Dental anxiety

Dental anxiety

Dental anxiety is common and while the effects may be apparent at any age they are most obvious in children aged under four years.⁴⁵ When parents/carers are unable to hide their own anxiety it can engender or increase anxiety in the child. A pre-appointment letter, welcoming the family to the practice, outlining what will happen and advising them how to prepare their child can reduce both parental and child anxiety. 

Dental anxiety may begin in childhood or adolescence.⁴⁶ Children with high caries are more likely to have dental anxiety and may require specialist input to manage them effectively. Identifying these children and establishing preventive protocols is a priority and also allows the dental team to modify their approach. 

The Modified Child Dental Anxiety Scale (MCDAS) is a self-completion measure for children aged eight years and older. It consists of eight questions about specific dental procedures. A five-point Likert scale range 1 (relaxed/not worried) to 5 (very worried) can differentiate between children with and without dental anxiety. A version using faces (MCDASf) is also available.^47,48 Both versions have been suggested as suitable for use in a dental surgery setting⁴⁹ and use of an anxiety questionnaire has been reported to alleviate anxiety to an extent.⁵⁰ The aim should be to reduce the anxiety score over time. The impact of a child’s anxiety about dental care needs to be considered in the context of the care required. Even very anxious children can be helped to accept preventive care.