The impact of radiographic examination timing and gag reflex on dental fear and cooperation in children: a comparative clinical study.

Purpose: Identifying factors that disrupt cooperation during radiographic examination, such as dental fear and the gag reflex, is crucial for achieving optimal radiographic outcomes. The aim of the present study is to evaluate the levels of dental fear and cooperation amongst children aged 4-9 years undergoing intraoral radiographic examination at different stages of dental treatment. It also investigates the impact of the gag reflex on children's behaviour during intraoral radiographic examination.

Methods: A total of 89 children with no prior dental experience were randomly divided into two groups (G1, G2). Children in G1 underwent radiographic examination during their first dental visit, whilst children in G2 underwent the same after the completion of dental prophylaxis at their second visit. Variables assessed included dental fear, gagging and behaviour during radiographic examination. Multivariate logistic and linear regression analysis were performed to assess the variables that have an impact on behaviour during radiographic examination and on dental fear, respectively.

Results: Children in G2 were more likely to exhibit better behaviour during radiographic examination than G1children (OR: 4.709, p value = 0.036). In addition, G1 children demonstrated a greater increase of CFSS-DS score compared to G2 children (β = - 0.698, p value = 0.001) after the second appointment. Gagging during radiographic examination was significantly associated with lower Frankl score during the examination (p = 0.015).

Conclusion: Gradual exposure to radiographic examination may significantly enhance children's cooperation during the procedure and confine the progression of dental fear. In contrast, the presence of a gag reflex can compromise patient's cooperation during intraoral radiographic assessment.