Child dental fear and behavior: The role of environmental factors in a hospital cohort

Information on the origin of dental fear and uncooperative behavior in a child patient is important for behavior management strategy. The effects of environmental factors have been comparatively less studied, especially in an Indian scenario. Objectives: To find the association of (1) age, gender, family characteristics, previous medical, and dental experiences with dental fear and behavior (2) dental fear with dental behavior. Materials and Methods: A cross-sectional questionnaire study involving 125 children aged between 7 and 14 years undergoing dental treatment under local anesthesia. The parent completed a questionnaire on family situation, medical history, and past dental experiences of the child. Child's dental fear was recorded using Children's Fear Survey Schedule-Dental Subscale and behavior was rated using Frankl Behaviour Rating Scale. Statistical Analysis: Data were analyzed using chi square test and binary logistic regression analysis. Results: Unpleasant experience in dental clinic and age of the child significantly influenced dental behavior. Visited pediatrician in the past one year, prior history of hospital admission, previous visit to dentist, experience at the first dental visit, and age of the child were contributing factors for dental fear. There was also significant association between dental fear levels and behavior. Conclusions: In 7 to 14 year olds, dental fear influences dental behavior, but the factors affecting them are not the same. Although dental fear decreases and dental behavior improves with age, experiences at the previous dental visits seem to influence both dental fear and behavior. Past medical experiences are likely to influence dental fear but not dental behavior.