The vicious cycle of dental fear at age 31 in a birth cohort in Southern Brazil.

Objectives: This longitudinal study assessed the prevalence of dental fear in adulthood and the association with socio-economic, behavioural and clinical variables. Also, the existence of a vicious cycle of dental fear was tested.

Methods: A random sample of adults (n = 535) from the 1982 Pelotas Birth Cohort, Brazil, was selected. Socio-economic data, behavioural characteristics and clinical variables were collected during different cohort waves. Oral health data were collected at ages 15, 24 and 31 years old, using questionnaires and oral examination. Dental fear (the outcome) was assessed by the question: 'Are you afraid of going to the dentist?', with possible responses: dichotomized into 'No' or 'A little/Yes/A lot'. Exposure variables were as follows: dental visit in the last years (at the ages 15 and 31); caries experience (DMFT ≥ mean) at the ages 15 and 31; the trajectory of caries prevalence from 15 to 31 years old; dental pain in the last six months in the two ages evaluated; and self-rated oral health at age 31. Several multivariable Poisson regression models were used to investigate the association between each of the exposure variables and dental fear.

Results: Dental fear prevalence was 22.1%, and it was more prevalent among non-white individuals and females. After controlling for potential confounders, dental fear was more likely to be reported by those individuals who had dental pain or a higher prevalence of dental caries at the age 15. Dental fear was also associated with a worse trajectory of dental caries, negative self-rated oral health at age 31 and with not having visited the dentist in the last year (at the age 31). Results supported the proposed vicious cycle of dental fear.

Conclusions: Dental fear in adulthood was related to exposures occurring across the lifecourse. Also, it was possible to observe the occurrence of the vicious cycle of dental fear in the 1982 Pelotas Birth Cohort. Therefore, preventive measures during different periods of the life course are required to prevent dental fear and adulthood.