Child Dental Patient's Anxiety and Preference for Dentist's Attire: A Cross-sectional Study.

Aim and objective: Initial perceptions of physicians can affect the level of comfort. Creating a strong rapport on the child's first visit helps to create a comfortable atmosphere. Child-friendly clothing of the dentists might possibly contribute to the dentist's empathy. Different attires may evoke different feelings. Hence, the purpose of the study was to assess the children's preferences for dentist's attire and its relation with anxiety. Materials and methods: Eighty children aged 5-12 years were included in the study. Five photographs of dentists wearing different attires were placed in the same order for every child. The child was asked to look at the photographs and decide which dentist they would prefer to take care of them. A facial image scale was used to evaluate the child's anxiety level. The children were asked to point at which face they felt almost like at that moment.
Results: 42.7% of males and 38.5% of females chose child-friendly attire. The least preferred by males was a pink apron (7.5%) compared with females (28.1%). Whereas the blue apron was least preferred by females (5.1%) compared with males (20%). A Chi-square test was done to access the association between dental anxiety and the dental attire the children chose, where statistically significant (0.030) results were found. Anxious children were found to prefer child-friendly attire.
Conclusion: Although the view that children are fearful of the white coat was not found, the concept of child-friendly attire might be more appropriate for anxious children and enhance an easy first communication with them. How to cite this article: Sujatha P, Nara A, Avanti A, et al. Child Dental Patient's Anxiety and Preference for Dentist's Attire: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(S-2):S107-S110.

Introduction

For many years, dental anxiety of children is for main concern.[1] As the reason for the dental anxiety is not clear, it acts as a barrier between the child and the dental treatment.[2]

The fear and anxiety of the dental care providers and the required dental treatment deprive quality dental services to an individual.[3] It has been reported that 5-6% of the population and 16% of school-aged children had fear of the dentist.[4]

It is observed that child dental patients judge, record, and analyze the dentist on their appearance, communication, his/her movements, and gesture.[5]

The three pathway theory given by Rachman stated that the development of anxious response in children occurs either directly through conditioning or indirectly through modeling and information received. Various researches have documented that these confounding factors and the way children precept the dentist mainly the dentist's empathy were significant contributors to child dental anxiety.[6,7]

It has been observed by a pediatrician that doctors who masked their identity by clowning helped in the management of children's anxious behavior.[8] Hence, the purpose of this study was to assess the preferences of child dental patients to dentist's attire and the correlation of the preference with the child's anxiety.

Materials and Methods

A qualitative study was conducted on 80 children between 5 years and 12 years old, were selected by random sampling to participate in the study. The personal data of participants such as age and gender were collected. Children who were able to cooperate and understand verbal communication were included in the study and those with any physical or medical illness, special children with special care needs were excluded. Five photographs of a dentist wearing different attire were placed in the same order. The attire was shown in Figures 12345 .

Fig. 1

Attire with pink apron

Fig. 2

Attire with blue apron

Fig. 3

Child-friendly attire

Fig. 4

White apron

Fig. 5

Attire without apron

The participants were asked to look at the photographs and to decide which dentist they would prefer to take care of their treatment.

Facial image scale validated by Buchanan and Niven (Fig. 6) was used to access the child's anxious behavior. The child was told to select the face they experienced the most at the moment.

Fig. 6

Facial image scale

Results

The data were processed with the SPSS software applied was Chi- square test. “p ” value <0.05 was taken into consideration for the results to be significant.

A total of 80 children aged between 5 and 12 were participated, mean age of children was 8.5 years. Out of 80 children, 42.7% of males and 38.5% of females chose child-friendly attire. Out of five attires the least preferred by males was a pink apron (7.5%) compared with females, whereas 28.1% preferred the pink one (Fig. 7). The blue apron was least preferred by females (5.1%) compared with males (20%) (Fig. 8).

Fig. 7

Preference of dentist's attire by male children

Fig. 8

Preference of dentist's attire by female children

A Chi-square test was done to access the correlation between dental anxiety and the dental attire the children chose, it was observed that anxious children preferred the child-friendly attire and the value was statistically significant with “p ” value 0.030.

Discussion

There are numerous research that studied the development of dental fear in children which has explained various etiological factors which includes Rachman's three pathways and disposition.[6,7] These factors explained the reason for dental anxiety.

A child's attitude toward dental care depends on the dental environment, attitude, and the dentist's attire so the dentist should identify and prevent the dental fear for the successful dental care of a child.[9]

The purpose of this study was to evaluate the child's preference for the dentist's attire by observing five photographs in different attire and their correlation with anxiety.

Studies have observed that the negative and positive types of emotions in children are also associated with color.[9] But, another showed that most of the children preferred their pediatric dentist to wear a white coat and colored scrubs and were highly anxious about looking at the dentist in protective wear.[10]

As preschool children cannot give a suitable verbal self-report, this age-group was excluded from the study.

The questionnaire cannot be completed by very young children due to their cognitive ability. The facial image scale was validated to be applied in the age group of the present study.[11]

Another study observed the preference of children based on the gender of the dentist, it was observed that most of the children preferred female dentists, and it was not related to the anxiety level but concluded that it is more appropriate to wear formal attire for an anxious child.[12] In this study, it was observed, the difference in children's gender and the color preference of attire. It was observed that the pink color was most commonly chosen by females and blue by males.

Prashant et al. observed that colorful attire of the dentist and also camouflaged syringe over conventional syringe was preferred by young children.[13]

Ikusaka et al. assessed older individuals regarding their preference of white coat over casual[11] and concluded the dental anxiety can be reduced by wearing casual attire during the child's first dental visit.[14] Another study observed that to have easy first communication with children in anxious children, the concept of “child-friendly” attire can be suitable.[15] Hence, results obtained from the present study observed that anxious children most likely preferred child-friendly attire over the other attire.

A limitation of the study is that the opinion of the parents and their views regarding the dentist's attire can also be taken into consideration.

Conclusion

A dentist's attire can help in developing a friendly atmosphere for the children and the behavior of the child can also be modified. It is always important to consider the concept of child-friendly attire for anxious children. Child-friendly attire should be considered to make the child feel more comfortable.

Clinical Significance

As dentist attire is one of the factors in a child's behavior management knowing the children's choice of attire helps in managing the patient effectively and efficiently.