The goal of this research study is to elucidate risk factors for dental fear and for lack of utilization of dental services, in a population of children 5-10 years old, who attend public schools and who come from financially disadvantaged homes. Disadvantaged and minority children are at high risk for both poor oral health and the development of significant fears. 1.
The aims of the proposed research are: a.To assess the prevalence distribution of dental fear in the low income segment of the population attending Seattle elementary public schools; b.To study the etiology of dental fear in children; and to assess the role of contextual factors, past experience and temperament on the expression of dental fear; c.To determine, in a prospective design, the effect of parental dental fear, attitudes and behaviors on the probability of thi child visiting the dentist following school-based screening and parent notification of the need for care; and d.To evaluate, among children for whom an episode of care has been initiated, the effect of dental practice style, net care price, treatment needs, parental dental fear and demographic factors on the probability of its completion within the school year. 2. Design A cross sectional design will be employed to estimate aim a, the prevalence of dental fear among low income, public school children, 5-10 years old, both dentally diseased and nondiseased. The sample derived for prevalence estimates will also serve the second aim b, namely, the ascertainment of the relative contribution of the child's previous dental and medical experiences and of health attitudes and behaviors of the parent to an explanatory model of dental fear. Nested in the design will be a cohort study of dental utilization (aims c & d) following referral, in which parental dental fear, assessed at baseline, will consist of the main risk factor of interest. A six month follow up arm will be added to the cross sectional design in order to allow a prospective examination of dental utilization. A sub-sample that will include all children that were referred for dental care will be followed for six months from referral time and dental utilization will be then assessed in a phone interview with the mother. Maternal report will be cross-validated by dental records.
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