FACTORS RELATED TO DENTAL FEAR AND ANXIETY IN

CHILDREN AGED 7 TO 9 YEARS AT PAEDO LAB RSGM

BAITURRAHMAH
Mila Sartika*, Sri Pandu Utami*
*Student, FKG Baiturrahmah University, Padang
*Paedodontia Department, FKG Baiturrahmah University, Padang

E-mail: Panduutamidrg@yahoo.co.id
mila.sartika18@gmail.com

KEYWORDS: ABSTRACT
Fear, Child's Dental Dental Fear and Anxiety (DFA) is one of the main challenges
Anxiety in pediatric dentistry. DFA is a common reason for avoiding
dental work, which over time, can lead to poor oral health.
DFA among children has a complex and multifactorial
etiology. Several interacting factors, both personal and
environmental, contribute to the development of fear and
anxiety in dental situations. Psychological factors such as
shyness and general fear or immaturity have previously been
investigated and found to be important. Cognitive abilities as
well as negative attitudes from parents or others are also
pathways for obtaining DFA. In Indonesia, a survey on dental
fear and anxiety measures the prevalence of anxiety about
certain dental treatments: tooth extraction, dental fillings and
oral hygiene. The results showed that about 20-30% of the
subjects felt afraid and anxious about the treatment. There are
limited data on the common causes of dental fear and anxiety
in Indonesian society. However, studies in other countries
report that the frequency of dental anxiety ranges from 5% to
20% and is higher in women.7,8 Furthermore, the prevalence
of dental anxiety in children ranges from 6% to 20%, and in
adolescents, it increases to 11%.6

KEYWORDS : ABSTRACT
Fear, Child's Dental Dental Fear and Anxiety (DFA) is one of the main challenges
Anxiety in pediatric dentistry. DFA is a common reason for avoiding
dental work, which over time, can lead to poor oral health.
DFA among children has a complex and multifactorial
etiology. Several interacting factors, both personal and
environmental, contribute to the development of fear and
anxiety in dental situations. Psychological factors such as
shyness and general fear or immaturity have previously been
investigated and found to be important. Cognitive abilities as
well as negative attitudes from parents or others are also
pathways for obtaining DFA. In Indonesia, a survey on dental
fear and anxiety measures the prevalence of anxiety about
certain dental treatments: tooth extraction, fillings and oral
hygiene. The results showed that about 20-30% of the subjects
felt afraid and anxious about the treatment. There are limited
data on the common causes of dental fear and anxiety in
Indonesian society. However, studies in other countries report
that the frequency of dental anxiety ranges from 5% to 20%
 and is higher in women.7,8 Furthermore, the prevalence of
dental anxiety in children ranges from 6% to 20%, and in
adolescents, it increases to 11%.6,
young as seven years old was more common
I. Introduction among those with foreign backgrounds

DFA is a common reason for avoiding compared to those from Sweden. Dental
experience also increases the risk of DFA. A
dental work, which over time, can lead to
study by Raadal et al. found that 68% of
poor oral health. DFA among children has a
children with high dental anxiety had more than
complex and multifactorial etiology. Several
five carious lesions in five.
interacting factors, both personal and
The age of the child is important when
environmental, contribute to the
dealing with stressful situations such as
development of fear and anxiety in dental
dental care (Pop-Jordanova et al, 2018).
situations. Psychological factors such as
shyness and general fear or immaturity have II. RESEARCH METHODS
previously been investigated and found to be
important. Cognitive abilities as well as PThe research used is descriptive. The
negative attitudes from parents or others are research design used was a cross sectional
also pathways for obtaining DFA. Several study.
studies have shown an association between A.Sampling Criteria
parent and child DFA. Culture is most likely
1.Inclusion Criteria
to influence DFA (Alasmari, A. et al, 2018).
The sample inclusion criteria in this study
In Indonesia, a survey on dental fear and
are:
anxiety measured the prevalence of anxiety
1) All children under 10 years old
about certain dental treatments: tooth
2) Willing to participate and give
extraction, fillings and oral hygiene; The
consent,
results showed that about 20-30% of the
2.Exclusion Criteria
subjects felt afraid and anxious about the
The exclusion criteria in this study are:
treatment. There are limited data on the
1) Children with special needs
common causes of dental fear and anxiety in
2) Parents who do not allow to be a
Indonesian society. However, studies in
participant
other countries report that the frequency of
B. Population
dental anxiety ranges from 5% to 20% and
is higher in women.7,8 Furthermore, the The population in this study were

prevalence of dental anxiety in children children aged 7-9 years who went to RSGM

ranges from 6% to 20%, and in adolescents, Baiturrahmah July 2022.

it increases to 11%.6 (Prihastari et al, 2020)

C. Sampling Technique
One study in a multicultural area on the outskirts
of Stockholm showed that DFA in children as Sampling is done by using this type
of sampling technique to determine the Care N Percentage
sample by accident (accidental). The
Primary dental 9 45%
researcher will take samples from people he
caries
happened to meet at the IKGA Lab, RSGM
Baiturrahmah Tooth Extraction 6 34%

D. Research Variables Tooth extraction 5 31%

a.Anxiety under local

b. Children's oral health anesthesia

E.Data analysis
Table 2 presents the results of 15 question
Data were entered in Microsoft
Excel 2010 software and analyzed. items, a high fear of injection scores of 60%,

Descriptive statistics such as percentage,
mean, and SD (standard deviation) were
calculated for the presentation of the data.
Presentation of data in tabular form.
and a fear of dentist drilling 10%. The fear
of dentist drilling, seeing the dentist's drill,
choking, having to go to the hospital, and

dentist cleaning teeth on average is 5%.

III. RESULTS Table 2. Average responses for items on the

We received all dental treatment schedule of the children's fear survey-dental

between the ages of seven and nine in July subscale

2022 for 20 patients. At 7-9 years, 45% of

children have developed caries in the

primary teeth, and in the permanent teeth;

34% have had extractions; and 31% had

received injections under local anesthesia.

Table 1. Treatments carried out at the age of

7-9 years in the IKGA Lab

 10% teeth cleaning care
5% white uniform
3% go to the hospital
0% choking
2% intrument in the mouth
5% burial sound
1%
burrowing signs
Item Kecemasan 10%
dentist burrowing
1%
somene who sees
1%
stranger touching
1%
open your mouth
1%
oral cavity examination
50%
injection
5%
Doctore
5%
Dentist

0% 10% 20% 30% 40% 50% 60%

studied in children aged 4 to 11 years using

III. DISCUSSION
the same CFSS-DS cut-o of 38, reported that

7% of Swedish children exhibited DFA.

This study diagnosed that at 7-9
Wogelius et al. found that 7% of Danish six-
years, 45% of the children had developed
year-olds, 5.7% of seven-year-olds, and
caries in the primary teeth, and in the
4.4% of eight-year-olds reported DFA. It is
permanent teeth; 34% have had extractions;
interesting to note that there was no
and 31% had received injections under local
observable decrease in the prevalence of
anesthesia. Parental fear of teeth, experience
DFA that paralleled the decrease in the
of toothache, painful dental treatment, and
prevalence of dental caries in children
development of caries between the ages of
(Dahlander et al, 2019).
seven and nine years was significantly
Tickle et al. (2009) reported similar
associated with the development of DFA
results using a five-point Likert scale to
between seven and nine years.
diagnose DFA [13]. They followed children
Most of the information on the
from five to nine years of age, and 12%
prevalence of DFA in children comes from
developed DFA during these years (Tickle
cross-sectional studies. Klingberg et al.
et al, 2009). Recently, Soares et al. found offices, so it may be unrealistic to expect

that 15% of children who reported no DFA this item to change much (Lara, A, 2012).

by age five had developed DFA by age nine. Dental fear and anxiety is a dynamic

Our results provide more conclusive process in individual growth and is

evidence for some transitions regarding significantly related to pain symptoms and

DFA in early school age. DFA can be used dental experience and parental fear of teeth.

with increasing age and cognitive We found a significant association with

development, but may also develop during parental DFA, experience of toothache,

this period, depending on: family factors and experience of painful dental treatment, and

factors related to poor oral health. CFSS-DS development of dental caries between the

has 15 items; This study found that fear of ages of seven and nine. First, previous

injections, dentist drilling, studies have shown an association between

This is similar to the research parental DFA and child's DFA. It is clear

conducted by Wogelius et al. (2009), who that the dental experience, a very painful

reported fear of injections, fear of choking, and traumatic experience, is likely a source

and fear of dentists drilling as the three of DFA (Dahlander et al, 2019).

highest-scoring items. In our study, fear of

the dentist drilling, seeing the dentist drill, IV. CONCLUSION

fear of choking, having to go to the hospital, In conclusion, this study demonstrated an

and having the dentist clean your teeth all increased prevalence of dental fear and

increased significantly between seven and anxiety between the ages of seven and nine

nine years. It is surprising that there is no years. Furthermore, the development of new

increased fear of injections. On the other carious lesions, the experience of toothache,

hand, only 19% of the children were and extraction were the most significant risk

injected during this period and this was the factors for the development of DFA. Dental

highest-scoring item at age seven, the start care should focus beyond the prevention of

of the study. Fear of injections often dental caries, on the psychological aspects

develops due to vaccinations in doctors' that treatment can lead to, thereby,
preventing painful and traumatic
experiences.
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ISSN(F): 2250-2386;
ISSN(E): 2321-0