Assessment of trait and state anxiety in 3-6-year old children during sequential phases of dental treatment

Priya Subramaniam1Orcid, Maryam Haqh2Orcid, Megha Gupta3Orcid


Dental anxiety influences children’s behavior in the operatory. An introductory dental visit is important for children, parents and the dental team.

Recording a child’s anxiety and behavior during successive appointments can assist in behavior management.

Scheduling initial appointments for preventive procedures reduces children’s anxiety and gains their cooperation at future dental visits.


Aim: To assess changes in trait and state anxiety of children during sequential phases of dental treatment. Methods: Three hundred children, aged between 3 to < 6 years, who reported for their first dental visit were included. Both parents and children were evaluated over five sequential phases of dental treatment. Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Modified Dental Anxiety Scale (MDAS) were used to assess child’s trait anxiety. Children’s Emotional Manifestation Scale (CEMS) and Facial Image Scale (FIS) were used to assess child’s state anxiety. Child’s behavior was rated using Frankl’s Behavior Rating Scale (FBRS). Paired sample t-test, Pearson’s Correlation coefficient and Spearman’s Rank Correlation coefficient was performed. Results: Mean CFSS-DS and CEMS scores decreased significantly from the first (26.55; 10.25) to the fifth visit (24.74; 8.1) (p<0.05). A significant decrease in the mean FIS (state anxiety) score from the first (2.70) to fifth (2.48) visit was seen (p<0.05) Children’s behavior differed significantly between the dental visits.(p<0.001) There was a significant inverse correlation between behavior and both trait and state anxiety (p<0.05). Conclusions: Sequential phases of dental treatment significantly reduced trait and state anxiety.

Keywords: Behavior Rating Scale; Child; Dental Anxiety; Dental Care

Author Affiliations

  1. Professor and Head, Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bangalore, India. (✉ Correspondence:
  2. Former Post Graduate Student,Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bangalore, India.
  3. Reader, Department of Pedodontics and Preventive Dentistry, Vyas Dental college and Hospital, Jodhpur, India.
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Article Info

Contemp Pediatr Dent 2020:1(1):22-32

Received: 26 August 2020

Accepted: 27 October 2020

Online First: 15 December 2020


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					Priya Subramaniam, Maryam Haqh, Megha Gupta. Assessment of trait and state anxiety in 3-6-year old children during sequential phases of dental treatment. Contemp Pediatr Dent 2020:1(1):22-32.

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