Aims

To analyse the 17 year old dental questionnaire data.

To create a body of work to support a future grant application for further dental work.

Analysis of 17 year old questionnaire

The first two pieces of work will be to look at predictors of dental anxiety and uptake of orthodontic care.

It has been suggested that dental anxiety may be the result of two different mechanisms either underlying constitutional vulnerability or conditioning i.e. endogenous or exogenous. Conditioning may be the result of direct experience, modelling or information exchange. This study seeks to investigate predictors of dental anxiety at age 17 in the ALSPAC cohort, we will use data from previous surveys to determine whether direct conditioning or modelling are important for the development of anxiety or whether endogenous underlying constitutional vulnerability is more important. Outcome will be whether the individual is dentally anxious or not. Exposure data will be previous dental treatment recorded at age 7.5 years and 10.5 years. Confounders considered in the analysis will include gender, age at time of outcome, maternal age at birth, maternal education, SES, child/adolescent general anxiety and maternal general anxiety.

Treatment with braces (orthodontic care) to correct crooked teeth (malocclusion) is provided by the NHS free of charge for those children who are considered to need it. However it is known that there are inequalities in the provision of orthodontic care with children from deprived areas less likely to receive care. Moreover studies have suggested that rather than the severity of the malocclusion other factors are more important predictors of uptake. Parental concerns and attitudes, dental attendance patterns of child and mother and the child's dental health have all been associated with the receipt of orthodontic care. For the orthodontic care project the intention is to use questionnaire data on attitudes to and experiences of oral health care and dental treatment from previous questionnaires to investigate the association between childhood factors and the offer and uptake of orthodontic care in adolescence.

The plan for further work will be around the experience of mouth ulcers and facial pain, trauma to teeth, oral hygiene, perceptions of oral health and attitudes to prevention of dental caries and periodontal disease.

Hypotheses

1. Dental anxiety in adolescents is associated with dental treatment received in childhood.

2. Receipt of orthodontic care is associated with parental concerns and attitudes and dental attendance patterns rather than solely the need for care as measured by the severity of malocclusion.

Variables

1. Dental anxiety

Outcome: Dental anxiety at age 17

Exposures: (1) Ever had a filling

(

2) Ever had an extraction under GA

Confounders: Gender, age at time of outcome measurement, maternal age, parity, maternal education, SES, child/adolescent general anxiety, maternal general anxiety

2. Orthodontic care

Outcome: Orthodontic experience at age 17

Exposures: (1) attitudes to appearance of teeth age 128 months

(2) dental attendance pattern age 128 months

Confounders: Gender, age at time of outcome measurement, maternal age, parity, maternal education, SES,

Perform regression analyses to investigate the association between childhood factors and the offer / uptake of orthodontic care in adolescence, both with and without adjustment for confounders

Data will be supplied by Dr Sam Leary and a datset will not need to be generated by ALSPAC team.