Psychological Factors in Paediatric Dentistry: A Cross-Sectional Study

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ABSTRACT

Aim

This study aimed to identify psychological, demographic, and environmental factors that influence dental anxiety in paediatric patients treated in a university clinic by undergraduate dental students.

Methods

A cross-sectional study was conducted with a total of 203 children aged 5–18 years attending the dental clinic of the Catholic University San Vicente Mártir, Valencia, Spain. Dental anxiety was assessed using the Children’s Fear Survey Schedule—Dental Subscale (CFSS-DS) for children and the Modified Dental Anxiety Scale (MDAS) for parents, along with additional questions regarding separation anxiety, gift reception, and room color preferences. Statistical analyses included t-tests, Pearson correlation analyses, and Kruskal–Wallis tests; p-values <0.05 were considered statistically significant.

Results

Female participants exhibited significantly higher CFSS-DS, room color, and total anxiety scores than males (p<0.05). Younger age correlated negatively with all anxiety measures, with the strongest association for total anxiety score (r=–0.331, p<0.001). First-time dental visitors reported higher anxiety across all variables (p<0.05). Cultural differences were notable: European children had the lowest anxiety levels, while Asian and Spanish participants showed the highest. Parental anxiety correlated weakly, but significantly with children’s CFSS-DS and total anxiety scores. Environmental factors, such as gift-giving and room colour, influenced anxiety responses differently across cultural groups.

Conclusion

Paediatric dental anxiety is multifactorial, influenced by age, gender, prior dental experience, parental anxiety, and cultural background. Simple non-pharmacological strategies, including environmental modifications and positive reinforcement, may help reduce anxiety, but their effectiveness may vary according to individual and cultural factors. These findings support early, culturally sensitive, and family-centered approaches in paediatric dentistry, particularly in educational clinical settings.

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