Intergenerational Dental Fear and Anxiety: Children’s Pattern of Dental Service Use

Resumo

Objectives
Dental care-related fear and anxiety, involving emotional reactions to dental situations, can negatively impact children's quality of life, oral and systemic health. Recognising maternal characteristics as key determinants of child health, this study examined the intergenerational relationship between dental fear/anxiety and early childhood dental service utilisation.
Methods
Data were drawn from the baseline (birth), 12-month, and four-year follow-ups of the 2015 Pelotas Birth Cohort Study (Brazil). Outcomes included child dental fear/anxiety and dental service use (frequency and reasons) at age four. Exposures were maternal dental fear/anxiety at 12-month and maternal assessment of child dental fear/anxiety. Covariates, including maternal education and family income, were collected perinatally. All variables were obtained through questionnaires administered to mothers at each follow-up. Analyses used Poisson and multinomial logistic regression models.
Results
The sample included 3809 mother–child dyads; 79.7% of mothers and 64.2% of children had no reported dental fear/anxiety, yet 64.0% of children had never visited a dentist. Adjusted analyses showed that maternal dental fear/anxiety was associated with a 1.20 times higher prevalence of childhood dental fear/anxiety (PR = 1.20, 95% CI = 1.09; 1.32). Children with dental fear/anxiety had a 1.89 times higher prevalence of visits for curative reasons (PR = 1.89, 95% CI = 1.45; 2.48) and a 2.10 times higher prevalence of never visiting a dentist (PR = 2.10, 95% CI = 1.78; 2.48), adjusting for maternal dental fear/anxiety.
Conclusion
Early and regular preventive visits may help mitigate dental fear/anxiety. This study highlights the intergenerational link between maternal and childhood dental fear and its impact on dental service utilisation.