Background Dental fear is a prevalent phenomenon among children and adolescents globally. Aim To investigate dental fear among 18-year-olds with cleft lip and/or palate (CLP) at their final follow-up cleft clinic visit, and to evaluate the association between dental fear and OHRQoL. Design This cross-sectional study included the cohort of children with CLP treated at the Oulu University Hospital Cleft Lip and Palate Center, in northern Finland since 1995. A total of 62 of 64 individuals participated in this study. The validated Finnish version of the Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL. Dental fear was studied using the validated Modified Dental Anxiety Scale (MDAS) and cognitive vulnerability model (CVM). Results Almost two fifths of the participants reported moderate dental fear. Participants with cleft including lip and participants reporting impact on OHRQoL reported higher mean MDAS scores. In an unadjusted model, adolescents with cleft including lip had risk for higher dental MDAS scores compared with the ones with cleft including only palate. Conclusions Dental fear is common among adolescents with CLP, specifically among those with clefts involving the lip. OHRQoL and dental fear seem to be associated.

Abstract Objectives This study aimed to examine Oral Health‐related Quality of Life (OHRQoL) among patients with cleft lip with or without palate (CLP) at their final scheduled follow‐up visit at the age of 18 years. Another aim was to investigate the motivation to attend multiple follow‐up appointments and the satisfaction with care given by the cleft team using inductive qualitative analysis. Methods This cross‐sectional study was conducted among the cohort of children born with CLP who had undergone treatment at the Oulu University Hospital Cleft Lip and Palate Centre, in northern Finland since 1995. OHRQoL was assessed using the validated Finnish version of the short form of the Oral Health Impact Profile (OHIP‐14). In addition to the OHIP‐14, two open‐ended questions were also included. These questions investigated the experience of each participant concerning their motivation to attend the Oulu University Hospital Cleft Lip and Palate Centre to receive complex treatments, and their satisfaction with care provided by the cleft team. Results were presented as proportions, means, and SD. Inductive content analysis method was performed for analysis of the open‐ended questions. Results A total of 63 patients with CLP participated in this study. More than half of the participants had cleft palate. More than half of the participants reported an impact on OHRQoL (OHIP‐14 score ≥ 3). All the participants with bilateral cleft lip and palate, three fourths of the participants with unilateral cleft lip and palate, and half of the participants with cleft palate reported impact on OHRQoL. Inductive content analysis showed that one fourth of the participants reported a good outcome as a motivation to attend cleft center despite of complex procedures. All the participants reported their appreciation of the cleft team. Conclusions Despite the comprehensive treatment received by the patients born with a CLP, they still experienced lower OHRQoL, especially physical pain and psychological discomfort were more pronounced. However, good outcome, support, and oral health care being a normal routine were the motivating factors to attend a long and demanding oral health care regimen.

BACKGROUND Dental fear seems to fluctuate, but concordance of changes in dental fears between parent/adolescent dyads has not been reported. AIM To study longitudinally the associations between adolescent and parental dental fears and their changes. DESIGN Adolescents and parents reported their dental fear independently of each other when adolescents were between 11-12 and 15-16-year-olds. Eight hundred and seventeen eligible parent/adolescent dyads were included in the analyses. Dental fear was measured with a single question using five response alternatives. Associations between adolescent and parental dental fears and their changes were analysed using χ2 tests and correlation coefficients. RESULTS Prevalence of dental fear remained rather similar during the study. There was a positive association between adolescent and parental dental fears in early adolescence (P < 0.001) but at middle adolescence only among parent/girl dyads (P = 0.007 for girls, P = 0.341 for boys). Changes in dental fear among parent/adolescent dyads did not correlate statistically significantly. Difference between girls' and boys' change in dental fear was statistically significant (P = 0.001). Dental fear increased more often among girls than among boys. Boys had stable low/no dental fear more often than girls did. CONCLUSION Adolescents' and parents' dental fears seemingly change independently of each other.

OBJECTIVE:The aim was to compare the oral health-related quality of life among 11- to 14-year-old patients with cleft lip and/or palate (CLP) and schoolchildren without CLP. The validity and reliability of the Finnish Child Perception Questionnaire designed for 11- to 14-year-olds (CPQ11-14) was also assessed. DESIGN AND SUBJECTS:Participants in this cross-sectional questionnaire survey study were children aged 11 to 14 years from two groups. The CLP sample included all children of this age who had had CLP selected from the regional treatment register (N = 51). The school sample included children from four school classes (N = 82). Informed consent from parents was obtained. Ethical clearance and parental informed consent were obtained. MAIN OUTCOME MEASURES:Oral health-related quality of life was measured with the CPQ11-14. RESULTS:The CPQ11-14 total and oral symptoms, functional limitations, emotional well-being, and social well-being subscores were poorer among patients with CLP than among schoolchildren without CLP (mean scores: 55.5 versus 15.0; 11.9 versus 5.1; 14.0 versus 2.8; 12.6 versus 4.2; and 17.1 versus 2.9, respectively; all P < .001 for Mann-Whitney tests). Cronbach alpha value was 0.97 for total scale and between 0.81 and 0.94 for subscales. Among all children in the school sample, intraclass correlation coefficient was 0.79 for total scale and varied between 0.65 and 0.74 for subscales. CONCLUSION:The oral health-related quality of life of Finnish children with CLP was considerably poorer than that of their peers in overall and all dimensions, especially social well-being. The CPQ11-14 showed appropriate reliability and validity.

OBJECTIVE:The aim was to study longitudinal changes in dental fear among children and one of their parents separately for girls, boys, mothers and fathers over a 3.5-year period.MATERIALS AND METHODS:11-12-year-old children in Pori, Finland (n = 1691) and one of their parents were invited to participate in this longitudinal study. Dental fear was measured in 2001, 2003 and 2005 when the children were 11-12, 13-14 and 15-16-years-old, respectively. The participants were asked if they were afraid of dental care (1 = 'not afraid', 2 = 'slightly afraid', 3 = 'afraid to some degree', 4 = 'quite afraid', 5 = 'very afraid' and 6 = 'I don't know'). The participants' gender was also registered. Mean values of the change scores were studied. Prevalence and incidence of dental fear and changes in dichotomized dental fear (responses 4-5 = high dental fear and responses 1-3 = low dental fear) were studied using cross-tabulations and Cochran's Q test.RESULTS:Overall, the prevalence of dental fear slightly increased and female preponderance in dental fear became more evident during the follow-up. Of the mothers and children with high dental fear at the baseline, 24% and 56%, respectively, reported not to be fearful at the end of the follow-up.CONCLUSIONS:Dental fear seems to be more stable in adulthood than in childhood. Thus, it might be better to intervene in dental fear during childhood rather than during adulthood.

We aimed to evaluate (i) changes in dental fear over time during pregnancy and after delivery among mothers and fathers and (ii) whether these changes inter-relate to changes in depression and anxiety. Longitudinal pilot data for the FinnBrain Cohort study were used. Of 254 pregnant families, 80% agreed to participate and 60% returned questionnaires at the first data-collection point. After three data-collection points [weeks 18-20 and 32-34 of pregnancy (H18-20 and H32-34, respectively), and 3 months after childbirth], 99 mothers and 74 fathers had filled out at least two out of three Modified Dental Anxiety Scale questionnaires and were included in this study. Other questionnaires used were the Edinburgh Postnatal Depression Scale, the State Trait Anxiety Inventory, and the Pregnancy Related Anxiety Questionnaire. All scales were analyzed as sum scores. Among mothers, dental fear decreased during late pregnancy and increased slightly after childbirth, but no statistically significant correlations between dental fear and depression or anxiety, except for fear of giving birth, were found. Among fathers dental fear increased and was correlated with depression and anxiety. Dental fear seems to fluctuate among women during pregnancy and could be affected by hormonal changes.

The aim of this study was to determine whether parents and their 11-16-yr-old children can evaluate each other's dental fear. At baseline the participants were 11-12-yr-old children from the Finnish Cities of Pori (n = 1,691) and Rauma (n = 807), and one of their parents. The children and their parents were asked if they or their family members were afraid of dental care. Fears were assessed using single 5-point Likert-scale questions that included a 'do not know' option. Children and parents answered the questionnaire independently of each other. Background variables were the child's and their parent's gender. Parents' and children's knowledge of each other's dental fear was evaluated with kappa statistics and with sensitivity and specificity statistics using dichotomized fear variables. All kappa values were < 0.42. When dental fear among children and parents was evaluated, all sensitivities varied between 0.10 and 0.39, and all specificities varied between 0.93 and 0.99. Evaluating dental fear among fearful children and parents, the sensitivities varied between 0.17 and 0.50 and the specificities varied between 0.85 and 0.94, respectively. Parents and children could not recognize each other's dental fear. Therefore, parents and children cannot be used as reliable proxies for determining each other's dental fear.

The databases CINAHL, EMbase, Medline, PsycINFO, Cochrane/DARE EBM were searched using OVID together with the reference lists of retrieved papers. Studies in English and German which investigated the relationship between parental and child dental fear and included children and young people aged 0–19 years were included. Particular emphasis was placed on studies which used established behaviour and anxiety measures to assess parental and child dental anxiety or child behaviour. A qualitative synthesis of the included studies was conducted with those studies which provided sufficient quantitative estimates of association between parental and child measures to enable transformation into effect sizes being used in a meta-analysis. A random-effects model was used. Forty-three studies were included from across the six continents. The studies ranged widely with respect to research design, methods used, age of children included and the reported link between parental and child dental fear. The majority of studies confirmed a relationship between parental and child dental fear. This relationship is most evident in children aged 8 years and under. A meta-analysis confirmed an association between parental and child dental fear. The narrative synthesis as well as the meta-analysis demonstrate a significant relationship between parental and child dental fear, particularly in children aged 8 years and under.

OBJECTIVES:This study aims to determine whether the oral-health-related quality of life (ORHQoL) and its dimensions differed among children with and without dental fear when different characteristics of fear were measured.MATERIAL AND METHODS:The participants were 11- to 14-year-old Finnish child volunteers from the Oulu University Hospital cleft lip and/or palate (CLP) treatment register (n = 51) and schoolchildren (n = 82). Dental fear was measured with 'Treatment of dental decay' and 'Attending dentist' dimensions of the modified Children's Fear Survey Schedule-Dental Subscale and a single question. ORHQoL was measured with CPQ(11-14). Background variables were gender and the dental care experienced.RESULTS:The response rates were 87% and 51% in the schoolchildren's and CLP groups, respectively. Those who were afraid of 'Treatment of dental decay' had higher mean CPQ(11-14 )total scores (33.2) and higher scores for social (8.8) and emotional well-being (9.0) than those who were not fearful (24.0, 6.2, and 5.8, respectively, P < 0.05), indicating poorer ORHQoL. Among those with experience of orthodontics, the association between dental fear and social and emotional well-being was weaker than among those with no experience of orthodontics.CONCLUSION:Dental fear may have a negative effect on a child's ORHQoL, especially on social and emotional well-being. Positive minor treatment experiences might weaken this effect.