{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:29:22Z","timestamp":1791239362891,"version":"4.1.0"},"reference-count":75,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Dent"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This article examines the etiology of dental anxiety, a common yet often overlooked condition in dental practice. Ranging from mild discomfort to severe dental phobia, dental anxiety significantly affects a patient's ability to receive necessary care. Despite its prevalence, it remains underexplored in scientific research, leading to inadequate treatment and insufficient attention. Understanding the factors behind dental anxiety is crucial for prevention and for providing effective psychotherapeutic and pharmacological interventions.<\/jats:p>\n                  <jats:p>The review was based on a comprehensive search of several scientific databases, including PubMed, Cochrane Database, and Dentistry &amp; Oral Sciences Source. Predefined keywords, such as \u201cDental Anxiety,\u201d \u201cDental Phobia,\u201d and \u201cEtiology,\u201d were used to ensure broad coverage of relevant studies. The factors contributing to dental anxiety are multifactorial and involve both internal and external influences. Internal factors, such as genetic predispositions and central nervous system dysfunctions, interact with external influences, including personal experiences, negative past dental encounters, and environmental stimuli. Demographic factors, such as age, gender, and socioeconomic status, along with personal characteristics like temperament and coping mechanisms, further contribute to the development of anxiety.<\/jats:p>\n                  <jats:p>Previous negative dental experiences and self-reported poor oral health exacerbate anxiety, increasing the likelihood of developing dental phobia, which often results in care avoidance. This avoidance worsens oral health, resulting in conditions such as caries and periodontal disease, and significantly diminishes the quality of life. Addressing dental anxiety is critical for improving patient cooperation and ensuring better long-term oral health outcomes. A more comprehensive understanding of dental anxiety will help identify at-risk patients early, prevent severe forms of dental phobia, and ensure dental care is accessible to all individuals.<\/jats:p>\n                  <jats:p>In conclusion, dental anxiety is a multifactorial issue that impacts access to dental care and overall oral health. The most significant factor contributing to dental anxiety is trauma associated with previous dental procedures. Expanding the understanding of its causes enables dental professionals to identify at-risk patients and develop tailored interventions. By addressing anxiety early and adopting evidence-based strategies, dental professionals can reduce the prevalence of dental anxiety and improve patient care.<\/jats:p>","DOI":"10.1055\/s-0045-1809146","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T19:31:37Z","timestamp":1747942297000},"page":"013-022","source":"Crossref","is-referenced-by-count":16,"title":["Etiology of Dental Anxiety and Dental Phobia: Review"],"prefix":"10.1055","volume":"20","author":[{"given":"Agnieszka","family":"Piechal","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CePT, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edyta","family":"Siekierska","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CePT, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0990-3017","authenticated-orcid":false,"given":"Kamilla","family":"Blecharz-Klin","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CePT, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"e70040","DOI":"10.1002\/cre2.70040","article-title":"Exploring the variations in the use of Modified Dental Anxiety Scale (MDAS) in literature: a survey of studies published from 2014 to 2023","volume":"10","author":"A WK Yeung","year":"2024","journal-title":"Clin Exp Dent Res"},{"issue":"03","key":"ref2","first-page":"248","article-title":"The prevalence of dental anxiety and fear in patients referred to Isfahan Dental School, Iran","volume":"12","author":"M Saatchi","year":"2015","journal-title":"Dent Res J (Isfahan)"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1111\/idh.12798","article-title":"Oral health with focus on dental fear and dental caries in Swedish preschool child populations attending public dental health care: trends over 30\u2009years","volume":"22","author":"A Nydell Helkimo","year":"2024","journal-title":"Int J Dent Hyg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"103632","DOI":"10.1016\/j.jdent.2021.103632","article-title":"Estimated prevalence of dental fear in adults: a systematic review and meta-analysis","volume":"108","author":"E R Silveira","year":"2021","journal-title":"J Dent"},{"issue":"04","key":"ref5","first-page":"304","article-title":"Dental fear and anxiety levels of patients attending a dental clinic","volume":"37","author":"H Erten","year":"2006","journal-title":"Quintessence Int"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1472-6831-9-20","article-title":"The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age","volume":"9","author":"G M Humphris","year":"2009","journal-title":"BMC Oral Health"},{"key":"ref7","first-page":"295","article-title":"The relationship between dental fear and sociodemographic variables","volume":"33","author":"S Arslan","year":"2011","journal-title":"Erciyes Med J"},{"issue":"04","key":"ref8","first-page":"329","article-title":"Anxiety and fear of dental treatment among users of public health services","volume":"9","author":"D L do Nascimento","year":"2011","journal-title":"Oral Health Prev Dent"},{"issue":"07","key":"ref9","first-page":"ZC105","article-title":"Evaluating the relationship of dental fear with dental health status and awareness","volume":"10","author":"T T Yildirim","year":"2016","journal-title":"J Clin Diagn Res"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"819","DOI":"10.3390\/healthcare9070819","article-title":"Causes and severity of dentophobia in Polish adults-a questionnaire study","volume":"9","author":"D Furga\u0142a","year":"2021","journal-title":"Healthcare (Basel)"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.3390\/ijerph19042380","article-title":"The relationship between dental fear and anxiety, general anxiety\/fear, sensory over-responsivity, and oral health behaviors and outcomes: a conceptual model","volume":"19","author":"L I Stein Duker","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"06","key":"ref12","first-page":"562","article-title":"Anxiety disorders: dental implications","volume":"51","author":"J W Little","year":"2003","journal-title":"Gen Dent"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/j.1600-0528.2004.00119.x","article-title":"The association between dental anxiety and oral health-related quality of life in Britain","volume":"32","author":"C McGrath","year":"2004","journal-title":"Community Dent Oral Epidemiol"},{"issue":"03","key":"ref14","first-page":"233","article-title":"Oral health condition and hygiene habits among adult patients with respect to their level of dental anxiety","volume":"12","author":"U Kanaffa-Kilijanska","year":"2014","journal-title":"Oral Health Prev Dent"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1472-6831-7-1","article-title":"The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear","volume":"7","author":"J M Armfield","year":"2007","journal-title":"BMC Oral Health"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1038\/sj.bdj.4800251a","article-title":"The psychology of dental patient care. 9. Communicating effectively: some practical suggestions","volume":"187","author":"R Freeman","year":"1999","journal-title":"Br Dent J"},{"issue":"01","key":"ref17","first-page":"13","article-title":"Dentofobia","volume":"22","author":"M Czer\u017cy\u0144ska","year":"2017","journal-title":"Nowa Stomatol"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.identj.2021.05.007","article-title":"Dental anxiety amongst pregnant women: relationship with dental attendance and sociodemographic factors","volume":"72","author":"S AlRatroot","year":"2022","journal-title":"Int Dent J"},{"issue":"10","key":"ref19","first-page":"e46360","article-title":"The prevalence of dental fear and its relationship to dental caries and gingival diseases among school children in Wardha","volume":"15","author":"S Agarwal","year":"2023","journal-title":"Cureus"},{"issue":"07","key":"ref20","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.janxdis.2014.07.013","article-title":"Clinical implications of panic symptoms in dental phobia","volume":"28","author":"C M Potter","year":"2014","journal-title":"J Anxiety Disord"},{"issue":"12","key":"ref21","doi-asserted-by":"crossref","first-page":"153","DOI":"10.3390\/dj9120153","article-title":"Treatment of dental anxiety and phobia-diagnostic criteria and conceptual model of behavioural treatment","volume":"9","author":"U Wide","year":"2021","journal-title":"Dent J"},{"issue":"07","key":"ref22","first-page":"e1001819","article-title":"Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement","volume":"12","author":"D Moher","year":"2015","journal-title":"PLoS Med"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1034\/j.1600-0528.2001.00011.x","article-title":"Dentists' perceived stress and its relation to perceptions about anxious patients","volume":"29","author":"R Moore","year":"2001","journal-title":"Community Dent Oral Epidemiol"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.joms.2007.06.662","article-title":"Factors related to patients' anxiety before and after oral surgery","volume":"66","author":"M Muglali","year":"2008","journal-title":"J Oral Maxillofac Surg"},{"issue":"12","key":"ref25","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1002\/da.22168","article-title":"Is dental phobia a blood-injection-injury phobia?","volume":"31","author":"C M van Houtem","year":"2014","journal-title":"Depress Anxiety"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.3389\/fpsyg.2017.01155","article-title":"The odyssey of dental anxiety: from prehistory to the present. 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India","volume":"27","author":"W Hu","year":"2023","journal-title":"Oral Maxillofac Surg"},{"issue":"04","key":"ref57","doi-asserted-by":"crossref","first-page":"ENEURO.0109","DOI":"10.1523\/ENEURO.0109-21.2021","article-title":"The epigenetics of anxiety pathophysiology: a DNA methylation and histone modification focused review","volume":"10","author":"N S Persaud","year":"2023","journal-title":"eNeuro"},{"key":"ref58","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1146\/annurev.neuro.23.1.155","article-title":"Emotion circuits in the brain","volume":"23","author":"J E LeDoux","year":"2000","journal-title":"Annu Rev Neurosci"},{"issue":"02","key":"ref59","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.tics.2010.11.004","article-title":"Emotional processing in anterior cingulate and medial prefrontal cortex","volume":"15","author":"A Etkin","year":"2011","journal-title":"Trends Cogn 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