Lee Chen-Yi, Chang Yong-Yuan, Huang Shun-Te
Graduate Institute of Dental Medicine, Kaohsiung Medical University, No. 100 Shih-chuan 1st Road, Sanmin District, Kaohsiung City, Taiwan.
Int J Paediatr Dent. 2008 Nov;18(6):415-22. doi: 10.1111/j.1365-263X.2008.00924.x. Epub 2008 May 16.
Dental fear has been singled out as one of the most troublesome problems facing paediatric dentistry today. Children with dental fear may avoid visiting dentists; therefore, their oral health protection is often compromised. However, the aetiology of dental fear is still not entirely understood.
This study investigated the dental visiting habit, the previous dental experiences, the conditioning pathway, and the clinically related predictors of dental fear in children.
The dental history of 247 children (2-10 years old) was obtained when they came to a dental clinic for treatment. The level of dental fear in these children was assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Observers rated the clinically anxious responses and uncooperative behaviour towards dental treatment in these children. Three stepwise regression analyses were performed to determine significant predictors of CFSS-DS score, clinically anxious responses, and uncooperative behaviour of children, respectively.
We found that the CFSS-DS score and clinical anxiety have different predictors, but age < or = 3.99 years old and cooperativeness in the first dental visit were important predictors for both the CFSS-DS score and the clinical anxiety. Furthermore, the other predictors of the CFSS-DS score were maternal dental fear, unbearable pain during the first dental visit, and visiting dentists in a regular dental clinic; the other predictors of clinical anxiety were first-born, regular dentist, and CFSS-DS score. Finally, the only significant predictor for uncooperative behaviour was clinical anxiety.
Children's dental fear and their anxious response during dental treatment were dynamic processes that consisted of many different factors. The direct conditioning of subjective experience of pain was more important than the objective pathway of child dental fear, and the indirect conditioning does not seem influential in this study sample.
牙科恐惧已被视为当今儿童牙科面临的最棘手问题之一。有牙科恐惧的儿童可能会避免看牙医；因此，他们的口腔健康保护常常受到影响。然而，牙科恐惧的病因仍未完全明确。
本研究调查了儿童的看牙习惯、既往牙科经历、条件作用途径以及与牙科恐惧相关的临床预测因素。
收集了247名2至10岁前来牙科诊所治疗儿童的牙科病史。使用儿童恐惧调查问卷-牙科分量表（CFSS-DS）评估这些儿童的牙科恐惧程度。观察人员对这些儿童在牙科治疗中的临床焦虑反应和不合作行为进行评分。分别进行了三项逐步回归分析，以确定CFSS-DS评分、临床焦虑反应和儿童不合作行为的显著预测因素。
我们发现CFSS-DS评分和临床焦虑有不同的预测因素，但年龄≤3.99岁以及首次看牙时的合作程度是CFSS-DS评分和临床焦虑的重要预测因素。此外，CFSS-DS评分的其他预测因素包括母亲的牙科恐惧、首次看牙时难以忍受的疼痛以及在正规牙科诊所看牙；临床焦虑的其他预测因素包括头胎、固定牙医和CFSS-DS评分。最后，不合作行为的唯一显著预测因素是临床焦虑。
儿童的牙科恐惧及其在牙科治疗期间的焦虑反应是由许多不同因素组成的动态过程。疼痛主观体验的直接条件作用比儿童牙科恐惧的客观途径更重要，并且在本研究样本中，间接条件作用似乎没有影响。
