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160 rev port estomatol med dent cir maxilofac. 2021;62(3):157-162

Table 2. Medians of scores for each CFSS ‑DS item and interquartile range for girls and boys and children aged 8 ‑10 years
with moderate and high dental fear levels.
Sex Age
Items F M 8 years 9 years 10 years
Median IQR Median IQR p ‑value a Median IQR Median IQR Median IQR p ‑value b
25 ‑75 25 ‑75 25 ‑75 25 ‑75 25 ‑75
Item 1 2.00 1.75–3 2.00 1–3 0.883 2.00 1–4 2.00 1–3 2.00 2–3 0.393
Item 2 2.00 1–4 2.00 1–4 0.773 2.00 1–4 2.00 1–4 2.00 1–3.5 0.509
Item 3 4.00 2–5 4.00 2–5 0.406 5.00 2–5 4.00 2–5 4.00 2–5 0.075
Item 4 2.00 1–3 2.00 1–3 0.732 2.00 1–3 2.00 1–3 2.00 1–3 0.820
Item 5 1.00 1–2 1.00 1–2 0.951 1.00 1–2 1.00 1–2 1.00 1–2 0.366
Item 6 4.00 2–5 3.00 2–5 0.196 5.00 3–5 3.00 2–5 2.00 1–5 0.001
Item 7 2.00 1–4 2.00 1–3 0.080 2.00 1–3 2.00 1–3 2.00 1–4 0.723
Item 8 3.00 1–5 3.00 1–5 0.789 3.00 1–5 3.00 1.5–5 4.00 2–5 0.256
Item 9 2.00 1–5 2.00 1–4 0.870 2.00 1–4 2.00 1–5 3.00 1.5–5 0.076
Item 10 2.00 1–4 3.00 1–5 0.422 2.00 1–4 3.00 1–5 3.00 2–4 0.221
Item 11 3.00 2–5 2.00 1–4 0.106 3.00 2–5 3.00 2–4 3.00 1–5 0.744
Item 12 5.00 3–5 5.00 4–5 0.160 5.00 4–5 5.00 3–5 5.00 3–5 0.107
Item 13 3.00 1–5 3.00 1–5 0.788 2.00 1–5 3.00 2–5 2.00 1–5 0.199
Item 14 1.00 1–2 1.00 1–3 0.266 1.00 1–3 2.00 1–3 1.00 1–2 0.181
Item 15 1.00 1–2 1.00 1–2 0.760 1.00 1–3 1.00 1–2 1.00 1–3 0.166
b
a
IQR – Interquartile Range; F – Female; M – Male; Mann -Whitney U Test; Kruskal -Wallis Test; *p<0,05.
Item 1 – “Dentists”; Item 2 – “Doctors”; Item 3 – “Injections”; Item 4 – “Having someone examine your mouth”; Item 5 – “Having to open your
mouth”; Item 6 – “Having a stranger touch you”; Item 7 – “Having somebody look at you”; Item 8 – “The dentist drilling”; Item 9 – “The sight of the
dentist drilling”; Item 10 – “The noise of the dentist drilling”; Item 11 – “Having somebody put instruments in your mouth”; Item 12 – “Choking”;
Item 13 – “Having to go to the hospital”; Item 14 – “People in White uniforms”; Item 15 – “Having the nurse clean your teeth”.

According to Table 2, no significant differences were ob- In the present study, most children had high dental fear,
served between girls and boys. On the other hand, a significant and the following CFSS -DS items obtained the highest median
difference was found between ages for the item “Having a values: “Injections,” “Having a stranger touch you,” “The den-
stranger touch you” (p=0.001), with those aged 8 years present- tist drilling,” “Having somebody put instruments in your
ing the highest median (5.00) and those aged 10 years the low- mouth,” “Choking,” and “Having to go to the dentist.” The item
est median (2.00) (Table 2). “Injections” was also prevalent in similar studies, 2,3,7,10,12 as
well as “Choking” and “The dentist drilling.” 2,3,10,12 Since the
main factors for dental fear may be due to invasive dental
Discussion procedures, these findings suggest that the anxiety about cer-
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tain items proposed by the CFSS -DS is constant across cultures
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Several factors can influence dental fear, including sex, and peoples, regardless of fear level.

age, 3,4,11,15 and sociodemographic, economic, and psychosocial In this research, girls were more prevalent, similar to the
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characteristics. Therefore, being aware of this condition can results by other authors. One of the possible explanations is
contribute to the establishment of a trusting relationship be- that girls, in general, are more open and honest about their
1
tween professional and patient and encourage routine care, feelings, including anxiety and fear, compared to boys. How-
ensuring that patients maintain ideal oral health. 5 ever, despite the greater female presence, there was no statis-
The sample of this study was composed of children aged tically significant difference in the questionnaire items be-
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8 -10 years. Older children have a better understanding of the tween sexes, unlike in a study conducted in Bulgaria, in which
procedures used than younger children, causing less dental girls had higher scores in the CFSS -DS questionnaire than boys.
fear. 12 In addition, in Indian children, girls had higher scores than
With regard to the CFSS -DS score, an average of 40.44 ± 6.81 boys in the items “Dentists,” “Having somebody look at you,”
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and a median of 40.00 were obtained. Similar studies found an “The dentist drilling,” and “People in White uniforms,” and in
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average of 37.0 ± 8.89 in English children aged 6 -12 years, 26.09 Saudi children, girls had higher scores than boys in all items of
± 10.70 in Saudi children aged 6 -12 years, and 24.8 ± 10.3 in the questionnaire. As Arab boys are raised to be brave and not
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Chinese children aged 5–12 years. These different averages show fear, this research confirms that cultural factors are rel-
can be related to methodological differences between surveys evant in the dental fear evaluation. 21
and cultural differences between locations, which can lead to A significant difference between ages was found for the
discrepant results. 22 item “Having a stranger touch you” (p=0.001), with children