Management of children's dental anxiety

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Dental anxiety may have major and long-lasting implications for the child and their family. Research has found that children with high levels of dental anxiety have a higher caries experience than children with low levels of dental anxiety . One explanation for the relationship between anxiety and poor oral health outcomes is the vicious cycle which develops whereby the individual’s fear leads them to avoid dental encounters, resulting in neglected dental care and increased unmet need . Fear of going to the dentist can be a significant barrier to the completion of dental treatment in both children and adults . Whilst it could be argued that children themselves may not be in control of whether they attend their dental appointments, there is evidence that parents who consistently fail to take their children to the dentist report that their children’s dental anxiety is one of the influencing factors for their avoidance behaviour . Interestingly, research has found that there may be long-term oral health implications resulting from children’s dental anxiety, as dentally anxious children are more likely to be symptomatic, rather than proactive, users of dental services in adulthood .

Caring for children with dental anxiety can also have a real impact on dental practitioners and dental service provision as it can be time consuming and stressful for the clinician . Previous research has revealed that dental anxiety is the single most important predictor of children’s behaviour in the dental setting and that there are strong associations between dental anxiety and perceived un-cooperative and problem behaviours . There are also financial implications of providing dental treatment to the anxious patient . Dental practices which operate on a fee-per-service basis may not be able to charge for the consultation unless the patient has allowed the dental procedure to be completed. Furthermore, the dentist may be reluctant to undertake dental treatment on the anxious patient for fear of reinforcing the patient’s anxiety . These factors may result in children being referred to secondary dental care services and having to wait longer periods of time for their dental treatment. Indeed, anxious children are one of the key groups that general dental practitioners refer to secondary care services .

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