RESUMEN
BACKGROUND: Maternal anxiety disorders can cause adverse consequences in child's health, cognitive development, and behavior. AIM: To investigate the association of maternal anxiety disorders with the occurrence of dental fear in children aged 24-36 months. DESIGN: This cross-sectional study is part of a cohort of adolescent mothers and their children (n = 527) in the city of Pelotas, RS, Brazil. Anxiety disorders in mothers were assessed using Mini International Neuropsychiatric Interview (DSM-IV), whereas the Dental Anxiety Question was used to assess children's dental fear. Clinical oral examinations were performed on the cohort. Poisson regression analysis was used to determine the association of maternal anxiety disorders with maternal perception of dental fear in children (p < .05). RESULTS: The prevalence of dental fear in children was 21.7% (n = 114), and maternal age, agoraphobia, social phobia, and maternal caries experience (p < .05) were associated with the presence of dental fear. After adjusted analysis, children of mothers presenting with agoraphobia (Prevalence ratios [PR] = 1.52; 95% confidence interval [CI] = 1.00-2.32) and social phobia (PR = 1.69; 95% CI = 1.06-2.71) had higher prevalence of dental fear than children whose mothers did not have any of these conditions. CONCLUSIONS: In this population of young mothers, agoraphobia and social phobia were associated with children's dental fear. Detection of and treatment for maternal mental disorders may aid in the prevention of dental fear and its oral health-related consequences.
Asunto(s)
Madres Adolescentes , Caries Dental , Femenino , Adolescente , Humanos , Niño , Ansiedad al Tratamiento Odontológico/epidemiología , Estudios Transversales , Madres/psicología , Caries Dental/epidemiología , Trastornos de AnsiedadRESUMEN
OBJECTIVES: This longitudinal study assessed the prevalence of dental fear in adulthood and the association with socio-economic, behavioural and clinical variables. Also, the existence of a vicious cycle of dental fear was tested. METHODS: A random sample of adults (n = 535) from the 1982 Pelotas Birth Cohort, Brazil, was selected. Socio-economic data, behavioural characteristics and clinical variables were collected during different cohort waves. Oral health data were collected at ages 15, 24 and 31 years old, using questionnaires and oral examination. Dental fear (the outcome) was assessed by the question: 'Are you afraid of going to the dentist?', with possible responses: dichotomized into 'No' or 'A little/Yes/A lot'. Exposure variables were as follows: dental visit in the last years (at the ages 15 and 31); caries experience (DMFT ≥ mean) at the ages 15 and 31; the trajectory of caries prevalence from 15 to 31 years old; dental pain in the last six months in the two ages evaluated; and self-rated oral health at age 31. Several multivariable Poisson regression models were used to investigate the association between each of the exposure variables and dental fear. RESULTS: Dental fear prevalence was 22.1%, and it was more prevalent among non-white individuals and females. After controlling for potential confounders, dental fear was more likely to be reported by those individuals who had dental pain or a higher prevalence of dental caries at the age 15. Dental fear was also associated with a worse trajectory of dental caries, negative self-rated oral health at age 31 and with not having visited the dentist in the last year (at the age 31). Results supported the proposed vicious cycle of dental fear. CONCLUSIONS: Dental fear in adulthood was related to exposures occurring across the lifecourse. Also, it was possible to observe the occurrence of the vicious cycle of dental fear in the 1982 Pelotas Birth Cohort. Therefore, preventive measures during different periods of the life course are required to prevent dental fear and adulthood.