Maternal depression and anxiety associated with dental fear in children: a cohort of adolescent mothers in Southern Brazil

Abstract

Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers' children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads) to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p < 0.05). At data collection, the prevalence of maternal depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children's dental fear was positively associated with mothers' presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child's perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.

The association between socioeconomic status, psychopathological symptom burden in mothers, and early childhood caries of their children

“…An influence of maternal dental anxiety and smoking on ECC has already been proven in several studies. Previous research confirmed the association between smoking in the household and ECC [17–20] as well as an increased caries prevalence in children of dentally anxious mothers [7–10,21–24]. In our study, 22% of the mothers in the CG, compared with 3% in the NON-CG, suffered from high dental anxiety.…”

“…We also examined PSBs, that were previously investigated rarely (e.g., alcohol [11]), not at all (e.g., eating disorders, subjective impairments due to somatic symptoms), or with contradictory evidence (e.g., depressiveness: positive studies [10,12–14], negative studies [15,16]). Our results confirm no significant group differences between CG and NON-CG with respect to alcohol dependency, symptoms of eating disorders, general anxiety, depressiveness or somatic symptom burden.…”

“…In most previous studies only one or few disorders were considered, making it difficult to compare the effects of the influencing factors. A few of these determinants are quite well verified (e.g., parental smoking [17–20,25], dental anxiety [7–10,21–24]), others have hardly (e.g., alcohol [11]) or not at all been investigated (e.g., childhood trauma, eating disorders), or study results are contradictory (e.g., depressiveness: positive studies [10,12–14], negative studies [15,16]).…”

“…Among the maternal psychopathologies, dental anxiety is one of the most studied risk factors. In children of mothers suffering from dental anxiety, an increased caries prevalence was confirmed in the majority of studies [7–10,21–24]. Mothers’ dental fear can impede the dental care of their children in two ways: apart from avoiding own dental visits, dentally anxious mothers take their children later and less regularly to the dentist [9].…”

“…Although maternal dental fear is a risk factor of ECC [7–10,21–24], nothing is known in this context about the influence of childhood traumatization, which is a common cause of dental anxiety in females [27]. Particularly traumatized women, who experienced sexual abuse in their childhood, often suffer from dental anxiety even in adulthood and perceive dental visits as intimidating [28,29].…”