ReviewDental anxiety: An understudied problem in youth

- We conducted a review of the literature on dental anxiety in youth.
- Early learning is key to the development of dental anxiety but cognitive and contextual factors also play a role.
- Many treatment studies have examined the prevention of dental anxiety.
- Treatments that prevent dental anxiety may not be effective in treating an established dental phobia.
- Multidisciplinary approaches to treatment that include exposure therapy need to be studied in youth.

Dental anxiety and dental phobia typically emerge during childhood; the associated avoidance of dental care can result in oral health problems and is associated with lower quality of life. In this review, we discuss the definition of dental phobia and dental anxiety and issues related to their differentiation. We then review the literature on dental anxiety and dental phobia, including its prevalence, assessment, and sequalae. Moreover, we provide a synthesis of findings on the etiology and maintenance of dental phobia and propose a comprehensive cognitive behavioral model to guide further study. We also present a systematic qualitative and a quantitative review of the treatment literature, concluding that although we have made strides in learning how to prevent dental anxiety in youth, the methods effective in preventing anxiety may not be equally effective in treating youth with dental phobia. We propose a multidisciplinary approach, including those with expertise in pediatric anxiety as well as pediatric dentistry, is likely required to move forward.