Peter; Newton, J. T.; Boyle, Carole; Heaton, Lisa J.; Donaldson, Nora
Objective To investigate whether the relationship between dental anxiety and referral for treatment under sedation is explained by attendance patterns and oral health. Methods Structural Equation Modeling was used on the covariance matrix of the covariates to test hypothesized inter-relationships. Subsequently, we modeled the probability of referral for treatment under sedation with a multiple logistic regression taking into account inter-relationships between the independent variables. Results A direct significant association of referral with dental anxiety and attendance patterns was detected but not with oral health status. However, oral health and anxiety were highly correlated. Also signaled were correlations between age and education and between gender and bad past experience. Conclusion Referral for treatment under sedation appears to be motivated by both fear and irregular patterns of attendance. Coupled with behavioral treatments to address dental fear and attendance, sedation can part of comprehensive care where curative treatments are long or unpleasant for patients. PMID:20545723
Dieleman, Gwendolyn C; Huizink, Anja C; Tulen, Joke H M; Utens, Elisabeth M W J; Tiemeier, Henning
We examined the longitudinal associations of autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis rest and reactivity measures with anxiety and depressive symptoms at one-year follow-up in children with anxiety disorders. In a clinical sample of 152 children with a primary DSM-IV anxiety disorder, aged 8 to 12 years, anxiety and depressive symptoms were assessed with the Multidimensional Anxiety Scale for Children and the Children's Depression Inventory at pre-treatment baseline and one year later, after treatment with cognitive behavioral therapy. At baseline, children participated in a 70min stress task. Salivary cortisol was measured directly prior to and 20min post stress task. Skin conductance level (SCL), heart rate and high frequency heart rate variability (HRV) were continuously measured during rest and the stress task. To investigate if rest or reactivity measures predicted anxiety and depressive symptoms at one year follow-up, linear regression analyses were conducted for rest and reactivity measures of SCL, heart rate, HRV and cortisol separately. Higher SCL reactivity predicted less decrease of anxiety symptoms at one-year follow-up. Cortisol reactivity showed a weak association with depressive symptoms at one-year follow-up: lower cortisol reactivity predicted less decrease in depressive symptoms. Only self-reported anxiety and depressive symptoms were used. However, all predictors were objective biological measures, hence there is no risk of shared method variance bias. These findings suggest that pre-treatment HPA and ANS responsiveness to stress are predictive biomarkers for a lack of symptom improvement in children with a clinical anxiety disorder. Copyright © 2016 Elsevier B.V. All rights reserved.
Morou-Bermudez, Evangelia; Rodriguez, Selena; Bello, Angel S.; Dominguez-Bello, Maria G.
Objective Urease enzymes produced by oral bacteria generate ammonia, which can have a significant impact on the oral ecology and, consequently, on oral health. To evaluate the relationship of urease with dental plaque microbial profiles in children as it relates to dental caries, and to identify the main contributors to this activity. Methods 82 supragingival plaque samples were collected from 44 children at baseline and one year later, as part of a longitudinal study on urease and caries in children. DNA was extracted; the V3–V5 region of the 16S rRNA gene was amplified and sequenced using 454 pyrosequencing. Urease activity was measured using a spectrophotometric assay. Data were analyzed with Qiime. Results Plaque urease activity was significantly associated with the composition of the microbial communities of the dental plaque (Baseline P = 0.027, One Year P = 0.012). The bacterial taxa whose proportion in dental plaque exhibited significant variation by plaque urease levels in both visits were the family Pasteurellaceae (Baseline P<0.001; One Year P = 0.0148), especially Haemophilus parainfluenzae. No association was observed between these bacteria and dental caries. Bacteria in the genus Leptotrichia were negatively associated with urease and positively associated with dental caries (Bonferroni P<0.001). Conclusions Alkali production by urease enzymes primarily from species in the family Pasteurellaceae can be an important ecological determinant in children’s dental plaque. Further studies are needed to establish the role of urease-associated bacteria in the acid/base homeostasis of the dental plaque, and in the development and prediction of dental caries in children. PMID:26418220
Wheatcroft, Rebecca; Creswell, Cathy
This study investigated the relative associations between parent and child anxiety and parents' cognitions about their children. One hundred and four parents of children aged 3-5 years completed questionnaires regarding their own anxiety level, their child's anxiety level and their cognitions about the child, specifically parents' expectations…
Ram, Diana; Shapira, Joseph; Holan, Gideon; Magora, Florella; Cohen, Sarale; Davidovich, Esti
To investigate the effect of audiovisual distraction (AVD) with video eyeglasses on the behavior of children undergoing dental restorative treatment and the satisfaction with this treatment as reported by children, parents, dental students, and experienced pediatric dentists. During restorative dental treatment, 61 children wore wireless audiovisual eyeglasses with earphones, and 59 received dental treatment under nitrous oxide sedation. A Frankl behavior rating score was assigned to each child. After each treatment, a Houpt behavior rating score was recorded by an independent observer. A visual analogue scale (VAS) score was obtained from children who wore AVD eyeglasses, their parents, and the clinician. General behavior during the AVD sessions, as rated by the Houpt scales, was excellent (rating 6) for 70% of the children, very good (rating 5) for 19%, good (rating 4) for 6%, and fair, poor, or aborted for only 5%. VAS scores showed 85% of the children, including those with poor Frankl ratings, to be satisfied with the AVD eyeglasses. Satisfaction of parents and clinicians was also high. Audiovisual eyeglasses offer an effective distraction tool for the alleviation of the unpleasantness and distress that arises during dental restorative procedures.
Cărăuşu, Elena Mihaela; Mihăilă, C B; Indrei, L L
Education for oral-dental health in children is that component of general health education aimed at creating cultural health models, cultivating in the young generation a healthy hygienic behaviour and outlying the opinions about the ways dental disorders can be prevented and treated. The most important goal of health education is to contribute to the preservation/improvement of children's oral health status. This study has two main goals: to assess the exact health education knowledge of the questioned parents and to evaluate their involvement in the oral health education and promotion. This study included 95 parents, aged between 25 and 49 years, with children in primary schools. For data collection a questionnaire was used. The questions were grouped on common features: food habits and healthy diet, causes of oral disease, prevention of oral disease, dental visit habits, oral hygiene habits. The study revealed that parents have a moderate knowledge about dental health education and dental caries prevention, no significant sex differences being found, and poor knowledge about periodontal diseases prevention. As to food hygiene, parents proved a sound knowledge about healthy and unhealthy diet. Our conclusions at the end of this study is that the family with children in primary schools do not get involved in oral/dental health education.
Karande, S; Kumbhare, N; Kulkarni, M; Shah, N
Parents of children with specific learning disability (SpLD) undergo stress in coping with their child's condition. To measure the levels of anxiety and find out the cause of anxiety in mothers of children with SpLD at time of diagnosis. Prospective rating-scale and interview-based study conducted in our clinic. One hundred mothers of children (70 boys, 30 girls) with SpLD were interviewed using the Hamilton anxiety rating scale (HAM-A) and a semi-structured questionnaire. Detailed clinical and demographic data of mothers were noted. Chi-square test or unpaired student's t-test was applied wherever applicable. The mean age of mothers was 40.14 years (+/-SD 4.94, range 25.07-54.0), 73% belonged to upper or upper middle socioeconomic strata of society, 67% were graduates or postgraduates, 58% were full-time home-makers, and 33% lived in joint families. Levels of anxiety were absent in 24%, mild in 75%, and moderate in 1% of mothers. Their mean total anxiety score was 5.65 (+/-SD 4.75, range 0-21), mean psychic anxiety score was 3.92 (+/-SD 3.11, range 0-13), and mean somatic anxiety score was 1.76 (+/-SD 2.05, range 0-10). Their common worries were related to child's poor school performance (95%), child's future (90%), child's behavior (51%), and visits to our clinic (31%). Most mothers of children with SpLD have already developed mild anxiety levels by the time this hidden disability is diagnosed. These anxieties should be addressed by counseling to ensure optimum rehabilitation of these children.
Michalska, Kalina J; Machlin, Laura; Moroney, Elizabeth; Lowet, Daniel S; Hettema, John M; Roberson-Nay, Roxann; Averbeck, Bruno B; Brotman, Melissa A; Nelson, Eric E; Leibenluft, Ellen; Pine, Daniel S
The eye region of the face is particularly relevant for decoding threat-related signals, such as fear. However, it is unclear if gaze patterns to the eyes can be influenced by fear learning. Previous studies examining gaze patterns in adults find an association between anxiety and eye gaze avoidance, although no studies to date examine how associations between anxiety symptoms and eye-viewing patterns manifest in children. The current study examined the effects of learning and trait anxiety on eye gaze using a face-based fear conditioning task developed for use in children. Participants were 82 youth from a general population sample of twins (aged 9-13 years), exhibiting a range of anxiety symptoms. Participants underwent a fear conditioning paradigm where the conditioned stimuli (CS+) were two neutral faces, one of which was randomly selected to be paired with an aversive scream. Eye tracking, physiological, and subjective data were acquired. Children and parents reported their child's anxiety using the Screen for Child Anxiety Related Emotional Disorders. Conditioning influenced eye gaze patterns in that children looked longer and more frequently to the eye region of the CS+ than CS- face; this effect was present only during fear acquisition, not at baseline or extinction. Furthermore, consistent with past work in adults, anxiety symptoms were associated with eye gaze avoidance. Finally, gaze duration to the eye region mediated the effect of anxious traits on self-reported fear during acquisition. Anxiety symptoms in children relate to face-viewing strategies deployed in the context of a fear learning experiment. This relationship may inform attempts to understand the relationship between pediatric anxiety symptoms and learning. © 2017 Association for Child and Adolescent Mental Health.
Dawkins, Erika; Michimi, Akihiko; Ellis-Griffith, Gregory; Peterson, Tina; Carter, Daniel; English, Gary
Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Study subjects were children aged 6 to 15 years who participated in the school-based dental sealant program through the mobile dental clinic operated by the Institute for Rural Health at Western Kentucky University between September 2006 and May 2011 (n = 2,453). Descriptive statistics were calculated for sociodemographic factors (age, gender, race/ethnicity, insurance status, and urban versus rural residential location) and caries status. We used chi-square tests to compare sociodemographic differences of children stratified by caries and no caries status as well as three levels of caries severity. We developed a logistic regression model to investigate factors associated with untreated dental caries while controlling for sociodemographic characteristics. The proportion of children having untreated dental caries was 49.7% and the mean number of untreated dental caries was 2.0. The proportion of untreated dental caries was higher in older children, children with no insurance and living in rural residential locations, and caries severity was also higher in these groups. Odds ratio indicated that older ages, not having private insurance (having only public, government-sponsored insurance or no insurance at all) and rural residential location were associated with having untreated dental caries after controlling for sociodemographic characteristics of children. Untreated dental caries was more likely to be present in older children living in rural areas without insurance. Health interventionists may use
Background Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Methods Study subjects were children aged 6 to 15 years who participated in the school-based dental sealant program through the mobile dental clinic operated by the Institute for Rural Health at Western Kentucky University between September 2006 and May 2011 (n = 2,453). Descriptive statistics were calculated for sociodemographic factors (age, gender, race/ethnicity, insurance status, and urban versus rural residential location) and caries status. We used chi-square tests to compare sociodemographic differences of children stratified by caries and no caries status as well as three levels of caries severity. We developed a logistic regression model to investigate factors associated with untreated dental caries while controlling for sociodemographic characteristics. Results The proportion of children having untreated dental caries was 49.7% and the mean number of untreated dental caries was 2.0. The proportion of untreated dental caries was higher in older children, children with no insurance and living in rural residential locations, and caries severity was also higher in these groups. Odds ratio indicated that older ages, not having private insurance (having only public, government-sponsored insurance or no insurance at all) and rural residential location were associated with having untreated dental caries after controlling for sociodemographic characteristics of children. Conclusions Untreated dental caries was more likely to be present in older children living in rural areas without
Orgilés Amorós, Mireia; Espada Sánchez, José Pedro; Méndez Carrillo, Xavier
Anxiety in children through separation from parents is one of the most frequent psychological problems in the infantile population. Children of divorce are more vulnerable to suffer this disorder due to the abrupt separation from one of the parents after the break-up, which they may experience as a traumatic event that predisposes them to react anxiously in daily separations. The purpose of this study is to examine the presence of symptoms of separation anxiety and general anxiety in a Spanish sample of 95 students of ages between 8 and 12 years. They were compared to a group of children of similar ages and sex whose parents are not divorced. The results show that children of divorce present higher levels of separation anxiety than the children whose parents remain together. Moreover, they show significant levels of generalized anxiety, but similar to that of the other group of children (undivorced parents). The clinical implications of these findings are discussed, emphasizing the importance of cooperation and frequent contact of the children with both parents to promote their security and autonomy.
Uldum, Birgitte; Hallonsten, Anna-Lena; Poulsen, Sven
The aim of this study was to describe the introduction and the first six years use of midazolam for conscious sedation in a municipal dental service in Denmark. In 1998, all dentists were introduced to midazolam conscious sedation. A sedation chart was filled in for each session, and parents' assessment was obtained. In 2004, all clinical materials were collected. Six hundred and eighty sessions were performed; 63.7% of the children were between 2 and 6 years of age; 88.5% belonged to American Society of Anesthesiologists grade 1; 74.8% of the sedations performed used the oral route of administration. Restorations were performed during 60.3% of the sessions, and extractions during 38.4%. Complications during the sessions were rare, the most frequent being double vision (6.1%), hiccups (2.7%), and paradoxical reaction (2.0%). Using Wilton's sedation scale, 42.9% were calm and 27.7% were agitated during treatment, whereas after treatment 61.7% were calm; 80.4% of the parents were very positive towards this sedation method. Sedation with midazolam for dental treatment of children with dental fear and anxiety is a feasible and an efficient method with a low rate of complications. It can probably reduce the need for dental treatment under general anaesthesia.
Shang, Lin; Xu, Tian-Le; Li, Fei; Su, Jiansheng; Li, Wei-Guang
Accumulating clinical and preclinical evidence indicates that chronic pain is often comorbid with persistent low mood and anxiety. However, the mechanisms underlying pain-induced anxiety, such as its causality, temporal progression, and relevant neural networks are poorly understood, impeding the development of efficacious therapeutic approaches. Here, we have identified the sequential emergence of anxiety phenotypes in mice subjected to dental pulp injury (DPI), a prototypical model of orofacial pain that correlates with human toothache. Compared with sham controls, mice subjected to DPI by mechanically exposing the pulp to the oral environment exhibited significant signs of anxiogenic effects, specifically, altered behaviors on the elevated plus maze (EPM), novelty-suppressed feeding (NSF) tests at 1 but not 3 days after the surgery. Notably, at 7 and 14 days, the DPI mice again avoided the open arm, center area, and novelty environment in the EPM, open field, and NSF tests, respectively. In particular, DPI-induced social phobia and increased repetitive grooming did not occur until 14 days after surgery, suggesting that DPI-induced social anxiety requires a long time. Moreover, oral administration of an anti-inflammatory drug, ibuprofen, or an analgesic agent, ProTx-II, which is a selective inhibitor of NaV1.7 sodium channels, both significantly alleviated DPI-induced avoidance in mice. Finally, to investigate the underlying central mechanisms, we pharmacologically blocked a popular form of synaptic plasticity with a GluA2-derived peptide, long-term depression, as that treatment significantly prevented the development of anxiety phenotype upon DPI. Together, these results suggest a temporally progressive causal relationship between orofacial pain and anxiety, calling for more in-depth mechanistic studies on concomitant pain and anxiety disorders.
Bahammam, Maha A.
Objectives: To test the psychometric properties of an adapted Arabic version of the state trait anxiety-form Y (STAI-Y) in Saudi adult dental patients. Methods: In this cross-sectional study, the published Arabic version of the STAI-Y was evaluated by 2 experienced bilingual professionals for its compatibility with Saudi culture and revised prior to testing. Three hundred and eighty-seven patients attending dental clinics for treatment at the Faculty of Dentistry Hospital, King Abdullah University, Jeddah, Kingdom of Saudi Arabia, participated in the study. The Arabic version of the modified dental anxiety scale (MDAS) and visual analogue scale (VAS) ratings of anxiety were used to assess the concurrent criterion validity. Results: The Arabic version of the STAI-Y had high internal consistency reliability (Cronbach’s alpha: 0.989) for state and trait subscales. Factor analysis indicated unidimensionality of the scale. Correlations between STAI-Y scores and both MDAS and VAS scores indicated strong concurrent criterion validity. Discriminant validity was supported by the findings that higher anxiety levels were present among females as opposed to males, younger individuals as compared to older individuals, and patients who do not visit the dentist unless they have a need as opposed to more frequent visitors to the dental office. Conclusion: The Arabic version of the STAI-Y has an adequate internal consistency reliability, generally similar to that reported in the international literature, suggesting it is appropriate for assessing dental anxiety in Arabic speaking populations. PMID:27279514
Jain, Meena; Tandon, Shourya; Sharma, Ankur; Jain, Vishal; Rani Yadav, Nisha
Background: An appropriate scale to assess the dental anxiety of Hindi speaking population is lacking. This study, therefore, aims to evaluate the psychometric properties of Hindi version of one of the oldest dental anxiety scale, Corah’s Dental Anxiety Scale (CDAS) in Hindi speaking Indian adults. Methods: A total of 348 subjects from the outpatient department of a dental hospital in India participated in this cross-sectional study. The scale was cross-culturally adapted by forward and backward translation, committee review and pretesting method. The construct validity of the translated scale was explored with exploratory factor analysis. The correlation of the Hindi version of CDAS with visual analogue scale (VAS) was used to measure the convergent validity. Reliability was assessed through calculations of Cronbach’s alpha and intra class correlation 48 forms were completed for test-retest. Results: Prevalence of dental anxiety in the sample within the age range of 18-80 years was 85.63% [95% CI: 0.815-0.891]. The response rate was 100 %. Kaiser-Meyer-Olkin (KMO) test value was 0.776. After factor analysis, a single factor (dental anxiety) was obtained with 4 items.The single factor model explained 61% variance. Pearson correlation coefficient between CDASand VAS was 0.494. Test-retest showed the Cronbach’s alpha value of 0.814. The test-retest intraclass correlation coefficient of the total CDAS score was 0.881 [95% CI: 0.318-0.554]. Conclusion: Hindi version of CDAS is a valid and reliable scale to assess dental anxiety in Hindi speaking population. Convergent validity is well recognized but discriminant validity is limited and requires further study. PMID:29744307
Jain, Meena; Tandon, Shourya; Sharma, Ankur; Jain, Vishal; Rani Yadav, Nisha
Background: An appropriate scale to assess the dental anxiety of Hindi speaking population is lacking. This study, therefore, aims to evaluate the psychometric properties of Hindi version of one of the oldest dental anxiety scale, Corah's Dental Anxiety Scale (CDAS) in Hindi speaking Indian adults. Methods: A total of 348 subjects from the outpatient department of a dental hospital in India participated in this cross-sectional study. The scale was cross-culturally adapted by forward and backward translation, committee review and pretesting method. The construct validity of the translated scale was explored with exploratory factor analysis. The correlation of the Hindi version of CDAS with visual analogue scale (VAS) was used to measure the convergent validity. Reliability was assessed through calculations of Cronbach's alpha and intra class correlation 48 forms were completed for test-retest. Results: Prevalence of dental anxiety in the sample within the age range of 18-80 years was 85.63% [95% CI: 0.815-0.891]. The response rate was 100 %. Kaiser-Meyer-Olkin (KMO) test value was 0.776. After factor analysis, a single factor (dental anxiety) was obtained with 4 items.The single factor model explained 61% variance. Pearson correlation coefficient between CDASand VAS was 0.494. Test-retest showed the Cronbach's alpha value of 0.814. The test-retest intraclass correlation coefficient of the total CDAS score was 0.881 [95% CI: 0.318-0.554]. Conclusion: Hindi version of CDAS is a valid and reliable scale to assess dental anxiety in Hindi speaking population. Convergent validity is well recognized but discriminant validity is limited and requires further study.
Beesdo, Katja; Knappe, Susanne; Pine, Daniel S.
This review summarizes findings on the epidemiology and etiology of anxiety disorders among children and adolescents including separation anxiety disorder, specific phobia, social phobia, agoraphobia, panic disorder, and generalized anxiety disorder, also highlighting critical aspects of diagnosis, assessment, and treatment. Childhood and adolescence is the core risk phase for the development of anxiety symptoms and syndromes, ranging from transient mild symptoms to full-blown anxiety disorders. This article critically reviews epidemiological evidence covering prevalence, incidence, course, and risk factors. The core challenge in this age span is the derivation of developmentally more sensitive assessment methods. Identification of characteristics that could serve as solid predictors for onset, course, and outcome will require prospective designs that assess a wide range of putative vulnerability and risk factors. This type of information is important for improved early recognition and differential diagnosis as well as prevention and treatment in this age span. PMID:19716988
Mogg, K; Salum, G A; Bradley, B P; Gadelha, A; Pan, P; Alvarenga, P; Rohde, L A; Pine, D S; Manfro, G G
Research with adults suggests that anxiety is associated with poor control of executive attention. However, in children, it is unclear (a) whether anxiety disorders and non-clinical anxiety are associated with deficits in executive attention, (b) whether such deficits are specific to anxiety versus other psychiatric disorders, and (c) whether there is heterogeneity among anxiety disorders (in particular, specific phobia versus other anxiety disorders). We examined executive attention in 860 children classified into three groups: anxiety disorders (n = 67), attention-deficit/hyperactivity disorder (ADHD; n = 67) and no psychiatric disorder (n = 726). Anxiety disorders were subdivided into: anxiety disorders excluding specific phobia (n = 43) and specific phobia (n = 21). The Attention Network Task was used to assess executive attention, alerting and orienting. Findings indicated heterogeneity among anxiety disorders, as children with anxiety disorders (excluding specific phobia) showed impaired executive attention, compared with disorder-free children, whereas children with specific phobia showed no executive attention deficit. Among disorder-free children, executive attention was less efficient in those with high, relative to low, levels of anxiety. There were no anxiety-related deficits in orienting or alerting. Children with ADHD not only had poorer executive attention than disorder-free children, but also higher orienting scores, less accurate responses and more variable response times. Impaired executive attention in children (reflected by difficulty inhibiting processing of task-irrelevant information) was not fully explained by general psychopathology, but instead showed specific associations with anxiety disorders (other than specific phobia) and ADHD, as well as with high levels of anxiety symptoms in disorder-free children.
Virtanen, Jorma I; Berntsson, Leeni T; Lahelma, Eero; Köhler, Lennart; Murtomaa, Heikki
Background An increase in the use of general practitioner services for children has taken place since the 1980s in the Nordic countries, but little is known about the use of dental services during this time. Aim To compare differences in children's use of dental services in the five Nordic countries and to analyse changes over time from the 1980s to the 1990s. Methods The participants were 20 500 children aged 2–17 years from Denmark, Finland, Iceland, Norway and Sweden. Cross‐sectional population surveys using random samples comprising 3000 children in each country were conducted in 1984 and 1996. Changes over time in the use of dental services were studied in each country by age, sex, level of parental education and living area. Results The prevalence of children's utilisation of dental services varied between 60% and 34% in 1984, and between 42% and 30% in 1996. A clear change towards decreasing utilisation over time (p<0.05) was found in all countries except Finland, where utilisation increased statistically significantly (p<0.05). Odds ratios (1984 = 1.00) for the changes ranged between 0.66 (95% confidence interval 0.58 to 0.75) in Sweden and 0.71 (0.62 to 0.81) in Iceland, while the corresponding figure was 1.32 (1.16 to 1.48) in Finland. In 1996, children from families with the lowest education in Finland and Norway used dental services more frequently than children from families with higher education. Conclusion Children's use of dental services decreased significantly in four of the five Nordic countries between the mid‐1980s and the mid‐1990s. PMID:18000131
Savost'ianova, O L
The peculiarities of premorbid stage in children, aged 5-15 years, with ICD-10 diagnosis of anxiety-phobic disorders have been studied. The patient's mental state has been described earlier (Savostyanova, 2001). Retrospective evaluation of the patient's state in premorbid allowed to detect the disturbances in personality formation, anxiety phobic reactions and autochthon phases, represented by continuum of subclinical disorders, from floating anxiety to the signs of vital anxiety. These traits are distinguished by instability and inconsistency as well as by mild expression, which did not reach a level of manifest disorders. Personality of the children, who develop anxiety phobic disorders, may be emotionally labile as well as rigid one inclining to negative effectiveness. Hereditable and environment factors influencing anxiety phobic disorders development were detected. The premorbid traits are concluded to reflect inherited anxiety diathesis, which determines the peculiarities of reaction to negative environment and results not only in personality development but also in the large spectrum of future anxiety phobic symptoms.
Brickhouse, Tegwyn H; Rozier, R Gary; Slade, Gary D
We compared levels of untreated dental caries in children enrolled in public insurance programs with those in nonenrolled children to determine the impact of public dental insurance and the type of plan (Medicaid vs State Children's Health Insurance Program [SCHIP]) on untreated dental caries in children. Dental health outcomes were obtained through a calibrated oral screening of kindergarten children (enrolled in the 2000-2001 school year). We obtained eligibility and claims data for children enrolled in Medicaid and SCHIP who were eligible for dental services during 1999 to 2000. We developed logistic regression models to compare children's likelihood and extent of untreated dental caries according to enrollment. Children enrolled in Medicaid or SCHIP were 1.7 times (95% confidence interval [CI] = 1.65, 1.77) more likely to have untreated dental caries than were nonenrolled children. SCHIP-enrolled children were significantly less likely to have untreated dental caries than were Medicaid-enrolled children (odds ratio [OR]=0.74; 95% CI=0.67, 0.82). According to a 2-part regression model, children enrolled in Medicaid or SCHIP have 17% more untreated dental caries than do nonenrolled children, whereas those in SCHIP had 16% fewer untreated dental caries than did those in Medicaid. Untreated tooth decay continues to be a significant problem for children with public insurance coverage. Children who participated in a separate SCHIP program had fewer untreated dental caries than did children enrolled in Medicaid.
White, Susan W.; Oswald, Donald; Ollendick, Thomas; Scahill, Lawrence
Anxiety and poor stress management are common concerns in clinical samples of children with autism spectrum disorders (ASD). Anxiety may worsen during adolescence, as young people face an increasingly complex social milieu and often become more aware of their differences and interpersonal difficulties. This review summarizes the state of research on the prevalence, phenomenology, and treatment of anxiety in youth with autism and related conditions such as Asperger’s disorder. Using search words autism, asperger(s), or pervasive developmental disorder and anxiety or anxious to find reports published between 1990 and 2008, this review identified 40 papers. The results of the review suggest that anxiety, whether measured categorically or dimensionally, is indeed common in children and adolescents with autism spectrum disorders and may be a source of additional morbidity. The assessment of anxiety disorders in ASD should be conducted using multiple informants and modalities, as children with ASD often do not display age-typical symptoms of anxiety. To date, relatively few controlled intervention studies using well-characterized samples have been conducted despite preliminary evidence for efficacy of select pharmacological and psychosocial approaches. Recommendations for future applied research are presented and clinical implications are explored. PMID:19223098
Yen, Chin-En; Huang, Yi-Chia; Hu, Suh-Woan
This study assessed the relationship between intake of nutrients and dental caries in preschool children. One hundred and eighty-two children aged three to six years were recruited from nine day care centers in central Taiwan. These children had an oral health examination, and their parents or guardians answered a questionnaire. Each child's intake of nutrients was estimated using the 24-hour dietary recall and food frequency questionnaire data. Logistic regression analysis was applied to assess the associations between dental caries and intake of each nutrient or food group, with adjustment for potential confounders. The prevalence of dental caries was 73 % and increased with age. Not being a first-born and having more between-meal snacks were associated with increased caries risk. After controlling for other important factors, vitamin A intake was significantly associated with fewer dental caries (deft, decayed, indicated for extraction, and filled primary teeth: ≥ 4 vs. < 4), with an odds ratio of 0.97 (95 % confidence interval: 0.94 - 0.99) for an 100-μg increase in vitamin A intake. There was no significant association between dental caries and energy, macronutrient intake, and Ca/P ratio, respectively. Vegetable intake was also significantly associated with lower dental caries score.
Pikramenou, V; Dimitraki, D; Zoumpoulakis, M; Verykouki, E; Kotsanos, N
This was to explore the association between dental caries and body mass index (BMI) by conducting a cross-sectional study of a sample of preschool children from a major Greek city. The sample consisted of 2180 children aged 2.5-5.9 years from 33 private day care centres of Thessaloniki. The examinations were performed on site in ample day light by one examiner using disposable dental mirrors and a penlight. Oral examinations included recording of dental caries by dmfs index. Subject's height and weight were measured using a portable measuring unit and a digital scale, respectively. The overall prevalence of underweight, normal weight, overweight and obese children in each BMI-based weight category was 11.8, 72.2, 12.8, and 3.2 %, respectively. The mean age of the total sample was 50.09 (±10.28) months, mean dmfs was 0.36 (±1.9) and the caries-free children were 90.0 %. Overweight children were 1.36 times and obese children 1.99 times more likely to have higher dmfs than normal weight children. The mean dmfs values of underweight children did not significantly differ than that of children with normal weight. The relatively higher dmfs of the obese and overweight children was mostly evident in the older (60-71 months) age group. Caries prevalence in this sample of Greek children attending private day care centres was low. Overweight and obese preschool children were at higher risk of dental caries than normal- and underweight children.
Kiluk, Brian D.; Weden, Sarah; Culotta, Vincent P.
Objective: Few studies have examined the psychological benefits of physical activity in children with ADHD who may be at higher risk for mood and anxiety problems. This study explores the relationship between participation in physical activity and emotional functioning in children with ADHD. Method: Scores on parent-reported measures of mood and…
McConachie, Helen; McLaughlin, Eleanor; Grahame, Victoria; Taylor, Helen; Honey, Emma; Tavernor, Laura; Rodgers, Jacqui; Freeston, Mark; Hemm, Cahley; Steen, Nick; Le Couteur, Ann
Aim: To investigate the acceptability and feasibility of adapted group therapy for anxiety in children with autism spectrum disorder in a pilot randomised controlled trial. Method: A total of 32 children aged 9-13 years were randomised to immediate or delayed therapy using the "Exploring Feelings" manual (Attwood, 2004). Child and parent…
Orgiles, Mireia; Mendez, Xavier; Spence, Susan H.; Huedo-Medina, Tania B.; Espada, Jose P.
The purpose of this study was to investigate the factorial structure and psychometric properties of the Spence Children's Anxiety Scale (SCAS) in a sample of 1,708 Spanish children aged between 8 and 12 years. The SCAS was demonstrated to have satisfactory internal consistency with the Spanish sample, and factor analysis confirmed the six-factor…
Pratt, Michelle L.; Hill, Elisabeth L.
Previous work has highlighted that children diagnosed with DCD may be at risk of greater problems related to emotional wellbeing. However, to date much work has relied on population based samples, and anxiety has not been examined within a group of children given a clinical diagnosis of DCD. Additionally, the profile of individual differences has…
Bodas, Jaee; Ollendick, Thomas H; Sovani, Anuradha V
The present investigation examined test anxiety in Indian children from a cross-cultural perspective. Test anxiety has been studied extensively in western countries but much less so in eastern countries. Furthermore, the cross-cultural research conducted in eastern countries possesses significant limitations and continues to possess a western bias. The present research attempted to advance cross-cultural research on test anxiety by adopting Berry's imposed etic-emic-derived etic methodology. Participants included 231 schoolchildren. Qualitative data were collected to examine culture-specific variables (emic considerations) using structured focus groups and open-ended questions. Next, quantitative data were collected using translated and adapted versions of Spielberger's Test Anxiety Inventory and the FRIEDBEN Test Anxiety Scale. Qualitative data indicated culture-specific elements of test anxiety in Indian youth, including the high stakes associated with exam performance and future schooling as well as the role of somatization and social derogation in the phenomenological experience of test anxiety. Although quantitative findings failed to confirm the importance of high-stakes environments on test anxiety, the importance of somatization and social derogation was substantiated. Ongoing desensitization to test anxiety and enhanced coping responses were proposed as possible explanations for the obtained relations.
Özyazıcıoğlu, Nurcan; Buran, Gonca
This is a descriptive study carried out to determine the state-trait anxiety and social support perceptions of parents with disabled children. This study has been carried out on 75 parents whose children attended the Private Rehabilitation Center. The data included the personal information form composed by the investigators, the state-trait anxiety inventory, and the multi-dimensional scale of perceived social support. The disabilities of the children were mental in 26.7%, physical in 25.3%, and physical/mental in 12%. As the degree of disability increased and the income levels decreased, the trait anxiety scores of the parents increased. There was a significant negative correlation between parental age and social support. Among the parents, 37.3% experienced problems with their spouses after having a child with a disability. The development and implementation of alternative support systems for of parents with disabled children would be beneficial. © 2014 Association of Rehabilitation Nurses.
Da Rosa, P; Rousseau, Marie-Claude; Edasseri, A; Henderson, M; Nicolau, B
Socioeconomic position (SEP) is inversely associated with most oral health outcomes, but the patterns of association may vary depending on the specific outcome. We estimated associations between SEP and two oral health outcomes, dental caries and traumatic dental injuries (TDI), in Quebec children. We used data from the baseline visit of the QUALITY (QUebec Adipose and Lifestyle Investigation in Youth) Cohort, an ongoing study in Montreal and Quebec, Canada. The analytical sample included 590 children aged 8-10 years. Data on parents' SEP (household income, education) and children's health behaviours and involvement in sports were obtained through questionnaires and interviews. Oral health outcomes (dental caries and TDI in permanent teeth) were assessed by clinical oral exam. Negative binomial regression was used to model dental caries (DMFS index) and number of teeth with TDI adjusting for selected covariates. The mean (SD) DMFS and number of TDI were 0.61 (1.43) and 0.12 (0.43), respectively. Compared to the upper quartile of income, children in the lower quartile had a DMFS approximately 3 times higher (PRR=2.68, 95% CI: 1.43, 5.04). Adjusting for oral health and nutritional behaviours had no effect. Conversely, children in the highest income quartile had a 3 times higher number of teeth with TDI compared to the lowest quartile (PRR=3.14, 95% CI: 1.22, 8.08). Physical activity did not explain this relationship. Parents' education was not associated with dental caries or TDI. SEP seems to play a different role in the cause of dental caries and TDI. Copyright© 2017 Dennis Barber Ltd.
Kopycka-Kedzierawski, Dorota T; Auinger, Peggy
The purpose of this study was to assess the oral health status and dental needs of a nationally representative sample of 1- to 17-year-old children with or without autism. In the 2003 National Survey of Children's Health, parents reported their child's oral health status and needs. The condition of the child's teeth, demographics, time since last dental visit, and dental needs were assessed in autistic children (N=495) and nonautistic children (N=95,059). For a subset of children with reported fair or poor teeth, specific problems about their dentition were assessed for autistic children (N=69) and nonautistic children (N=7,002). Weighted percentages and chi-square statistics were calculated. According to parents, 69% of nonautistic children and 52% of autistic children had their teeth in excellent or very good condition (P <.001). The dental status of children with autism and without autism, identified with fair or poor teeth, was comparable. Overall, parents of US autistic children were more likely to report their children's dentition to be in fair or poor condition than parents of US nonautistic children. Children with or without autism who had fair or poor teeth are faced with similar dental problems.
Ahmadi, Atefeh; Mustaffa, Mohamed Sharif; Haghdoost, Ali Akbar; Mansor, Syed Mohamed Shafeq
Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study. 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20) consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21). Teacher ratings of children's mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother's educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes. Results provide support for the effectiveness of eclectic art and CBT to improve children's mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety.
Kathariya, Mitesh D; Nikam, Atul Pralhad; Chopra, Kirti; Patil, Namrata N; Raheja, Hitesh; Kathariya, Renuka
The purpose of the present study is to investigate the prevalence of dental anomalies according to gender among children. This cross-sectional study was conducted a group of 600 children, of them 293 (48.8%) were males and 275 (45.8%) females which were taken with proper sampling technique. Type III clinical examination was done to know the prevalence of dental anomalies. The Statistical software namely SPSS version 16.0 was used for data analysis. Chi-square test was used at p value of 0.05 or less. Impactions (39.2%) were the most common anomaly in this study and most of the impacted teeth were related to maxilla. A significant difference was seen in case of hypodontia, microdontia and talons cusp according to gender in which first two anomalies were more among females and last one among males. Children with one dental anomaly were 25.8%, and 13.4% were having more than one. The percentage of dental anomalies were high specially impaction and rotated teeth. So these anomalies should be treated earlier to avoid further complications. How to cite this article: Kathariya MD, Nikam AP, Chopra K, Patil NN, Raheja H, Kathariya R. Prevalence of Dental Anomalies among School Going Children in India. J Int Oral Health 2013; 5(5):10-4.
Creswell, Cathy; Waite, Polly; Cooper, Peter J
Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm. PMID:24636957
Creswell, Cathy; Waite, Polly; Cooper, Peter J
Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm.
Villalobos-Rodelo, Juan José; Medina-Solís, Carlo Eduardo; Maupomé, Gerardo; Lamadrid-Figueroa, Hector; Casanova-Rosado, Alejandro José; Casanova-Rosado, Juan Fernando; Márquez-Corona, María de Lourdes
To identify the effect of unmet dental treatment needs and socioeconomic and sociodemographic variables on the patterns of dental visits in the presence of dental pain in 6- to 12-year-old Mexican schoolchildren. A case-control study included 379 patients that had a dental visit because of dental pain in the 12 months preceding this study and 1,137 controls. Mothers and/or guardians supplied sociodemographic, socioeconomic, and oral health-related information through a questionnaire. The profiles of unmet dental needs and of oral hygiene were ascertained by means of a standardized dental examination administered to participating children. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated with logistic regression. Higher unmet dental needs and lack of health insurance were associated with the experience of dental visits because of dental pain in the preceding 12 months. Boys who attended public schools had a 70% (95% CI = 1.29 to 2.23) higher probability of having had a dental visit in which dental pain was one of the main reasons for attendance, compared to boys attending private schools. The effect for girls was only 28% (95% CI = 1.10 to 1.50) higher for girls attending a public school, compared to girls attending private schools. Older children had a higher occurrence of dental visits because of dental pain than younger children. While higher unmet dental needs and lack of health insurance were strong predictors of having had dental visits because of dental pain in the preceding 12 months, some socioeconomic variables and sociodemographic variables modified these relationships.
Wong, Yee Chen; Mohan, Mandakini; Pau, Allan
To investigate the antibiotic prescribing training received by dental students, clinical experience in treating child patients, awareness of antibiotic prescribing guidelines, preparedness in antibiotic prescribing, and compliance with antibiotic prescribing guidelines for the management of dental infections in children. This was a cross-sectional study involving final year dentals students from Malaysian and Asian dental schools. A self-administered questionnaire consisting of five clinical case scenarios was e-mailed to all final year students at selected dental schools. Students' responses were compared for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association. Compliance in each scenario was tested for association with their preparedness in antibiotic prescribing, previous training on antibiotic prescribing and awareness of antibiotic prescribing guidelines using Chi-square test. Data collected were analyzed using SPSS statistics version 20. A total of 108 completed responses were received. About 74 (69%) students were from Malaysian dental schools. The compliance rate with prescribing guidelines ranged from 15.7% to 43.5%. Those attending Malaysian dental schools (47.3%) and those who had treated child patient more often (46.3%) were more likely (P < 0.05) to be aware of the guidelines. Those who had received antibiotic prescribing training (21.3%) were more likely to think they were well prepared in antibiotic prescribing (P < 0.05). Final year dental students had low awareness and compliance with antibiotic prescribing guidelines. Further research is needed to investigate how compliance with the guidelines may be enhanced.
Barry, S; O'Sullivan, E A; Toumba, K J
This study examined the problems encountered by children with autism spectrum disorder (ASD), when accessing dental care. This was a cross-sectional, case-control questionnaire study. A piloted questionnaire was developed to identify the main barriers to dental care experienced by patients with ASD in Hull and East Riding. The study group was comprised of parents/carers of children with ASD, and the control group was comprised of parents/carers of age matched healthy, neurotypical children. Results were analysed using Chi-square and Fisher's exact tests where appropriate. Significance was deemed at p < 0.05. Ordinal data was presented using medians and 25th and 75th centiles and compared using Mann-Whitney U test. A piloted questionnaire was developed to identify the main barriers to dental care experienced by patients with ASD in Hull and East Riding. The study group was comprised of parents/carers of children with ASD, and the control group was comprised of parents/carers of age matched healthy, neurotypical children. 112 subjects completed the questionnaire. There was no significant difference in accessing dental care between study and control groups (p = 0.051), although access was perceived as more difficult in the ASD group (p < 0.001). There was a significantly greater perceived difficulty in travelling to the dental surgery in the ASD group. Predicted negative behaviours were more frequent in the ASD group. All suggested interventions were predicted to be helpful in a significantly greater proportion of the ASD group. Difficulties exist for children with ASD in accessing dental care in the Hull and East Riding area.
Bögels, S M; van Oosten, A; Muris, P; Smulders, D
Retrospective studies suggest a relationship between parental rearing practices and social phobia. The present study investigated whether socially anxious children perceive their current parental rearing as rejecting, overprotective, and lacking emotional warmth, and as emphasizing the importance of other's opinion, and de-emphasizing social initiatives and family sociability. Furthermore, we examined whether parents of socially anxious children report to rely on such rearing practices, and suffer themselves from social fears. A regression analysis as well as extreme group comparisons were applied. Little support was found for the presumed role of the assessed family rearing aspects in the development of social anxiety in children. Solely family sociability (children's and mothers' report) and children's perception of overprotection of the mother predicted social anxiety in the regression analysis. Given the influence of the mentioned rearing practices, social anxiety of the mother still significantly predicted social anxiety of the child. In the extreme group comparisons, differences in the expected direction were found between socially anxious and normal children on parental rejection, emotional warmth, and family sociability. However, the lack of differences between socially anxious and clinical control children suggests that these variables do not form a specific pathway to social fears.
Noorani, Hina; Shivaprakash, PK
ABSTrACT Objective: Objectives of our studies were to predict dental fear in a child patient depending on salivary alpha amylase (sAA) level before and after dental treatment and to evaluate correlation of later with behavior of child patient during dental treatment. Materials and methods: Seventy-seven children between age of 5 and 12 years were divided in three groups. Group 1 consisted of 25 school children who did not undergo any dental treatment. Groups 2 and 3 underwent dental treatment without and with local anesthesia respectively. Groups 2 and 3 were administered child fear survey schedule-dental subscale (CFSS-DS) questionnaire before treatment. Salivary samples were collected for sAA estimation in groups 2 and 3 children before and after completion of dental treatment and behavior during treatment was noted using Frankel behavior rating scale. Group 1 acted as control in which salivary sample was collected in absence of dental stress. Results: When groups 2 and 3 were combined, pretreatment sAA level had a statistically significant (p = 0.0094) correlation with CFSS-DS scores. Conclusion: Alpha amylase can be used as a screening tool to predict level of dental fear in a child patient. How to cite this article: Noorani H, Joshi HV, Shivaprakash PK. Salivary Alpha Amylase as a Noninvasive Biomarker for Dental Fear and Its Correlation with Behavior of Children during Dental Treatment. Int J Clin Pediatr Dent 2014;7(1):19-23. PMID:25206232
Kotsopoulos, S; Mellor, C
Nine children with conduct and nine with anxiety disorder participated in the study. The subjects were requested to respond to verbal tasks (counting, picture description, story telling). Disturbance of conduct was associated with short initial hesitation before speaking. It is suggested that the initial hesitation variables are measures of reflection and cognitive planning. Anxiety across subjects was associated with increased breath rate and lower output of speech per breath. It is suggested speech breath variables are reliable measures of anxiety. Implication for the diagnosis and management of child psychiatric disorders are discussed.
Willis, Thomas A; Gregory, Alice M
Sleep problems are common in children and adolescents. A growing body of research has explored the relationship between sleep problems and anxiety in youth. When reviewing the literature, methodologic inconsistencies need to be considered, such as variation in conceptualization of sleep problems, measurement of sleep, and the classification of anxiety. Despite this, there seems to be good evidence of concurrent and longitudinal associations between sleep difficulties and anxiety in community and clinical samples of young people. Potential mechanisms are proposed. There is a need for further exploration of these relationships, with the hope of aiding preventive capability and developing useful treatments. Copyright © 2015 Elsevier Inc. All rights reserved.
Pinto, Inês; Wilkinson, Simon; Virella, Daniel; Alves, Marta; Calhau, Conceição; Coelho, Rui
This observational study explores potential links between obese children's cortisol, and parental mental state, family functioning, and the children's symptoms of anxiety and depression. A non-random sample of 104 obese children (55 boys), mean age 10.9 years (standard deviation 1.76), was recruited from a childhood obesity clinic. Obesity was defined as body mass index above the 95th age- and gender-specific percentiles. Neuroendocrine biomarkers were measured. Symptoms of anxiety and depression were assessed with self and parent-reported questionnaires (Anxiety, Depression and Stress Scales; Child Behaviour Checklist). Family functioning was assessed with parent-reported questionnaires (Family Adaptation and Cohesion Scales-III). A significant, negative correlation (rs = -0.779; p = 0.003) between girls' cortisol and their parents' anxiety symptoms was found, limited to high functioning families. Boys scored significantly higher than girls on parent-reported internalizing symptoms but not on self-report. No association was found between cortisol in children and parental depressive symptoms. Whether the association between cortisol levels in obese children and parental mental health is effectively restricted to girls from high functioning families or is due to study limitations, requires further research. The lack of associations between cortisol in children and parental depressive symptoms, suggests a specific association between cortisol and parental anxiety symptoms. These results highlight the importance of taking into account family functioning, parental mental state and gender, when investigating neuroendocrine biomarkers in obese children associated with symptoms of anxiety and depression.
Prathima, Gajula Shivashankarappa; Sajeev, Renganathan; Kayalvizhi, Gurusamy; Ramesh, Venkatesan; Ezhumalai, Govindasamy
Introduction Dental setting plays an important role in child’s behavior and cooperation to the planned dental treatment. Adding attractive colours to the dental environment and by incorporating colourful equipments can make the child feel good and be at ease. This study tries to convey the relationship between colours and dental anxiety among children. Aim To evaluate the colour preference to emotions in relation to children’s age, gender and anxiety level. Materials and Methods A total of 382 children aged 6-12 years were randomly selected from schools in and around Puducherry. Modified dental anxiety scale was recorded by a calibrated examiner. Each question was scored from one (not anxious) to five (extremely anxious); such that the total score ranges from 5 to 25, wherein a score of 15 or more was considered to be anxious. Based on this, children were divided into anxious and non-anxious groups. All the children were provided with eight different coloured crayon pencils and were asked to shade two cartoon emoticons indicating happiness and sadness with their preferred colour. Values were tabulated and statistically analyzed to evaluate the association between the variables using Z test, Chi-square, Chi-square goodness of fit and odds ratio. (p≤0.05 was considered statistically significant). Results Among 382 children, 77% (294) were graded as anxious and 23% (88) as non- anxious. For positive emotion (happiness), 31.2% (119) children preferred blue followed by pink 29.3% (112). For negative emotion (sadness), 52.1% (199) of children preferred black and 46.9% (179) preferred red. Association between colour and emotion was highly significant (p= 0.005). Conclusion From the colours preferred by the children in our study, it can be concluded that colours like blue and pink in the dental set-up could enhance a positive attitude while black and red could develop a negative outlook in their mind. PMID:27630948
van Steensel, Francisca J. A.; Bogels, Susan M.; Dirksen, Carmen D.
Comorbid anxiety disorders are common in children with autism spectrum disorders (ASD). However, studies comparing children with ASD to clinically anxious children are rare. This study investigated anxiety problems and health-related quality of life in children with high-functioning ASD and comorbid anxiety disorders (referred to as the ASD…
Rupnow, Allan A.
Two research reports are included in this document. The first is a study of children's anxiety. A sixteen-item trait anxiety scale was used on a population of students in grades 4 through 6. The first ten items measured anxiety about making mistakes in performing physical education activities, and the remaining six items measured general anxiety.…
Shaban, R; Kassim, S; Sabbah, W
Aim To assess socioeconomic inequality regarding specific preventive interventions (fissure sealants or any treatment to prevent caries) and dental visits among UK children.Method Data were from the Children's Dental Health Survey 2003, which included participants from England, Wales, Scotland, and Northern Ireland. The number of children in the analysis was 2,286. Variables were sex, age, area of residency (for example, England), mother's education, family social class, and deprivation level. Descriptive and regression analyses were performed.Results There were no significant socioeconomic differences in the use of preventive services. Deprivation and family social class (for example, intermediate and manual) were significantly associated with less regular dental visits (odd ratio 0.41, 95% CI [0.28, 0.63]; odd ratio 0.53, 95% CI [0.31, 0.89]; odd ratio 0.37, 95% CI [0.24, 0.58], respectively). Regular dental visits were associated with reporting preventive care for caries (odds ratio 2.25, 95% CI [1.45, 3.49]) and with the number of sealed tooth surfaces (rate ratio 1.73, 95% CI [1.16, 2.60]).Conclusion Despite apparent socioeconomic inequalities in regular dental visits, there was no significant inequality in using specific preventive interventions by children in the UK. This finding should be interpreted with caution considering the relatively small subsample included in this analysis.
Petraccone Caixeta, Anna Cristina; Andrade, Ildeu; Bahia Junqueira Pereira, Tatiana; Franco, Letícia Paiva; Becker, Helena Maria Gonçalves; Souki, Bernardo Quiroga
The purposes of this study were to investigate the dental arch changes after adenotonsillectomies in prepubertal children and to compare the dental arch dimensions of mouth-breathing and nasal-breathing children. The sample included 49 prepubertal severely obstructed mouth-breathing children and 46 prepubertal nasal-breathing children. Twenty-four of the 49 mouth-breathing children had an adenotonsillectomy and composed the adenotonsillectomy subgroup. The 25 children in whom the mouth-breathing pattern was unchanged during the 1-year study period composed the control subgroup. The mouth-breathing children showed a deeper palatal vault, a larger mandibular width, and a larger mandibular arch length in comparison with the nasal-breathing children. After airway clearance, the adenotonsillectomy group showed a significant maxillary transverse width gain compared with the control subgroup. The control subgroup showed a significant deepening of the palatal height when compared with the adenotonsillectomy subgroup after 1 year. The adenotonsillectomy subgroup had a significantly different pattern of arch development compared with the untreated controls. After adenotonsillectomy, the mouth-breathing children showed greater maxillary transverse development than did the controls. The palatal vault deepened in the untreated children. The mouth-breathing children showed a deeper palatal vault, a larger mandibular width, and a larger mandibular arch length in comparison with the nasal-breathing children. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Azodo, C C; Chukwumah, N M; Ezeja, E B
To determine the incidence and causes of dentoalveolar abscess among children attending an outpatient dental clinic in Nigeria. This is a retrospective study of paediatric dental patients treated in University of Benin Teaching Hospital, Benin City from October 2010 to September 2011. The incidence of dentoalveolar abscess was 6.4% (53/824). However only 42 cases had their case notes retrieved for final research analysis. It occurred mostly in the lower right quadrant of the mouth. The affected children were majorly males and first or second child of monogamous family. A total 17 (40.5%) of the affected children were in the 6-11 years age group. This was the first dentist consultation among 35 (83.3%) of the children. The presenting complaint was toothache among two-thirds of the children. History of asthma, tonsillitis, peptic ulcer disease and previous surgery were medical history elicited from 6 (14.3) of the patients. The most implicated tooth was deciduous first molar. The causes of abscess include untreated dental caries 35 (83.3%), trauma 5 (11.9%), failed restoration 1 (2.4%) and periodontal diseases 1 (2.4%). Periapical radioluscency was predominant radiological finding among affected children. Tooth extraction was commonest treatment done. The incidence of dentoalveolar abscess among children was significant. The high frequency of untreated dental caries as the cause of dentoalveolar abscess indicates the need for school and community-based preventive strategies like encouraging infant oral health and preventive dentistry programs and early treatment intervention and dental health education.
Ishikawa, Shin-ichi; Shimotsu, Saki; Ono, Tetsuya; Sasagawa, Satoko; Kondo-Ikemura, Kiyomi; Sakano, Yuji; Spence, Susan H
Using parental reports, the current study investigated anxiety symptoms among Japanese children as part of the process of developing the Japanese version of the Spence Children's Anxiety Scale for Parents (SCAS-P). The participants were 677 parents and children aged 9-12 years. Confirmatory factor analysis on 568 parents and children supported that the SCAS-P had a 6-factor structure. The scale showed satisfactory internal consistency and good convergent validity. A MANOVA indicated no significant gender or age differences except for the obsessive-compulsive disorder subscale. Among Japanese children, the most prevalent symptoms within the parental report were items related to fear of the dark and of insects/spiders. Finally, we observed very low correlations between parental and child reports of anxiety symptoms; the relationships between child and parental reports were rather poor among Japanese children. We briefly discuss the utility of the SCAS-P as a screening instrument assessing parental reports of anxiety symptoms.
The article introduces a new anxiety scale, called the LAOM (Lestvica anksioznosti za otroke in mladostnike [The anxiety scale for children and adolescents]) for measuring self-reported multidimensional anxiety. The scale has been developed with a special focus on the school setting, using one sample from an elementary school which is…
Brown, Tammie D.; And Others
Researchers have not yet been able to determine the effect of divorce on children's level of anxiety. Many studies suggest that divorce and remarriage can cause a great deal of anxiety in children. A study was conducted to determine if elementary, middle, and high school students differ in levels of state anxiety (level of anxiety at a particular…
Klein, Anke M; Rapee, Ronald M; Hudson, Jennifer L; Schniering, Carolyn A; Wuthrich, Viviana M; Kangas, Maria; Lyneham, Heidi J; Souren, Pierre M; Rinck, Mike
The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of 87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli. Copyright © 2015 Elsevier Ltd. All rights reserved.
Edwards, Susan L.; Rapee, Ronald M.; Kennedy, Susan J.; Spence, Susan H.
The purpose of this study was to test the validity and factorial structure of a modified version of the Preschool Anxiety Scale (Spence, Rapee, McDonald, & Ingram, 2001). The measure was completed by 764 mothers and 418 fathers of children aged 3 to 5 years. After removing, two items tapping obsessive compulsive symptoms, confirmatory factor…
Drachev, Sergei N; Brenn, Tormod; Trovik, Tordis A
The objective was to assess the prevalence of and factors associated with dental anxiety (DA) in medical and dental students in North-West Russia. This cross-sectional study included 422 medical and 285 dental undergraduate Russian students aged 18-25 years from the Northern State Medical University in Arkhangelsk. Corah's Dental Anxiety Scale (DAS) was applied to measure DA. Information on socio-demographic and socioeconomic factors, oral health behaviour and general and oral health was obtained from a structured, self-administered questionnaire. A clinical examination was performed to assess caries experience, Simplified Oral Hygiene Index, and Gingival Index. DAS score ≥13 was found in 13.7% and 2.2% of medical and dental students, respectively. Female sex (incidence rate ratio [IRR] = 1.11, p = 0.013), lower education of mother (IRR = 1.13, p = 0.001), and poor self-assessed oral health (IRR = 1.15, p < 0.001) were associated with DA in medical students. Corresponding factors in dental students were female sex (IRR = 1.16, p = 0.001), irregular dental visits (IRR = 1.19, p = 0.001), infrequent tooth-brushing (IRR = 1.17, p = 0.007), pain in mouth (IRR = 1.09, p = 0.031) and number of missing teeth (IRR = 1.13, p = 0.007). The prevalence of high DA was lower in dental students than in medical students. DA was associated with sex, mother's education, poor oral health behaviour and self-assessed and clinically assessed oral health.
Baker, J R; Hudson, J L
Whilst shy, socially anxious or socially withdrawn children in nonclinical community samples report lower friendship quality (FQ) than nonanxious children, no study has examined the FQ of clinically anxious children. The aim of the study was to examine the FQ of children with anxiety disorders; and whether it differs for clinical children with or without a diagnosis of social phobia (SP). The study design was cross-sectional self-report. Clinical children - 39 anxiety-disordered children with SP and 28 anxiety-disordered children without SP (No-SP) - presented for psychological treatment, and 29 nonclinical children were recruited from the community. Same-sex close friends were invited to participate using an unrestricted nomination procedure. All children were aged between 7 and 13 years. Both target child and friend completed the Friendship Quality Questionnaire and the Spence Children's Anxiety Scale. Using multilevel modeling within the framework of the Actor-Partner Interdependence Model, SP dyads were found to report lower overall FQ than No-SP dyads. SP dyads did not report lower overall FQ than nonclinical dyads. Children with SP in their diagnostic profile may be unique in their friendship experiences relative to children with other anxiety disorders.
Save-Pédebos, Jessica; Bellavoine, Vanina; Goujon, Estelle; Danse, Marion; Merdariu, Dana; Dournaud, Pascal; Auvin, Stéphane
Many studies have shown that anxiety disorders are common in children with epilepsy. We explored symptoms of anxiety simultaneously in children and their parents. We conducted a cross-sectional study using the Revised Children's Manifest Anxiety Scale in children and the State-Trait Anxiety Inventory for Adult in parents. We included 118 parents and 67 children, who were divided into three groups: (1) first seizure, (2) epilepsy, and (3) nonepileptic paroxysmal event. We found that the level of anxiety in parents and children differed. We observed a significant increase in the anxiety level of parents whose children have had a first seizure, while we found a significant increase in the anxiety level of children and adolescents followed for epilepsy. These findings suggest that there is no direct relationship in the anxiety of the parents and their child. Further studies are needed to understand this variation over time. Copyright © 2013 Elsevier Inc. All rights reserved.
McKernan, Susan C; Pooley, Mark J; Momany, Elizabeth T; Kuthy, Raymond A
Using administrative data from Iowa Medicaid and a large private dental insurer, we compared distance to the nearest primary care dentist for children ages 6-15 in 2012. Additionally, we examined rates of provider bypass in both populations as an indicator of spatial accessibility to dental care. We calculated measures of travel burden, including distance to the nearest primary care dentist and distance to current primary care dentist. Distance outcomes and rates of bypass, traveling beyond the nearest dentist for care, were compared by insurance type. We found that Medicaid-enrolled children lived farther from the nearest dentist and farther from their current dentist than privately insured children. However, rates of bypass were higher among the privately insured population. These results were consistent among urban and rural residents; additionally, both rural populations demonstrated greater travel distances than urban dwellers. Travel burden was greater among Medicaid-enrolled children. Lower rates of bypass, in conjunction with lower rates of dental utilization in this population, may indicate a distance threshold beyond which dental care becomes unattainable. © 2016 American Association of Public Health Dentistry.
Wehry, Anna M.; Beesdo-Baum, Katja; Hennelly, Meghann M.; Connolly, Sucheta D.; Strawn, Jeffrey R.
Recent advances in the developmental epidemiology, neurobiology and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive-behavioral therapy (CBT) are efficacious in the treatment of these conditions in youth and that combination of CBT + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy. PMID:25980507
Debs, Nahla Nassif; Aboujaoude, Samia
Objectives: The aim of the present prospective study is to determine the effect of an intellectual colored game (ICG) on the severity of gag reflex (GR) and anxiety in children during dental alginate impression. Materials and Methods: Forty-one children, aging between 5 and 11 years, having a GR varying from normal to moderate had upper alginate impressions. The children's anxiety was evaluated with a facial image scale (FIS) before (T0) and after first failed impression (T1), then, after playing an intellectual colored game (ICG) at T2, while taking an upper alginate impression. Results: 42.9 % of the children had a gag reflex of stage 2 and 31.0 % a facial scale of 3. Initial GR was not significantly associated with the final success of the impression (P =0.260) whereas final impression success was strongly associated with FIS (P <0.001). There was a statistically significant reduction in median GR score from T0 to T2 (P < 0.001) and FIS dropped significantly at T2 with ICG (P < 0.001). Conclusion: This study highlights the clinical performance of the intellectual distraction approach in GR management PMID:29387614
Tang, J M; Altman, D S; Robertson, D C; O'Sullivan, D M; Douglass, J M; Tinanoff, N
OBJECTIVES: To assess the prevalence of dental caries in a large group of preschool children, to determine the extent to which the children received dental treatment, to examine the association between demographic and socioeconomic factors and the prevalence of caries, and to compare these findings with those from previous studies of preschool populations in the United States. METHODS: Dental caries exams were performed on 5171 children ages 5 months through 4 years, and a parent or other caregiver was asked to complete a questionnaire giving information about the child and her or his household. The children were recruited from Head Start programs; Women, Infants, and Children (WIC) nutrition programs; health fairs; and day care centers in a representative sample of Arizona communities with populations of more than 1000 people. RESULTS: Of the 994 one-year-old children examined, 6.4% had caries, with a mean dmft (decayed, missing [extracted due to caries], and filled teeth) score of 0.18. Nearly 20% of the 2-year-olds had caries, with a mean dmft of 0.70. Thirty-five percent of the 3-year-olds had caries, with a mean dmft of 1.35, and 49% of the 4-year-olds had caries, with a mean dmft of 2.36. Children whose caregivers fell into the lowest education category had a mean dmft score three times higher than those with caregivers in the highest education category. Children with caregivers in the lowest income category had a mean dmft score four times higher than those with caregivers in the highest category. Children younger than age 3 had little evidence of dental treatment, and most of the children with caries in each age group had no filled or extracted teeth. CONCLUSIONS: The data show that dental caries is highly prevalent in this preschool population, with little of the disease being treated. Timing of diagnostic examinations and prevention strategies for preschool children need to be reconsidered, especially for children identified as having a high risk of
Nasseh, Kamyar; Vujicic, Marko
To measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children. 2007 and 2011-2012 National Survey of Children's Health. Difference-in-differences and triple differences models were used to measure the impact of reforms. Relative to Medicaid-ineligible children and all children from a group of control states, preventive dental care utilization increased among Medicaid-eligible children in Connecticut and Texas. Unmet dental need declined among Medicaid-eligible children in Texas. Increasing Medicaid dental fees closer to private insurance fee levels has a significant impact on dental care utilization and unmet dental need among Medicaid-eligible children. © 2015 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Services Research.
Bart, Orit; Bar-Haim, Yair; Weizman, Einat; Levin, Moran; Sadeh, Avi; Mintz, Matti
Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder…
Nahás Pires Corrêa, Maria Salete; Nahás Pires Corrêa, Fernanda; Nahás Pires Corrêa, José Paulo; Murakami, Christiana; Mendes, Fausto Medeiros
BaCKGROUND. The prevalence of dental erosion seems to be rising in young populations, particularly among individuals of higher socioeconomic status. AIM. To assess the prevalence and associated factors of dental erosion in children and adolescents of a private dental practice. DESIGN. A total of 232 participants, aged 2-20 years, were examined. Dietary habits, oral hygiene, and medical data were collected from dental records. Logistic regression analyses were conducted. RESULTS. Dental erosion prevalence was of 25.43% and was highest on the occlusal surfaces (76%). Associated factors were: frequent consumption of soft drinks (OR = 2.33; 95% CI = 1.01-5.38) and candies (OR = 3.23; 95% CI = 1.25-8.32); and interaction between these two factors (OR = 3.95; 95% CI = 1.60-9.75). On anterior teeth, associated factors were: frequent consumption of fruits (OR = 2.53; 95% CI = 1.09-5.91); and age (OR = 1.07 95% CI = 1.01-1.14). Milk consumption was associated with a lower prevalence of dental erosion (OR = 0.40; 95% CI = 0.17-0.94). CONCLUSIONS. A relatively high prevalence of erosion was found in association with frequent intake of soft drinks, candies, and fruits. The consumption of milk seemed to protect against dental erosion on anterior teeth. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.
Oyedeji, Olusola Adetunji; Gbolahan, Olalere Omoyosola; Abe, Elizabeth Oluwatoyin; Agelebe, Efeturi
Oral diseases in the HIV infected children though commonly encountered are under researched and often overlooked by physicians in developing countries. The aim of this study is to document the types and frequency of oral lesions in HIV infected children and examine the effects of management with HAART on their rates. A cross sectional study designed to identify the oral lesions in consecutive HIV infected children and their distribution at a Paediatric Anti-retroviral clinic. Information on oral disease and clinical features of the subjects were obtained by history and clinical examination and laboratory investigations by the pediatricians and dental surgeons. The 58 children studied consisted of 34 boys and 24 girls with their ages ranging from 3 months to 13 years. Thirty seven (63.8%) of the 58 children had oral diseases. Enamel hypoplasia, candidiasis, caries, angular chelitis, and herpes labialis were the most common oral lesions found in the patients. Oral soft tissue lesions were less frequently encountered among children on HAART. Statistical significance was recorded among those infected with candidiasis. More than 60% of the children diagnosed with oral disease had no knowledge of the state of their oral health before the study. Oral diseases are very common amongst the children studied. Awareness of oral disease among the children and their caregivers is low. Administration of HAART may have a preventive effect on the development of oral soft tissue disease. There is a need to integrate dental care into the paediatric HIV care programs.
Alanzi, Abrar; Minah, Glenn; Romberg, Elaine; Catalanotto, Frank; Bartoshuk, Linda; Tinanoff, Norman
This study's purpose was to determine the caries experiences of preschool children whose mothers exhibited various genetic taste sensitivities to sweet foods, as reflected by their ability to taste the chemical 6-n-propylthiouracil (PROP). A convenience sample of 38 healthy two- to three-year-old preschool children and their mothers was selected. Data regarding maternal demographics and children's oral hygiene practices were obtained by questionnaires. Children received oral clinical examinations. Mothers received a PROP test to determine their taste type. Twenty mothers were PROP supertasters (disliking sweet food), and 18 mothers were PROP nontasters (liking sweet food). Children of nontaster mothers were found to have a greater prevalence of dental caries and a greater number of decayed, missing, and filled surfaces (dmfs) of maxillary anterior teeth than those of supertaster mothers (P<.05). Children of nontaster mothers whose grandparents reportedly lived in the same household had increased dmfs vs. those without grandparents in the household (P<.05). The prevalence of dental caries in two- to three-year-old-children was significantly greater in children of mothers who couldn't taste the chemical 6-n-propylthiouracil than those of mothers who could. A mother's PROP type could be an important variable related to the caries experience of preschool children.
Jameson, Molly M.
Math anxiety has been historically overlooked in samples of children. This may be due in part to the lack of appropriate tools to measure anxiety in young children. The current exploratory study reports on the development and examination of reliability, validity, and factor structure of a new tool to measure math anxiety in young children. The…
Begzati, Agim; Meqa, Kastriot; Siegenthaler, David; Berisha, Merita; Mautsch, Walter
Objectives: The aim of this study was to assess caries prevalence of preschool and school children in Kosovo. Methods: The assessment, which was carried out between 2002 and 2005, included measurements of early childhood caries, deft and DMFT. Results: In total, 1,237 preschool and 2,556 school children were examined. The mean deft of preschool children was 5.9, and the mean DMFT of school children aged 12 was 5.8. The caries prevalence for 2- to 6-year-old preschool children was 91.2%, and the prevalence for 7- to 14-year-old school children was 94.4%. The prevalence of early childhood caries was 17.6%, with a mean deft of 10.6. Conclusions: All data assessed showed the very poor oral health status of children in Kosovo. Interviews with children and teachers indicated poor knowledge regarding oral health. Significant measures must be taken to improve this situation. PMID:21228954
Korolenkova, M V
The aim of the study was to assess the efficiency of atraumatic restorative treatment (ART) with cavity preparation by means of dental endo motor. ART method was applied in 94 children (50 females and 44 males, 301 teeth treated) aged 21-96 months. Wireless dental endo motor (Endo Mate TC2, NSK, Japan) was used for cavity preparation. The cavities (102 (33.9%) class I, 156 (51.8%) class V, 20 (6.6%) class II, 18 (6%) class III and 5 (1.7%) class IV) were then filled with glass-ionomer cement (Fuji IX, GC, Japan). Success rate was assessed 3, 6, 12 and 18 months after treatment. Overall ART procedure success rate (good marginal fit, no occlusal wearing or restoration fractures) at 18-month follow up was 88.7% (267 fillings out of 301) with the highest survival in class I (96.1%) and class V (96.2%) restoration and poorest in class II (50%), class III (44.4%) and class IV (20%) restorations. Cavity preparation with wireless dental endo motor was well tolerated even by infants (12 children were younger than 24 months), as it is noiseless and significantly faster than conventional manual preparation. ART method with the use of dental endo motor showed good success rate and proved to be highly efficient in small and apprehensive children. The method, however, should be avoided in class III and IV cavities as the success rate is poor mostly because of restoration fractures.
Weckwerth, Solange Aparecida Modesto; Weckwerth, Giovana Maria; Ferrairo, Bunna Mota; Chicrala, Gabriela Moura; Ambrosio, Alexandre Macedo Natitucci; Toyoshima, Guilherme Hideki Lima; Bastos, José Roberto Magalhães; Pinto, Edu Cassiano; Velasco, Sofia Rafaela Maito; Bastos, Roosevelt Silva
The aim of this study was to evaluate the parents' perception of dental caries in children with intellectual disability. This cross-sectional study was conducted with 6 to 14 years old schoolchildren: Group 1 (50 children diagnosed with intellectual disabilities) and Group 2 (50 children without it). The dental caries was assessed by the World Health Organization (WHO) criteria for primary and permanent teeth. Parents' psychosocial perception was assessed by Early Childhood Oral Health Impact Scale (ECOHIS). Similar prevalence of caries free children was found between groups in both dentitions. In primary dentition the caries index was higher in Group 2, and the opposite occurred in permanent teeth. Group 1 presented higher impact (p < .05) in the dimension drinking, eating and pronunciation, whereas in Group 2 there was higher impact (p = .01) on pain, sleep, irritation, the smile and family finances. Findings showed significant impact of dental caries on parents' perception of the oral health related quality of life of children with intellectual disabilities. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.
Amaya, Andrea Crane; Campbell, Marilyn
Introduction: This cross-cultural study compared both the symptoms of anxiety and their severity in a community sample of children from Colombia and Australia. Method: The sample comprised 516 children (253 Australian children and 263 Colombian children), aged 8 to 12-years-old. The Spence Children's Anxiety Scale (SCAS) was used to measure both…
Kopycka-Kedzierawski, D T.; Billings, R J.
Aim To assess dental caries prevalence and dental care utilization in pre-school children enrolled in urban childcare centres that participated in a comparative-effectiveness study. Study design Cross-sectional study. Methods Caries prevalence was determined in a cohort of children 12-60 months of age. Eligible children were randomized into two groups: group one received a traditional visual/tactile oral examination and group two received a Teledentistry examination. Questionnaires were administered to the children's parents/guardians to gather demographics and information about using dental and medical services. Results Of 234 children examined, approximately 28% had caries experience. The mean dfs score was 1.56 with a range of 0 to 34 carious surfaces. The mean dfs score for the children examined by means of Teledentistry was 1.75 and for the children examined by means of the traditional visual/tactile method mean dfs was 1.40; the means between the two groups were not significantly different. Twenty-six children showed evidence of being treated for dental caries. According to the parents, 31.5% of the children had never had a dental check-up before, only 3% of the children were lacking dental insurance and majority of the parents (92%) did not perceive accessing dental care for the children as a problem. Statistics The Wilcoxon Mann-Whitney test and the Kruskal-Wallis test were used to assess statistical differences among groups of children. Conclusions The data show that 28% of the children had caries and, of these, 61% had never been treated for caries, thus indicating that continued efforts are needed to improve oral health care utilization by inner-city preschool children. PMID:21640057
Gunduz, Mehmet; Arslan, Nur; Unal, Ozlem; Cakar, Sevim; Kuyum, Pınar; Bulbul, Selda F.
Objective: To investigate the existence of depression and/or anxiety with underlying risk factors among parents of children with classical phenylketonuria (PKU). Methods: This cross-sectional study was conducted in the Division of Pediatric Metabolism, Ankara Children’s Hospital, Dokuz Eylul University, Kırıkkale University, and Erzurum Local Research Hospital, Turkey, between January and July 2014. Parents of 61 patients and 36 healthy controls completed the self-report questionnaires. We used Beck Depression Inventory (BDI) to assess the parental depression and State-Trait Anxiety Inventory S-T (STAI S-T) to assess parental anxiety. Results: Depression and anxiety scores were significantly higher in the case group (BDI 12.3±9.1; STAI-S: 38.2±9.6; STAI-T: 43.2±6.9) than controls (BDI: 5.4±4.1 p=0.000; STAI-S: 31.8±7.6 p=0.001; STAI-T: 37.0±7.2 p=0.000). Mothers of the patients had higher scores than the other parental groups (BDI: p=0.000, STAI-S: p=0.001 and STAI-T: p=0.000). Logistic regression analysis showed that low educational level of the parent was the only independent factor for depression (OR 9.96, 95% CI: 1.89-52.35, p=0.007) and state anxiety (OR: 6.99, 95% CI: 1.22-40.48, p=0.030) in the case group. Conclusion: A subset of parents with PKU patients have an anxiety or depressive disorder. Supportive services dealing with the parents of chronically ill children such as PKU are needed in order to reduce the level of anxiety. PMID:26492114
Orgilés, Mireia; Penosa, Patricia; Morales, Alexandra; Fernández-Martínez, Iván; Espada, José P
Maternal anxiety is known to be associated with childhood separation anxiety. However, there is little research on the mediating factors of this relationship, despite the possible consequences separation anxiety might have for children's development and autonomy. The objective of this study was to analyze the possible mediating effects of 4 parenting styles (overprotective, assertive, punitive, and inhibited) on the relationship between maternal anxiety and child separation anxiety. Participants were 235 mothers with children aged 3 to 6 years, recruited from 6 preschools in the southeast of Spain. Maternal trait anxiety, maternal parenting style, and child separation anxiety were evaluated. A parallel multiple-mediation analysis revealed that the overprotective parenting style was a significant mediator of the relationship between maternal trait anxiety and child separation anxiety. In addition, mothers with higher trait anxiety scores exhibited a greater likelihood of using an overprotective, punitive, or less assertive parenting style. Younger mothers were more likely to use an overprotective parenting style, and compared with girls, boys were more exposed to the assertive style. This study provides initial evidence that parenting style acts as a mediator of the relationship between maternal anxiety and child separation anxiety.
Scharfstein, Lindsay A; Beidel, Deborah C
Whereas much is known about the deficits in social behaviors and social competence in youth with social anxiety disorder (SAD), less is known about those characteristics among youth with generalized anxiety disorder (GAD). This study aimed to better elucidate the social repertoire and peer acceptance of youth with SAD and youth with GAD, relative to normal control (NC) youth. The sample consisted of 58 primarily Caucasian children, ages 6 to 13 years: 20 SAD (12 female), 18 GAD (12 female), and 20 NC (9 female). Diagnoses were based on Anxiety Disorders Interview Schedule for DSM-IV: Children and Parent Versions interviews. A multimodal assessment strategy included parent and child reports, observer ratings of social performance, computer-based analysis of vocal qualities of speech, and peer ratings of likeability and friendship potential. Whereas self- and parental report did not differentiate the two diagnostic groups, differences on observable behaviors were apparent. Children with SAD exhibited anxious speech patterns, extended speech latencies, a paucity of speech, few spontaneous vocalizations, and ineffective social responses; they were perceived by peers as less likeable and socially desirable. Children with GAD had typical speech patterns and were well liked by their peers but displayed fewer spontaneous comments and questions than NC children. Parent and child reports are less sensitive to what could be important differences in social skill between youth with SAD and GAD. Direct observations, computer-based measures of speech quality, and peer ratings identify specific group differences, suggesting the need for a comprehensive evaluation to inform treatment planning.
Mercer, Joyce Ann
Children's spirituality has become a significant for-profit enterprise in North American consumer culture. This article explores the marketing of children's spirituality as an aspect of the larger construction of children as consumers in the context of late globalized capitalism. Playing off of parental anxieties over the need to avail their…
Chahal, Nita; Clarizia, Nadia A; McCrindle, Brian W; Boydell, Katherine M; Obadia, Maya; Manlhiot, Cedric; Dillenburg, Rejane; Yeung, Rae S M
The objective of this study was to explore the lived experience of parents of children diagnosed with Kawasaki disease (KD) and to identify factors associated with increased levels of parental anxiety. Three focus groups were conducted including 25 parents of 17 patients with KD, seven (41%) of whom had coronary artery complications. A conceptual model was developed to depict parental experiences and illustrate the key issues related to heightened anxiety. Themes identified included anxiety related to the child's sudden illness and delay in obtaining a correct diagnosis because of the lack of health care providers' awareness and knowledge regarding KD. Parents were frustrated by the lack of information available in lay language and the limited scientific knowledge regarding the long-term consequences of the disease. Parents also reported positive transformations and different perspective toward challenges in life. However, the parents of children with coronary artery complications expressed persistent anxiety even years after the acute phase of the illness due to the uncertainty of the long-term prognosis. There remains a critical need for richly textured research data on the perspective and experience of families of children with KD. Copyright 2010 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J
The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P < .01); 18% to 37% of children with an elevated risk of experiencing caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P < .01) compared with sealants for 10- to 14-year-olds (range, 8.4-11.1%; χ(2) = 22.7; P < .01), overall sealant placement rates were lower for 10- to 14-year-olds. These evidence-based, caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention
Mohinderpal Chadha, Gagandeep; Kakodkar, Pradnya; Chaugule, Vishwas; Nimbalkar, Vidya
The objective of this study was to assess the oral hygiene practices, dietary pattern, dental caries status and needs of institutionalized autistic children. The sample consisted of 35 children (28 males and 7 females) in the age group of 5 to 10 years from two institutions in Maharashtra, India. The parents of the children were interviewed regarding oral hygiene practices of their respective ward and instructed to maintain a 4-day diet chart for their children. A clinical examination was conducted using WHO dentition status and treatment needs index and a simplified oral hygiene index for ages 4 to 6 years and 7 to 10 years (deciduous and mixed dentition) was used to assess the oral hygiene. The results of diet chart analysis according to Nizel AE and Papas AS score showed the 'at meal' sugar exposure close to nil, while the 'in between' meal sugar exposure was observed to be more than three times per day among maximum children. The oral hygiene status was poor with abundance of soft debris and fair calculus accumulation. The mean caries experience (deft) in these children was 6.4. The present study provided baseline data which has been used for planning a comprehensive oral health care program. How to cite this article: Chadha GM, Kakodkar P, Chaugule V, Nimbalkar V. Dental Survey of Institutionalized Children with Autistic Disorder. Int J Clin Pediatr Dent 2012;5(1):29-32.
Kakodkar, Pradnya; Chaugule, Vishwas; Nimbalkar, Vidya
ABSTRACT The objective of this study was to assess the oral hygiene practices, dietary pattern, dental caries status and needs of institutionalized autistic children. The sample consisted of 35 children (28 males and 7 females) in the age group of 5 to 10 years from two institutions in Maharashtra, India. The parents of the children were interviewed regarding oral hygiene practices of their respective ward and instructed to maintain a 4-day diet chart for their children. A clinical examination was conducted using WHO dentition status and treatment needs index and a simplified oral hygiene index for ages 4 to 6 years and 7 to 10 years (deciduous and mixed dentition) was used to assess the oral hygiene. The results of diet chart analysis according to Nizel AE and Papas AS score showed the ‘at meal’ sugar exposure close to nil, while the ‘in between’ meal sugar exposure was observed to be more than three times per day among maximum children. The oral hygiene status was poor with abundance of soft debris and fair calculus accumulation. The mean caries experience (deft) in these children was 6.4. The present study provided baseline data which has been used for planning a comprehensive oral health care program. How to cite this article: Chadha GM, Kakodkar P, Chaugule V, Nimbalkar V. Dental Survey of Institutionalized Children with Autistic Disorder. Int J Clin Pediatr Dent 2012;5(1):29-32. PMID:25206131
conducting an in-depth study of the relationship between SOR, attention, and anxiety symptoms in preschool age children with ASD, using parent report...of study on risk factors for anxiety in young children with ASD. 9/29/2017 0% 0% 0% Specific Aim 2 Evaluate whether anxiety symptoms/disorders...of SOR on 6/29/2017 0% 0% 0% 6 negative outcomes for children with ASD Milestone #14: Publish study on the role of anxiety as a mediator of
Background This paper describes the oral healthcare system and disease situation amongst children in Turkey. Considering the high prevalence and severity of dental caries, a proposal for improvement of oral health in this population group is formulated. Discussion A virtual absence of palliative, preventive and restorative care characterises juvenile oral healthcare in Turkey. Consequently, carious cavities remain untreated, which may lead to pain, discomfort and functional limitation and, further, may impact negatively upon general health and cognitive development. As a first step to controlling dental caries, a national health programme including promotional, preventive and minimal intervention approaches for managing dental caries is proposed. The pros and cons of community-oriented caries-preventive measures are discussed. Daily tooth brushing with fluoridated toothpaste at home, in mother- and child-care centres, kindergartens, and schools is highlighted. Summary The dental profession, government, university officials and other stakeholders need to meet and determine how best the oral health of children in Turkey can be improved. The present proposed plan is considered a starting point. PMID:19939240
Carrillo, Camila Merida; Corrêa, Fernanda Nahás Pires; Lopes, Nilza Nelly Fontana; Fava, Marcelo; Odone Filho, Vicente
Cancer is the third most frequent cause of death in children in Brazil. Early diagnosis and medical advances have significantly improved treatment outcomes, which has resulted in higher survival rates and the management of late side effects has become increasingly important in caring for these patients. Dental abnormalities are commonly observed as late effects of antineoplastic therapy in the oral cavity. The incidence and severity of the dental abnormalities depend on the child's age at diagnosis and the type of chemotherapeutic agent used, as well as the irradiation dose and area. The treatment duration and aggressivity should also be considered. Disturbances in dental development are characterized by changes in shape, number and root development. Enamel anomalies, such as discoloration, opacities and hypoplasia are also observed in these patients. When severe, these abnormalities can cause functional and esthetic sequelae that have an impact on the children's and adolescents' quality of life. General dentists and pediatric dentists should understand these dental abnormalities and how to identify them aiming for early diagnosis and appropriate treatment.
Somaraj, Vinej; Shenoy, Rekha P; Panchmal, Ganesh Shenoy; Jodalli, Praveen S; Sonde, Laxminarayan; Karkal, Ravichandra
This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences ( P <0.05) between assessed knowledge and anxiety. Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant ( P =0.983). There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.
Beil, Heather; Mayer, Michelle; Rozier, R Gary
The authors compared children with special health care needs (CSHCN) and children without special health care needs (SHCN) with respect to the odds, amount and determinants of having any dental care and dental care expenditures. The authors assessed data from the 2004 Medical Expenditures Panel Survey, Agency for Healthcare Research and Quality, to identify a sample of 8,518 children aged 2 to 17 years. The authors used logistic regression to determine the effect of having SHCN on the probability of having any dental care expenditure, for total dental care expenditures and procedure-specific expenditures. They tested the modifying effect between CSHCN and other variables on the probability of having any dental care expenditure. Compared with children without SHCN, CSHCN did not differ in the probability (odds ratio = 0.91, 95 percent confidence interval [CI] = 0.76 to 1.09) or amount (beta = 30.17, 95 percent CI = -162.93 to 223.27) of total dental care expenditures. Likewise, CSHCN did not differ in their likelihood of having undergone a preventive, restorative, diagnostic or other procedure. Known determinants of dental care utilization did not modify the relationships between having SCHN and any dental care expenditure. Despite the reported difficulty in CSHCN's accessing dental care, the authors found that CSHCN had dental care utilization and expenditures that were comparable with those of children without SHCN. Furthermore, the association of CSHCN status and any dental care expenditure was not modified by known determinants of dental care utilization. Future research should focus on characterizing risk for dental disease among CSHCN more accurately and identifying factors that affect dental care utilization in CSHCN, including provider and parent characteristics. The study results highlight low rates of dental care utilization among all young children, including CSHCN. Efforts to increase dental care utilization among children are warranted and need to
Arane, Karen; Behboudi, Amir; Goldman, Ran D
Question Pain and anxiety are common in children who need procedures such as administering vaccines or drawing blood. Recent reports have described the use of virtual reality (VR) as a method of distraction during such procedures. How does VR work in reducing pain and anxiety in pediatric patients and what are the potential uses for it? Answer Recent studies explored using VR with pediatric patients undergoing procedures ranging from vaccinations and intravenous injections to laceration repair and dressing changes for burn wounds. Interacting with immersive VR might divert attention, leading to a slower response to incoming pain signals. Preliminary results have shown that VR is effective, either alone or in combination with standard care, in reducing the pain and anxiety patients experience compared with standard care or other distraction methods. Copyright© the College of Family Physicians of Canada.
Arane, Karen; Behboudi, Amir; Goldman, Ran D.
Abstract Question Pain and anxiety are common in children who need procedures such as administering vaccines or drawing blood. Recent reports have described the use of virtual reality (VR) as a method of distraction during such procedures. How does VR work in reducing pain and anxiety in pediatric patients and what are the potential uses for it? Answer Recent studies explored using VR with pediatric patients undergoing procedures ranging from vaccinations and intravenous injections to laceration repair and dressing changes for burn wounds. Interacting with immersive VR might divert attention, leading to a slower response to incoming pain signals. Preliminary results have shown that VR is effective, either alone or in combination with standard care, in reducing the pain and anxiety patients experience compared with standard care or other distraction methods. PMID:29237632
Chi, Donald L; Momany, Elizabeth T; Mancl, Lloyd A; Lindgren, Scott D; Zinner, Samuel H; Steinman, Kyle J
Medicaid-enrolled children with autism spectrum disorder (ASD) encounter significant barriers to dental care. Iowa's I-Smile Program was implemented in 2006 to improve dental use for all children in Medicaid. This study compared dental home and preventive dental utilization rates for Medicaid-enrolled children by ASD status and within three time periods (pre-implementation, initial implementation, maturation) and determined I-Smile's longitudinal influence on ASD-related dental use disparities. Data from 2002-2011 were analyzed for newly Medicaid-enrolled children aged 3-17 years (N=30,059); identified each child's ASD status; and assessed whether the child had a dental home or utilized preventive dental care. Log-linear regression models were used to generate rate ratios. Analyses were conducted in 2015. In 2003-2011, 9.8% of children with ASD had dental homes compared with 8% of children without ASD; 36.3% of children with ASD utilized preventive care compared to 45.7% of children without ASD. There were no significant differences in dental home rates by ASD status during pre-implementation, initial implementation, or maturation. There were no significant differences in preventive dental utilization by ASD status during pre-implementation or initial implementation, but children with ASD were significantly less likely to utilize preventive care during maturation (rate ratio=0.79, p<0.001). Longitudinal trends in dental home and preventive dental utilization rates were not significant (p=0.54 and p=0.71, respectively). Among newly Medicaid-enrolled children in Iowa's I-Smile Program, those with ASDs were not less likely than those without ASD to have dental homes but were significantly less likely to utilize preventive dental care. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Lu, Weili; Daleiden, Eric; Lu, Shou-En
This study evaluated the relationship between threat perception bias and anxiety among children and adolescents in China. A sample of 1,004 elementary, middle and high school students aged 9 to 19 years listened to stories containing themes of generalized anxiety, social anxiety and separation anxiety in either an ambiguous or non-ambiguous…
Nelson, Travis; Chim, Amelia; Sheller, Barbara L; McKinney, Christy M; Scott, JoAnna M
The authors evaluated the effectiveness of a dental desensitization program for children with autism spectrum disorder (ASD) and determined characteristics associated with a successful dental examination. The authors performed a retrospective review of clinical behavioral data and previsit questionnaires for 168 children with ASD who attended a university-based dental desensitization program. Data elements included demographic, treatment, and behavioral characteristics. The primary outcome was receiving a minimal threshold examination (MTE) while seated in a dental chair. An MTE was achieved for 77.4% of all children within 1 to 2 visits and 87.5% in 5 visits or less. Several factors predicted a successful dental examination: ability to be involved in group activities (relative risk [RR], 1.18; P = .02), ability to communicate verbally (RR, 1.17; P < .01), understanding of most language (RR, 1.14; P = .02), moderate versus severe caregiver-rated ASD severity (RR, 1.24; P = .04), and ability to dress self (RR, 1.27; P = .04). Desensitization was effective in achieving an MTE for most children. Those with characteristics consistent of a milder presentation of ASD were more likely to be successful. Desensitization can be a successful approach to providing dental care for children with ASD. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.
Chiu, Sheau-Huey; Dimarco, Marguerite A; Prokop, Jessica L
Childhood obesity and dental caries are increasing epidemics, especially among children who are living below the poverty level. This study was conducted to determine the relationship between body mass index (BMI) and caries in homeless children. A secondary data analysis with a correlational design was used. A convenience sample of 157 children was recruited from a homeless shelter. Pearson's and partial correlations were used to explore the relationships among age, BMI, and caries. Most of the children were girls and were African American. Slightly more than half of the children were overweight (19.7%) or obese (30.6%) and had caries (50.3%). Significant positive correlations between age and BMI (p = .03) as well as between age and caries (p = .003) were found. As BMI increased, so did caries (p = .08). Consistent with reports from the Centers for Disease Control and Prevention, homeless children had higher BMI and caries rates than the national averages. Although a definitive conclusion between obesity and dental caries cannot be drawn, these two health issues are important areas for all pediatric health care providers to address at every visit. Copyright © 2013 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
Providing dental care for children can be challenging. Successful treatment is often dependent upon the effectiveness of the communication between the dentist, parent and patient. Effective communication should be developed by establishing rapport and trust during the initial visit. Few parents realize the disadvantage of the dentist who is introduced to a child who is anxious, afraid or resistant. They undoubtedly expect the dentist to provide care regardless of the child's reaction.
Bart, Orit; Bar-Haim, Yair; Weizman, Einat; Levin, Moran; Sadeh, Avi; Mintz, Matti
Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder without noticing possible effects on the other disorder. In Study 1, children with balance dysfunction were compared to normally balanced controls on anxiety and self-esteem. In study 2, children with balance dysfunction were assigned to either balance training or a waiting-list control. Training consisted of 12 weekly sessions of balance treatment. Anxiety and self-esteem were tested before and after treatment/waiting. Study 1 confirmed significantly higher anxiety and lower self-esteem in the balance dysfunction group compared to the control group. Study 2 showed that treatment improved balance performance, reduced anxiety, and increased self-esteem relative to the control waiting list group. Taken together, the present findings are in accord with the observations of comorbidity between balance and anxiety disorders in adults and confirm their validity in children younger than 7 years of age. This profile of comorbidity between balance dysfunction and anxiety also include lower self-esteem.
Johnson, Suzanne Bennett
As behavioral approaches for the treatment of clinically significant fears became more accepted, the same techniques began to be applied to normal youngsters' reactions to highly stressful situations in an attempt to prevent the development of excessive fears in children. Although there is widespread acceptance of preventative approaches to help…
Heinrich-Weltzien, R; Bartsch, B; Eick, S
We aimed to assess caries experience and microbiota in systemically healthy children with black stain (BS) and non-discoloured plaque. Forty-six children with BS and 47 counterparts with non-discoloured plaque aged 7.9 ± 1.3 years were clinically examined. Dental caries was scored using WHO criteria. Samples of BS and non-discoloured dental plaque were collected from tooth surfaces. The DNA of the samples was extracted and real-time PCR was performed to determine the total number of bacteria and the species Streptococcus mutans, S. sobrinus, Lactobacillus sp., Actinomyces naeslundii, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum. Children with BS had lower DMFT (p = 0.013), lower DT values (p = 0.005) and a tendency to lower caries prevalence (p = 0.061) than children with non-discoloured plaque. Plaque samples of the BS group contained higher numbers of A. naeslundii (p = 0.005) and lower numbers of F. nucleatum (p = 0.001) and Lactobacillus sp. (p = 0.001) compared to the non-discoloured plaque samples of the control group. Comparing the children with BS and non-discoloured plaque, higher counts for A. naeslundii (p = 0.013) were observed in caries-free children with BS while in caries-affected children with BS, lower counts of F. nucleatum (p = 0.007) were found. Counts of Lactobacillus sp. were higher in non-discoloured plaque samples than in BS of caries-free and caries-affected children. Results suggest that the different microbial composition of BS might be associated with the lower caries experience in affected subjects. The role of black-pigmented bacteria associated with periodontitis needs further studies.
Jitlina, Katia; Zumbo, Bruno; Mirenda, Pat; Ford, Laurie; Bennett, Teresa; Georgiades, Stelios; Waddell, Charlotte; Smith, Isabel M.; Volden, Joanne; Duku, Eric; Zwaigenbaum, Lonnie; Szatmari, Peter; Vaillancourt, Tracy; Elsabbagh, Mayada
Although anxiety is frequently reported in children with autism spectrum disorder (ASD), existing anxiety scales are often psychometrically inappropriate for this population. This study examined the internal structure, reliability, convergent and discriminant validity of the Spence Children's Anxiety Scale-Parent Report (SCAS-P; Spence 1999) in…
Gopinath, Vellore Kannan; Awad, Manal A
The aim of this study was to evaluate the proportion of completed treatments and to study the factors affecting the full mouth dental rehabilitation in pediatric patients treated by undergraduate students at the College of Dental Medicine Teaching Clinics, University of Sharjah. A retrospective study was conducted on 270 children aged less than 12 years (mean age 7.6, SD 2.04). Comprehensive dental rehabilitation reports of child patients that were completed by final year dental undergraduate students from the year 2009 to 2011 were reviewed. Data on complete history, oral examination, dental charting, and treatment plan were collected from pediatric dentistry case sheet. Dental caries was charted using WHO 1997 criteria. Dental treatment needs and completion of dental care delivered to children involved in this study were assessed using DMFT/deft scores. Percentages of treatment provided included completed restorations (94%) and space management (84%) in primary dentition, whereas 98% of restoration and 94% of required sealants were completed in permanent dentition. The percentage of completed dental treatment including sealant placement was 61%. Age of the child and the number of decayed teeth present before the start of the treatment significantly correlated with the children in the incomplete treatment category (P < 0.05). Therefore, a worthy dental care was provided in a holistic approach to the children attending College of Dental Medicine training clinics. Age of the child and the number of decayed teeth were the factors affecting dental rehabilitation in children aged 3-12 years.
Scharfstein, Lindsay; Alfano, Candice; Beidel, Deborah; Wong, Nina
A common assumption is that all youth with anxiety disorders (AD) experience impaired peer relationships relative to healthy control children. Social impairments have been identified among youth with certain AD (e.g., social anxiety disorder; SAD), but less is known about the peer relationships of children with generalized anxiety disorder (GAD).…
Bilgiç, Ayhan; Türkoğlu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Yılmaz, Savaş; Yüksel, Tuğba
Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD.
Capozza, Lauren E; Bimstein, Enrique
The purpose of this study was to describe the preferences of parents of children with or without autism spectrum disorders (ASDs) concerning oral health and dental treatment. A questionnaire that queried demographics, dental needs, perceptions of dental materials and treatments, and parental concerns regarding relevant ASD issues in medicine and dentistry was distributed in the waiting rooms of a pediatric dental clinic and an autism clinic to parents or legal guardians of children undergoing treatment. The responses for the children with or without ASDs were compared. Statistically significant differences between the ASDs (N=23) and non-ASDs (N=33) groups existed for: parental age; frequency of dental visits per year; supervision of tooth-brushing; and use of a fluoridated toothpaste. Statistically insignificant differences were found in attitudes toward: amalgam; composite; fluoride products; or behavior guidance techniques. Parents or legal guardians of children with autism spectrum disorders are likely to have special beliefs and preferences regarding dental materials and dental behavior guidance.
Stassart, Céline; Dardenne, Benoit; Etienne, Anne-Marie
This study evaluated the impact of the mother's and father's anxiety sensitivity (AS) and learning experiences on children's AS, and the influence of two moderators: the children's femininity orientation and the children's emotional intelligence (EI). The sample comprised 200 non-clinical children, aged 9-13 years, and their parents (mothers and fathers). Results revealed that the effect of parental AS on children's AS is moderated by the children's EI for maternal AS and by their femininity traits for paternal AS. Learning experiences following somatic sensations influenced the children's level of AS. More specifically, special attention by parents following a child's somatic sensations (reinforcement and transmission of information) was associated with high AS in children. Parental reactions of fear following a parent's somatic sensations (modelling) seem to predict higher scores for AS when the link is moderated by the child's femininity orientation. The implications of these findings are discussed. Statement of contribution What is already known on this subject The influence of parental factors in child's AS has been demonstrate, but these studies are limited. Specific mechanisms might condition the relationship between child's AS and parental factors. What does this study add? Learning experiences and parental AS influence the child's level of AS. It is important to consider the influence of mothers and fathers in child's AS. Child's emotional intelligence and expressive traits may moderate the effect of parental factors. © 2017 The British Psychological Society.
Sluder, R. S.; Luder, Linda C.
Notes that children with special needs often require specific considerations with regard to dental care. Discusses some of the physical disabilities and how they interfere with dental hygiene, and how child caregivers can modify daily routines and assist disabled children with areas of hygiene the children may find difficult. (HTH)
Bönecker, Marcelo; Abanto, Jenny; Tello, Gustavo; Oliveira, Luciana Butini
The literature reports that dental caries can cause functional, physical and aesthetic impairment, often with repercussions on children's general health at an early age. Moreover, recent studies have investigated how caries lesions can compromise children's quality of life. This paper aims to describe the current situation of dental caries prevalence in children and how this oral health disease can impact their quality of life.
Finlayson, Tracy L.; Gansky, Stuart A.; Shain, Sara G.; Weintraub, Jane A.
Background Agricultural worker families encounter multiple barriers to accessing all needed dental care. This study investigated predisposing, enabling, and need factors associated with children's past year dental utilization among Hispanic agricultural worker families in central California. Methods Oral health survey and clinical data were collected from families participating in a larger, population-based study in 2006-7. Generalized estimating equation logit regression assessed effects on a dental visit among children aged 0-17 (n=405). Analyses adjusted for clustering of children in the same household. Predisposing (sociodemographics), enabling (child's dental insurance, usual source of dental care, caregiver past year dental visit, acculturation level, income and education), and need (caregiver's oral health rating, perception of cavities, and clinically-determined treatment urgency) factors were examined. Results Half (51%) the children had a past year dental visit, while 23% had never been to a dentist. In the final model, children were less likely to have a past year dental visit if they were foreign-born, male, had caregivers that thought they had cavities or were unsure, and if the dentist recommended treatment ‘at earliest convenience’. Children aged 6-12, with a regular dental care source, and whose caregivers had a recent dentist visit were more likely to have a past year dental visit. Conclusions Children were more likely to have a past year dental visit if they had a usual source of dental care (OR =4.78, CI=2.51-9.08), and if the caregiver had a past year dental visit (OR=1.88, CI=1.04-3.38). Emphasis should be placed on these two modifiable factors to increase children's dental utilization. PMID:25621285
van Steensel, Francisca J. A.; Deutschman, Amber A. C. G.; Bögels, Susan M.
The psychometric properties of a questionnaire developed to assess symptoms of anxiety disorders (SCARED-71) were compared between two groups of children: children with high-functioning autism spectrum disorder and comorbid anxiety disorders (ASD-group; "n" = 115), and children with anxiety disorders (AD-group; "n" = 122).…
Bakhshaee, Mehdi; Ashtiani, Sara Jafari; Hossainzadeh, Mana; Sehatbakhsh, Samineh; Najafi, Mona Najaf; Salehi, Maryam
Background: Allergic rhinitis (AR) may be overdocumented in cases of dental caries because of controversies in the literature This study was conducted to investigate the potential relationship between AR and dental caries in children. Materials and Methods: A total of 296 children were included in this cross-sectional study. Participants were evaluated using the decay-missing-filled (DMF) index, and their AR status was evaluated by physical examination and through a standard questionnaire. Baseline demographics and clinical characteristics were compared among groups using Student's t-test or the Mann–Whitney U-test, the Chi-square test, and/or Fisher's exact test as appropriate. A level of P < 0.05 was regarded as statistically significant. Results: Evidence of AR was found in 77 (35.1%) participants. There was no significant difference in the rate of tooth decay or DMF between participants with or without AR (P = 0.07), but a significant difference was observed in the number of missing and filled teeth between those with and without AR (P < 0.05). There were no significant differences in educational level, family income, milk intake, use of pacifier, use of a toothbrush, saliva secretion, or body mass index (P > 0.05 in all cases) between AR-positive and AR-negative patients. Fluoride therapy and oral breathing were identified as confounding factors and controlled using log-linear analysis. The mean rate of DMF in patients who also had AR was 20% greater than in the AR-negative group (odds ratio [OR] = 1.21, confidence interval [CI]: 1.05–1.35) and 15% greater in among children who breathed orally than those who did not (OR = 1.15 CI: 1.02–1.31). Conclusion: AR and oral breathing may have an effect on oral health and dental condition, leading to an increased rate of tooth loss, oral fillings, and development of dental caries. PMID:29238375
Gates, L; Lineberger, M R; Crockett, J; Hubbard, J
Children (N = 404), 7 to 12 years old, were given the Children's Depression Inventory, the State-Trait Anxiety Inventory for Children, and the Piers-Harris Self-Concept Scale. First-born children scored significantly lower on depression than second-, third-, fourth-born, and youngest children. First borns showed significantly less trait anxiety than third-born children. First-born children also showed significantly higher levels of self-esteem than second-born and youngest children. Girls in this study showed significantly more trait anxiety than boys.
Gerreth, Karolina; Borysewicz-Lewicka, Maria
A patient's with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of their parents' opinion. A questionnaire survey was carried out among 264 parents/caregivers of children from eight special-care schools in Poznan (Poland). Close-ended questions concerned children's barriers in access to dental care and parents' satisfaction with their children's dental care. Only 31.8% parents/caregivers did not have any problems with access to dental care and the most commonly reported barrier to obtaining dental care was protracted waiting time for a visit (36.7%). Most commonly, children were treated in dental surgery conditions (90.1%). Only 42.1% respondents were satisfied with their children's dental care. The research revealed that there is a need to improve the access of children with disability to dental care. Hence, it seems to be beneficial to set up specialist dental surgeries in special-care schools which would improve the access of children with disability to prophylaxis as well as dental treatment. © 2015 John Wiley & Sons Ltd.
Strøm, Kjetil; Rønneberg, Anne; Skaare, Anne B; Espelid, Ivar; Willumsen, Tiril
The purpose of this study was to explore the relationship between dentists' education in treatment of dental anxiety (DA), dentists' attitudes towards patients with DA and dentists' use of BMT. An anonymous questionnaire was sent electronically to 611 dentists in the Public Dental Service in Norway. Statistical evaluation was done using cross tabulation with Chi square and logistic regression analyses. The response rate was 65 % (n = 391). About half of the respondents (53 %, n = 208) had followed postgraduate courses in treating patients with DA. The following were the most common attitudes towards treating young patients with DA: it feels like making a contribution (72 %, n = 286), it is difficult or tiresome (54 %, n = 215) and it is a positive challenge (51 %, n = 203). Dentists who had taken postgraduate courses in DA more often reported anxious patients as a positive challenge (60 vs. 42 %, p < 0.001) and were less reluctant to treat these patients (5 vs. 15 %, p = 0.002). The most frequently used BMT was tell-show-do (87 %, n = 340), followed by relaxation (35 %, n = 132), distraction (25 %, n = 94), systematic cognitive behaviour therapy (22 %, n = 84) and conscious sedation (18 %, n = 69). Dentists without postgraduate courses in DA used fewer techniques when treating these patients (OR 2.1, 95 % CI 1.3-3.3, p = 0.001) compared with dentists who had taken these courses. Country of graduation and postgraduate courses in DA had a strong relationship with dentists' use of BMT and dentists' attitudes towards young patients with DA.
Luoto, Anni; Tolvanen, Mimmi; Rantavuori, Kari; Pohjola, Vesa; Karlsson, Linnea; Lahti, Satu
The aim was to study longitudinal changes in dental fear among children and one of their parents separately for girls, boys, mothers and fathers over a 3.5-year period. 11-12-year-old children in Pori, Finland (n = 1691) and one of their parents were invited to participate in this longitudinal study. Dental fear was measured in 2001, 2003 and 2005 when the children were 11-12, 13-14 and 15-16-years-old, respectively. The participants were asked if they were afraid of dental care (1 = 'not afraid', 2 = 'slightly afraid', 3 = 'afraid to some degree', 4 = 'quite afraid', 5 = 'very afraid' and 6 = 'I don't know'). The participants' gender was also registered. Mean values of the change scores were studied. Prevalence and incidence of dental fear and changes in dichotomized dental fear (responses 4-5 = high dental fear and responses 1-3 = low dental fear) were studied using cross-tabulations and Cochran's Q test. Overall, the prevalence of dental fear slightly increased and female preponderance in dental fear became more evident during the follow-up. Of the mothers and children with high dental fear at the baseline, 24% and 56%, respectively, reported not to be fearful at the end of the follow-up. Dental fear seems to be more stable in adulthood than in childhood. Thus, it might be better to intervene in dental fear during childhood rather than during adulthood.
Meyer, Beau D; Lee, Jessica Y; Casey, Mark W
Many studies reporting dental utilization under general anesthesia (GA) are dated. The purpose of this study was to provide contemporaneous data about children receiving dental GA by: (1) determining trends in utilization and associated expenditures; and (2) examining the effects of provider distribution. This time series cross-sectional study of Medicaid-eligible children ages zero to eight years old in North Carolina used aggregate Medicaid claims from State Fiscal Years (SFY) 2011 to 2015 to collect demographic and dental treatment information. Descriptive statistics were stratified by age and year to examine trends over time. Panel analysis techniques were used to explore regional effects of provider distribution on dental GA utilization. For SFY 2011 to 2015, the overall dental utilization rate was 517.1 per 1,000 (total enrolled equals 632,941 children/year), and the dental GA utilization rate was 15.8 per 1,000. Total dental expenditures averaged $113 million per year, and dental GA averaged $16.7 million per year. The dental GA proportion of expenditures increased over time (P<.001). Provider distribution did not affect dental GA utilization rate (P=.178) but did increase the number of children receiving dental GA (P<.001). Utilization and expenditures associated with dental treatment under general anesthesia continue to increase. While this reflects increased access to care, interventions should be examined to provide preventive care earlier in a child's life.
Kramer, Paulo Floriani; Ardenghi, Thiago Machado; Ferreira, Simone; Fischer, Laura de Almeida; Cardoso, Luciana; Feldens, Carlos Alberto
The aim of this study was to assess the use of dental services and age at first dental visit in preschool children in Canela, Rio Grande do Sul State, Brazil. A representative sample of under-five children was surveyed on National Children's Vaccination Day. Children's parents completed questionnaires containing socio-demographic data and age at first dental visit. Data were analyzed using multiple logistic regression. 192 children were examined. 13.3% of the sample had already visited the dentist at least once, but only 4.3% had their first dental visit by one year of age. The number of children who had already visited a dentist increased with age. Girls showed higher odds of having visited a dentist (OR = 1.46; 95%CI: 1.01-2.1). Public health strategies are needed to determine the effectiveness of health promotion and improve the use of dental services by preschool children.
AWARD NUMBER: W81XWH-14-1-0526 TITLE: Precursors to the Development of Anxiety Disorders in Young Children with Autism Spectrum Disorder...2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Precursors to the Development of Anxiety Disorders in Young Children with Autism Spectrum Disorder...SUPPLEMENTARY NOTES 14. ABSTRACT Anxiety disorders are extremely common among individuals with autism spectrum disorder (ASD). The presence of an anxiety
AWARD NUMBER: W81XWH-14-1-0527 TITLE: Precursors to the Development of Anxiety Disorders in Young Children with Autism Spectrum Disorder ...AND SUBTITLE 5a. CONTRACT NUMBER Precursors to the Development of Anxiety Disorders in Young Children with Autism Spectrum Disorder 5b. GRANT...ABSTRACT Anxiety disorders are extremely common among individuals with autism spectrum disorder (ASD). The presence of an anxiety disorder
Storch, Eric A.; Eisenberg, Philip S.; Roberti, Jonathan W.; Barlas, Mitchell E.
A study examined the psychometric properties of the Social Anxiety Scale for Children--Revised (SASC-R) in a sample of 159 predominantly Dominican and Puerto Rican fifth- and sixth-grade students from New York City. Findings provided initial support for SASC-R reliability and validity in Hispanic children. Convergent validity was supported by…
Bagattoni, Simone; D'Alessandro, Giovanni; Sadotti, Agnese; Alkhamis, Nadia; Piana, Gabriela
Audiovisual distraction using video eyeglasses is useful in managing distress and reducing fear and anxiety in healthy children during dental treatments. To evaluate the effect of audiovisual distraction on behavior and self-reported pain of children with special healthcare needs (SHCN) without intellectual disability during dental restorations and its influence on the operator stress and the time of the appointment. This randomized controlled crossover trial comprised 48 children with SHCN requiring at least two dental restorations. One restoration was done wearing the video eyeglasses and one wearing conventional behavior management techniques. Subjective and objective pain was evaluated using the Faces Pain Scale - Revised (FPS-R) and the revised Face, Leg, Activity, Cry, and Consolability scale (r-FLACC). The operator stress using a VAS, the time of the appointment, and the child satisfaction were recorded. The use of video eyeglasses significantly reduced the operator stress. The bivariate analysis showed that the mean FPS-R score and the mean r-FLACC score were significantly lower using the video eyeglasses only during the second clinical session. Audiovisual distraction could be useful in managing distress in SHCN children without intellectual disability but cannot replace the conventional behavior management techniques. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Choi, Hye Seon; Ahn, Hye Young
The purpose of this study was to identify the effects of mothers' involvement in a dental health program for their elementary school children. This study was a non-equivalent control group pre-post test design in which knowledge and behaviors related to dental health, perceived benefits and barriers, self-efficacy and plaque control scores were compared between the experimental group (n=26) for whom the dental health program included the direct involvement of the mothers, and the control group (n=24) for whom knowledge related to dental health was provided through brochures. Scores for the experimental group in which the mothers were involved in the dental health program were significantly higher for knowledge, behaviors in dental health, self-efficacy and plaque control compared to the control group. Results of this study suggest that mothers involvement in the dental health program is effective in reinforcing dental health enhancing behavior in elementary school children.
Bhagavatula, Pradeep; Xiang, Qun; Eichmiller, Fredrick; Szabo, Aniko; Okunseri, Christopher
Most studies on the provision of dental procedures have focused on Medicaid enrollees known to have inadequate access to dental care. Little information on private insurance enrollees exists. This study documents the rates of preventive, restorative, endodontic, and surgical dental procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI) in Milwaukee. We analyzed DDWI claims data for Milwaukee children aged 0-18 years between 2002 and 2008. We linked the ZIP codes of enrollees to the 2000 U.S. Census information to derive racial/ethnic estimates in the different ZIP codes. We estimated the rates of preventive, restorative, endodontic, and surgical procedures provided to children in different racial/ethnic groups based on the population estimates derived from the U.S. Census data. Descriptive and multivariable analysis was done using Poisson regression modeling on dental procedures per year. In 7 years, a total of 266,380 enrollees were covered in 46 ZIP codes in the database. Approximately, 64 percent, 44 percent, and 49 percent of White, African American, and Hispanic children had at least one dental visit during the study period, respectively. The rates of preventive procedures increased up to the age of 9 years and decreased thereafter among children in all three racial groups included in the analysis. African American and Hispanic children received half as many preventive procedures as White children. Our study shows that substantial racial disparities may exist in the types of dental procedures that were received by children. © 2012 American Association of Public Health Dentistry.
Boka, V; Arapostathis, K; Karagiannis, V; Kotsanos, N; van Loveren, C; Veerkamp, J
To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece. Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children⁁s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale. Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of <0.05. First sample: The mean CFSS-DS score was 27.1±10.8. Age was significantly (p<0.05) related to dental fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DS< 33 was defined as 'no dental fear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DS<33). Dental fear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).
Hurrell, Katherine E; Hudson, Jennifer L; Schniering, Carolyn A
Research has demonstrated that parental reactions to children's emotions play a significant role in the development of children's emotion regulation (ER) and adjustment. This study compared parent reactions to children's negative emotions between families of anxious and non-anxious children (aged 7-12) and examined associations between parent reactions and children's ER. Results indicated that children diagnosed with an anxiety disorder had significantly greater difficulty regulating a range of negative emotions and were regarded as more emotionally negative and labile by their parents. Results also suggested that mothers of anxious children espoused less supportive parental emotional styles when responding to their children's negative emotions. Supportive and non-supportive parenting reactions to children's negative emotions related to children's emotion regulation skills, with father's non-supportive parenting showing a unique relationship to children's negativity/lability. Copyright © 2015 Elsevier Ltd. All rights reserved.
Roberts, T; Chetty, M; Kimmie-Dhansay, F; Fieggen, K; Stephen, L X G
To assess the dental needs of a group of children with intellectual disability (ID) attending six special educational facilities in Cape Town, South Africa. Methods. This was a cross-sectional study based on a convenience sampling method. One hundred and fifty-seven children with ID attending six special educational facilities in Cape Town were included in the survey. Five schools were exclusively funded by the State and one school received additional private financial support. The oral examinations complied with guidelines drafted by Special Olympics Special Smiles programme and the Centers for Disease Control, USA. The most common dental disorders requiring management were gingival disease (69%) and untreated dental caries (68%). Almost 50% of the children had missing teeth. Twenty-nine percent needed orthodontic correction of malocclusion and 7% had structural abnormalities of their teeth that required either aesthetic or functional intervention. Fillings were evident in only 8% of the children. Females required more dental treatment than males. The dental needs of children with ID increased with age. There were no significant differences in the dental needs of children attending State-funded schools and those attending the single school that received additional financial assistance. The frequency of unmet dental needs of children with ID attending special educational facilities in Cape Town was high and the dental care available to them was minimal. The study highlights the need for improved dental services to ensure that optimal oral health is accessible to children with ID attending special educational facilities in Cape Town.
Cheon, Kyounga; Moser, Stephen A.; Wiener, Howard W.; Whiddon, Jennifer; Momeni, Stephanie S.; Ruby, John D.; Cutter, Gary R.; Childers, Noel K.
This longitudinal cohort study evaluated the diversity, commonality, and stability of Streptococcus mutans genotypes associated with dental caries history. Sixty-seven 5 and 6 yr-old children, considered being at high caries risk, had plaque collected from baseline through 36 months for S. mutans isolation and genotyping with repetitive extragenic palindromic-PCR (4,392 total isolates). Decayed, missing, filled surfaces (dmfs/DMFS) for each child were recorded at baseline. At baseline, 18 distinct genotypes were found among 911 S. mutans isolates from 67 children (diversity) and 13 genotypes were shared by at least 2 children (commonality). The number of genotypes per individual was positively associated with the proportion of decayed surfaces (p-ds) at baseline. Twenty-four of the 39 children who were available at follow-up visits maintained a predominant genotype for the follow-up periods (stability) and was negatively associated with p-ds. The observed diversity, commonality, and stability of S. mutans genotypes represent a pattern of dental caries epidemiology in this high caries risk community, which suggest fewer decayed surfaces are significantly associated with lower diversity and stability of S. mutans genotypes. PMID:23659236
Krikken, J B; ten Cate, J M; Veerkamp, J S J
This was to investigate the relation between general emotional and behavioural problems of the child and dental anxiety and dental behavioural management problems. Dental treatment involves many potentially unpleasant stimuli, which all may lead to the development of dental anxiety and behavioural management problems (BMP). It is still unclear why some children get anxious in the dental situation while others, with a comparable dental history, do not. Besides the latent inhibition theory it is suggested that this can be explained by differences in child rearing and personality traits. The sample consisted of 50 children (4-12 years old) and their parents participated in this study. Parents filled out the Child Fear Survey Schedule Dental Subscale (CFSS-DS) and the Child Behaviour Checklist (CBCL) on behalf of their child. Child behaviour during consecutive dental treatments was assessed using the Venham scale. There were 39 children subject to analysis (21 boys) with a mean CFSS score of 40.4. Children aged 4 and 5 years who had sleeping problems, attention problems and aggressive behaviour, as scored by parents on the CBCL, displayed more disruptive behaviour during dental treatment. Children with emotionally/ reactive and attention problems were more anxious. In this pilot study a possible relation between general emotional and behavioural problems of young children and dental anxiety was shown. Also a relation between emotional and behavioural problems and dental behavioural management problems was shown. Because of the small number of subjects in our study, further research will be needed to confirm these results.
Katsouda, Maria; Provatenou, Efthymia; Arapostathis, Konstantinos; Coolidge, Trilby; Kotsanos, Nikolaos
No studies assessing the association between gagging and dental fear are available in pediatric samples. To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Dionigi, Alberto; Sangiorgi, Diego; Flangini, Roberto
This study investigated whether a clown doctor intervention could reduce preoperative anxiety in children hospitalized for minor surgery and in their parents. A randomized controlled trial was conducted with 77 children and 119 parents: the clown group consisted of 52 children accompanied in the preoperating room by their parents (n = 89) and two clowns while the comparison group consisted of children accompanied by the parents only. The clown intervention significantly reduced the children's preoperative anxiety: children benefited from the clown's presence and showed better adjustment than children in the comparison group. Mothers in Comparison Group showed higher anxiety.
Trachtenberg, Felicia L.; Hauser, Russ; McKinlay, Sonja; Shrader, Peter; Tavares, Mary; Bellinger, David C.
BACKGROUND AND OBJECTIVE: Resin-based dental materials may intraorally release their chemical components and bisphenol A. The New England Children’s Amalgam Trial found that children randomized to amalgam had better psychosocial outcomes than those assigned to composites for posterior tooth restorations. The objective of this study was to examine whether greater exposure to dental composites is associated with psychosocial problems in children. METHODS: Analysis of treatment-level data from the New England Children’s Amalgam Trial, a 2-group randomized safety trial comparing amalgam with the treatment plan of bisphenol A-glycidyl methacrylate (bisGMA)-based composite and urethane dimethacrylate–based polyacid-modified composite (compomer), among 534 children aged 6 to 10 years at baseline. Psychosocial function at follow-up (n = 434) was measured by using the self-reported Behavior Assessment System for Children (BASC-SR) and parent-reported Child Behavior Checklist (CBCL). RESULTS: Children with higher cumulative exposure to bisGMA-based composite had poorer follow-up scores on 3 of 4 BASC-SR global scales: Emotional Symptoms (β = 0.8, SE = 0.3, P = .003), Clinical Maladjustment (β = 0.7, SE = 0.3, P = .02), and Personal Adjustment (β = –0.8, SE = 0.2, P = .002). Associations were stronger with posterior-occlusal (chewing) surfaces, where degradation of composite was more likely. For CBCL change, associations were not statistically significant. At-risk or clinically significant scores were more common among children with greater exposure for CBCL Total Problem Behaviors (16.3% vs 11.2%, P-trend = .01) and numerous BASC-SR syndromes (eg, ≥13 vs 0 surface-years, Interpersonal Relations 13.7% vs 4.8%, P-trend = .01). No associations were found with compomer, nor with amalgam exposure levels among children randomized to amalgam. CONCLUSIONS: Greater exposure to bisGMA-based dental composite restorations was associated with impaired psychosocial function
Mantonanaki, Magdalini; Koletsi-Kounari, Haroula; Mamai-Homata, Eleni; Papaioannou, William
To assess dental caries and use of dental services experience in 5-year-old children attending public kindergartens in Attica, Greece and to examine the influence of certain socioeconomic factors and living conditions as well as dental behaviours and attitudes. In this cross-sectional study, a random and stratified sample of 605 Greek children was examined using decayed, missing, filled tooth surfaces and simplified debris indices. The use of dental services was measured by children's dental visits (any dental visit up to the age of 5 years). Care Index was also calculated. Risk indicators were assessed by a questionnaire. Zero-inflated Poisson and Logistic Regression Analysis were generated to test statistical significant associations. The prevalence of dental caries was 16.5%. Care Index was 32% and dental visits were reported for the 84% of the children. Medium Socio-Economic Level (SEL) was associated with no detectable caries. High SEL was related to decreased decayed, missing, filled teeth values, while female gender and rented houses had the opposite effect. The age of the mother (35-39 years) and the higher SEL were related to higher levels of dental services use. It is suggested that there are differences in the experience of dental caries and use of dental services among preschool children in Attica, which are related to demographic, socioeconomic factors and living conditions. Dental public polices should focus on groups with specific characteristics in order to improve oral health levels of disease-susceptible populations. © 2013 FDI World Dental Federation.
Muris, Peter; Meesters, Cor; Knoops, Miranda
This study examined the relation between gender role orientation and fear and anxiety in a sample of nonclinic-referred children (N = 209) ages 10 to 13 years. Children and their parents completed questionnaires assessing children's gender role orientation, toy and activity preferences, and fear and anxiety. Results generally indicated that…
Huang, Keng-Yen; Cheng, Sabrina; Calzada, Esther; Brotman, Laurie Miller
Anxiety is one of the most prevalent mental health problems in young children but there has been a dearth of studies focusing on Asian American children. This study examines the patterns and the predictors of childhood anxiety and related symptoms in young children in a diverse Asian American (ASA) sample (n = 101). Findings indicate that ASA…
Pugliese, Cara E.; White, Bradley A.; White, Susan W.; Ollendick, Thomas H.
The present study examined the degree to which social anxiety predicts aggression in children with high functioning autism spectrum disorders (HFASD, n = 20) compared to children with Social Anxiety Disorder (SAD, n = 20) or with Oppositional Defiant Disorder or Conduct Disorder (ODD/CD, n = 20). As predicted, children with HFASD reported levels…
Lonigan, Christopher J.; And Others
Examined self-reported depression and anxiety in 233 inpatient children diagnosed with anxiety disorder or depressive disorder. Depressed children reported more problems related to loss of interest and low motivation and had more negative view of themselves. Anxious children reported more worry about future, their well-being, and reactions of…
Abikoff, Howard; McGough, James; Vitiello, Benedetto; McCracken, James; Davies, Mark; Walkup, John; Riddle, Mark; Oatis, Melvin; Greenhill, Laurence; Skrobala, Anne; March, John; Gammon, Pat; Robinson, James; Lazell, Robert; McMahon, Donald J.; Ritz, Louise
Objective: Attention-deficit/hyperactivity disorder (ADHD) is often accompanied by clinically significant anxiety, but few empirical data guide treatment of children meeting full DSM-IV criteria for ADHD and anxiety disorders (ADHD/ANX). This study examined the efficacy of sequential pharmacotherapy for ADHD/ANX children. Method: Children, age 6…
Renahan, Navanith; Varma, R Balagopal; Kumaran, Parvathy; Xavier, Arun M
The number of deaf children has dramatically increased in the past few decades. These children present to the pediatric dentist a unique set of challenges mostly pertaining to the establishment of communication with them. There have been very few attempts in the past to break down these challenges and formulate a strategy on how to manage them effectively. This is a case report of a child who was successfully managed using two different modes of communication. Finally, the advantages and disadvantages are mentioned, and a common strategy incorporating the positives of both the methods has been devised. Renahan N, Varma RB, Kumaran P, Xavier AM. Unique Approach to Dental Management of Children with Hearing Impairment. Int J Clin Pediatr Dent 2017;10(1):107-110.
Nelson, T M; Huebner, C E; Kim, A; Scott, J M; Pickrell, J E
This study examined factors related to young children's distress during preventive oral health visits. Additionally, associations between parent-reported child behaviour during the dental visit and during previous medical visits were tested. One hundred twenty-two children under 3 years of age enrolled in a government insurance programme for low-income children were seen for examination, prophylaxis, and fluoride application at a university-based dental clinic. Child distress was rated by parents on a numerical rating scale. The average age of children enrolled was 23.5 ± 7.3 months. The majority (55.7 %) were judged to have little or no distress pre-examination. Mild or no distress during the examination was reported for 42.6 % of the children and severe distress was reported for 39.4 %. Intensity of distress during the examination was not associated with the child's age, gender, dental health, or previous experience with dental care. Distress was also unrelated to the caregiver's education level or own dental health. Intensity of distress was associated with the child's pre-dental examination distress and distress during prior medical examinations and injections. Dental professionals can better anticipate child distress by assessing children before a dental examination and enquiring about previous medical experiences. Strategies to prepare parents and alleviate distress may help children cope with the preventive dental visit.
Ginsburg, G S; Silverman, W K
Research on gender differences in children's fears has generally shown that girls are more fearful than boys. A common hypothesis offered for this finding is that gender role orientations or expectations may be operating. However, this hypothesis has not been directly investigated in child samples. The present study examined the relation between a self-report measure of gender role orientation (i.e., masculinity/femininity) and the intensity of self-reported fears in a clinic sample of children (N = 66; ages 6-11; 41 boys and 25 girls) with anxiety disorders. Results revealed that masculinity was negatively related to overall levels of fearfulness as well as specific fears of failure and criticism, medical fears, and fears of the unknown. In contrast, no relation was found between femininity and fearfulness. These findings suggest that gender role orientation, especially masculinity, may play a role in the development and/or maintenance of fearfulness in children.
The Test Anxiety Inventory for Children and Adolescents (TAICA): Examination of the Psychometric Properties of a New Multidimensional Measure of Test Anxiety among Elementary and Secondary School Students
Lowe, Patricia A.; Lee, Steven W.; Witteborg, Kristin M.; Prichard, Keri W.; Luhr, Megan E.; Cullinan, Christopher M.; Mildren, Bethany A.; Raad, Jennifer M.; Cornelius, Rebecca A.; Janik, Melissa
The Test Anxiety Inventory for Children and Adolescents (TAICA) is a new multidimensional measure used to assess test anxiety in elementary and secondary school students. The TAICA is a 45-item self-report measure consisting of a Total Test Anxiety scale, four debilitating test anxiety subscales (Cognitive Obstruction/Inattention, Physiological…
Waite, Polly; Creswell, Cathy
Parental behaviors, most notably overcontrol, lack of warmth and expressed anxiety, have been implicated in models of the development and maintenance of anxiety disorders in children and young people. Theories of normative development have proposed that different parental responses are required to support emotional development in childhood and adolescence, yet age has not typically been taken into account in studies of parenting and anxiety disorders. In order to identify whether associations between anxiety disorder status and parenting differ in children and adolescents, we compared observed behaviors of parents of children (7-10 years) and adolescents (13-16 years) with and without anxiety disorders (n = 120), while they undertook a series of mildly anxiety-provoking tasks. Parents of adolescents showed significantly lower levels of expressed anxiety, intrusiveness and warm engagement than parents of children. Furthermore, offspring age moderated the association between anxiety disorder status and parenting behaviors. Specifically, parents of adolescents with anxiety disorders showed higher intrusiveness and lower warm engagement than parents of non-anxious adolescents. A similar relationship between these parenting behaviors and anxiety disorder status was not observed among parents of children. The findings suggest that theoretical accounts of the role of parental behaviors in anxiety disorders in children and adolescents should distinguish between these different developmental periods. Further experimental research to establish causality, however, would be required before committing additional resources to targeting parenting factors within treatment.
Mount, Kristin S; Crockenberg, Susan C; Jó, Patricia S Bárrig; Wagar, Jessica-Lyn
The goal of this study was to predict the development of anxiety in 2½ year olds as a function of maternal anxiety and child inhibited temperament, and to test the mediating, moderating, and curvilinear effects of maternal sensitivity. Participants were 83 mothers and their 2½-year-old children (32 females). Maternal anxiety, child inhibition, and child anxiety were assessed by maternal report. Maternal sensitivity was rated based on the appropriateness and timeliness of mothers' responses to children's fear observed during their exposure to novel events in the laboratory and from mothers' diaries documenting their responses to children's fear in everyday situations. Gender predicted child anxiety, with mothers reporting girls as more anxious, as did child inhibition, with more inhibited children exhibiting more anxiety. Maternal sensitivity predicted child anxiety as a main effect and, in addition, inhibition moderated the curvilinear association of maternal sensitivity and child anxiety. For highly inhibited children, maternal sensitivity predicted anxiety in both a negative linear and a curvilinear fashion; anxiety decreased as maternal sensitivity increased up to a moderately high level, then increased at very high levels of maternal sensitivity. For less inhibited children, maternal sensitivity showed only a significant negative linear association with child anxiety. Copyright © 2010. Published by Elsevier Inc.
Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Okunseri, Christopher
Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008. Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received. Approximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group. DDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees. © 2016 American Association of Public Health Dentistry.
Skinner, Asheley Cockrell; Slifkin, Rebecca T.; Mayer, Michelle L.
Background: Unmet need for dental care is the most prevalent unmet health care need among children with special health care needs (CSHCN), even though these children are at a greater risk for dental problems. The combination of rural residence and special health care needs may leave rural CSHCN particularly vulnerable to high levels of unmet…
McFarland, Kimberly K.; Salama, Fouad; Yaseen, Muhammad
Background: Pediatric dentists are too few in number to care for all children. Therefore, the level of pediatric dental services provided by general dentists, especially in rural areas, is crucial to improving the dental health of children. Purpose: The objectives of the study were to establish a baseline in regard to the quantity of pediatric…
Tickle, M; Moulding, G; Milsom, K; Blinkhorn, A
To measure the relationship between tooth decay, contact with dental services and deprivation at electoral ward level. The study was carried out in 1998 in Ellesmere Port in the North West of England. All children younger than six years resident in Ellesmere Port registered with GDS services and those using CDS services were matched against the HA population register to identify unregistered children. Rates for children aged 3-5 years 'in contact' with primary dental care services, whether CDS or GDS, were calculated at ward level. One calibrated examiner examined all 5-year-old children in Ellesmere Port and dmft scores were calculated at ward level. Ward deprivation was measured using the Jarman score. Bivariate linear regressions at ward level were performed in turn between: dmft and Jarman score; rates for 3-5-year-olds in contact with dental services and Jarman score; and dmft and rates for 3-5-year-olds in contact with dental services. A significant linear relationship was observed between dmft and Jarman score (P=0.02, R2 = 0.43). Significant inverse relationships were found between rates for 3-5-year-olds in contact with dental services and Jarman score (P=0.001, R2 = 0.67), and also between dmft and rates for 3-5-year-olds in contact with dental services (P=0.002, R2 = 0.65). A strong inverse relationship was found between dental caries and contact with primary dental care services at electoral ward level. This relationship needs to be explored over a wider geographical area to establish if it is consistent and independent of deprivation.
Peerbhay, F B M
This study evaluated the self-reported preventive dental care compliance of parents/families whose children received dental treatment under general anaesthesia. Complete records of 68 pediatric patients who attended the University of Stellenbosch's Paediatric Dentistry Department for dental treatment were included in the survey. Parents of 41 (60%) patients were interviewed telephonically to evaluate parental dental health knowledge and preventive practices. The majority (85%) of parents had a good idea about the aetiology of dental caries. An assessment of the children's dental health behaviour reveals that parents were mostly responsible for brushing the childs' teeth (44%).The majority of parents (51%) reported that following dental treatment of the child under general anaesthesia, there was no change in their child's frequency of sugar consumption. Sixty-three percent of children treated under GA had returned for the one-week follow-up. However, only 22% of children returned for the three-month follow up appointment. Parents were informed about the importance of these follow-up appointments. Parental belief that proper dental health behaviour helps maintain the teeth, did not influence parents preventive compliance, despite them having received preventive instruction. Parents were mostly responsible for brushing their child's teeth following dental treatment of their children under general anaesthesia. This research found however that, in the majority of cases there was no change in the children's frequency of sugar intake.
Chi, Donald L.; Momany, Elizabeth T.; Neff, John; Jones, Michael P.; Warren, John J.; Slayton, Rebecca L.; Weber-Gasparoni, Karin; Damiano, Peter C.
Background Although Medicaid-enrolled children with a chronic condition (CC) may be less likely to use dental care because of factors related to their CC, dental utilization for this population is poorly understood. Objective To assess the relationship between CC status and CC severity, respectively, on dental utilization for Iowa Medicaid-enrolled children. Research Design Retrospective cohort study of Iowa Medicaid data (January 1, 2003 to December 31, 2006). Subjects Medicaid-enrolled children aged 3 to 14 (N = 71,115) years. Measures The 3M Corporation Clinical Risk Grouping methods were used to assess CC status (no/yes) and CC severity (episodic/life-long/malignancy/complex). The outcome variable was any dental utilization in 2006. Secondary outcomes included use of diagnostic, preventive, routine restorative, or complex restorative dental care. Results After adjusting for model covariates, Iowa Medicaid-enrolled children with a CC were significantly more likely to use each type of dental care except routine restorative care (P = 0.86) than those without a CC, although the differences in the odds were small (4%–6%). Compared with Medicaid-enrolled children with an episodic CC, children with a life-long CC were less likely to use routine restorative care (P < 0.0001), children with a malignancy were more likely to use complex restorative care (P < 0.03), and children with a complex CC were less likely to use each type of dental care except complex restorative care (P = 0.97). Conclusions There were differences in dental utilization for Iowa Medicaid-enrolled children by CC status and CC severity. Children with complex CCs were the least likely to use dental care. Future research efforts should seek to understand why subgroups of Medicaid-enrolled children with a CC exhibit lower dental utilization. PMID:21150799
Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie
This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done.
Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie
This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done. PMID:24753975
Bruns, Timothy; Perinpanayagam, Hiran
Children and adolescents who suffer traumatic injuries often seek emergency treatment at a Children's Hospital. Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5-10 years) to early adolescence (11-15 years) and then decreased rapidly in late adolescence (16-19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint.
Chi, Donald L.; Momany, Elizabeth T.; Jones, Michael P.; Kuthy, Raymond; Damiano, Peter C.
We compared the extent to which having an intellectual or developmental disability was associated with rates at which Iowa Medicaid-enrolled children ages 3 to 8 had first dental checkups after an initial dental examination. We hypothesized that these children would have later first dental checkups than would children without an intellectual or…
Costa, Francine Dos Santos; Azevedo, Marina Sousa; Ardenghi, Thiago Machado; Pinheiro, Ricardo Tavares; Demarco, Flávio Fernando; Goettems, Marília Leão
This study aimed to investigate the influence of depressive and anxiety symptoms in young mothers on their perception in relation to their children's oral health-related quality of life (COHRQoL). This cross-sectional study was carried out in Pelotas, Southern Brazil, and it was nested in a cohort of adolescent mothers having their prenatal care in public health service, starting in 2008. When the children were aged 24-36 months, they and their mothers were interviewed and submitted to clinical examination by a trained team. Socioeconomic, educational, behavioural and psychological assessments were collected in the interview and oral examination investigated caries and gingival bleeding (in mothers) and caries and dental trauma (in children). Maternal perception of impact on COHRQoL was evaluated by Early Childhood Oral Health Impact Scale (ECOHIS). The outcome in the present study was the occurrence of impact on COHRQoL (ECOHIS≥2), that is the presence of at least one ECOHIS item reported as occasionally (score 2), often (score 3) or very often (score 4). Analysis was conducted using Poisson regression with robust variance and obtained prevalence ratios (PR) and respective 95% confidence intervals (CI). This study comprised 537 mother-child dyads. After adjustment, higher scores of COHRQoL remained significantly associated with depressive symptoms (PR=1.80, 95% CI: 1.36-2.38) and maternal anxiety symptoms (PR=2.28, 95% CI: 1.72-3.00). Mothers with anxiety symptoms or depressive symptoms had a prevalence of impact 91% higher when compared with mothers without any symptoms (PR=1.91; CI 95% 1.35-2.68), and mothers with both symptoms had almost 2.5 times higher risk of perception of negative impact on COHRQoL (PR=2.48; CI 95% 1.78-3.45). Poorer COHRQoL was associated with maternal depression and anxiety symptoms. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Huebner, Colleen E; Chi, Donald L; Masterson, Erin; Milgrom, Peter
This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Study methods included 90 parent interviews and dental examinations of their preschool-age children. Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37% experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.
Huebner, Colleen E.; Chi, Donald L.; Masterson, Erin; Milgrom, Peter
Purpose This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Methods Study methods included 90 parent interviews and dental examinations of their preschool-age children. Results Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37 percent experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Conclusions Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. PMID:25082666
Umamaheshwari, N; Asokan, Sharath; Kumaran, Thanga S
The child's perception of the dental environment is a significant factor causing dental anxiety. If the color of the dental environment can have a positive impact on the child's behavior, it is possible that those colors may add to the comfort of a child, thus reducing dental anxiety. To evaluate the association between color and emotions of children in a pediatric dental set-up. A total of 300 children aged 6-12 years were divided into 2 groups: Younger children (6-9 years, n = 156) and older children (9-12 years, n = 144). All the children were asked to shade two cartoon faces representing happiness and fear with their most preferred color. For the positive emotion, 44% (n = 132) of the children preferred yellow, followed by blue 32.67% (n = 98). For negative emotion, 56.67% (n = 170) of the children preferred black and 42.67% (n = 128) preferred red. Association between color and emotion was highly significant (P < 0.001). This study has attempted to advance the area of color research to dental anxiety in children visiting a dental clinic. The use of child friendly colors like yellow and blue in the dental work place could enhance a positive dental attitude in the child's mind.
Sorvo, Riikka; Koponen, Tuire; Viholainen, Helena; Aro, Tuija; Räikkönen, Eija; Peura, Pilvi; Dowker, Ann; Aro, Mikko
Children have been found to report and demonstrate math anxiety as early as the first grade. However, previous results concerning the relationship between math anxiety and performance are contradictory, with some studies establishing a correlation between them while others do not. These contradictory results might be related to varying operationalizations of math anxiety. In this study, we aimed to examine the prevalence of math anxiety and its relationship with basic arithmetic skills in primary school children, with explicit focus on two aspects of math anxiety: anxiety about failure in mathematics and anxiety in math-related situations. The participants comprised 1,327 children at grades 2-5. Math anxiety was assessed using six items, and basic arithmetic skills were assessed using three assessment tasks. Around one-third of the participants reported anxiety about being unable to do math, one-fifth about having to answer teachers' questions, and one tenth about having to do math. Confirmatory factor analysis indicated that anxiety about math-related situations and anxiety about failure in mathematics are separable aspects of math anxiety. Structural equation modelling suggested that anxiety about math-related situations was more strongly associated with arithmetic fluency than anxiety about failure. Anxiety about math-related situations was most common among second graders and least common among fifth graders. As math anxiety, particularly about math-related situations, was related to arithmetic fluency even as early as the second grade, children's negative feelings and math anxiety should be identified and addressed from the early primary school years. © 2017 The British Psychological Society.
Salari, Elham; Shahrivar, Zahra; Mahmoudi-Gharaei, Javad; Shirazi, Elham; Sepasi, Mitra
Parents play an important role in development and continuation of anxiety disorders in children. Yet the evidence on parent contribution in cognitive behavioral therapy (CBT) for childhood anxiety is limited. This open randomized trial examined the effectiveness of a parent-directed group CBT to manage children with anxiety disorders. Parents of 42 children aged 6-12 with primary anxiety disorders were allocated to a six, two-hour weekly intervention and a wait-list (WL) control. The Revised Children's Manifest Anxiety, Children's Depression Inventory, Strengths and Difficulties Questionnaire-Home Version, Depression-Anxiety-Stress Scale, Children Global Assessment Scale, and Global Relational Assessment of Functioning were used to assess children's and parents' functioning and emotional symptoms. Parents completed consumer satisfaction questionnaire. Parents in the CBT group reported significant improvement in their depressive symptoms (p=0.006) and the family functioning (p=0.04), as well as reduction in children's emotional symptoms (p=0.007). Clinician rating of children's functioning showed significant improvement in the CBT group(p=0.001). There was no significant difference in children rating of their anxiety within groups from pre- to post-intervention. Parents were satisfied mostly with the intervention. A brief parent-only CBT based intervention can be effective in the management of childhood anxiety.
Storch, Eric A.; Barlas, Mitchell E.; Dent, Heather C.; Masia, Carrie L.
Used the Social Anxiety Scale for Children-Revised and additional questions to examine the relationship of social anxiety to sport anxiety and avoidance in a sample of urban Hispanic American fifth and sixth graders. Found that, for girls, fear of negative evaluation and social avoidance of general and new situations were associated with sport…
Vukovic, Rose K.; Kieffer, Michael J.; Bailey, Sean P.; Harari, Rachel R.
This study explored mathematics anxiety in a longitudinal sample of 113 children followed from second to third grade. We examined how mathematics anxiety related to different types of mathematical performance concurrently and longitudinally and whether the relations between mathematics anxiety and mathematical performance differed as a function of…
van Steensel, Francisca J. A.; Bogels, Susan M.; Perrin, Sean
There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic…
Parker, Julia H; Van Lenten, Scott A; Pina, Armando A
Anxious youth typically experience sleep-related difficulties, but little is known about the role children's coping and perceived control over anxiety may play in these relations. We examined children's perceived levels of control over external anxiety-provoking events and internal anxious emotional reactions, as well as two dispositional coping tendencies (avoidant, support-seeking), and whether these were associated with anxious children's (N = 86) presleep arousal. Low perceived control over anxiety was significantly associated with high levels of presleep arousal. For children with low perceived control, higher avoidance was associated with greater presleep arousal, whereas lower avoidance was associated with lower presleep arousal levels. Findings suggest that efforts to avoid stressful life events may contribute to presleep arousal, especially under conditions where anxious arousal seems uncontrollable.
Olivares, José; Sánchez-García, Raquel; López-Pina, José Antonio
The purpose of this study was to analyze the component structure and reliability of the Liebowitz Social Anxiety Scale for Children and Adolescents, self-report version (LSAS-CA-SR), in a Spanish community population. The sample was made up of 422 students from elementary and high schools, aged between 10 and 17 years. Exploratory factor analysis isolated one component for the Anxiety subscale and one component for the Avoidance subscale. Medium-strong associations were found between the total score and subscale scores. LSAS-CA-SR scores had stronger associations with instruments of social anxiety. Internal consistency for the Fear subscale was .91, and for the Avoidance subscale, it was .89. Gender and age effects were assessed for LSAS-CA-SR scores. Effect sizes for age and gender and interaction of age and gender were very low on both the Fear and the Avoidance subscales. There were significant differences between female and male means on the Fear subscale. The findings suggest that the LSAS-CA-SR is reliable and valid.
Sagheri, Darius; McLoughlin, Jacinta; Nunn, June H
Dental caries among preschool children remains a significant dental public health problem. In Ireland, there are no national data available regarding dental caries levels in preschool children. Furthermore, the number of young children with disabilities and their dental caries levels remains unknown. The aim of the present study was to measure the dental caries levels in a sample of preschool children with disabilities. A team of trained and calibrated dentists examined a sample of all 0- to 6-year old preschool children with disabilities in two health service administrative areas under standardized conditions. Dental caries was recorded using WHO criteria. Of a total of 422 participants, 337 datasets were included in the study. Of these 337 examined children, approximately 75.1% had a cognitive disability and 12.9% had a noncognitive disability. In 12% of the children, a diagnosis had not yet been established. Dental caries at dentin level was detected from the age of 4 years. The overall mean decayed/missing/ filled teeth (dmft) was 0.49 (SD, 1.39). The analysis of mean dmft levels in children with positive (dmft > 0) scores revealed a mean dmft of 1.14. The evidence from this study demonstrated that dental caries levels in preschool children with disabilities in Ireland are low when compared with the general population. Furthermore, children aged 3 years or younger exhibited no dental caries at dentin level and therefore were not affected by early childhood caries. An adjustment of current oral health prevention practice may lead to a further reduction in dental caries levels in this section of the child population.
Grembowski, David; Spiekerman, Charles; Milgrom, Peter
For mothers of Medicaid children aged 3 to 6 years, we examined whether mothers’ characteristics and local supply of dentists and public dental clinics are associated with having a regular source of dental care. Disproportionate stratified sampling by racial/ethnic group selected 11,305 children aged 3 to 6 in Medicaid in Washington state. Mothers (N=4,373) completed a mixed-mode survey that was combined with dental supply measures. Results reveal 38% of mothers had a regular dental place and 27% had a regular dentist. Dental insurance, greater education, income, and length of residence and better mental health were associated with having a regular place or dentist for Black, Hispanic and White mothers, along with increased supply of private dentists and safety net clinics for White and Hispanic mothers. Mothers lacking a regular source of dental care may increase oral health disparities in their children. PMID:17982208
Chu, May; Sweis, Luciana E; Guay, Albert H; Manski, Richard J
Improvements in oral health care services have not reached evenly across every segment of American society. The authors examine the role of nondentist practitioners in referring child patients for dental care by analyzing data from the 2003 Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. The authors provide national estimates of the percentage of the civilian noninstitutionalized population of the United States aged 2 through 17 years who had a dental visit, who had a dental checkup and who received advice from a nondentist health care provider to have a dental checkup. Overall, 38 percent of all poor, near-poor or low-income children and 60 percent of all middle- or high-income children aged 2 through 17 years reported having had a dental checkup during 2003. The authors observed no significant differences between poor, near-poor and low-income children and higher-income children in terms of having been advised by a nondentist health care provider to have a dental checkup. Although income may not predict the likelihood of patients' receiving advice from a nondentist health care provider to have a dental checkup, children from families with higher levels of income were more likely to seek dental care than were children from families with lower levels of income. Practice Implications. Efforts to increase access to dental care should aim to maximize the benefit of advice provided by nondentist health care practitioners to receive a dental checkup, so that children from families with limited income are as likely to receive a dental checkup as are children from families with higher levels of income.
Rantavuori, Kari; Lahti, Satu; Hausen, Hannu; Seppä, Liisa; Kärkkäinen, Sakari
Our aim was to describe the occurrence of dental fear among Finnish children of different ages and to ascertain how oral health and family characteristics are associated with dental fear. The subject groups were aged 3, 6, 9, 12, and 15 years in two middle-sized cities, and the 1474 participants were distributed over fairly equal samples of each age. A questionnaire given to each child to be filled out at home enquired about social background, oral hygiene habits, diet, and dental fear. Oral health status was examined clinically and radiographically by two calibrated dentists. Multiple logistic regression analyses were performed for each age group in order to study the associations between dental fear and selected factors. Dental fear was higher among 12- and 15-year-old children than among the younger ones. Pain, drilling, and local anesthesia were reported to be the most frightening aspects. Excluding the 12-year-olds, children whose family members reported dental fear were more likely to report dental fear than children whose family members did not report dental fear. Six- and 12-year-olds who had experienced caries were more likely to report dental fear than were caries-free children. Among 6-year-olds, father's education modified the effect of a child's caries experience on child dental fear. Frequent intake of sugary items and a limit on eating candies to only one day per week were associated with higher dental fear. Fear of dental treatment is still fairly common among Finnish children, and the factors associated with it differ with the age of the child.
Tong, H J; Rudolf, M C J; Muyombwe, T; Duggal, M S; Balmer, R
To investigate whether children with obesity experienced more erosion and caries than children with normal weight. This study involved children aged 7-15 years. The study and control group comprised 32 children with BMI > 98th centile and 32 healthy children with normal BMI-for-age, respectively. O'Sullivan Erosion Index and WHO Caries Index were used in the examination of erosion and caries, respectively. Stimulated salivary flow rate, buffering capacity, Streptococcus mutans and lactobacilli counts (CFU/ml) were evaluated. A cross-sectional questionnaire survey was employed to collect information on participant's demographic background, oral health history and habits, and utilisation of dental care services. Children with obesity were more likely to have erosion than healthy children (p < 0.001), and had more erosion in terms of severity (p < 0.0001) and area affected (p < 0.0001), but not in the number of surfaces affected (p = 0.167). Posterior teeth were less likely than anterior teeth to be affected by erosion (OR 0.32, 95 % CI 0.012-0.082). Gender had no effect on erosion. There were no statistically significant differences in the DMFT, saliva profiles or questionnaire responses between the groups. Children with obesity may have high risk of dental erosion, but do not necessarily have higher risk of dental caries than children with normal weight.
Huang, Keng-Yen; Cheng, Sabrina; Calzada, Esther; Brotman, Laurie Miller
Anxiety is one of the most prevalent mental health problems in young children but there has been a dearth of studies focusing on Asian American children. This study examines the patterns and the predictors of childhood anxiety and related symptoms in young children in a diverse Asian American (ASA) sample (n = 101). Findings indicate that ASA children are at higher risk for anxiety, somatization, and depressive problems than their peers. Parents' level of acculturation (i.e., American identity, English competence), parental negative emotion socialization, conflicted parent-child relationship, child emotional knowledge and adaptive skills, as well as teachers' ethnic background and school class types were all associated with ASA children's anxiety. A combination of cultural, family, and school factors explained from 17 to 39 % of the variance in anxiety symptoms. Findings inform prevention services for young ASA children.
Pourat, Nadereh; Finocchio, Len
Poor oral health has important implications for the healthy development of children. Children in Medicaid, especially Latinos and African Americans, experience high rates of tooth decay, yet they visit dentists less often than privately insured children. Even Latino and African American children with private insurance are less likely than white children to visit dentists and have longer intervals between dental visits. Furthermore, Latino and African American children in Medicaid are more likely than white children in Medicaid to have longer intervals between visits. These findings raise concerns about Medicaid's ability to address disparities in dental care access and, more broadly, in health care.
Mayes, Susan Dickerson; Calhoun, Susan L.; Murray, Michael J.; Ahuja, Meesha; Smith, Laura A.
Maternal ratings of anxiety, depression, and irritability were analyzed in 1390 children (6-16 years of age), including 233 children with high functioning autism (HFA, IQ greater than or equal to 80), 117 children with low functioning autism (LFA, IQ less than 80), 187 typical children, and 853 children with other disorders. As a group, children…
Keil, Verena; Asbrand, Julia; Tuschen-Caffier, Brunna; Schmitz, Julian
Deficits in emotion regulation (ER) are an important factor in maintaining social anxiety disorder (SAD) in adults. As SAD and ER problems typically develop during childhood and adolescence, and are maintained dynamically within the parent-child dyad, research on families can help to reveal the role ER plays in the early development of SAD. The current study assessed self-reported habitual ER in dyads of children with SAD (n = 31), children with mixed anxiety disorders (MAD; n = 41) and healthy control children (HC; n = 36), and their parents. Results indicate a transdiagnostic quality of ER in that, children with SAD and children with MAD similarly reported less adaptive and more maladaptive ER strategies than HC children, whereas no group differences in parental ER strategies emerged. Furthermore, children's ER strategies aggressive action, withdrawal and self-devaluation and the parental ER strategy reappraisal were associated with social anxiety symptoms. These results suggest that there may be deficits in ER which generalize across childhood anxiety disorders. Our results are discussed in relation to current theories and their implications for treatment of childhood SAD.
Waite, Polly; Creswell, Cathy
Reports of the clinical characteristics of children and adolescents with anxiety disorders are typically based on community populations or from clinical samples with exclusion criterion applied. Little is known about the clinical characteristics of children and adolescents routinely referred for treatment for anxiety disorders. Furthermore, children and adolescents are typically treated as one homogeneous group although they may differ in ways that are clinically meaningful. A consecutive series of children (n=100, aged 6-12 years) and adolescents (n=100, aged 13-18 years), referred to a routine clinical service, were assessed for anxiety and comorbid disorders, school refusal and parental symptoms of psychopathology. Children with a primary anxiety disorder were significantly more likely to be diagnosed with separation anxiety disorder than adolescents. Adolescents with a primary anxiety disorder had significantly higher self and clinician rated anxiety symptoms and had more frequent primary diagnoses of social anxiety disorder, diagnoses and symptoms of mood disorders, and irregular school attendance. Childhood and adolescence were considered categorically as distinct, developmental periods; in reality changes would be unlikely to occur in such a discrete manner. The finding that children and adolescents with anxiety disorders have distinct clinical characteristics has clear implications for treatment. Simply adapting treatments designed for children to make the materials more 'adolescent-friendly' is unlikely to sufficiently meet the needs of adolescents. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.
Ezpeleta, Lourdes; Navarro, José Blas; Osa, Núria de la; Penelo, Eva; Bulbena, Antoni
To obtain joint hypermobility classes in children from the general population and to study their characteristics in relation to anxiety measures. A total of 336 nine-year-old children from the general population were clinically assessed through 9 items of hypermobility, and their parents reported about the severity of anxiety symptoms. Latent class analysis was estimated to group the children according to the presence of hypermobility symptoms, and the obtained classes were related to anxiety. A 2-class solution, labeled as high hypermobility and low hypermobility, best fitted the data. Children in the high hypermobility group scored higher in separation anxiety, social phobia, physical injury fears, and total anxiety than did those in the low group. When applying the threshold reference scores to the total anxiety score, 7.4% of children in the high hypermobility group versus 6% in the low group were reported to experience clinical elevations on total anxiety. High symptoms of hypermobility are associated with higher scores in anxiety symptoms in children from the general population. Children with frequent symptoms of hypermobility may benefit from screening for anxiety symptoms because a subset of them are experiencing clinical elevations and may need comprehensive physical and psychological treatment.
McKinney, Christy M.; Nelson, Travis; Scott, JoAnna M.; Heaton, Lisa J.; Vaughn, Matthew G.; Lewis, Charlotte W.
Objective Unmet dental need in children with autism spectrum disorder (ASD) is common. We tested hypotheses that lacking a medical home or having characteristics of more severe ASD is positively associated with having unmet dental need among children with ASD. Methods Using data from the 2009–2010 National Survey of Children with Special Health Care Needs, we analyzed 2,772 children 5–17 years old with ASD. We theorized unmet dental need would be positively associated with not having a medical home and having characteristics of more severe ASD (e.g. parent reported severe ASD, an intellectual disability, communication or behavior difficulties). Prevalence of unmet dental need was estimated, and unadjusted and adjusted odds ratios (ORs), 95% confidence intervals (CIs), and p-values were computed using survey methods for logistic regression. Results Nationally, 15.1% of children with ASD had unmet dental need. Among children with ASD, those without a medical home were more apt to have unmet dental need than those with a medical home (adjusted OR 4.46, 95% CI: 2.59, 7.69). Children with ASD with intellectual disability or greater communication or behavioral difficulties had greater odds of unmet dental need than those with ASD without these characteristics. Parent reported ASD severity was not associated with unmet dental need. Conclusions Children with ASD without a medical home and with characteristics suggestive of increased ASD-related difficulties are more apt to have unmet dental need. Pediatricians may use these findings to aid in identifying children with ASD who may not receive all needed dental care. PMID:25439161
McKinney, Christy M; Nelson, Travis; Scott, JoAnna M; Heaton, Lisa J; Vaughn, Matthew G; Lewis, Charlotte W
Unmet dental need in children with autism spectrum disorder (ASD) is common. We tested hypotheses that lacking a medical home or having characteristics of more severe ASD is positively associated with having unmet dental need among children with ASD. Using data from the 2009 to 2010 National Survey of Children with Special Health Care Needs, we analyzed 2772 children 5 to 17 years old with ASD. We theorized that unmet dental need would be positively associated with not having a medical home and having characteristics of more severe ASD (eg, parent reported severe ASD, an intellectual disability, communication, or behavior difficulties). Prevalence of unmet dental need was estimated, and unadjusted and adjusted odds ratios, 95% confidence intervals, and P values were computed using survey methods for logistic regression. Nationally, 15.1% of children with ASD had unmet dental need. Among children with ASD, those without a medical home were more apt to have unmet dental need than those with a medical home (adjusted odds ratio, 4.46; 95% confidence interval, 2.59-7.69). Children with ASD with intellectual disability or greater communication or behavioral difficulties had greater odds of unmet dental need than those with ASD without these characteristics. Parent-reported ASD severity was not associated with unmet dental need. Children with ASD without a medical home and with characteristics suggestive of increased ASD-related difficulties were more apt to have unmet dental need. Pediatricians might use these findings to aid in identifying children with ASD who might not receive all needed dental care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Arcia, Emily; Castillo, Hector; Fernández, María C
This study was undertaken to describe how Caribbean Latina mothers understand distress in children, the behaviors that they attribute to it, and the labels that they use to express their cognitions. Findings from 62 mothers of young children with disruptive behaviors indicated that mothers made attributions about anxiety in 40% of the children with a high likelihood of clinical anxiety. Hyperactive and restless behavior, but not children's fears, was understood by mothers to reflect anxiety. References to 'nervios' could be categorized into: an illness condition, a crisis condition, and a temperament type. Only temperament usage was applied to children.
Morrisey, Michael A.; Sen, Bisakha
Importance There is a recommendation for children to have a dental home by 6 months of age, but there is limited evidence supporting the effectiveness of early preventive dental care or whether primary care providers (PCPs) can deliver it. Objective To investigate the effectiveness of preventive dental care in reducing caries-related treatment visits among Medicaid enrollees. Design, Setting, and Participants High-dimensional propensity scores were used to address selection bias for a retrospective cohort study of children continuously enrolled in coverage from the Alabama Medicaid Agency from birth between 2008 and 2012, adjusting for demographics, access to care, and general health service use. Exposures Children receiving preventive dental care prior to age 2 years from PCPs or dentists vs no preventive dental care. Main Outcome and Measures Two-part models estimated caries-related treatment and expenditures. Results Among 19 658 eligible children, 25.8% (n = 3658) received early preventive dental care, of whom 44% were black, 37.6% were white, and 16.3% were Hispanic. Compared with matched children without early preventive dental care, children with dentist-delivered preventive dental care more frequently had a subsequent caries-related treatment (20.6% vs 11.3%, P < .001), higher rate of visits (0.29 vs 0.15 per child-year, P < .001), and greater dental expenditures ($168 vs $87 per year, P < .001). Dentist-delivered preventive dental care was associated with an increase in the expected number of caries-related treatment visits by 0.14 per child per year (95% CI, 0.11-0.16) and caries-related treatment expenditures by $40.77 per child per year (95% CI, $30.48-$51.07). Primary care provider–delivered preventive dental care did not significantly affect caries-related treatment use or expenditures. Conclusions and Relevance Children with early preventive care visits from dentists were more likely to have subsequent dental care, including caries
Ahmed, Mohammad I; Farrell, Maureen A; Parrish, Katie; Karla, Aman
It is important for anesthesiologists to appreciate the impact of preoperative anxiety in children. Not only does it cause suffering in many children prior to their surgical experience, it has a negative impact on their postoperative recovery and possibly long afterwards. Because of these concerns, continued research is warranted to seek ways of minimizing their fears in the perioperative setting. In this review, we will examine the risk factors for preoperative anxiety, tools for quantifying children and parent's anxiety, and strategies that may play a part in decreasing preoperative anxiety. Variables, which influence preoperative anxiety in children, include their age, temperament, prior hospital experience and parent coping abilities. This review will also explore issues surrounding parental presence during a child's anesthesia induction and how understanding child development can enhance their cooperativeness during the preoperative period, especially during anesthesia induction. Non-pharmacological interventions as a means of decreasing pediatric anxiety will be explored. Finally recent trends and new directions will be touched upon.
Yilmaz, H; Erkin, G; Nalbant, L
Studies investigating depression and anxiety levels in mothers of children with CP and related factors are limited, and controversial findings are reported in these studies. The study was aimed to determine depression and anxiety levels in mothers of children with cerebral palsy (CP) and to define factors related to depression and anxiety levels. A descriptive study. Outpatient physical medicine and rehabilitation clinic of an education and research hospital. The study was composed of two groups: group 1, 116 mothers of children with CP and group 2, 114 mothers of healthy children. Mothers of children with spastic-type CP were included into group 1. Functional levels in children with CP were investigated with The Gross Motor Function Classification System (GMFCS). Depression levels of mothers in both groups were assessed with Beck Depression Inventory (BDI), and anxiety levels with Beck Anxiety Inventory (BAI). BDI and BAI scores were statistically and significantly higher in group 1, compared to group 2. Among mothers in group 1, a positive correlation was determined between GMFCS score, and depression and anxiety levels. However, no correlation was detected between depression and anxiety levels, and body involvement of CP, education status, age and economic level among patients. In logistic regression analysis, the most significant risk factors of depressive symptoms were detected to be GMFCS score and speech defects. Our findings indicate that depression and anxiety levels of mothers with CP children are higher than those with healthy children and associated with speech defects and functional disability levels in children with CP. Healthcare professionals should take into account that depression and anxiety levels may be higher in mothers of children with CP. For an effective rehabilitation program related to children with CP, depression and anxiety levels in mothers of such children should be taken into account, and mothers should closely be followed and if
Mertz, Elizabeth; Mouradian, Wendy
The Surgeon General's Report on Oral Health (SGROH) and the Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist to population ratio is declining, while mal-distribution of dentists continues for rural and underserved communities. The diversity of the dental workforce has only improved slightly, while the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include: enhanced training in children's oral health for general dentists; expanded scope of practice for allied dental health professionals; new dental practitioners including the dental health aid therapist; and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts and strong partnerships with communities will be needed to effect substantive changes in children's oral health. PMID:19854121
Mertz, Elizabeth; Mouradian, Wendy E
Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.
Venkatesh Babu, N S; Bhanushali, Parin Vasant
Iron deficiency anemia accounts for 90% of all types of anemia in the world. Although the prevalence has declined in recent years, it remains an important pediatric public health problem. Iron deficiency has also been associated with dental caries. It impairs salivary gland function causing reduced salivary secretion and buffering capacity leading to increased caries activity. The aim of the study is to explore an association between dental caries and serum levels of iron and ferritin in children aged 3-12 years. Subjectsand Methods: The study group included 120 children, hospitalized for uncomplicated medical problems. Blood reports were evaluated to determine serum iron and ferritin levels. Dental caries experience was assessed using deft index. The collected data were tabulated and analyzed using Student's t-test and Pearson's correlation coefficient. Out of 120 children, 38 children showed low serum iron levels of which 31 children had dental caries and nine out of 15 children in the high serum iron level group showed dental caries. High ferritin levels were seen in three children among which two children were caries-free and only one child had a low ferritin level who also had a positive deft score. Based on the results, it was concluded that there is an inverse association between serum iron levels and dental caries whereas there is no association between serum ferritin levels and dental caries.
Muris, Peter; Meesters, Cor; Knoops, Miranda
This study examined the relation between gender role orientation and fear and anxiety in a sample of nonclinic-referred children (N = 209) ages 10 to 13 years. Children and their parents completed questionnaires assessing children's gender role orientation, toy and activity preferences, and fear and anxiety. Results generally indicated that femininity and a preference for girls' toys and activities were positively associated with fear and anxiety, whereas masculinity and a preference for boys' toys and activities were negatively related to these emotions. Furthermore, gender role orientation accounted for more of the variance in fear and anxiety scores than the child's sex.
Caglar, E; Sandalli, N; Panagiotou, N; Tonguc, K; Kuscu, O O
To evaluate the prevalence and aetiology of dental erosion in Greek minority school children living in Istanbul (Turkey). The present study was initiated in four Greek minority elementary schools in Istanbul where a total of 83 children (46 girls, 37 boys) between ages 7-14 years old were examined. Children were categorised into 7-11 and 12-14 ages groups. Data were obtained by clinical examination, questionnaire and standard data reco