Transmission of dental fear from parent to adolescent in an Appalachian sample in the USA.

BACKGROUND: Dental fear/anxiety is associated with numerous negative outcomes. State dental fear is known to be transmitted from parents to their children in the dental setting, but it is not known how trait fear/anxiety might be shared between parents and offspring long term, and especially for adolescents. AIM: This study aimed to: (a) compare dental fear levels of adolescents and their parents; (b) predict adolescent dental fear based on demographic variables, fear of pain, and parental dental fear; and, (c) determine relative contributions of mothers' and fathers' dental fear to adolescent fear. DESIGN: In this cross-sectional study, the Dental Fear Survey and Fear of Pain Questionnaire-9 were administered to 350 adolescents (age range 11-17) and 515 of their parents, with t test and ANOVA used to calculate between-group differences; multiple linear regression was used to predict adolescent fear from parent fear. RESULTS: Adolescents' dental fear was predicted by their own fear of pain and their parents' dental fear, but not their parents' fear of pain nor their own age or gender. When considered together, fathers' but not mothers' dental fear predicted adolescents' dental fear. CONCLUSIONS: Parents' fears/anxieties about dentistry are associated with adolescents' dental fear in a manner suggestive of intergenerational transmission.

Correlates of pediatric behavior and distress during intramuscular injections for invasive dental procedures.

Relations between general behavior, temperament, and procedure-related behavior and distress were examined in children receiving intramuscular injections before undergoing restorative dental procedures. Younger children are likely to benefit the most from interventions prior to and during dental procedures. Children's anxiety before dental procedures could help identify those at risk of displaying problematic behaviors. General behavior and temperament seem useful at identiying children who may experience greater levels of pain.

Occulocerebrocutaneous syndrome: a case report.

Occulocerebrocutaneous syndrome is a rare condition characterized by orbital cysts and skin tags. The presence of supernumerary teeth has not previously been associated with this syndrome. A primary supernumerary tooth with a permanent supernumerary successor was found in this case. This highlights the importance of very careful examination when assessing children with syndromes.

Stress management for dental students performing their first pediatric restorative procedure.

Research has demonstrated that dental students experience considerable stress during their training. Students' anxiety is likely to be especially high when they perform their first pediatric restorative procedure. The aims of this study were to provide a description of dental students' level of anxiety and typical coping strategies and to evaluate the use of a distress management intervention for reducing anxiety around their first pediatric restorative procedure. Dental students were randomly assigned to either an Anxiety Management or an Attention Control group. The management group received training on relaxation strategies (i.e., deep breathing, progressive muscle relaxation). The control group attended a lecture on the relation among stress, anxiety, and health. No significant differences were found between group levels of anxiety related to their first pediatric restorative procedure. Information is provided on students' reported level of anxiety and general coping strategies. Limitations of the current study and suggestions for future research are provided.

Pain reduction during pediatric immunizations: evidence-based review and recommendations.

The pain associated with immunizations is a source of anxiety and distress for the children receiving the immunizations, their parents, and the providers who must administer them. Preparation of the child before the procedure seems to reduce anxiety and subsequent pain. The limited available data suggest that intramuscular administration of immunizations should occur in the vastus lateralis (anterolateral thigh) for children <18 months of age and in the deltoid (upper arm) for those >36 months of age. Controversy exists in site selection for 18- to 36-month-old children. A number of studies suggest that the ventrogluteal area is the most appropriate for all age groups. Longer needles are usually associated with less pain and less local reaction. During the injection, parental demeanor clearly affects the child's pain behaviors. Excessive parental reassurance, criticism, or apology seems to increase distress, whereas humor and distraction tend to decrease distress. Distraction techniques vary with the age, temperament, and interests of the child, but their efficacy is well supported in the literature. Sucrose solution instilled directly into the mouth or administered on a pacifier reduces evidence of distress reliably in children <6 months of age and should be used routinely. Although there is no perfect topical anesthetic available at this time, selective use for children who are particularly fearful or who have had negative experiences in the past is highly endorsed. Pressure at the site, applied with either a device or a finger, clearly reduces pain. Finally, in the era of multiple injections, it seems that parents prefer that multiple injections be given simultaneously, rather than sequentially, if there are enough personnel available. Immunizations are stressful for many children; until new approaches are developed, systematic use of available techniques can significantly reduce the burden of distress associated with these procedures.