Dental anxiety in Hong Kong preschool children: Prevalence and associated factors

Background: This study is designed to determine the prevalence of dental anxiety and contributing factors in Hong Kong preschool children. Methods: All first-time visitors between the ages of three and five to the Prince Philip Dental Hospital, Hong Kong between were recruited between August 2014 and June 2015. Questionnaires on background information, parent’s self-reported Modified Dental Anxiety Scale (MDAS), and parental proxy of the Modified Child Dental Anxiety Scale (MCDAS) were completed by parents. An oral examination was carried out to assess and record the caries experience and oral hygiene status of the child. The child’s dental anxiety level was rated using the Clinical Anxiety Rating Scale (CARS). Ordered logistic regression analysis was performed to assess the association of parent’s and children’s characteristics with the CARS scores. Results: Among 299 children, the mean CARS score reported was 1.16 (SD 1.06) with only 8% of the subjects rating 3 or above, indicating those who were uncooperative and demonstrated real behavioural problems that might interfere with dental procedures. Data analysis showed that the child’s age (p=0.004, OR=0.659, 95%CI=0.497-0.872), the child’s previous dental experience (p=0.013, OR=0.518, 95%CI=0.307-0.867), parental proxy MCDAS score (p=0.002, OR=2.439, 95%CI=1.376-4.353), and the dental attendance pattern of the parents (p=0.013, OR=0.530, 95%CI=0.321-0.870) were associated with the CARS scores. Conclusion: Dental behavioural management problems are not prevalent in Hong Kong preschool children, but such problems are associated with both the parent’s and child’s characteristics such as the child’s age, previous dental experience, and dental attendance pattern of the parents.