Reciprocal longitudinal relationship between dental fear and oral health in schoolchildren

Background No longitudinal study has evaluated the mutual relationship between dental fear and oral health in the same investigation. Aim To evaluate the reciprocal longitudinal relationship between dental fear and oral health in schoolchildren. Design This longitudinal study monitored 416 Brazilian children aged 5-7 years of age at baseline for 2 years. The decayed, filled and missing teeth were clinically assessed for each child. Dental fear was evaluated by Dental Anxiety Question. Multilevel mixed-effects linear and logistic regressions analysed the reciprocal relationship between dental fear and oral health. Results Children with caries experience had 1.8 times higher odds of dental fear compared to children who were caries free. The presence of a carious tooth increased the odds of dental fear by 1.2 times. Children with dental fear had 0.46 additional carious tooth; an additional 0.22 tooth indicated for extraction; and a 0.67 higher caries experience score compared to children without dental fear. Conclusions We observed a reciprocal relationship between dental fear and poor oral health. Both parents and dentists should provide realistic information for the children, discouraging biased negative expectations regarding dental treatment. Ultimately, the child would acquire positive perceptions of the dental environment, reducing their phobia and consequently improving oral health.