European Archives of Paediatric Dentistry

, Volume 19, Issue 5, pp 321–329 | Cite as

Association between children’s perceptions of the dentist and dental treatment and their oral health-related quality of life

  • M. Frauches
  • L. Monteiro
  • S. Rodrigues
  • C. Dias
  • M. DinizEmail author
Original Scientific Article



To examine children’s perceptions of dentists and dental treatment and their association with oral health-related quality of life.


Participants were 60 children, aged 8–10 years old, who completed the Child Perceptions Questionnaire (CPQ8 − 10), Facial Image Scale (FIS) interview, and picture drawing.


The children displayed slight fear and anxiety on the FIS (95.0%). A positive view of the dentist (83.4%) and dental treatment (75.0%) was observed through the drawings. The majority of children (96.7%) noted an impact of oral diseases on quality of life, with no significant differences in gender (p = 0.5791) or age (p = 0.1808). No significant associations were observed between the perceptions of the dentist and dental treatment and the impact of oral diseases on quality of life (p = 0.8131).


The majority of children had a positive image of the dentist and dental treatment, and this perception was not associated with oral health-related quality of life.


Quality of life Child psychology Dentist-patient relationships Fear Anxiety 



This study was submitted to the Cruzeiro do Sul University, São Paulo, Brazil, as a requirement for the doctoral degree in paediatric dentistry of Dr. Frauches.


  1. Aguilar-Díaz FC, Irigoyen-Camacho ME, Borges-Yanéz SA. Oral-health-related quality of life in schoolchildren in an endemic fluorosis area of Mexico. Qual Life Res. 2011;20:1699–706.CrossRefGoogle Scholar
  2. Alaki S. Dental anxiety in middle school children and their caregivers: prevalence and severity. J Dent Oral Hygiene. 2012;4:6–11.Google Scholar
  3. Alsarheed M. Children’s perception of their dentists. Eur J Dent. 2011;5:186–90.PubMedPubMedCentralGoogle Scholar
  4. Aminabadi NA, Ghoreishizadeh M, Oskouei SG. Can drawing be considered a projective measure for children’s distress in paediatric dentistry? Int J Paediatr Dent. 2011;21:1–12.CrossRefGoogle Scholar
  5. Appukuttan DP. Strategies to manage patients with dental anxiety and dental fobia: literature review. Clin Cosmet Investig Dent. 2016;8:35–50.CrossRefGoogle Scholar
  6. Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007;7:1.CrossRefGoogle Scholar
  7. Baier K, Milgrom P, Russell S, Mancl L, Yoshida T. Children’s fear and behavior in private pediatric dentistry practices. Pediatr Dent. 2004;26:316–21.PubMedGoogle Scholar
  8. Barbosa TS, Tureli MCM, Gavião MBD. Validity and reliability of the child perceptions questionnaires applied in Brazilian children. BMC Oral Health. 2009;9:13.CrossRefGoogle Scholar
  9. Barbosa TS, Vicentin MDS, Gavião MBD. Quality of life and oral health in children—part I: Brazilian version of the child perceptions questionnaire 8–10. Ciênc Saúde Coletiva. 2011;16:4077–85.CrossRefGoogle Scholar
  10. Berggren U. Psychosocial effects associated with dental fear in adult dental patients with avoidance behaviours. Psychol Health. 1993;8:185–96.CrossRefGoogle Scholar
  11. Buchanan H, Niven N. Validation of a facial image scale to assess child dental anxiety. Int J Paediatr Dent. 2002;12:47–52.PubMedGoogle Scholar
  12. Carter AE, Carte G, Boschen M, AlShwaimi E, George R. Pathways of fear and anxiety in dentistry: a review. World J Clin Cases. 2014;2:642–53.CrossRefGoogle Scholar
  13. Cohen SM, Fiske J, Newton JT. Behavioural dentistry: The impact of dental anxiety on daily living. Br Dent J. 2000;189:385–90.PubMedGoogle Scholar
  14. Davies EB, Buchanan H. An exploratory study investigating children’s perceptions of dental behavioural management techniques. Int J Paediatr Dent. 2013;23:297–309.CrossRefGoogle Scholar
  15. Diercke K, Ollinger I, Bermejo JL, et al. Dental fear in children and adolescents: a comparison of forms of anxiety management practised by general and paediatric dentists. Int J Paediatr Dent. 2012;22:60–7.CrossRefGoogle Scholar
  16. Eichenbaum IW, Dunn NA. Projective drawings by children under repeated dental stress. J Dent Res. 1971;38:164–73.Google Scholar
  17. Frankl SN, Shiere FR, Fogels HR. Should the parent remain with the child in the dental operatory? J Dent Child. 1962;29:150–63.Google Scholar
  18. Gao X, Hamzah SH, Yiu CK, McGrath C, King NM. Dental fear and anxiety in children and adolescents: qualitative study using YouTube. J Med Internet Res. 2013;15:e29.CrossRefGoogle Scholar
  19. Gherunpong S, Tsakos G, Sheiham A. The prevalence and severity of oral impacts on daily performances in Thai primary school children. Health Qual Life Outcomes. 2004;2:57.CrossRefGoogle Scholar
  20. Gupta A, Marya CM, Bhatia HP, Dahiya V. Behaviour management of an anxious child. Stomatologija. 2014;16:3–6.PubMedGoogle Scholar
  21. Jaakkola S, Rautava P, Alanen P. Dental fear: one single clinical question for measurement. Oper Dent J. 2009;3:161–6.Google Scholar
  22. Jokovic A, Locker D, Tompson B, Guyatt G. Questionnaire for measuring oral health-related quality of life in eight- to ten-year-old children. Pediatr Dent. 2004;26:512–8.PubMedGoogle Scholar
  23. Klinberg G. Dental anxiety and behaviour management problems in paediatric dentistry—a review of background factors and diagnostics. Eur Arch Paediatr Dent 2008;9(Suppl 1):11–5.CrossRefGoogle Scholar
  24. Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent. 2007;17:391–406.CrossRefGoogle Scholar
  25. Kuscu OO, Akyuz S. Is it the injection device or the anxiety experienced that causes pain during dental local anaesthesia? Int J Paediatr Dent. 2008;18:139–45.CrossRefGoogle Scholar
  26. Looman WS. A development approach to understanding drawings and narratives from children displaced by hurricane Katrina. J Pediatr Health Care. 2006;20:158–66.CrossRefGoogle Scholar
  27. Luoto A, Lahti S, Nevanpera T, Tolvanen M, Locker D. Oral-health-related quality of life among children with and without dental fear. Int J Paediatr Dent. 2009;19:115–20.CrossRefGoogle Scholar
  28. Majstorovic M, Veerkamp JSP, Skrinjaric I. Reliability and validity of measures used in assessing dental anxiety in 5- to 15-year-old Croatian children. Eur J Paediatr Dent. 2003;4:197–202.PubMedGoogle Scholar
  29. Marques KBG, Gradvohl MPB, Maia MCG. Fear and anxiety previous to dental treatment in children from Acaraú-CE. Braz J Health Promot. 2010;23:358–67.Google Scholar
  30. Martins MATS., Ferreira FM, Oliveira AC. Preliminary validation of the Brazilian version of the child perceptions questionnaire 8–10. Eur J Paediatr Dent. 2009;10:135–40.PubMedGoogle Scholar
  31. McGrath C, Broder H, Wilson-Genderson M. Assessing the impact of oral health on the life quality of children: implications for research and practice. Community Dent Oral Epidemiol. 2004;32:81 – 5.CrossRefGoogle Scholar
  32. Mittal R, Sharma M. Assessment of psychological effects of dental treatment on children. Contemp Clin Dent. 2012;3:S2-7.CrossRefGoogle Scholar
  33. Naidoo S, Chikte UM, Sheiham A. Prevalence and impact of dental pain in 8-10-year-olds in the western Cape. SADJ 2001;56:521–3.Google Scholar
  34. Rantavuori K, Lahti S, Hausen H, Seppä L, Kärkkäinen S. Dental fear and oral health and family characteristics of Finnish children. Acta Odontol Scand. 2004;62:207–13.CrossRefGoogle Scholar
  35. Ratnayake N, Ekanayake L. Prevalence and impact of oral pain in 8-year-old children in Sri Lanka. Int J Paediatr Dent. 2005;15:105 – 12.CrossRefGoogle Scholar
  36. Shepherd MA, Nadanovsky P, Sheiham A. The prevalence and the impact of dental pain in 8 year-old-school children in Harrow. Br Dent J. 1999;187:38–41.PubMedGoogle Scholar
  37. Sonnenberg E, Venham L. Human figure drawings as a measure of the child’s response to dental visits. ASCD J Dent Child. 1977;44:438–42.Google Scholar
  38. Ten Berge M. Dental fear in children: prevalence, aetiology and risk factors. [Dissertation]. Amsterdam: ACTA; 1999. p. 152.Google Scholar
  39. Vranić-Stavljenić L, Anić A, Rajić Z, Bastajić L. The possibilities of recognizing fear by the analysis of children’s drawings. Acta Stomatol Croat. 1988;22:89–99.PubMedGoogle Scholar
  40. Wechsler SM, Schelini PW. Validity of human figure drawing for children’s cognitive assessment. Aval Psicol. 2002;1:29–38.Google Scholar
  41. Wogelius P, Gjørup H, Haubek D, Lopez R, Poulsen S. Development of Danish version of child oral-health-related quality of life questionnaires (CPQ8–10 and CPQ11–14). BMC Oral Health. 2009;9:11.CrossRefGoogle Scholar
  42. World Health Organization. WHOQOL: measuring quality of life. The World Health Organization quality of life instruments. Geneva: World Health Organization, 1997.Google Scholar

Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  • M. Frauches
    • 1
  • L. Monteiro
    • 2
  • S. Rodrigues
    • 3
  • C. Dias
    • 4
  • M. Diniz
    • 5
    Email author
  1. 1.Pediatric Dentistry ClinicVale do Rio Doce University/UNIVALEGovernador ValadaresBrazil
  2. 2.PsychologyGraduate Program of the Federal University of Espírito Santo/UFESVitóriaBrazil
  3. 3.Integrated Dental ClinicVale do Rio Doce University/UNIVALEGovernador ValadaresBrazil
  4. 4.Department of Tourism, School of Interdisciplinary HumanitiesFederal University of Vales do Jequitinhonha e Mucuri/UFVJMDiamantinaBrazil
  5. 5.Pediatric Dentistry, Post-graduate Program in DentistryCruzeiro do Sul UniversitySão PauloBrazil

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