Dental anxiety and oral health in 15-year-olds: a repeated cross-sectional study over 30 years.

OBJECTIVES: To report the prevalence of dental anxiety in Swedish 15-year-olds over a 30-year period (1973-2003) and how dental anxiety relates to oral health. BASIC RESEARCH DESIGN: The study used a repeated cross-sectional design. PARTICIPANTS: In 1973, 1983, 1993, and 2003, random samples of 96 to 107 15-year-olds were selected from the city of Jönköping, Sweden, 405 overall. MAIN OUTCOME MEASURES: Dental anxiety (DA) and its association with oral health (caries, gingivitis, plaque, fillings) were analysed (α = 0.05). RESULTS: The proportions of dentally anxious during the period were 38% (n = 37) in 1973, 26% (n = 28) in 1983, 18% (n = 15) in 1993 and 13% (n = 12) in 2003 a clearly decreasing trend with time. The strongest predictor of DA was gender, with girls reporting higher levels of DA. In three of the four examination years, adolescents with DA had more filled permanent surfaces than those without DA. Those with DA had a greater caries experience only in 1973. No associations were found between DA and plaque or gingivitis. Multivariate logistic modelling confirmed that DA decreased over time and that girls had higher levels of DA. CONCLUSIONS: This study showed a clear decrease in DA in 15-year-olds over a 30-year period, with a greater proportion of girls being more dentally anxious. The results also indicate a relationship between DA and oral health; the dentally anxious having more filled surfaces and, only in 1973, more decayed tooth surfaces.

Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents. A cross-sectional epidemiological investigation covering two decades.

AIMS: These were to 1) estimate the prevalence of subjective symptoms and clinical signs of temporomandibular disorders (TMD) in children and adolescents in the city of Jönköping, Sweden, 2) follow possible variations in TMD signs and symptoms over a 20-year period, and 3) study possible associations between TMD symptoms and signs and factors of interest. DESIGN: About 100 individuals in the age groups of 3, 5, 10 and 15 years participated in cross-sectional stratified epidemiological investigations in 1983, 1993 and 2003. METHODS: All participants were asked to fill in a questionnaire including questions on general and oral health, dental care habits and some socio-demographic issues. More specific questions recorded the presence or absence of subjective symptoms: tiredness in the jaws on awakening or during chewing; clicking sounds or crepitations from the temporomandibular joints (TMJs); locking/ catching of the mandible; luxation of the mandible; reduced jaw movement capacity; pain during jaw movements; other pain conditions in the jaws or in the TMJ regions. Subjects were examined clinically at each time period for; jaw mobility (maximum jaw opening including vertical overbite, maximum laterotrusion to the right and to the left, maximum protrusion); TMJ function (normal function, deflection on jaw opening of >2 mm, TMJ clicking or crepitations, TMJ locking, TMJ luxation); pain on jaw movement (no pain on movements, pain on one movement, pain on more than one movement); muscle pain (no muscle pain, pain on palpation in 1-3 sites, pain on palpation in >3 sites); TMJ pain (no joint pain, pain on lateral palpation of one or both joints, pain on posterior palpation of one or both joints). No functional examination of the masticatory system was performed in children aged 3 and 5 years. RESULTS: TMD-related symptoms were very rare in 3- and 5-year-olds. In the age groups of 10- and 15-year olds, 5-9% of the participants reported more severe symptoms, up to 50% showed one or more TMD signs, while it was estimated that 1-2% were in need of TMD treatment. Several symptoms and signs increased with age. No gender differences, with the exception of recurrent headache, were noted. Oral parafunctions were reported by 11-47%. Apart from a few variables, no statistically significant changes in the prevalence of TMD symptoms and signs were observed over the 20-year period. Clenching/grinding of teeth and general health factors were found to be associated with TMD symptoms and signs. CONCLUSIONS: The prevalence of more severe TMD symptoms and signs in children and adolescents was generally low in all three examinations and did not change significantly during the 20-year period. Increasing age, general health factors and oral parafunctions were associated with TMD symptoms and signs in 10- and 15-year-olds.