Review
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World J Clin Cases. Nov 16, 2014; 2(11): 642-653
Published online Nov 16, 2014. doi: 10.12998/wjcc.v2.i11.642
Pathways of fear and anxiety in dentistry: A review
Ava Elizabeth Carter, Geoff Carter, Mark Boschen, Emad AlShwaimi, Roy George
Ava Elizabeth Carter, Geoff Carter, Roy George, School of Dentistry and Oral Health Griffith University, Southport, Gold Coast, QLD 4215, Australia
Geoff Carter, School of Human Education and Resources and Oral Health Griffith University, Southport, Gold Coast, QLD 4215, Australia
Geoff Carter, Mark Boschen, School of Applied Psychology, Griffith University, Southport, Gold Coast, QLD 4215, Australia
Emad AlShwaimi, College of Dentistry, University of Dammam, Dammam 31411, Saudi Arabia
Author contributions: Carter AE, Carter G and George R contributed equally to the creation and design of this work; Boschen M and AlShwaimi E contributed by providing their expertise in the field of pain and anxiety and helped edit the document; George R is the senior author and completed final review prior to submission.
Correspondence to: Dr. Roy George, BDS, MDS (Endo), PhD (QLD), MRACDS (Endo), GCHE (QLD), Discipline Head Endodontics, School of Dentistry and Oral Health Griffith University, Parklands Drive, Southport, Gold Coast, QLD 4215, Australia. drroygeorge@gmail.com
Telephone: +61-7-56780751 Fax: +61-7-56780751
Received: June 11, 2014
Revised: July 21, 2014
Accepted: September 4, 2014
Published online: November 16, 2014
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.

Keywords: Dentistry, Fear and anxiety, Phobia, Origin, Therapies and management

Core tip: (1) 5 pathways to the origin of dental fear and anxiety have been identified in this review: Cognitive Conditioning, Informative, Visual Vicarious, Verbal Threat, and Parental; (2) Development of fear and anxiety may be unique for each individual, with patients often associating fear to a combination of factors (Pathways); and (3) Management of fear and anxiety should include an understanding of the origins of dental fear.