Dental Anxiety and Periodontal Health
Condition: Dental Anxiety; Periodontal Health; Oral Hygiene
MeSH terms: Anxiety Disorders
Study type: Observational

Summary: 
      Mothers usually have the primary role in bringing up children and developing health-related
      behaviors. The aim of this study was to determine the effect of mothers' dental anxiety and
      oral hygiene on the dental anxiety and periodontal health of their children.

      The study included 280 randomly selected children, aged 4-12 years, who came to the dentist
      for the first time and their mothers. Demographic and oral hygiene information of the mothers
      was collected through a questionaire. Dental anxiety of the mothers and children was assessed
      using the Modified Dental Anxiety Scale (MDAS) and the Venham Picture Test (VPT),
      respectively.
    

Detailed description: 
      Anxiety is a neurotic syndrome in which patients have difficulty in explaining internal
      restlessness, anxiety and fear reaching the level of panic, which causes physiological and
      behavioral disorders as a result of affecting motor tension and even autonomic hyperactivity.
      Anxiety and fear are frequently encountered in dentistry clinical practice in both adults and
      children. Dental anxiety is also defined as intense fear and anxiety that occurs as a result
      of the thought that patients will be harmed, that they will have an unknown operation outside
      their control, and because they have had previous negative dental treatment experiences.

      Direct factors such as previous traumatic dental experiences, postoperative complications,
      age, gender, anxious temperament in childhood, and indirect factors such as the effect of
      family on the approach to dental treatment and sociodemographic factors have been reported to
      have an effect on the development of dental anxiety. Most early school-age children begin to
      imitate their parents as role models. Children in this age group internalize their mothers'
      values, attitudes and behaviors, since they usually spend more time with their mothers. It is
      thought that especially parents' dental anxiety may have an effect on their children's dental
      anxiety through modeling and knowledge.

      Children with dental anxiety try every way to avoid dental treatment. The thought that
      patients will feel more pain than normal due to the anxiety they experience during dental
      treatments makes treatment difficult. Anxiety might lead to individuals discontinuing
      treatment, thereby worsening their dental health. As a result, necessary dental treatment
      becomes more time-consuming, invasive, and costly. At the same time, treatment anxiety
      impedes the clinical process, jeopardizes treatment results, and causes professional stress
      for dentists.

      Dental anxiety is evaluated through projective tests, behavioral assessments, psychometric
      assessments, and physiological techniques. Behavioral assessment is based on the dentist or
      researchers scoring the behaviors visually. For this purpose, the Frankl Behavior Scale and
      the Yale Preoperative Anxiety Scale are used. Psychometric assessments are made with
      questionnaires, which are the most preferred because of their ease of application, and these
      are used to measure the anxiety of children or adults before dental treatment. At the present
      time, the Modified Dental Anxiety Scale (MDAS) is frequently used for adults, while the
      Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) is used for children. Projective
      techniques also use pictures or narratives of objects that may cause anxiety and fear in
      young children. The Venham Picture Test (VPT) and Children's Dental Fear Picture Test are
      commonly used projective techniques. Physiological techniques measure anxiety-related
      parameters such as salivary cortisol level, blood pressure, and dorsal skin response.
      However, it is thought that the equipment used in this technique may increase anxiety,
      especially in children.

      From a review of literature it can be seen that there are few studies conducted in Turkey
      which have evaluated the effect of the mother on the child's dental anxiety and oral hygiene.
      The aim of this study was to determine the effects of mothers' dental anxiety and oral
      hygiene on the dental anxiety and periodontal health of their children, using psychometric
      analysis and projective methods.
    

Intervention name(s): dental anxiety and oral hygiene
Intervention type(s): Behavioral
Intervention description(s): Evaluation of the effect of mothers' dental anxiety and oral hygiene on children's dental anxiety and periodontal status.
Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        The study inclusion criteria for mothers were the absence of any systemic and psychiatric
        disorders, not being pregnant or breastfeeding, non-smoking, not having received
        periodontal treatment in the last 6 months, and with at least 20 teeth and willing to
        participate in the study. The inclusion criteria for children were defined as age 4-12
        years, having no known systemic disease, visiting a dentist for the first time, and not
        having reported acute pain. Only one child per family was included in the study for
        mother-child pairs.