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Dentistry Journal
Special Issues
Dental Anxiety: The Current Status and Developments
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Dental Anxiety: The Current Status and Developments

A special issue of Dentistry Journal (ISSN 2304-6767).

Deadline for manuscript submissions: 30 November 2026 | Viewed by 4379

Special Issue Editors

Prof. Dr. Magnus Hakeberg

E-Mail Website
Guest Editor
Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Interests: oral health; dental anxiety
Prof. Dr. Ulla Wide

E-Mail Website
Guest Editor
Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Interests: dentistry; dental anxiety; odontological behavioural science

Special Issue Information

Dear Colleagues,

Dental care-related anxiety: Where do we stand today with regard to public dentistry and public health, measurement methods, diagnostic issues and comorbidities, treatment modalities and outcomes, financial issues/insurance and cost, and interdisciplinary issues?

Dental care-related anxiety is a prevalent condition among children, adolescents and adults. Its prevalence worldwide is typically reported to be around 10%, in spite of the use of evidence-based treatments, as have been detailed in systematic reviews and meta-analyses. Thus, it is a public health issue, one at the crossroads of dentistry and psychology, which brings both opportunities for collaboration between these scientific fields, but also difficulties in working across the boundaries of each field. Much of these difficulties arise from conservatism and protectionism; some also arise from financial and insurance issues. We believe it is time to further discuss and explore dental care-related anxiety with the purpose of investigate these issues while expanding our knowledge and collaborative possibilities in treating dental care-related anxiety.

Manuscripts addressing the topics outlined above are welcome for this Special Issue of Dentistry. Clinical trials and observational studies adhering to adequate designs and methods are invited; different types of reviews such as narrative, scoping and systematic reviews, are also welcome.

Prof. Dr. Magnus Hakeberg
Prof. Dr. Ulla Wide
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Dentistry Journal is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oral health
  • dental anxiety
  • public dentistry
  • dental care

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Published Papers (6 papers)

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Research

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14 pages, 244 KB  
Article
Modest Longitudinal Associations Between Parent-Reported Dental Fear at Age 5 and Child-Reported Dental Fear at Age 9: A FinnBrain Birth Cohort Study
by Mika Kajita, Akie Yada, Vesa Pohjola, Linnea Karlsson, Hasse Karlsson and Satu Lahti
Dent. J. 2026, 14(6), 344; https://doi.org/10.3390/dj14060344 - 5 Jun 2026
Viewed by 178
Abstract
Background/Objectives: Parent report is often used to assess dental fear in early childhood, but its association with later child-reported dental fear remains unclear. This study primarily examined whether parent-reported dental fear at age 5 was associated with child-reported dental fear at age [...] Read more.
Background/Objectives: Parent report is often used to assess dental fear in early childhood, but its association with later child-reported dental fear remains unclear. This study primarily examined whether parent-reported dental fear at age 5 was associated with child-reported dental fear at age 9, and secondarily explored two options derived from the modified Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS-M): a single general dental fear item and a pragmatic multi-item score. Methods: This secondary longitudinal observational analysis used data from the FinnBrain Birth Cohort Study. Mothers and fathers rated child dental fear at age 5 using the CFSS-DS-M. Children self-reported dental fear at age 9 using the Modified Dental Anxiety Scale (MDAS). Associations of the single item and five-item score with age-9 MDAS score were examined separately for mother- and father-reported data using Spearman correlations and adjusted linear regression models. Exploratory factor analysis examined the structure of the five-item score. Results: Treatment-specific CFSS-DS-M items frequently received “no experience” responses. The pragmatic five-item score showed an exploratory one-factor structure and was more feasible than the full 11-item score. Associations with age-9 dental fear were small. In adjusted analyses, both mother-reported measures were positively associated with age-9 dental fear. In father-reported data, the single item was not associated, whereas the five-item score showed a positive predictor-level association, although the adjusted model was not statistically significant. Conclusions: Parent-reported dental fear at age 5 provides modest information about later child-reported dental fear. In population-based cohorts in early childhood, less treatment-specific items may be useful when assessing dental fear. Full article
(This article belongs to the Special Issue Dental Anxiety: The Current Status and Developments)
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12 pages, 558 KB  
Article
Level of Dental Anxiety and Its Role Among Barriers to Habitual Use of Oral Health Care in Adult Finns
by Vesa Pohjola, Anna Liisa Suominen, Mika Kajita, Pirjo Kurki, Ulla Harjunmaa and Satu Lahti
Dent. J. 2026, 14(5), 306; https://doi.org/10.3390/dj14050306 - 18 May 2026
Viewed by 356
Abstract
Objectives: The aims were to compare prevalence of high dental anxiety (DA) in 2000, 2011 and 2023, to compare the age- and sex-specific levels of DA, and to study if total, anticipatory, and treatment-related DA have an independent association with the non-habitual [...] Read more.
Objectives: The aims were to compare prevalence of high dental anxiety (DA) in 2000, 2011 and 2023, to compare the age- and sex-specific levels of DA, and to study if total, anticipatory, and treatment-related DA have an independent association with the non-habitual use of oral health care considering age, sex, education, current perceived treatment need, and reported barriers to use of oral health in nationally representative samples of adult Finns (n = 1950). Methods: DA was assessed with a single question (n = 1770) for prevalence and with the Modified Dental Anxiety Scale (MDAS) (n = 1739) for DA levels described as means, medians, standard errors (SE), interquartile ranges, and 95% confidence intervals (CI). Multivariable logistic regression analyses were used to assess the independent effect of total, anticipatory, and treatment-related DA on habitual use of oral health care (regular = habitual, for toothache or other problems = non-habitual) adjusted for age, sex, level of attained education, current perceived treatment need, and barriers to using oral health care (care costs and long queues). Results: Among women, the prevalence of high DA decreased from 2000 to 2011, but the decrease did not continue between 2011 and 2023. Among men, the prevalence of high DA decreased between 2000 and 2023. The mean MDAS (SE) for women was 10.1 (0.1) and for men 8.4 (0.1). Total, anticipatory, and treatment-related dental DA had an independent association with non-habitual use of oral health services. Conclusions: DA as an independent barrier to oral health care can prevent habitual care utilization, potentially leading to poor oral health. Full article
(This article belongs to the Special Issue Dental Anxiety: The Current Status and Developments)
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9 pages, 223 KB  
Article
Age Adaption and Psychometric Properties of the Swedish Version of the Four-Components and Stimulus Module from the Index of Dental Anxiety and Fear (IDAF) for Children and Adolescents
by Jonas Rafi, Magnus Hakeberg and Ulla Wide
Dent. J. 2026, 14(5), 276; https://doi.org/10.3390/dj14050276 - 7 May 2026
Viewed by 276
Abstract
Background/Objectives: Valid and reliable measurement of dental anxiety is of importance in both clinical and research settings. The aim of this study was to adapt and evaluate the Swedish child and adolescent version of the index of dental anxiety and fear (IDAF). [...] Read more.
Background/Objectives: Valid and reliable measurement of dental anxiety is of importance in both clinical and research settings. The aim of this study was to adapt and evaluate the Swedish child and adolescent version of the index of dental anxiety and fear (IDAF). Methods: A total of 142 dental patients aged 10–15 completed the four-components (IDAF-4C) and stimulus module (IDAF-S). Convergent validity was evaluated by correlating IDAF with CFSS-DS and a single item question on self-reported dental anxiety (SQDA). Reliability was investigated using Cronbach’s alpha, test–retest measurements (n = 16) and interviews. Results: IDAF-4C had a high correlation to CFSS-DS (r = 0.72). IDAF-4C convergent validity to SQDA (r = 0.76) was higher than the correlation between CFSS-DS and SQDA (r = 0.62). Convergent validity between IDAF-S and CFSS-DS was high (r = 0.83). Test–retest for IDAF-4C resulted in a moderate ICC of 0.72 (95% CI 0.37–0.89) and a correlation coefficient of 0.74. The difference in skipped items suggests that IDAF has higher usability than CFSS-DS. Conclusions: IDAF-4C provides a reliable estimate of dental anxiety, while IDAF-S provides clinical insights in individual aspects of dental anxiety similar to CFSS-DS. Further research includes evaluating the specific phobia module of IDAF and include more test–retest participants. The Swedish child and adolescent version of IDAF-4C and IDAF-S show good psychometric properties and usability and may be used as a dental anxiety measurement among children and adolescents. Full article
(This article belongs to the Special Issue Dental Anxiety: The Current Status and Developments)
10 pages, 230 KB  
Article
Parents’ Dental Anxiety in Early Pregnancy and Toothbrushing Stability for Parent and Child Until Age 4—A Longitudinal Study
by Arja Liinavuori, Risto Virtanen, Auli Suominen, Hanna Suokko, Vesa Pohjola, Mimmi Tolvanen, Mika Kajita, Hasse Karlsson, Linnea Karlsson and Satu Lahti
Dent. J. 2026, 14(5), 271; https://doi.org/10.3390/dj14050271 - 5 May 2026
Viewed by 430
Abstract
Objectives: This longitudinal study examined the association of parents’ dental anxiety during early pregnancy with the stability of brushing their own and their children’s teeth from the age of one to four years. Methods: The study used data from the FinnBrain Birth Cohort [...] Read more.
Objectives: This longitudinal study examined the association of parents’ dental anxiety during early pregnancy with the stability of brushing their own and their children’s teeth from the age of one to four years. Methods: The study used data from the FinnBrain Birth Cohort Study, which included 816 mothers and 379 fathers who completed questionnaires on dental anxiety at gestational week 14 and on toothbrushing frequency for themselves and their child at the ages of 1, 2, and 4 years. Dental anxiety was assessed using the Modified Dental Anxiety Scale. The stability of toothbrushing was categorized as stable good (twice daily or more at all time points), fluctuating, good at 4 years (fluctuates over time points, but good at age 4 years), fluctuating, poor (less than twice daily) at 4 years (fluctuates over time points, but poor at age 4 years), stable poor (poor at all time points). Unordered multinomial logit models regarding the association of parents’ dental anxiety on brushing their own and their children’s teeth were adjusted for education, and education and parents’ own toothbrushing, respectively. Results: Compared to the mothers who brushed their teeth twice daily throughout the study (“stable good”), those belonging to the “fluctuating, good at 4 years” group and those belonging to the “stable poor/poor at 4 years” group were more likely to have higher dental anxiety (OR = 1.07, 95% CI = 1.01–1.13 and OR = 1.04, 95% CI = 1.00–1.08, respectively). This association was not found among fathers. Parents’ dental anxiety was not associated with the brushing of their children’s teeth. Conclusions: Attending to the mother’s dental anxiety during pregnancy could improve her toothbrushing. Full article
(This article belongs to the Special Issue Dental Anxiety: The Current Status and Developments)
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11 pages, 712 KB  
Article
Assessment of Anxiety and Local Anesthesia Experiences in Dental Students Using the Modified Dental Anxiety Scale (MDAS)
by Emilia Bologa, Andra Claudia Tărăboanță-Gamen, Ionuț Tărăboanță, Otilia Boișteanu, Alexandra-Lorina Platon, Șerban-Ovidiu Stelea, Ana-Maria Andreea Simionescu, Anca Irina Grădinariu, Alina Jehac, Cristina Bologa and Carmen Gabriela Stelea
Dent. J. 2025, 13(10), 445; https://doi.org/10.3390/dj13100445 - 28 Sep 2025
Cited by 2 | Viewed by 1731
Abstract
Background and Objectives: Dental anxiety can hinder both treatment delivery and dental education. Few studies have examined this issue among Romanian dental students. This study assessed the prevalence, intensity, and main procedural triggers of dental anxiety, with a focus on experiences related [...] Read more.
Background and Objectives: Dental anxiety can hinder both treatment delivery and dental education. Few studies have examined this issue among Romanian dental students. This study assessed the prevalence, intensity, and main procedural triggers of dental anxiety, with a focus on experiences related to local anesthesia. Methods: A cross-sectional survey was conducted (January–May 2024) among 122 fourth-year students using the validated Romanian version of the Modified Dental Anxiety Scale (MDAS) and additional items on demographics, prior anesthesia and perceived complications. Data analysis included descriptive statistics, chi-square tests, and t-tests. Results: Overall, 21.3% of respondents scored in the low anxiety range, 75.4% in the moderate range, and 3.3% in the severe range (MDAS ≥ 19). No significant gender differences were identified (p > 0.05). Injections with local anesthetic were rated as the most distressing procedure, followed by drilling, whereas scaling was reported as least stressful. The majority (86.9%) had undergone previous local anesthesia, with very few adverse events recalled. Conclusions: Romanian dental students reported moderate dental anxiety overall, with local anesthesia injections as the main trigger. The lack of gender differences points to a potential buffering effect of clinical exposure. Incorporating structured anxiety management into dental curricula may enhance both student well-being and patient care. Full article
(This article belongs to the Special Issue Dental Anxiety: The Current Status and Developments)
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Review

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13 pages, 1673 KB  
Review
Dental Anxiety as a Potential Bottleneck in Oral–Systemic Health Pathways: A Conceptual Mapping Review of Review Articles
by Mika Kajita, Vesa Pohjola, Gerald Humphris and Satu Lahti
Dent. J. 2026, 14(4), 227; https://doi.org/10.3390/dj14040227 - 10 Apr 2026
Viewed by 774
Abstract
Background/Objectives: Although many studies have examined the determinants and management of dental anxiety (DA), its broader placement as a potential bottleneck along oral–systemic health pathways, from the determinants of DA to consequences through dental avoidance, oral outcomes, psychosocial impacts, and possible systemic health [...] Read more.
Background/Objectives: Although many studies have examined the determinants and management of dental anxiety (DA), its broader placement as a potential bottleneck along oral–systemic health pathways, from the determinants of DA to consequences through dental avoidance, oral outcomes, psychosocial impacts, and possible systemic health outcomes, has not been mapped across the review literature. This review aimed to conceptually map how existing DA reviews are distributed across this pathway, whether this broad framing changed across 5-year periods, and how systemic health outcomes were framed. Methods: We conducted a conceptual mapping review of DA-focused review articles published between 2005 and 2025. PubMed and Scopus were searched for English-language narrative, systematic, scoping and umbrella reviews and meta-analyses addressing the determinants or consequences of DA. One reviewer screened records, extracted review characteristics, and classified each review into predefined domains using binary framed/not framed coding rules. A structured AI-assisted prompt was used only to support full-text evaluation across domains; all final coding decisions were made by the reviewer. Results: The search identified 851 records; after removing 426 duplicates, 425 unique records were screened, and 39 reviews met the inclusion criteria. Framing concentrated on environmental and psychological determinants and on the pathway from DA to avoidance and poor oral health, whereas broader consequences, including shame, OHRQoL, and systemic health outcomes, were less consistently framed. Across 5-year periods, the broad pattern of framing remained relatively stable. Systemic health outcomes were framed in only a minority of reviews. Conclusions: Future research should test hypothesized pathways from DA to broader health consequences using clearly specified bridge mechanisms and appropriate temporal designs. Full article
(This article belongs to the Special Issue Dental Anxiety: The Current Status and Developments)
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