Dental Fear among Youth in Appalachia

OBJECTIVES: Level and type of general fears change over the course of infancy, childhood, and adolescence. High levels of dental fear have been shown to appear most commonly in the first decade of life, but there is a dearth of information about how such fears change across development. Information about dental fear in Appalachia is only beginning to emerge. Little is known about dental fear level differences associated with developmental level among youth in this region. METHODS: In the present cross-sectional study, there were 856 youth between the ages of 1 and 21 years, part of the population-based cohort of families ascertained by the Center for Oral Health Research in Appalachia, focusing on rural areas of West Virginia and Pennsylvania. Parental report was used to establish dental fear level among children ages 10 and younger, based on the Dental Subscale of the Children's Fear Survey Schedule. Youth ages 11 through 21 provided self-report of dental fear level using the Dental Fear Survey. RESULTS: Dental fear levels were found to initially be higher, and then to be lower in middle childhood. Levels remain lower through adolescence, only to be higher again in later adolescence and early adulthood. CONCLUSION: Results suggest that dental fear levels vary systematically early in the lifespan, likely responding to increased exposure to dental situations among the youth as they grow. Specific implications for Appalachia are that culturally-sensitive interventions to reduce fears might best be targeted toward parents of very young children, and towards late adolescents and young adults. R01-DE014889.