title: Children's use of dental services: influence of maternal dental anxiety, attendance pattern, and perception of children's quality of life.
abstract: OBJECTIVE
  The purpose of the study was to investigate the influence of a child's clinical condition; maternal characteristics such as dental anxiety and dental visit pattern; socioeconomic conditions; and maternal perception of the child's oral health-related quality of life (OHRQoL) on a child's use of dental care services.
  
  
  METHODS
  A cross-sectional study of 608 mother-child dyads was conducted during the Children's Immunization Campaign in Pelotas, Brazil. Mothers answered a questionnaire regarding their use of dental services, dental anxiety (Dental Anxiety Scale), socioeconomic status, and perception of their children's OHRQoL (the Early Childhood Oral Health Impact Scale). Clinical examination of the children was performed to assess dental caries (dmf-t). Associations between the above-mentioned factors and child use of dental services were assessed using Poisson regression models (prevalence ratio [PR]; 95% CI; P ≤ 0.05).
  
  
  RESULTS
  The majority of children (79.3%) had never had a dental appointment and of the children who had visited a dentist, 55 (43.65%) presented with untreated dental caries at the time of examination. More than half the mothers (60.2%) did not visit a dentist regularly. In the final model, low schooling level of mothers (PR, 0.64) and irregular visits to a dentist by the mother (PR, 0.48) were factors because of which a child did not have a dental appointment. Children who had experienced pain (PR, 1.56), those who had poor OHRQoL (PR, 1.49), and older children (PR, 2.14) visited a dentist with higher frequency.
  
  
  CONCLUSIONS
  Use of dental care services by preschool children was low, and treatment was neglected even among children who had visited a dentist. Children of mothers with low schooling level who do not visit a dentist regularly were at greater risk of not receiving dental care. Maternal perception of their child's oral health motivated visits to the dentist.
authors.affiliation: Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil. mariliagoettems@hotmail.com
authors.forename: Marília L
authors.initials: ML
authors.lastname: Goettems
authors.forename: Thiago M
authors.initials: TM
authors.lastname: Ardenghi
authors.forename: Flávio F
authors.initials: FF
authors.lastname: Demarco
authors.forename: Ana R
authors.initials: AR
authors.lastname: Romano
authors.forename: Dione D
authors.initials: DD
authors.lastname: Torriani
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016854:Dental Anxiety; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D016012:Poisson Distribution; D011788:Quality of Life; D011795:Surveys and Questionnaires