The Impact of Language Barriers on Dental Anxiety in Pediatric Patients: A Feasibility Pilot Study

Background/Objectives: Effective communication between practitioners and their patients is pivotal to achieving successful treatment outcomes. The objective was to evaluate differences in post-examination anxiety and intra-operative behavior among pediatric patients when examined by a language-concordant dentist versus one with whom there was a language barrier. Methods: This controlled prospective pilot study included 60 children aged 4-10 years, divided into two groups: a control group consisting of patients and dentists who spoke the same language, and a study group comprising patients and dentists with discordant primary languages. Anxiety levels were measured using the Facial Image Scale before and after dental examination, and behavior was assessed by the clinician using the Frankl Behavioral Rating Scale. Results: The groups were similar in mean age, gender distribution, and baseline anxiety. No significant differences were found between the groups in post-examination anxiety levels (p = 0.99), behavior during clinical examination (p = 0.871), or behavior during radiographic examination (p = 0.615). However, within the study group, significant correlations were found between higher pre-examination anxiety and more negative behavior during clinical examination (p = 0.045), as well as between higher post-examination anxiety and more negative behavior during clinical examination (p = 0.029); these correlations were not observed in the control group. Conclusions: Language differences between the dentist and the patient did not increase anxiety or negative behavior in children during dental examinations within this sample. Non-verbal communication and the presence of a translating parent may be important mediating factors in reducing anxiety among pediatric patients when language barriers exist. Future larger, well-controlled studies are needed.