Dental fear and anxiety among kindergarten children in Hong Kong

Abstract

Background: The factors associated with dental fear and anxiety (DFA) in children are known to be complex. DFA is a major issue affecting children’s oral health and dental service providers. Objectives: To describe the prevalence of DFA of kindergarten children in Hong Kong; and to investigate the associated factors with children’s dental fear. Method: Parents of children aged 4 to 5 were recruited from 5 kindergartens in Hong Kong between January and March 2022. Parents completed a questionnaire on family demographic background, parent's and child's dental histories, and parental proxy of 15-item Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Children's DFA level was determined by the parent-reported CFSS-DS. Bivariate analysis using Chi-square test and multiple logistic regression was conducted to identify the association of parental and children characteristics with children's DFA level. Results: Among the 153 children studied, DFA was present in 34.6% of children (CFSS-DS scored at least 38). The mean CFSS-DS score was 35.5 (SD = 11.0). Children with systemic conditions had a higher chance of having DFA (OR = 9.83; 95% CI: 1.11 – 86.85; p = 0.040) compared to their counterparts without systemic conditions. Children with parents that were fairly or very afraid of going to the dentist had a higher chance of having DFA (OR = 2.54; 95% CI: 1.12 – 5.76; p = 0.025) compared to children with parents that were not afraid or slightly afraid of the dentist. Conclusion: Approximately one-third of Hong Kong kindergarten children were found to have DFA. The study also revealed that presence of parental dental fear and children’s systemic conditions are significantly associated with DFA in kindergarten children.