Pathways to dental fear from childhood to adolescence: A 10‐year cohort study

Abstract

BackgroundDental fear affects children's oral health; there is, however, no evidence regarding the pathways linking possible predictors for its occurrence.AimThis study aimed at exploring the direct and indirect effects of sociodemographic, clinical, behavioural and psychosocial factors on the development of dental fear in schoolchildren over time.DesignThis is a prospective cohort study, with 10 years of follow‐up. The first assessment started in 2010 (T1) with a sample of 639 children aged 1–5 years from Southern Brazil. For this study, the follow‐up (T2) of these individuals was performed in 2020. Dental fear was assessed at T2 using the Brazilian version of the Children's Fear Survey Schedule–Dental Subscale (CFSS–DS). Socio‐economic, demographic, psychosocial and oral health measures were collected in both assessments. A structural equation model was performed to assess the direct and indirect pathways among variables at T1 and T2 to predict the CFSS–DS scores at T2.ResultsOf the 639 children, 429 were re‐evaluated at T2. Higher levels of untreated dental caries, younger individuals, dental visits for nonroutine reasons and low sense of coherence at T2 directly impacted dental fear at T2. Considering the indirect effects, the presence of dental caries and low household income at T1 indirectly impacted higher levels of dental fear over 10 years via dental caries at follow‐up.ConclusionOur findings suggest that socio‐economic, demographic, clinical, psychosocial and behavioural conditions can influence dental fear from childhood to adolescence.

Structural Relationships between Asthma and Dental Caries in Children: A Birth Cohort Study in Southern Brazil

“…Structural equation modeling (SEM) appears as an alternative allowing to consider multiple mediators and post-and base confounders (i.e., covariates influencing the exposure and the mediator association with outcome, respectively) to improve inference using observational studies [17][18][19]. Studies considering subjective measures of oral health as outcome already adopted the use of SEM previously [20][21][22][23]. In counterpart, considering objective measures of oral health in general, just in the recent years, this analysis was widespread, and few studies could be found [23][24][25].…”