| Summary: | 碩士 === 高雄醫學大學 === 口腔衛生科學研究所 === 98 === Background: In children, fear of dental treatment has long been considered to be a significant problem inthe area of patient management. Moreover, dental fear results in avoidance of dental visits. It had a negative impact on the oral health.
Aims: To assess Rachman''s Three Pathways Theory: directly (conditioning) and indirect (modeling and information) pathways of fear acquisition to dental fear in school based children.
Methods: Multistage cluster sampling was used to obtain a representative sample (n=1582) in 26 elementary schools, in southern Taiwan. The data were collect from 3rd to 6th grade students and their mothers in 2009 in Kaohsiung. The Dental Subscale (CFSS-DS) of the Children’s Fear Survey Schedule was used to measure the level of dental fear. Logistic Regression was used to analyze the relationship between children’s dental fear and the three pathways.
Result: The higher mean CFSS-DS score (29.3, SD=13.4, 29.3, SD=13.2, reapectively) was observed in mountain and rual area children, rather than in urban area children (26.6, SD=12.1). After adjusting for covariates, significantly associations were observed between modeling pathway and having dental fear in mountain area children (adjusted odd ratio (aOR)=3.96); whereas the strongest association were found between conditioning and having dental fear in rual and urban area children (aOR=5.74, 5.52, reapectively). The higher mean CFSS-DS score (29.4,SD=13.3) was observed in low income children, rather than in non-low income (27.7, SD=12.6). After adjusting for covariates, significantly associations were observed between modeling pathway and having dental fear in low income children (aOR=5.38); whereas the strongest association were found between conditioning and having dental fear in non-low income children (aOR=7.34).
Conclusions: A significantly higher mean DS score was observed with respect to mountain, rual area and low income children than in urbun area and non-low income. In addition, the link between pathways of fear acquisition and their dental fear experience was different for area and economy groups. Our findings suggest that schools should provide appropriate dental psychological counseling and/or activities as part of their regular healthcare services in order to help reduce children’s dental fear, especially with respect to remote area and low-income children.
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