A prospective study of dental anxiety in a cohort of children followed from 5 to 9 years of age

Background. The development of dental anxiety in children is poorly understood. Aims. The aims of this study were to measure changes in dental anxiety over time and to examine the relationship between anxiety, dental care, and other factors. Design. A prospective cohort study of children in the north-west of England followed from 5 to 9 years of age. The participants were clinically examined and their parents completed the same questionnaire at 5 and 9 years. Results. The majority (54.3% N = 38) of participants who were anxious at 5 years were no longer anxious at 9 years, but a large proportion of children who were anxious at 5 remained anxious at 9 years of age (45.7% N = 32). During the follow-up period, a larger proportion of children developed anxiety (11.7% N = 85) than the proportion of children who were reported as being anxious at baseline (8.8% N = 70). At 9 years of age, dental anxiety was significantly associated with girls; parental anxiety; a history of extraction; and irregular, asymptomatic dental visiting. These factors were also significantly associated with dental anxiety at 5 years old. Conclusions. Dental anxiety was cumulative in the study population over time, and its development influenced by multiple variables. Results suggest that adverse conditioning and vicarious learning are both important in the development of this condition.