Developmental changes in dental anxiety in a normative population of Dutch children

The aim of this study was to ascertain age and gender related differences that contribute to dental anxiety and to find relations with early onset of child dental anxiety in a population of 4-11 years old Dutch children.

The study was conducted among 2,865 patients (48.2% girls) aged between 4 and 11 years old. The sample included a normative (n = 2,153) and an anxious group of children (n = 712), who were referred to the Special Dental Care Clinic in Amsterdam because of manifested dental phobia. Children were divided into three age groups (4-6, 7-9 and 10-11 years). Dental anxiety was assessed using the Children Fear Survey Schedule-Dental Subscale. Three levels of dental anxiety were used: low (CFSS-DS = 15-25), moderate (CFSS-DS = 26-36) and high (CFSS-DS above 37). Only children with CFSS-DS scores above 37 were considered dentally phobic.

Statistical analysis was performed in Statistics for Windows 10.

In the total group a significantly higher level of dental anxiety was found among girls (p = 0.004; t = -3.262). There was a considerably lower number of dentally phobic boys (7.1%) and girls (9.2%) in the older group compared with the younger (51.8%, 52.8% respectively). One way Anova results revealed a statistically significant age related difference between the oldest and the youngest as well as the middle-aged groups (p < 0.001, p = 0.001). In general dental anxiety was explained better in the younger than in the older group. The regression analysis accounted for a higher percentage of the explained variance.

The study confirmed the highest level of dental anxiety was present at 4 years of age and an overall decrease in dental anxiety occurred as children became older. In different age groups, dental anxiety seems to be related to different aspects of dentistry, indicating the causes shift from simple initial stimuli to more complex events.