Wednesday, September 27, 2017

Dental fear/anxiety and dental behavior management problems in children and adolescents: a review of prevalence and concomitant psychological factors

Department of Pediatric Dentistry
Lutheran Medical Center
           
Resident’s Name: Brian Darling                                                                     Date: 9/27/2017
Article Title: Dental fear/anxiety and dental behavior management problems in children and adolescents: a review of prevalence and concomitant psychological factors
Author(s): Gunilla Klingberg; Anders Broberg
Journal: International Journal of Pediatric Dentistry
Date: 2007; 17: 391-406
Major Topic: Behavior management of fearful/anxious children and adolescents
Type of Article: Literature review
Main Purpose: This article aimed to describe the literature regarding the prevalence of dental fear/anxiety and dental behavior management problems and their relationships to age, sex, general anxiety, temperament, and general behavioral problems
Key Points: Understanding of concomitant psychological factors is essential in both prevention and treatment of dental fear/anxiety and behavior management problems.
·      Dental Fear: normal emotional reaction to 1 or more specific threatening stimuli in the dental situation
·      Dental Anxiety: state of apprehension that something dreadful is going to happen in relation to dental treatment and is coupled with a sense of losing control
·      Dental Phobia: severe type of dental anxiety characterized by marked and persistent anxiety in relation either to clearly discernible situations/objects (e.g. drilling, injection) or to dental situation in general
o   Must result in either avoidance of necessary dental treatment or enduring treatment with dread and in an adjusted treatment situation
·      Self-reports are often used when studying adolescents while parental reports are normally for children under 13 years
·      ~9% of children have dental fear/anxiety and/or dental behavior management problems
·      Behavior management problems decline with age
·      Dental fear/anxiety and behavior management problems are more prevalent in girls and related to general fear and internalizing and externalizing behavioral problems
·      General behavior problems correlate with dental behavior management problems more so than it correlates with fear/anxiety
·      Only 27% of children with behavior management problems also have dental fear/anxiety. Only 61% of children with dental fear/anxiety show behavior management problems
·      Dental behavior management problems are not a quality of the child himself/herself but of the relationship between the child and dentist
·      Dental fear/anxiety decreases with age
·      Dental behavior management problems decline with age
·      General fear/anxiety may be correlated with having dental fear/anxiety
·      Children at risk of developing internalizing disorders (anxiety, depression, psychosomatic problems, etc) tend to have more dental fear/anxiety
·      It is likely that children with neuropsychiatric disorders may present with dental behavior management problems as part of their diagnosis. For example, children who react with anger and opposition to sitting still in the dental chair may demonstrate a symptom of oppositional defiant disorder.
·      Dental fear/anxiety is associated with temperamental traits of shyness, inhibition, negative emotionality.
·      Dental behavior management problems are more associated with activity and impulsivity.
·      There is a very low correlation between child and parental rations of the child’s internalizing problems
·      Uncooperative children are not difficult children
·      There is much room for improvement of the CFSS-DS (Children’s Fear Survey Schedule Dental Subscale) and DAS (Cora Dental Anxiety Scale) – the main scales for measuring fear in children and adolescents, respectively.

Remarks:
1-
2-
Assessment of Article:  Level of Evidence/Comments: III


No comments:

Post a Comment