Pathways of fear and anxiety in dentistry: A review

Abstract

The aim of this article was to analyze the theories underpinning dental fear, anxiety and phobias. To be included, articles must have been published between the years of 1949 and 2013 concerning fears and phobias within dentistry and/or psychiatry. Of 200 articles originally under review, 140 were included and reviewed by the authors.Five specific pathways relating to dental fear and anxiety were identified; Cognitive Conditioning, Informative, Visual Vicarious, Verbal Threat, and Parental. Eight currently accepted management techniques across all dental disciplines for dental fear and anxiety were identified. Further research is required to identify clinical diagnosis and treatment for fears originating from different pathways.

Use of dental anxiety questionnaire and clinical approaches: A National survey among pediatric dentists in India

“…[8] Carter et al in his article on pathways of fear and anxiety in dentistry said that fear and anxiety hinders the provision of routine dental treatment on a daily basis for most dental practices. [9] Similarly, Buchanan et al did validation of a facial image scale to assess child dental anxiety status in a clinical context. [10] There are a variety of selfreported dental anxiety assessments available.…”

Adult dental anxiety: recent assessment approaches and psychological management in a dental practice setting

“…[12] Prominent are the learning theory models where contingencies between stimuli and responses are closely linked. [13] Critical is the traumatic experience in the past functioning to precipitate a fearful reaction when exposed to a similar situation.…”

Salivary Cortisol Measurement as a Test for Dental Anxiety Before Tooth Extraction

“…Emotional anxiety is a sense of danger and uncertainty together with exasperation, annoyance, waiting for the unpleasant event, feeling light-headed, impaired concentration and fear of loss of self-control [3,6].…”

“…Somatic vegetative symptoms are associated with increased activation of the sympathetic nervous system, and thus tachycardia, dry mucous membranes, increased blood pressure, shallow breathing, discomfort in the area of the heart and/ or stomach, excessive sweating, heat stroke, pale skin, increased bowel motion, intestinal spasms, diarrhea, nausea, paresthesia of the limbs, dizziness and metabolic changes: hyperglycemia and increased cortisol secretion appear [3,7].…”

“…Behavioral anxiety causes changes in facial expressions (anxiety, pain, fear, horror) and restlessness (manipulative, locomotor) and immobility or verbal phenomena -scream, moan [3].…”