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Review
. 2022 Feb 18;19(4):2380.
doi: 10.3390/ijerph19042380.

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model

Leah I Stein Duker  1 , Mollianne Grager  2 , Willa Giffin  1 , Natasha Hikita  1 , José C Polido  3
Affiliations
Review

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model

Leah I Stein Duker et al. Int J Environ Res Public Health. .

Abstract

Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.

Keywords: dental anxiety; dental behavior management problems; dental fear; general anxiety; oral health behaviors; sensory over-responsivity.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Preliminary conceptual model. Note. Dashed lines indicate relationships with support from only two or fewer independent studies (e.g., did not meet required inclusion criteria for final model).
Figure 2
Figure 2
Conceptual model of the relationships between dental fear and anxiety, general anxiety/fear, sensory over-responsivity, and oral health behaviors and outcomes.
Figure 3
Figure 3
Number of articles included in conceptual model by year of publication. Note. Articles published in 2021 (n = 21) not included in figure.
See this image and copyright information in PMC

References

    1. Armfield J.M. How do we measure dental fear and what are we measuring anyway? Oral Health Prev. Dent. 2010;8:107–115. - PubMed
    1. Cianetti S., Lombardo G., Lupatelli E., Pagano S., Abraha I., Montedori A., Caruso S., Gatto R., De Giorgio S. Dental fear/anxiety among children and adolescents. A systematic review. Eur. J. Paediatr. Dent. 2017;18:121–130. - PubMed
    1. Coxon J.D., Hosey M.T., Newton J.T. The oral health of dentally anxious five- and eight-year-olds: A secondary analysis of the 2013 Child Dental Health Survey. Br. Dent. J. 2019;226:503–507. doi: 10.1038/s41415-019-0148-3. - DOI - PubMed
    1. Guentsch A., Stier C., Raschke G.F., Peisker A., Fahmy M.D., Kuepper H., Schueler I. Oral health and dental anxiety in a German practice-based sample. Clin. Oral Investig. 2017;21:1675–1680. doi: 10.1007/s00784-016-1951-8. - DOI - PubMed
    1. Kakkar M., Wahi A., Thakkar R., Vohra I., Shukla A.K. Prevalence of dental anxiety in 10-14 years old children and its implications. J. Dent. Anesth. Pain Med. 2016;16:199–202. doi: 10.17245/jdapm.2016.16.3.199. - DOI - PMC - PubMed

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