The relationship between problematic media use and their fear, anxiety and behavior during dental treatment in children

This study aimed to investigate individual, familial, and media-related factors associated with dental fear and anxiety (DFA) and dental behavior management problems (DBMP) in school-age children, with particular emphasis on problematic media use (PMU). In this cross-sectional study, 145 children aged 6-12 years undergoing restorative dental treatment were evaluated. Sociodemographic characteristics, maternal dental anxiety, children's media use characteristics, and PMU were assessed using parental questionnaires and the Problematic Media Use Measure-Short Form (PMUM-SF). Children's dental fear and anxiety were assessed using validated child questionnaires, namely the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the Modified Child Dental Anxiety Scale (MCDASf), while behavior during dental treatment was assessed using the standardized Frankl Rating Scale (FRS). Group comparisons, correlation analyses, and multivariable logistic regression analyses were performed. Dental anxiety and uncooperative behavior during dental treatment were more common among early school-age children than pre-teens (p = 0.011 and p = 0.002, respectively). Maternal dental anxiety was independently associated with uncooperative behavior during dental treatment (AOR = 2.93, 95% CI:1.36-6.30) and dental fear (AOR = 2.86, 95% CI:1.38-5.94). PMUM-SF scores did not differ significantly between children with and without dental anxiety in unadjusted analyses. However, after adjustment for potential confounders, higher PMUM-SF scores were independently associated with dental fear (AOR = 1.07, 95% CI:1.01-1.13). The observed correlations between PMUM-SF scores and dental anxiety-related measures were statistically significant but weak. Younger age and maternal dental anxiety were among the factors most consistently associated with children's dental fear and behavior. Although PMU showed only weak associations with dental anxiety-related outcomes, higher PMUM-SF scores were independently associated with dental fear after adjustment for potential confounders. These findings should be interpreted cautiously and considered exploratory given the cross-sectional design and modest effect sizes.