Dental Anxiety in Children
Dental fear and treatment problems (DBMP) affect 15% of children in Sweden, often due to past negative experiences, parental fear, or socioeconomic factors. Treatment includes psychological methods like Tell-Show-Do and CBT to reduce fear and enhance cooperation.
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This article is based on an original article in Swedish which can be found here
There is extensive research on treatment problems of a psychological nature in pediatric dentistry. The nomenclature is not straightforward, and several terms are used. Treatment problems of a psychological nature – Dental Behaviour Management Problems abbreviated to DBMP – refer to a lack of cooperation with a behavior that complicates or makes dental treatment impossible, i.e., DBMP is an assessment made by the dental care team. Dental fear – abbreviated to DF – refers to the patient's experience of a reaction to a well-defined object, or anxiety that is more nonspecific. The term phobia is used to describe an intense, irrational fear, where the emotional reaction prevents the patient from coping with the demands of the situation, in this case, the dental care situation, which may be associated with varying degrees of avoidance reactions. The prevalence of dental fear (DF) and/or psychological treatment problems (DBMP) among children and adolescents in Sweden is around 15%. It has been shown that the different phenomena only partially overlap. In a large population study conducted in Gothenburg, 7% of children (aged 4–6 and 9–11 years) were estimated to be dentally fearful (DF), and 11% exhibited treatment problems (DBMP). Of the dentally fearful children, 61% also exhibited treatment problems, while only 27% of children with treatment problems were rated as dentally fearful.
Figure adapted from Arnrup (2003) based on data from Klingberg (1995).
Treatment problems in dentistry are not always due to fear, anxiety, or any form of phobia, but explanations for treatment problems can include;
- The child's own personality (age and maturity, general anxiety, temperament, behavior, and ability)
- The parents (dental fear, competence, and parenting style)
- The environment (socioeconomics, norms, and values)
- Previous experiences from, among other things, dental care
- The interaction between the dental care team, patient, and parent. Cancelling or missing scheduled appointments is a common phenomenon and sometimes a consequence of fear.
The combination of caries or other dental diseases and dental fear or treatment problems is the most common reason for referral to a pediatric dentist.
