Abstract
Introduction Dental anxiety and fear is widely prevalent in the population, including children. This research is a further analysis of the Child Dental Health Survey 2013, to explore the impact of dental anxiety on factors relating to oral health.
Aim To explore the relationship between dental anxiety and oral health and the impact dental anxiety has on the quality of family life.
Design Regression analysis of data of 4,916 children aged 5 years and 8 years who participated in the Child Dental Health Survey 2013.
Setting National Epidemiological Survey in schools in the UK.
Materials and methods A series of logistic regression analyses was carried out for markers of oral health and impact of the child's oral health on the family's quality of life. The variables entered as predictors in the models included dental anxiety, socio demographic status and oral health-related behaviours.
Results Dental anxiety was associated with poorer oral health on nearly all measures (decay experience p = <0.001, active decay p = <0.001, primary tooth being restored p = 0.010, signs of oral infection p = 0.007) and had a greater impact on their family's quality of life (p = <0.001).
Conclusions Dentally anxious children have more dental disease and this has a greater impact on their family's quality of life.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Klingberg G. Dental anxiety in children and adolescents. Cognitive behaviour therapy for dental phobia and anxiety. 1st ed. West Sussex: Wiley-Blackwell, 2013.
Klingberg G, Broberg A G. 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.
McGrath C, Bedi R. The association between dental anxiety and oral health-related quality of life in Britain. Community Dent Oral Epidemiol 2004; 32: 67-72.
Heidari E, Banerjee A, Newton J T. Oral health status of non-phobic and dentally phobic individuals; a secondary analysis of the 2009 Adult Dental Health Survey. Br Dent J 2015; 219: 1-7.
Luoto A, Lahti S, Nevanperä T et al. Oral-health-related quality of life among children with and without dental fear. Int J Paediatr Dent 2009; 19: 115-120.
Klingberg G, Broberg A G. 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.
Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013.
Klingberg G, Berggren U, Carlsson S G, Noren J G. Child dental fear: cause-related factors and clinical effects. Eur J Oral Sci 1995; 103: 405-412.
Townend E, Dimigen G, Fung D. A clinical study of child dental anxiety. Behav Res Ther 2000; 38: 31-46.
Nuttall N M, Gilbert A, Morris J. Children's dental anxiety in the United Kingdom in 2003. J Dent 2008; 36: 857-860.
Hallberg U, Camling E, Zickert I, Robertson A, Berggren U L. Dental appointment no-shows: why do some parents fail to take their children to the dentist?. Int J Paediatr Dent 2008; 18: 27-34.
Ramos-Jorge JO, Marques L S, Homem M A et al. Degree of dental anxiety in children with and without toothache: prospective assessment.?. Int J Paediatr Dent 2013; 23: 125-130.
Coxon J D, Hosey M T, Newton J T. The oral health of dentally anxious five-and eight year olds: a secondary analysis of the 2013 Child Dental Health Survey. Br Dent J 2019; 226: 503.
Lee C.Y, Chang Y.Y and Huang S T. Prevalence of dental anxiety among 5 to 8 year old Taiwanese children. J Public Health Dent 2007; 67: 99-102.
Pitts N B, Chestnutt I G, Evans D, White D, Chadwick B, Steele J G. The dentinal caries experience of children in the United Kingdom, 2003. Br Dent J 2006; 200: 313.
Locker D, Jokovic A, Stephens M et al. Family impact of child oral and oro-facial conditions. Community Dent Oral Epidemiol 2002; 30: 438-448.
Cox D R, Snell E J. The analysis of binary data. 2nd ed. London: Chapman and Hall, 1989.
Rantavuori K, Lahti S, Hausen H, Seppä L, Kärkkäinen S. Dental fear and oral health and family characteristics of Finnish children. Acta Odontologica Scandinavica 2004; 62: 207-213.
Martins-Júnior P A, Vieira-Andrade R G, Corrêa-Faria P, Oliveira-Ferreira F, Marques L S, Ramos-Jorge M L. Impact of early childhood caries on the oral health-related quality of life of preschool children and their parents. Caries Res 2013; 47: 211-218.
Krikken J B, Van Wijk A J, Ten Cate J M et al. Measuring dental fear using the CFSS-DS. Do children and parents agree? Int J Paediatr Dent 2013; 23: 94-100.
Raadal M, Skaret E. Chapter 2: Background Description and Epidemiology. In Ost, L G, Skaret E (eds) Cognitive behaviour therapy for dental phobia and anxiety. pp. 21-33. Chichester: Wiley-Blackwell, 2013.
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.
Humphris G.M, Dyer T.A, Robinson P G. The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age BMC Oral Health 2009; 9: 20.
Humphris G, Crawford J R, Hill K, Gilbert A, Freeman R. UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results. BMC Oral Health 2013; 13: 29.
Al-Namankany A, De Souza M, Ashley P. Evidence-based dentistry: analysis of dental anxiety scales for children. Br Dent J 2012; 212: 219-222.
Brocklehurst P, Bridgman C, Davies G. A qualitative evaluation of a Local Professional Network programme 'Baby Teeth DO Matter'. Community Dent Health 2013; 30: 241-248.
Chestnutt I G. Addressing oral health inequalities in the United Kingdom-the impact of devolution on population-based fluoride policy. Br Dent J 2013; 215: 11.
Klaassen M A, Veerkamp J S, Hoogstraten J. Young children's Oral health-related quality of life and dental fear after treatment under general anaesthesia: a randomized controlled trial. Eur J Oral Sci 2009; 117: 273-278.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Coxon, J., Hosey, M. & Newton, J. The impact of dental anxiety on the oral health of children aged 5 and 8 years: a regression analysis of the Child Dental Health Survey 2013. Br Dent J 227, 818–822 (2019). https://doi.org/10.1038/s41415-019-0853-y
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41415-019-0853-y
This article is cited by
-
Effects of animal-assisted therapy on dental anxiety, behavior, and perceptions in young pediatric patients: a blinded randomized controlled trial
Trials (2025)
-
The relationship between Body Mass Index and dental anxiety among pediatric patients in Jeddah, Saudi Arabia: a cross-sectional study
BMC Oral Health (2025)
-
Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study
Scientific Reports (2025)
-
Effectiveness of behavioural therapy and inhalational sedation in reducing dental anxiety among patients attending dental clinics - a systematic review and meta-analysis
Evidence-Based Dentistry (2025)
-
Evaluating pain, fear, anxiety or stress/distress using children’s drawings in paediatric dentistry: a scoping review
European Archives of Paediatric Dentistry (2022)


