Factors for determining dental anxiety in preschool children with severe dental caries

Abstract The aim of this study was to assess the clinical and socioeconomic indicators associated with dental anxiety in preschool children with severe dental caries. A total of 100 children between 3 and 5 years of age were selected during a dental screening procedure. The selection criteria were having at least one tooth with dental caries and a visible pulpal involvement, ulceration, fistula, and abscess (PUFA) index of ≥1 in primary teeth. Before the clinical examination or any treatment procedure was performed, we evaluated the children’s dental anxiety using the Facial Image Scale (FIS). Parents completed a questionnaire on socioeconomic conditions, which included the family structure, number of siblings, parental level of education, and family income. A dentist blinded to FIS and socioeconomic data performed the clinical examination. Poisson regressions associate clinical and socioeconomic conditions with the outcome. Most of the children (53%) experienced extensive dental caries (dmf-t ≥ 6), and all children had severe caries lesions, with a PUFA index of ≥1 in 41% and that of ≥2 in 59%. The multivariate adjusted model showed that older children (4–5-year old) experienced lower dental anxiety levels compared with younger children (3-year old) (RR = 0.35; 95%CI: 0.17–0.72 and RR = 0.18; 95%CI: 0.04–0.76, respectively), and children with three or more siblings were associated with higher levels of dental anxiety (RR = 2.27; 95%CI: 1.06–4.87). Older age is associated with low dental anxiety, and more number of siblings is associated with high dental anxiety in preschool children, whereas the severity or extent of dental caries is not associated with dental anxiety.

Caregiver Burden for Dementia Patients

OBJECTIVES: The caregiver burden means emotional, social, financial, psychological, physical problems which could be experienced by occupational caregivers or families who cared disable patients. The caregiver burden affected by primary stressors (severity of disability in dementia patients) and secondary stressors (withdrawal from society, conflict between job and caregiving, loss of personal identity) may result in physical ill-health, depression, anxiety for the caregivers. The aims of this study were to assess caregiver burden in dementia, and to identify affecting factors. METHOD: 30 caregivers for dementia patients who had been treated at the "Dementia-Geriatric Mental Health Clinic" in the Kosin University Gospel Hospital and 44 healthy volunteers were selected. Using the Screen for Caregiver Burden (SCB), the degree of caregiver burden was measured. The demographic data was obtained by structured interview. Primary and secondary stressors were also analyzed. The severity of depression and anxiety was assessed by the Hamilton Depression Scale (HDS) and Hamilton Anxiety Scale (HAS). The severity of cognitive dysfunction (MMSE, CDR, GDS), behavioral symtoms (Revised Memory and Behavior Problems Checklist, RMBPC), daily functional disability (ADL, IADL) for the dementia patients were evaluated. RESULTS: 1) The SCB scores were significantly (p<0.001) higher in dementia caregivers (8.71+/-4.90) than in controls (0.23+/-0.48). 2) The SCB scores were not correlated with age of caregivers (gamma=0.081), education (gamma=-0.163), duration of caregiving (gamma=0.275). The RMBPC scores had statistically significant positive correlation with SCB scores (gamma=0.545, p<0.01), while age of dementia patients (gamma=-0.234), onset age of dementia (gamma=-0.280), duration of dementia (gamma=0.029), CDR (gamma=0.080), GDS (gamma=-0.125), MMSE (gamma=-0.212), ADL (gamma=-0.315), IADL (gamma=0.155) had not. 3) The SCB scores had statistically significant positive correlation with degree of secondary stress (gamma=0.581, p<0.01) and anxiety (gamma=0.376, p<0.05). The degree of secondary stress had statistically significant positive correlation with degree of emotional stress (gamma=0.757, p<0.01), depression (gamma=0.482, p<0.01), anxiety (gamma=0.376, p<0.01). CONCLUSIONS: The caregiver burden in dementia seemed to be originated from primary stressors related to the behavioral symptoms as well as secondary stressors (degree of emotional stress, depression, anxiety, etc.). Therefore, active intervention by the geriatric specialists might be helpful to reduce their strain.