LAUSR

AIM Dental fear affects children's oral health; however, there is no evidence regarding the pathways linking possible predictors for its occurrence. Thus, this study aimed to explore the direct and indirect effects of sociodemographic, clinical, behavioural and psychosocial factors on the development of dental fear in schoolchildren over time. DESIGN This is a prospective cohort study, with 10 years of follow-up. The first assessment started in 2010 (T1) with a sample of 639 children aged 1 to 5 years from Southern Brazil. For this study, the follow-up (T2) of these individuals was performed in 2020. Dental fear was accessed at T2 using the Brazilian version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Socioeconomic, demographic, psychosocial, and oral health measures were collected in both assessments. A structural equation model was performed to assess the direct and indirect pathways among variables at T1 and T2 to predict the CFSS-DS scores at T2. RESULTS From the 639 children, 429 were re-evaluated at T2. Higher levels of untreated dental caries, younger individuals, dental visits for non-routine reasons, and low sense of coherence (SOC) at T2 directly impacted dental fear at T2. Considering the indirect effects, presence of dental caries and low household income at T1 indirectly impacted higher levels of dental fear over 10 years via dental caries at follow-up. CONCLUSION Our findings suggest that socioeconomic, demographic, clinical, psychosocial, and behavioural conditions can influence dental fear from childhood to adolescence.