Influence of parental anxiety on children's behaviour during dental treatment in relation to the caries experience among 3-5-years-olds in three public dental clinics in Nairobi
Abstract
Background: Dental anxiety is a fear traditionally defined as an irrational and
exaggerated fear of dentists and dental procedures. It is a worldwide
phenomenon with a prevalence ranging from 3-43%. Females have been known
to have higher anxiety than males and the younger age groups also have higher
anxiety than the older age groups. Anxious parents might incorporate this anxiety
onto their children and this can manifest as poor behaviour of the child during
dental treatment. Also, anxious parents might present their children late to the
clinic as a result of their own fear and this can predispose the children to a high
caries experience.
Objective: To determine the influence of parental anxiety on child behaviour
during treatment in relation to the child caries experience among the 3-5-yearolds.
Study Design: This was a descriptive cross-sectional study.
Study Area: Using purposive sampling, three public dental clinics in Nairobi were
selected, namely, Kenyatta National Hospital, the University of Nairobi, School of
Dental Sciences, and the Lady Northey City Council Clinic.
Methods and Materials: All patients who met the inclusion criteria during the
duration of the study were included, and this involved a total of 330 children aged
between 3-5-years of age and their accompanying parents/guardians. A semistructured
questionnaire was used to obtain information on the parent/guardian
on previous clinical experiences for themselves and the children. The Modified
Dental Anxiety Scale was used to determine' parental anxiety and child behaviour
was measured using the Frankl Scale and recorded in a clinical examination
form. Children were examined for dental caries experience using the WHO
Criteria 1997 (dmft) and the caries experience recorded in a clinical examination
form.
Data analysis and presentation: The data collected was coded, and analyzed
using the statistical package for social sciences [SPSS] 12.0[SPSS Inc, Chicago,
lIIinois,USA.] Results were presented using charts, graphs and tables. Chisquare
(X2) test was used to determine the relationship between variables for the
categorical data. Mann Whitney U Rank test was used to determine relationship
between non-categorical variables. A P-value of less than 0.05 was considered
significant. Descriptive analysis was done using frequencies for various variables.
Results: Overall prevalence of high anxiety was 3.9%. Among those with high
anxiety 12 (92.3%) were mothers, 1 (7.7%) were fathers and none of the
guardians had any high anxiety. There was no relationship between parental
anxiety and previous clinical experience (p=0.40). Similarly, there was no
relationship between parental/guardian anxiety and history of previously visiting a
dentist or not was obtained (p=0.09). Parents/guardians were accurately able to
rate their own anxiety correctly (p=O.OO).
'Definitely negative' behaviour was observed among 33 (10%) of the children,
while 94 (28.5%) had 'negative' behaviour, 108 (32.7%) had 'positive' behaviour
and 95 (28.8%) had 'definitely positive' behaviour. There was no relationship
between child behaviour and previous clinical experience of the parent/guardian
(p=0.21). The older children were significantly better behaved than the younger
children (p=0.04). There was a significant relationship between child behaviour
xv
exhibited and previous clinical experience of the child (p=O.004). However, there
was no relationship between behaviour exhibited by the children and previous
history of visiting a dentist (p=O.21). Parents/guardians were accurately able to
predict the behaviour of their children in the clinic (p=O.OO).
Prevalence of dental caries was 93.6% and a mean dmft of 8.14. There was a
high proportion of unmet treatment needs with a mean decayed component of
7.27, mean missing component of 0.80 and a mean filed component of 0.06.
There was a significant increase in caries experience with increase in age
(p=0.01). There was no association between parental/guardian anxiety and child
behaviour (p=O.08). Similarly there was no association between parental anxiety
and caries experience of the child (p=0.42). Also, there was no association
between child behaviour and child dental caries experience (p=0.21).
CONCLUSIONS: The overall prevalence of high dental anxiety was low but
parents/guardians were accurately able to predict their own anxiety. Majority of
the children had positive behaviour and their behaviour was significantly related
to the age. Parents are able to accurately predict the behaviour of their children,
and the same behaviour was also significantly related to previous clinical
experience of the child. There was a high dmft score for the children of 8.14 with
a high unmet treatment with the decay (d) component contributing the biggest
portion with a very low filled component of 0.06. There was no association
between parental/guardian anxiety and child behaviour or dental caries
experience of the child.
Citation
Masters degree in paediatric dentistrySponsorhip
University of NairobiPublisher
Department of paediatric dentistry & orthodontics, school of dental sciences, college of health sciences, university of Nairobi