European Archives of Paediatric Dentistry

, Volume 11, Issue 6, pp 283–286 | Cite as

Child dental fear and general emotional problems: a pilot study

  • J. B. Krikken
  • J. M. ten Cate
  • J. S. J. Veerkamp


AIM: This was to investigate the relation between general emotional and behavioural problems of the child and dental anxiety and dental behavioural management problems. BACKGROUND: Dental treatment involves many potentially unpleasant stimuli, which all may lead to the development of dental anxiety and behavioural management problems (BMP). It is still unclear why some children get anxious in the dental situation while others, with a comparable dental history, do not. Besides the latent inhibition theory it is suggested that this can be explained by differences in child rearing and personality traits. METHODS: The sample consisted of 50 children (4–12 years old) and their parents participated in this study. Parents filled out the Child Fear Survey Schedule Dental Subscale (CFSS-DS) and the Child Behaviour Checklist (CBCL) on behalf of their child. Child behaviour during consecutive dental treatments was assessed using the Venham scale. RESULTS: There were 39 children subject to analysis (21 boys) with a mean CFSS score of 40.4. Children aged 4 and 5 years who had sleeping problems, attention problems and aggressive behaviour, as scored by parents on the CBCL, displayed more disruptive behaviour during dental treatment. Children with emotionally/ reactive and attention problems were more anxious. CONCLUSION: In this pilot study a possible relation between general emotional and behavioural problems of young children and dental anxiety was shown. Also a relation between emotional and behavioural problems and dental behavioural management problems was shown. Because of the small number of subjects in our study, further research will be needed to confirm these results.

Key words

CFSS-DS dental fear behavioural management emotional problems children 


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  1. Aartman, IH, van, Everdingen T, Hoogstraten, J, Schuurs, A. H. Self-report measurements of dental anxiety and fear in children: a critical assessment. ASDC J Dent Child 1998; 65(4):252–30.PubMedGoogle Scholar
  2. Achenbach, TM. Manual for the Child Behavior Checklist/4–18 and 1991 profiles, manuscript 1991; Burlington: University of Vermont.Google Scholar
  3. Arnold, J, Jacobowitz, D. Handleiding Programma Child Behavior Checklist/ 4–18. Rotterdam: Sophia Kinderziekenhuis. 1996.Google Scholar
  4. Brown, D.F, Wright, F.A, McMurray, NE. Psychological and behavioral factors associated with dental anxiety in children. J Behav Med 1986; 9(2):213–218.PubMedCrossRefGoogle Scholar
  5. Corkey, B, Freeman, R. Predictors of dental anxiety in six-year-old children: findings from a pilot study. ASDC J Dent Child 1994; 61(4):267–271.PubMedGoogle Scholar
  6. Cuthbert, M, Melamed, BG. A screening device: children at risk for dental fears and management problems. ASDC J Dent Child 1982; 49(6):432–436.PubMedGoogle Scholar
  7. Davey, GC. Dental phobias and anxieties: evidence for conditioning processes in the acquisition and modulation of a learned fear. Behav Res Ther 1989; 27(1):51–58.PubMedCrossRefGoogle Scholar
  8. de Jongh A, Muris, P, ter Horst G, Duyx, MP. Acquisition and maintenance of dental anxiety: the role of conditioning experiences and cognitive factors. Behav Res Ther 1995; 33(2):205–210.PubMedCrossRefGoogle Scholar
  9. Fiset, L, Milgrom, P, Weinstein, P, Melnick, S. Common fears and their relationship to dental fear and utilization of the dentist. Anesth Prog 1989; 36(6):258–264.PubMedGoogle Scholar
  10. Hardy, DF, Power, TG, Jaedicke, S. Examining the relation of parenting to children’s coping with everyday stress. Child Dev 1993; 64(6):1829–1841.PubMedCrossRefGoogle Scholar
  11. Klingberg, G, Reliability and validity of the Swedish version of the Dental Subscale of the Children’s Fear Survey Schedule, CFSS-DS. Acta Odontol Scand 1994; 52(4):255–256.PubMedCrossRefGoogle Scholar
  12. Klingberg, G, Berggren, U, Carlsson, SG., Noren, JG. Child dental fear: cause-related factors and clinical effects. Eur J Oral Sci 1995; 103(6):405–412.PubMedCrossRefGoogle Scholar
  13. Klingberg, G, Berggren, U, Noren, JG. Dental fear in an urban Swedish child population: prevalence and concomitant factors. Community Dent Health 1994; 11(4):208–214.PubMedGoogle Scholar
  14. Klingberg, G, Broberg, AG. Temperament and child dental fear. Pediatr Dent 1998; 20(4):237–243.PubMedGoogle Scholar
  15. Liddell, A. Personality characteristics versus medical and dental experiences of dentally anxious children. J Behav Med 1990; 13(2):183–194.PubMedCrossRefGoogle Scholar
  16. Milgrom, P, Jie, Z, Yang, Z, Tay, K-M. Cross-cultural validity of the Dental Fear Survey Schedule for children in Chinese. Behav Res Ther 1994; 32:131–135.PubMedCrossRefGoogle Scholar
  17. Raadal, M, Milgrom, P, Weinstein, P, Mancl, L, Cauce, AM. The prevalence of dental anxiety in children from low-income families and its relationship to personality traits. J Dent Res 1995; 74(8):1439–1443.PubMedCrossRefGoogle Scholar
  18. Rachman, S. The conditioning theory of fear-acquisition: a critical examination. Behav Res Ther 1977; 15(5):375–387.PubMedCrossRefGoogle Scholar
  19. Scherer, MW. Nakamura, CY. Afear survey schedule for children (FSS-FC): a factor analytic comparison with manifest anxiety (CMAS). Behav Res Ther 1968; 6(2):173–182.PubMedCrossRefGoogle Scholar
  20. ten Berge M, Hoogstraten, J, Veerkamp, JS, Prins, PJ. The Dental Subscale of the Children’s Fear Survey Schedule: a factor analytic study in The Netherlands. Community Dent Oral Epidemiol 1998; 26(5):340–343.PubMedCrossRefGoogle Scholar
  21. ten Berge M, Veerkamp, JS, Hoogstraten, J. The etiology of childhood dental fear: the role of dental and conditioning experiences. J Anxiety Disord 2002a; 16(3):321–329.PubMedCrossRefGoogle Scholar
  22. ten Berge M, Veerkamp, JS, Hoogstraten, J, Prins, PJ. Behavioural and emotional problems in children referred to a centre for special dental care. Community Dent Oral Epidemiol 1999; 27(3):181–186.PubMedCrossRefGoogle Scholar
  23. ten Berge M, Veerkamp, JS, Hoogstraten, J, Prins, PJ. Childhood dental fear in the Netherlands: prevalence and normative data. Community Dent Oral Epidemiol 2002b; 30(2):101–107.PubMedCrossRefGoogle Scholar
  24. Veerkamp, JS, Gruythuysen, RJ, van Amerongen, WE, Hoogstraten, J, Weerheijm, KL. Dentist’s ratings of child dental-patients’ anxiety. Community Dent Oral Epidemiol 1995; 23(6):356–359.PubMedCrossRefGoogle Scholar
  25. Veerkamp, JS, van Amerongen, WE., Hoogstraten, J, Groen, HJ. Dental treatment of fearful children, using nitrous oxide. Part I: Treatment times. ASDC J Dent Child 1991; 58(6):453–457.PubMedGoogle Scholar
  26. Venham, LL, Gaulin-Kremer, E, Munster, E, Gston-Audia, D, Cohan, J. Interval rating scales for children’s dental anxiety and uncooperative behavior. Pediatr Dent 1980; 2(3):195–202.PubMedGoogle Scholar
  27. Verhulst, FC, van der Ende, J, Koot, HM. Handleiding voor de CBCL/4-18, Nederlandse versie. Rotterdam: Sophia Kinderziekenhuis/Academisch Ziekenhuis/Erasmus Universiteit Rotterdam. 1996.Google Scholar
  28. Versloot, J, Veerkamp, J, Hoogstraten, J. Assessment of pain by the child, dentist, and independent observers. Pediatr Dent 2004; 26:445–9.PubMedGoogle Scholar
  29. Versloot, J, Veerkamp, J, Hoogstraten, J. Dental anxiety and psychological functioning in children: its relationship with behaviour during treatment. Eur Arch Paediatr Dent 2008; 9 Suppl 136–40.CrossRefGoogle Scholar

Copyright information

© Adis International 2010

Authors and Affiliations

  • J. B. Krikken
    • 1
  • J. M. ten Cate
    • 1
  • J. S. J. Veerkamp
    • 1
  1. 1.Dept. of CariologyEndodontology and Paedodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and VU University AmsterdamThe Netherlands

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