UAE Children’s Dental Anxiety (Self and Proxy Reported) and their Dental Behavior
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Child dental anxiety and uncooperative behavior in dental practice are common and intertwined. To assess the prevalence of dental anxiety (self and proxy reported) in a subgroup of 7–16- year-old children and to evaluate both child-self and parent-proxy reported child dental anxiety in relation to child dental behavior in the United Arab Emirates (UAE). Data were collected from a sample of 156 parent/child pairs (child mean age 9.95 +2.17 years) attending a UAE postgraduate pediatric dentistry clinic in 2017. Demographics, self and proxy reported dental anxiety scores using a six-questions, five-point Likert scale, faces version of the Modified Child Dental Anxiety Scale (MCDAS scores from 6 to 30, where >19 was severely dentally anxious) in addition to dentist recorded numerical Frankl Behavior Rating Scale scores (FBRS: 1 to 4 where 1 was extremely uncooperative) were recorded and compared. Chi square test, Pearson’s correlation, Kappa-coefficient, one-way ANOVA and independent t-test statistical analysis were used (p<0.05). The prevalence of self and proxy severe dental anxiety was 22.40% (n=35) and 33.30% (n=52) respectively, while only 9.00% (n=14) were dentally uncooperative. In both groups, tooth extraction caused the highest anxiety followed by injections and fillings (p<0.001). The mean score for self-reported dental anxiety was (15.02+4.90) and for proxy reported dental anxiety was (15.70+6.07). There was a positive linear correlation between self and proxy reported dental anxiety scores and a negative linear correlation between self/proxy reported dental anxiety scores and the FBRS (p<0.001). Self/ proxy concordance of severe-anxiety/none-to-moderate-anxiety was fair (68.60%, kappa=0.23, p=0.003). Both self/FBRS and proxy/FBRS concordance of severe- anxiety/none-to-moderate-anxiety/behavior was fair (78.80%, kappa=0.23, p=0.001) and (71.80%, kappa=0.22, p<0.001) respectively. In the UAE sample studied, the dental anxiety is not uncommon. There was a fair agreement between child-self and parent-proxy reported dental anxiety. Increased dental anxiety led to uncooperative dental behavior.