Assessment of the multidimensional nature of dental fear and anxiety among children and adolescents in Bosnia and Herzegovina

Background: The aim of the present study was to determine whether differences exist in the expression of the multidimensional components of DF A among school-aged children in Bosnia and Herzegovina. Subjects and Methods: This cross-sectional observational study included mentally and physically healthy participants of both sexes, aged 8-15 years, attending a scheduled dental appointment involving either invasive or non-invasive procedures. Prior to treatment, participants completed IDAF-4C core module and the IDAF-S stimulus module independently. Behavioral responses during treatment were assessed using the Frankl Behavior Rating Scale by an independent observer. Results: The findings were presented descriptively in tables. Differences were identified in the expression of the multidimensional components of DF A assessed with the IDAF-4C module. The behavioural component demonstrated the lowest level of expression, followed by the cognitive and physiological components, whereas the emotional component demonstrated the highest level of expression (Friedman test = 238.963; p < 0.0005). Differences were also observed according to the invasiveness of dental procedures, with all components demonstrating higher (more negative) scores during invasive dental treatments: emotional component (Mann-Whitney U = 21,894.000; p = 0.004), behavioural component (Mann-Whitney U = 21,211.500; p = 0.009), physiological component (Mann-Whitney U = 23,570.500; p < 0.0005), and cognitive component (Mann-Whitney U = 20,749.500; p = 0.048). Conclusion: There were no statistically significant differences in the expression of the multidimensional components of the DF A among school-aged children in BiH between the younger and older age groups of respondents. A statistically higher level of DF A components was observed in association with invasive treatments, indicating a link between the intensity of dental fear and the presence of specific stimuli.