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Article 8 Volume 1 - A critical appraisal..


INTRODUCTION

Dental fear in children has continued to generate a lot of interest in pediatric dentistry. This is because of the handicapping complications associated with it. For one, it causes stress for many dentists who have to manage such children especially those who have associated behavioural problems. In addition, the chair time required to manage these children is long and some specialized training is also needed in the effective management of these children1.

However, to effectively manage this handicapping trait, it is important to determine the prevalence of the problem in a community so as help in the planning of public health services. Secondly, tools are needed to aid diagnosing its presence and the severity in individuals to help tailor individual treatment. Finally, there is also a need for tools which can measure treatment need and successes of therapy. This would help with monitoring and evaluating treatment outcomes.

Various measures have been developed in a bid to develop a uniform method of assessing and grading dental fear in children. Many of these measures quantify dental fear by measuring, scoring and summarizing the results. The development of a measure that can record the prevalence, help in recognizing treatment needs and priorities and help in the monitoring and evaluation of treatment outcomes would be ideal. This is because such a measure would help in ensuring uniformity in treatment planning and help in evaluation of various results.

Any such measures should be able to demonstrate the following features:

 

  1. it should be reliable meaning it should have a high level of intra and inter examiner reproducibility
  2. it should be valid, measuring what it is intended to measure
  3. it should be simple and easy to use
  4. it should enable the assessment required to be done quickly and accurately without the use of special instruments or special instructions
  5. it must be able to distinguish between a handicapping and non handicapping trait
  6. it should be objective in nature and yield quantitative data which may be analysed by current statistical methods

The currently existing measures for dental fear are numerous. Past classifications have been based on the type of the tools. They where classified as psychometric scales, behavioural rating scales, physiological and hormonal measures and projection techniques.

However, there may be the need to readdress this broad classification which does not take cognizance of the possible uses these tools could be put into. This article tries to classify the existing measures for dental fear in children based on their possible use for assessments. It also critically appraises the tools in light of the ideal requirements and makes recommendations. It proposes a new and functional method of classifying various measures of dental fear in children. The classification is based on possible use of the tools rather than on their type.