J.S.J. Veerkamp

The etiology of childhood dental fear: the role of dental and conditioning experiences

This study was aimed to examine the relative importance of invasive treatment experiences in the acquisition of dental fear in children. For this purpose, the complete dental history of 401 children (5-10 years) was studied. The level of dental fear in these children was assessed using the Dental Subscale of the Childrens Fear Survey Schedule (CFSS-DS). Differences in treatment variables between fearful and low fearful children were analyzed, and regression analysis was performed to determine significant predictors of dental fear. A significant but weak relation with the number of extractions was found, while no relation with the number of fillings was found. The results have indicated that within the (direct) conditioning pathway, objective dental experiences seem to play a minor role in childrens fear acquisition, and it was suggested that subjective dental experiences may play a more decisive role. In addition, clinical support for the latent inhibition theory was provided.

The Dental Subscale of the Children's Fear Survey Schedule: Predictive Value and Clinical Usefulness

This study reports on the predictive value and clinical usefulness of the Dutch parental version of the Dental Subscale of the Childrens Fear Survey Schedule (CFSS-DS). Parents of 718 children (4–12 years) completed this CFSS-DS version before or during the childs visit. The dentist rated the childs dental fear during treatment on a 5-point Likert-type Scale from 1 (not afraid at all) to 5 (very afraid). Reliability analysis was performed, and correlation coefficients between the two measures were calculated. The reliability of the scale proved to be high (Cronbachs α = .93) and significant correlation coefficients were found (r = .58 and r = .68, p < .01). The negative predictive value of the CFSS-DS was high (.96), whereas its positive predictive value was relatively low (0.41). It was concluded that the CFSS-DS might be of clinical value as a screening device of dental fear, whereas its predictive value of fearful behavior should not be overestimated.

Childhood dental fear in relation to parental child-rearing attitudes.

The aim of this study was to assess the relation between parental self-reported child-rearing attitudes and dental fear in children. The parents of 51 children with high dental fear and of 56 children with low dental fear, of different age groups, completed the Amsterdam version of the Parental Attitude Research Instrument. In addition, parents were asked to rate their own dental fear. Multivariate analysis of variance (child fear x parental fear x child age) showed a significant main effect only of child dental fear on parental self-complaints (p = .03). For parental dental fear, main effects were found on overprotection and on promotion of autonomy (p ≤ .01). No age effects were found. Also, no relation between childrens dental fear and parental dental fear was found. Based on the present findings, it was concluded that parents may play a more secondary, mediating role in the etiological process of dental fear in children.