Parental depressive symptoms as a family psychosocial marker for dental cooperation and visit-pattern difficulties in pediatric dentistry

Background: Parental depressive symptoms may be related to children’s dental cooperation and continuity of care, but their role in pediatric dental visit patterns and treatment burden remains unclear. This study evaluated whether maternal and paternal depressive symptoms were associated with dental cooperation, visit-pattern difficulty, referral characteristics, and treatment outcomes. Methods: This retrospective observational study reviewed pediatric dental records and parental Beck Depression Inventory (BDI) assessments from a tertiary pediatric dental clinic. To reduce temporal ambiguity, only BDI assessments completed at the child’s first dental visit or within 3 months before the initiation of dental treatment were included. Maternal and paternal BDI scores were analyzed separately, with BDI scores of ≥20 indicating elevated depressive symptoms. Results: Maternal BDI data were available for 300 mothers and paternal BDI data for 264 fathers. Maternal BDI ≥20 was associated with at least one missed or rescheduled visit ≥1 (odds ratio (OR) 2.91, p = 0.021), unplanned loss to follow-up (OR 3.57, p = 0.003), examination-oriented visits (OR 2.74, p < 0.001), and referral from pediatrics (OR 3.34, p < 0.001). We also observed an association with negative dental cooperation (OR 2.13, p = 0.030). Paternal BDI ≥20 was not significantly associated with these variables. Neither maternal nor paternal BDI status was directly associated with dental treatment outcomes, including sedation or treatment under general anesthesia. Cooperation and visit-pattern difficulties were associated with greater treatment burden, including sedation and/or general anesthesia, restorative treatment, and pulp therapy. Conclusions: Maternal depressive symptoms were associated primarily with dental visit-pattern and care-navigation difficulties, rather than with dental treatment outcomes themselves. Maternal BDI may serve as a family psychosocial marker for identifying children who could benefit from enhanced behavior guidance, appointment-navigation support, and coordinated pediatric dental care.

Beck Depression Inventory; Parental depressive symptoms; Pediatric dentistry; Dental cooperation; Dental visit pattern; Treatment burden

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