Self-assessed oral health, cognitive vulnerability and dental anxiety in children: testing a mediational model.

OBJECTIVE To explain the association between children's self-perceived oral health status and dental anxiety, by considering their levels of cognitive vulnerability. METHODS Participants were 161 children (47.8% female; mean age = 11.93 years) who filled in a questionnaire comprising self-assessed oral health-related status, dental treatment-related cognitive vulnerability and dental anxiety measures. Gender, age and number of decayed, missing and filled permanent teeth were controlled for. Bivariate correlations, hierarchical regression analyses and structural equation modelling were conducted to test the hypotheses. RESULTS Subjective oral health status, cognitive vulnerability variables and dental anxiety were strongly correlated. Regression and structural models testing the mediating effects of cognitive vulnerability variables on the relationship between perceived oral health and dental anxiety were supported. CONCLUSIONS The activation of the cognitive vulnerability schema, as a mediating variable, is a mechanism by means of which children's self-perceptions of a poor oral health might lead to dental anxiety. Both components of vulnerability analysed (threat and disgust) contribute decisively to this potential process.