Dental fear and anxiety and its sociodemographic associations among public and private schoolchildren aged 8 to 12 years in Depok, Indonesia: a cross-sectional study

BACKGROUND: Dental fear and anxiety (DFA) affect dental visits and oral health outcomes in children. Sociodemographic factors linked to DFA are understudied in Indonesia. OBJECTIVES: This study examined the prevalence, triggers, and sociodemographic factors associated with DFA among schoolchildren aged 8-12 years in Depok City, Indonesia. The goal is to inform targeted interventions in school-based settings. METHODS: A total of 460 schoolchildren aged 8-12 years were recruited from five elementary schools in Depok City by using randomised multistage cluster sampling. The participant's parents also participated in the study. The questionnaires were adapted from the Indonesian Modified Dental Anxiety Scale with Facial Image Scale pictorial response aids (MDAS + FIS), Riskesdas, and Susenas and were administered by trained enumerators. The DFA scores were analysed as continuous and categorical data: no DFA (score 5), mild (6-11), and high (> 11). The covariates included age, sex, birth order, school grade, and school type. The statistical methods employed included descriptive statistics, linear regression, ordered logit regression, and generalised ordered logit regression. Sensitivity analyses for alternatives outcomes were conducted. RESULTS: The mean DFA score was 11.1 (SD: 3.46), median 11 (IQR 9-13). In total, 53.2% of children had mild DFA, and 43.6% had high DFA. Injections (mean 3.13) and tooth drilling (mean 2.79) were the most common triggers. Older age (11-12 vs. 8-10 years), attending private schools, and higher birth order were consistently associated with lower DFA. Sex had weaker associations. Multivariate analysis confirmed these associations, with private schools and older age being the strongest predictors of reduced DFA. Sensitivity analyses affirmed robustness. CONCLUSIONS: There is a high prevalence of mild to high DFA. Early DFA strategies are needed to improve dental attendance and cooperation among Depok City schoolchildren. Lower DFA is associated with older age, later birth order, higher grades, and private schools. The major triggers were dental injections and drilling. These findings provide locally relevant evidence to tailor long-term oral health strategies.