title: The relationship of dental caries and dental fear in Malaysian adolescents: a latent variable approach.
abstract: BACKGROUND
  To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia.
  
  
  METHODS
  A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience.
  
  
  RESULTS
  The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (χ2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence.
  
  
  CONCLUSIONS
  In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.
authors.affiliation: Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia. rashidah@um.edu.my.
authors.forename: Rashidah
authors.initials: R
authors.lastname: Esa
authors.forename: Ai Leng
authors.initials: AL
authors.lastname: Ong
authors.forename: Gerry
authors.initials: G
authors.lastname: Humphris
authors.forename: Ruth
authors.initials: R
authors.lastname: Freeman
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology; D016009:Chi-Square Distribution; D002681:China / Q000208:ethnology; D004245:DMF Index; D016854:Dental Anxiety / Q000453:epidemiology*; D003731:Dental Caries / Q000453:epidemiology*; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006801:Humans; D007194:India / Q000208:ethnology; D016013:Likelihood Functions; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data; D016388:Tooth Loss / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data