Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Cheryl B. McNeil

Committee Member

Daniel W. McNeil

Committee Member

Christa L. Lilly


Positive oral health practices should begin early in life (AAPD; 2013; 2014; 2015); however, dental care-related fear and anxiety and behavior management problems are prevalent among young children in oral health (Klingberg & Broberg, 2007). The study explored caregiver and child dental care-related fear and anxiety, child behavior, and caregiver-child interactions during early childhood dental appointments. Caregiver-child dyad participants (N = 140) were collected from dental practices in West Virginia, Ohio, and Tennessee. Children (n = 139) in the sample were largely White (69.8%) and male (54.0%), with an average age of 3.05 years. Video-taped dental appointments for children under six years were used to code for verbal and behavioral interactions between the caregiver and child. Caregiver dental fear, caregiver-report of child dental fear, and provider-report of child behavior during the dental appointment were also used in subsequent analyses. Analyses indicated that child dental fear had a statistically significant negative association with child behavior during dental appointments (r = -.39, p < .001). Children with high dental fear were significantly more likely (OR = 3.65) of having negative behavior during dental appointments. Caregiver dental fear was not significantly (rs = .10, p = .25) associated with child behavior. Children complied significantly more with direct commands (Mdn = .25) compared to indirect commands (Mdn = .00) from caregivers (T = -3.91, p < .001). Providers and caregivers have opportunities to improve early dental experiences for young children. Providers may benefit from screening for child dental fear to improve patient care. Caregivers may consider using direct commands to elicit child compliance, as well as increase their overall usage of labeled praise to make appointments more positive overall.