Frontiers in oral health · 2026
The change in dental fear and anxiety toward dental examinations among preschool children in Hong Kong. 18-months longitudinal study.
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Lam Phoebe Pui Ying, Almarzouq Sarrah S F S, Yiu Cynthia
Аннотация
PURPOSE: Dental fear and anxiety (DFA) can profoundly impact on children's oral health and pose challenges for dental care providers due to behavioural issues. This 18-month cohort study aimed to investigate the changes in the prevalence and levels of DFA among preschool children towards dental examination in a familiar kindergarten setting and different potential risk factors that may influence the changes in dental fear levels among preschool children.
METHODS: Parental questionnaires consisting the child's demographic information, oral health status, socio-economic background, previous dental experiences, parental and child self-reported DFA were administered. During each biannual review, the children underwent examinations for plaque scores and dental caries. Their DFA was evaluated based on behaviours and perceived pain levels both before and immediately after the clinical examination using Frankl Scale (FBRS) and Venham Scale (VBRS). The children's perceived pain levels were self-assessed using Wong-Baker Faces Pain Scale (WBFS).
RESULTS: A total of 300 healthy kindergarten children aged 2-5 years were enrolled, with 209 children being reviewed at 18 months. A notable increase in children's cooperativeness pre-operatively and post-operatively over time was observed when assessed using FBRS (p < 0.001) and VBRS (p < 0.05), but not for self-rated WBFS. Following multiple imputation, children with higher dft and dt scores were significantly associated with pre-operative uncooperative behaviours. Other sociodemographic factors, clinical findings, or reported dental fear and anxiety (DFA) by parents and children were not significantly linked to uncooperative behaviours either pre-operatively or post-operatively.
CONCLUSION: The prevalence of DFA among preschool children towards dental examination in familiar kindergarten settings decreased significantly over time, suggesting the positive impact of repeated, non-threatening dental encounters. Past caries experience and untreated dental decay remained as significant factors associated with DFA.
METHODS: Parental questionnaires consisting the child's demographic information, oral health status, socio-economic background, previous dental experiences, parental and child self-reported DFA were administered. During each biannual review, the children underwent examinations for plaque scores and dental caries. Their DFA was evaluated based on behaviours and perceived pain levels both before and immediately after the clinical examination using Frankl Scale (FBRS) and Venham Scale (VBRS). The children's perceived pain levels were self-assessed using Wong-Baker Faces Pain Scale (WBFS).
RESULTS: A total of 300 healthy kindergarten children aged 2-5 years were enrolled, with 209 children being reviewed at 18 months. A notable increase in children's cooperativeness pre-operatively and post-operatively over time was observed when assessed using FBRS (p < 0.001) and VBRS (p < 0.05), but not for self-rated WBFS. Following multiple imputation, children with higher dft and dt scores were significantly associated with pre-operative uncooperative behaviours. Other sociodemographic factors, clinical findings, or reported dental fear and anxiety (DFA) by parents and children were not significantly linked to uncooperative behaviours either pre-operatively or post-operatively.
CONCLUSION: The prevalence of DFA among preschool children towards dental examination in familiar kindergarten settings decreased significantly over time, suggesting the positive impact of repeated, non-threatening dental encounters. Past caries experience and untreated dental decay remained as significant factors associated with DFA.