Dental Fear and Anxiety in Children: Association with Individual and Familiar Factors Using Structural Equational Modelling.

Dental fear and anxiety (DFA) are common among children, and their occurrence needs to be assessed in population-based studies. This study aimed to evaluate a structural model for the association of DFA in children with individual and family-related factors. A representative cross-sectional study was conducted in Carmópolis de Minas, Brazil, with 272 children aged 4-6 years. Children's DFA was self-reported using the Children's Fear Survey Scale-Dental Subscale, and caregivers' DFA using the Dental Fear Survey. Caregivers provided sociodemographic information on the family and children's health. Two calibrated dentists examined the children for dental caries using the DMFT index. Structural equation modelling was performed. Dental caries showed a direct association with greater DFA in children (β = 0.145; p = 0.036). Toothache showed an indirect association with children's DFA through the variable "dental visit", as children with toothache had visited the dentist more recently (β = 0.401; p < 0.001), and a more recent dental visit was associated with DFA (β = -0.158; p = 0.037). Maternal depression was associated with greater caregiver DFA (β = 0.124; p = 0.006), but no association was found between children's DFA and caregiver's DFA (p > 0.05). Children with caries-related toothache who visited the dentist within six months before data collection-and more recently-had higher DFA.