Psychosocial Problems Are Common in Children With Dental Fear

Children and adolescents with severe dental fear often come from families with a turbulent background. It is also more common that they have had counselling contact with a psychologist. These are the conclusions of research carried out at the Sahlgrenska Academy at the University of Gothenburg, Sweden.

Annika Gustafsson, specialist in child dentistry, has studied children and adolescents of school age who have received specialist dental care because they develop many cavities and also suffer from severe dental fear. "I wanted to investigate how children and adolescents with dental behaviour management problems who received specialist dental care differed from patients of the same age within ordinary dental care. I also wanted to discover why they cancel appointments and fail to attend appointments more often," says Annika Gustafsson.

Just over 250 children and adolescents with dental behaviour management problems and their parents have completed questionnaires describing their family situation and everyday life. Their answers have been compared with answers from the same number of patients within ordinary dental care. "The children and adolescents with dental behaviour management problems suffered significantly more from dental fear, and they lived in families with lower social class and poor economy. Most often, they lived in single-parent families, they had fewer leisure activities and more psychosocial problems than patients within ordinary dental care," says Annika Gustafsson.

Their parents, in turn, stated that they also suffered from severe dental fear and had greater problems with anxiety and worry than parents of children and adolescents within ordinary dental care. "I believe that it has a negative effect on a child or adolescent if their parent does not want to go to the dentist with them due to the parent's own fear," says Annika Gustafsson, who has compared the number of cancelled appointments and appointments that they failed to attend for the children and adolescents with dental fear and for those in ordinary dental care. "Children and adolescents that avoided dental appointments had had contact with a psychologist or counsellor four times as often," says Annika Gustafsson.

She believes that it is important that these patients are met with respect and understanding within the dental care system. "We must also become better at discovering at an early age which children and adolescents need help and support. We should collaborate more closely with the social services," says Annika Gustafsson.

Dental fear

About 5% of Sweden's population suffer from severe dental fear. The very thought of dental care produces severe anxiety in these patients. The fear may have been caused by frightening experiences of dental care during childhood. Fortunately, many types of help are available, including medication for anxiety, nitrous oxide gas, hypnosis and -- in severe cases -- anaesthesia.