Prevalence of Dental Anxiety and the Influence of Various Factors in Children Aged 12 to 18 Years in Zagreb, Croatia

Background/Objectives: Children who experience high levels of dental anxiety tend to exhibit poor cooperation during dental visits, which compromises treatment outcomes and leads to a vicious cycle with poor oral health and caries prevention outcomes. The purpose of this study is to analyze the prevalence of dental anxiety in a sample of clinical subjects with children and possible correlations with other factors, as well as the longitudinal nature of anxiety. Methods: This cross-sectional and longitudinal study was conducted on a sample of 150 children aged 12 to 18 years in the city of Zagreb and Zagreb County. The MDAS (Modified Dental Anxiety Scale) was used to collect data related to dental anxiety at three time intervals: before the clinical examination (T1), after the clinical examination (T2), and after a period of 3 months (T3). Results: Significant differences between the MDAS before and after the clinical examination were found, suggesting that dental anxiety decreased in most children (p < 0.001). The MDAS test results were 9.79 and 8.03 for the T1 and T2 periods, respectively, indicating mild anxiety. There are statistically significant differences between individual time points T1, T2, and T3 (p < 0.001), and these differences are significant between T1 and T2 (p = 0.045) and between T1 and T3 (p = 0.012), while between T2 and T3, the differences are not statistically significant (p = 0.616). At T1, children mostly exhibited mild dental anxiety (55.3%), followed by moderate (41.3%) and severe dental anxiety (3.3%). At T2, children mostly exhibited mild dental anxiety (77.2%), followed by moderate anxiety (22.8%) and no severe dental anxiety. Financial influence on the use of dental services (p = 0.014), the type of dental service [public/private/semi-private] (p = 0.008), and experience with the dentist (p = 0.004) were statistically significant factors. The initial MDAS and cariogenic diet scores (p < 0.012) have a negative correlation with the change in the MDAS score; greater fear before the clinical examination (T1) is associated with a greater reduction in fear after the clinical examination (T2). A low-cariogenic diet is associated with a greater reduction in fear after the clinical examination (T2). Conclusions: Most of the children in this study had mild to moderate anxiety, which decreased after a visit to the dentist. Financial influence on the use of dental services, the type of dental service, and experience with the dentist may be associated with dental anxiety. No statistically significant difference was found between dental anxiety and gender or socioeconomic status. Furthermore, a cariogenic diet may also be associated with higher dental anxiety. Better oral hygiene and oral status, higher socioeconomic status, and a low-cariogenic diet may influence the dental anxiety levels in children.