March 2020

Objective: The aim of this cross-sectional study was to evaluate the association between tobacco use and dental fear when adjusting for gender, parent’s level of education and oral health habits. Material and methods: This secondary analysis used questionnaire data from 15- and 16-year-old adolescents and their parents (n=2486). Ninety-four percent of the adolescents and 73% of the parents responded. For logistic regression analysis, variables were categorized as follows: dental fear (dependent) 0=not at all to somewhat afraid, 1=quite or very afraid; tobacco use (independent) 0=never, 1=occasionally or more often; and for confounders: tooth-brushing 0=at least twice a day, 1=once a day or less often; xylitol products 0=at least three times a day, 1=two times a day or less often; and parents’ occupation: 0=both low, 1=high+low, and 2=both high. Results: 2223 adolescents were included in the final analyses resulting in a 89% response rate. Those using tobacco at least occasionally were more likely to have dental fear than those who reported they had never used tobacco, also when adjusting for oral health habits, gender and parents’ occupation (OR=1.74, 95% CI=1.31–2.33). Conclusions: Adolescent tobacco users were more likely to have dental fear than non-users. Dental teams should consider this when meeting adolescents who have dental fear and/or are using tobacco. The possible common vulnerability factors for dental fear and tobacco use needs further study. Keywords: Adolescent, dental anxiety, smoking, toothbrushing