Tiny teeth in terrified tots - what is the global prevalence of paediatric dental fear and anxiety?

Aims: To establish the worldwide prevalence of paediatric dental fear and anxiety (DFA) and its associated components.

Design: A systematic review and meta-analysis of 25 observational studies found on three well known English language publication databases dating from 2000. 2895 studies were identified relating to paediatric dental fear, anxiety, or phobia. 25 met the inclusion criteria and were subject to the Joanna Briggs Institute quality assessment tool and subsequently analysed using PRISMA framework. Studies exploring levels of DFA in children 2-6 years old were included. Studies were excluded if they were not published in English, included children with 'special needs' including intellectual disabilities, and studies which explored DFA intervention. Of the included studies, the following was recorded: Country of Origin, DFA prevalence, age of participants, study design, sample size, assessment method and who reported on the level of DFA of the child.

Results: The pooled level of DFA of children aged 2-6 was estimated to be 30% (95% CI = 25, 36). Children with no dental experience and children with caries experience were found to have higher odds of experiencing DFA (OR = 1.37, 95% CI = 1.18, 1.59) and (OR = 1.18, 95% CI = 1.09, 1.27), respectively.

Conclusion: This review shows that approximately 30% of 2-6-year-old children will experience a level of dental and anxiety. Levels are expected to be higher in children who have not visited the dentist and children with dental caries.