Objective: This study aimed to investigate the prevalence of dental fear in preschool children and to estimate its association with maternal and children characteristics. Methods: The study was nested in a population-based birth cohort from Pelotas, Brazil, started in 2004. A sample of 1,129 children aged 5 years was dentally examined, and their mothers were interviewed. Dental fear was investigated using a validated instrument through the question ‘Do you think that your child is afraid of going to the dentist?'. The possible answers were (1) ‘no', (2) ‘yes, a little', (3) ‘yes' and (4) ‘yes, a lot'. The outcome was dichotomized as ‘children without dental fear' (answers 1 and 2) and ‘children with dental fear' (answers 3 and 4). Exploratory variables included demographic characteristics, socioeconomic status, maternal oral health status and maternal behaviors. The main explanatory variables were caries and dental pain. Data were analyzed using multivariable Poisson regression. Results: The prevalence of dental fear was 16.8% (95% confidence interval 14.6-19.0). Multivariate analysis showed that the lower the family income at birth and the higher the severity of dental caries, the higher the prevalence of dental fear. Children who never visited the dentist and those who frequently experienced dental pain were positively associated with higher dental fear prevalence. Conclusions: Presence of dental caries and dental pain were associated with dental fear regardless of socioeconomic origin and lack of dental service use in childhood.

Keywords:
Cohort study, Dental caries, Dental fear, Epidemiology, Oral health
1.
Armfield JM: What goes around comes around: revisiting the hypothesized vicious cycle of dental fear and avoidance. Community Dent Oral Epidemiol 2013;41:279-287.
2.
Armfield JM, Slade GD, Spencer AJ: Dental fear and adult oral health in Australia. Community Dent Oral Epidemiol 2009;37:220-230.
3.
Boeira GF, Correa MB, Peres KG, Peres MA, Santos IS, Matijasevich A, Barros AJD, Demarco FF: Caries is the main cause for dental pain in childhood: findings from a birth cohort. Caries Res 2012;46:488-495.
4.
Carrillo-Díaz M, Crego A, Armfield J, Romero M: The moderating role of dental expectancies on the relationship between cognitive vulnerability and dental fear in children and adolescents. Community Dent Oral Epidemiol 2013;41:269-278.
5.
Carrillo-Díaz M, Crego A, Armfield JM, Romero-Maroto M: Treatment experience, frequency of dental visits, and children's dental fear: a cognitive approach. Eur J Oral Sci 2012;120:75-81.
6.
Crego A, Carrillo-Díaz M, Armfield JM, Romero M: Applying the Cognitive Vulnerability Model to the analysis of cognitive and family influences on children's dental fear. Eur J Oral Sci 2013;121:194-203.
7.
Folayan MO, Idehen EE: Effect of information on dental anxiety and behaviour ratings in children. Eur J Paediatr Dent 2004;5:147-150.
8.
França-Pinto CC, Cenci MS, Romano AR, Peres MA, Peres KG, Matijasevich A, Santos IS, Barros AJD, Demarco FF: Association between black stains and dental caries in primary teeth: findings from a Brazilian population-based birth cohort. Caries Res 2012;46:170-176.
9.
Goettems ML, Ardenghi TM, Demarco FF, Romano AR, Torriani DD: Children's use of dental services: influence of maternal dental anxiety, attendance pattern, and perception of children's quality of life. Community Dent Oral Epidemiol 2012a;40:451-458.
10.
Goettems ML, Ardenghi TM, Romano AR, Demarco FF, Torriani DD: Influence of maternal dental anxiety on oral health-related quality of life of preschool children. Qual Life Res 2011;20:951-959.
11.
Goettems ML, Ardenghi TM, Romano AR, Demarco FF, Torriani DD: Influence of maternal dental anxiety on the child's dental caries experience. Caries Res 2012b;46:3-8.
12.
Klingberg G, Berggren U, Carlsson SG, Noren JG: Child dental fear: cause-related factors and clinical effects. Eur J Oral Sci 1995;103:405-412.
13.
Klingberg G, Broberg AG: Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent 2007;17:391-406.
14.
Lee CY, Chang YY, Huang ST: The clinically related predictors of dental fear in Taiwanese children. Int J Paediatr Dent 2008;18:415-422.
15.
Luoto A, Lahti S, Nevanpera T, Tolvanen M, Locker D: Oral-health-related quality of life among children with and without dental fear. Int J Paediatr Dent 2009;19:115-120.
16.
Luoto A, Tolvanen M, Rantavuori K, Pohjola V, Lahti S: Can parents and children evaluate each other's dental fear? Eur J Oral Sci 2010;118:254-258.
17.
Marshman Z, Innes N, Deery C, Hall M, Speed C, Douglas G, Clarkson J, Rodd H: The management of dental caries in primary teeth - involving service providers and users in the design of a trial. Trials 2012;13:143.
18.
Milsom KM, Tickle M, Humphris GM, Blinkhorn AS: The relationship between anxiety and dental treatment experience in 5-year-old children. Br Dent J 2003;194:503-506.
19.
Neverlien PO: Assessment of a single-item dental anxiety question. Acta Odontol Scand 1990;48:365-369.
20.
Nicolas E, Bessadet M, Collado V, Carrasco P, Rogerleroi V, Hennequin M: Factors affecting dental fear in French children aged 5-12 years. Int J Paediatr Dent 2010;20:366-373.
21.
Nuttall NM, Gilbert A, Morris J: Children's dental anxiety in the United Kingdom in 2003. J Dent 2008;36:857-860.
22.
Porritt J, Buchanan H, Hall M, Gilchrist F, Marshman Z: Assessing children's dental anxiety: a systematic review of current measures. Community Dent Oral Epidemiol 2013;41:130-142.
23.
Oliveira MM, Colares V: The relationship between dental anxiety and dental pain in children aged 18 to 59 months: a study in Recife, Pernambuco State, Brazil. Cad Saude Publica 2009;25:743-750.
24.
Rantavuori K, Zerman N, Ferro R, Lahti S: Relationship between children's first dental visit and their dental anxiety in the Veneto Region of Italy. Acta Odontol Scand 2002;60:297-300.
25.
Santos IS, Barros AJ, Matijasevich A, Domingues MR, Barros FC, Victora CG: Cohort profile: the 2004 Pelotas (Brazil) birth cohort study. Int J Epidemiol 2011;40:1461-1468.
26.
SB-Brasil P: Pesquisa nacional de saude bucal 2010, resultados principais. 2011. http://dab.saude.gov.br/CNSB/sbbrasil/arquivos/projeto_sb2010_relatorio_final.pdf (accessed March 30, 2013).
27.
Ten Berge M, Veerkamp JS, Hoogstraten J: The etiology of childhood dental fear: the role of dental and conditioning experiences. J Anxiety Disord 2002;16:321-329.
28.
Themessl-Huber M, Freeman R, Humphris G, MacGillivray S, Terzi N: Empirical evidence of the relationship between parental and child dental fear: a structured review and meta-analysis. Int J Paediatr Dent 2010;20:83-101.
29.
Thomson WM, Broadbent JM, Locker D, Poulton R: Trajectories of dental anxiety in a birth cohort. Community Dent Oral Epidemiol 2009;37:209-219.
30.
Thomson WM, Williams SM, Broadbent JM, Poulton R, Locker D: Long term dental visiting patterns and adult oral health. J Dent Res 2010;89:307-311.
31.
Tickle M, Jones C, Buchannan K, Milsom KM, Blinkhorn AS, Humphris GM: A prospective study of dental anxiety in a cohort of children followed from 5 to 9 years of age. Int J Paediatr Dent 2009;19:225-229.
32.
Townend E, Dimigen G, Fung D: A clinical study of child dental anxiety. Behav Res Ther 2000;38:31-46.
33.
Victora CG, Huttly SR, Fuchs SC, Olinto MT: The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol 1997;26:224-227.
34.
Wigen TI, Skaret E, Wang NJ: Dental avoidance behaviour in parent and child as risk indicators for caries in 5-year-old children. Int J Paediatr Dent 2009;19:431-437.
35.
Yengopal V, Harneker SY, Patel N, Siegfried N: Dental fillings for the treatment of caries in the primary dentition. Cochrane Database Syst Rev 2009;2:CD004483.
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2014
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