title: Dental fear-related cognitive vulnerability perceptions, dental prevention beliefs, dental visiting, and caries: a cross-sectional study in Madrid (Spain).
abstract: OBJECTIVE
  This study aimed to analyze the role that psychosocial elements may play concerning dental attendance and oral health in children. In particular, we explored the associations among dental fear-related cognitive vulnerability perceptions, dental prevention beliefs, the pattern of dental visits, and the number of decayed teeth.
  
  
  METHODS
  A cross-sectional design was used to collect data from 250 Spanish schoolchildren who completed a questionnaire. Oral health status was evaluated by pediatric dentists. Statistical analyses were mainly based on binary logistic regression and multiple linear regression, which allowed us to test possible associations among variables as well as interaction and mediation effects.
  
  
  RESULTS
  Children with more vulnerability-related cognitions (Adj. OR = 0.74 P < 0.05) and more unfavorable dental prevention beliefs (Adj. OR = 1.47 P < 0.01) were less likely to attend the dentist regularly. Moreover, the interaction between dental prevention beliefs and cognitive vulnerability perceptions was associated with more decayed teeth (β = -0.13 P < 0.05). The irregular pattern of dental visit, associated with fearful and unfavorable dental prevention cognitions, accounted for 20% of the effects of these variables on dental caries.
  
  
  CONCLUSIONS
  The combination of greater cognitive vulnerability-related perceptions and low awareness of the benefits of dental prevention increased the risk of dental caries. Children with this profile also tended to demonstrate a more inadequate pattern of dental attendance. Preventive oral health programs would benefit from considering the role of children's cognitions on their oral health habits and dental health.
authors.affiliation: Department of Paediatric Dentistry, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Carrillo-Diaz
authors.affiliation: Department of Psychology, Madrid Open University (UDIMA), Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Crego
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Armfield
authors.affiliation: Department of Paediatric Dentistry, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Martin
authors.initials: M
authors.lastname: Romero
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D004245:DMF Index; D016854:Dental Anxiety / Q000453:epidemiology* / Q000523:psychology; D019140:Dental Care for Children / Q000523:psychology / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: cognitions; cognitive vulnerability; dental caries; dental fear; dental prevention beliefs; dental visits; oral health