Fatores associados à ansiedade odontológica em crianças: um estudo piloto

Abstract

Dental anxiety may be associated with refusal to seek treatment, delays or missed appointments, or behavioral problems of the child during care, which may compromise the child's oral health status. This pilot study aimed to evaluate the influence of oral hygiene, dietary and harmful habits, dental history and dental caries experience on the level of dental anxiety in children patients. The sample consisted of 30 five to thirteen-yr-old children (♂ = 15) undergoing dental treatment at the Integrated Children's Clinic of the Federal University of Juiz de Fora, campus of Governador Valadares. The following information was collected from patient records: gender, age, frequency of tooth brushing (per day), type of diet (cariogenic or non-cariogenic), past dental experience and behavior, harmful habits (nail biting, etc.), dental caries experience (DMFT/dmft index). Dental anxiety was assessed by applying, through an interview with the child, the faces version of the Modified Child Dental Anxiety Scale (MCDASf), previously translated and adaptated to Brazilian Portuguese language, which contains eight questions, with five-point Likert scale response options, ranging from from "relaxed/not worried" (score 1) to "very worried" (5). The total score ranges from eight (little or no anxiety) and forty points (extreme anxiety). Data were analyzed by descriptive statistics, Chi-square partition/independence, unpaired t-test, one-way ANOVA, with significance level of α=0.05. Males were on average older than females (9.4 vs. 7.73 years; p<0.05). Approximately half of the children reported toothbrushing 3 times/per day (43.3%, p<0.05). Most participants had a cariogenic diet (♂ = 93.3%; ♀ = 86.7%). Question 2 ("having your teeth looked at") had a higher frequency of "very slightly worried" response (36.7%, p<0.05). Almost half of the sample reported feeling "very worried" about "having a tooth taken out" (43.3%, question 6) and 1/3 about "having an injection in the gum to freeze a tooth" (30%, question 4) (p<0.05). In the comparison between genders, 53.3% of girls felt “very worried” about "having an injection in the gum to freeze a tooth" when compared with 6.7% of boys (p<0.05). Items 7 and 8 were misunderstood by approximately half of the sample (43.3 and 50%, respectively) and item 4 by nearly 1/3 of children (33.3%) (p<0.05), mostly boys (46.7%, 60% and 66.7%, respectively) (p<0.05). MCDASf total score ranged from 7 to 27 points, with a mean of 23.1 (± 7.3), indicating that the measure detected substantial variability in children's perception of dental anxiety. There was no floor effect (score = 0) and ceiling effect (maximum score). Although not significant, higher MCDASf values were observed in eight to ten-yr-old children (25.1), male (23.8), with brushing habits 3 or more times per day (23.5), diet cariogenic (23.6) and with experience of dental caries in 7 or more teeth (25.9) (p>0.05, one-way ANOVA test). In the evaluated sample, higher dental anxiety was reported regarding the procedures of extraction and anesthesia, the latter being more feared by the girls.