Risk factors for dental anxiety and cooperativeness in pediatric patients with or without oral habits (bruxism, nail biting, and thumb sucking).

INTRODUCTION: Anxiety and fear can deter patients from visiting dentists and can deteriorate their oral health. In children, this can also affect their cooperativeness. No studies exist on potential links between oral habits and dental fear and children's cooperation. Moreover, predictors of dental anxiety and patient cooperativeness are controversial. Therefore, this study was conducted with the objectives of (1) evaluating associations between oral habits and children's dental fear and cooperativeness as well as (2) potential risk factors of dental anxiety, cooperation, and oral habits. METHODS: This quasi-experimental study was performed on 169 child patients aged from 4 to 10 years needing dental treatment (82 boys [6.9 +/- 1.7 years], 87 girls [6.7 +/- 1.7 years]). After a diagnostic visit, patients were treated. Their anxiety and behavior were evaluated through Venham scales. Their cooperativeness was examined using Frankl scale. The following factors were collected: oral habits (bruxism, thumb sucking, and nail biting), children's and parents' demographics and education, history of dental treatment, continuation of the habit, if the parents sought advice to quit the habit, previous treatment history (its type, cooperativeness, pain). The associations between anxiety/cooperativeness with these factors were assessed using chi-square, Spearman correlation coefficient, and multiple linear regressions (alpha = 0.05). RESULTS: The average Venham and Frankl scores were 1.45 +/- 1.45 and 0.76 +/- 0.95, respectively. The multiple linear regression identified the children's cooperation in visiting the previous dentist, the pain experienced during treatment by the previous dentist, and the current treatment type to be associated with both Venham/Frankl scores (P < 0.05). None of the assessed oral habits were found to be associated with the anxiety and cooperativeness of children. Definitive risk factors of children's anxiety and cooperativeness (according to both Venham and Frankl scales) were their previous cooperativeness in the previous dental treatment session, the pain experienced during treatment by the previous dentist, and the type of the treatment administered in the current dental session. The scales were excellently correlated with each other. CONCLUSIONS: The children's anxiety and cooperativeness are not associated with their evaluated oral habits 'bruxism, nail biting, or thumb sucking'. Risk factors for children's cooperation and anxiety are their previous experiences of pain and previous cooperativeness as well as the current treatment type.