Prevalence and risk factors of children's dental anxiety in China: A longitudinal study

Abstract

Objectives Dental anxiety remains widespread among children, may continue into adulthood and affect their oral health-related quality of life and clinical management. The aim of the study was to explore the trend of children's dental anxiety over time and potential risk factors. Design Longitudinal study. Methods Children aged between 5 and 12 years were investigated with the Chinese version of face version of Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Frankl Behavior Rating scale from 2008 to 2017, and influential factors were explored. Results Clinical data were available from 1061 children, including 533 (50.2%) male participants and 528 (49.8%) female participants. The total CFSS-DS scores ranged from 16 to 66, with a mean of 24.8±10.3. The prevalence of dental anxiety is 11.59%. No significant differences in total CFSS-DS scores between girls and boys were found. According to the Frankl scale, 238 children were allocated to the uncooperative group and the remaining 823 children were allocated to the cooperative group. Scores of CFSS-DS were negatively correlated with the clinical behaviour level of Frankl. Children aged 11-12 years old had significantly decreased scores compared with other age groups, and there was a decline in the scores of the group aged 8-10 years old over time. The factor analysis divided 15 items of CFSS-DS into four factors, and the total scores of 'less invasive oral procedures' items belonging to factor III decreased significantly over time in the group aged 8-10 years old. Conclusions Age is a significant determinant for children's dental anxiety, and dental anxiety outcomes have improved for Chinese children aged 8-10 years. This study is one of the few reports on changes of children's dental anxiety in a new era of information, but the results may be extrapolated to other populations with caution.