Trends in five key areas of dental anxiety research

Fraser Macdonald, Dental Tribune International

Thu. 5. February 2026

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TAIPEI, Taiwan: Dental anxiety research has surged over the past three decades, reflecting growing recognition of its impact on oral health and patient behaviour. A major bibliometric review of more than 1,500 scientific papers has mapped how the field has evolved, revealing clear thematic priorities and shifting clinical focus. Together, these trends show a discipline moving beyond description towards prevention, personalisation and multidisciplinary care.

At the foundation of the literature sits the topic of aetiology and risk factors, which remains the most persistent research theme. Early studies focused heavily on traumatic dental experiences, fear conditioning and personality traits. More recent work widens the lens to include broader psychological vulnerability, health anxiety and social determinants, such as socio-economic status and access to care. This shift reflects a growing understanding that dental anxiety is typically multifactorial and develops through interacting biological, psychological and environmental factors.

Research into clinical presentation and consequences was the second major theme. Studies consistently associate high anxiety with avoidance of care, delayed attendance and poorer oral health outcomes. Adults with long-standing anxiety often present late with advanced disease, while older patients may experience compounded anxiety because of cognitive decline or complex medical needs. The literature increasingly frames dental anxiety as a driver of health inequality.

The third dominant theme was prevalence and assessment tools. Large population studies have established dental anxiety as one of the most common specific fears, and severe forms affect a clinically significant minority of patients. This has fuelled development and validation of screening instruments, from brief single-item questions to more nuanced psychometric scales. Reliable assessment is now viewed as essential for identifying at-risk patients early and tailoring care pathways accordingly.

Perhaps the most dynamic area of research concerns treatment and preventive interventions—the fourth major theme. While pharmacological management and sedation remain important, the evidence base has expanded decisively towards non-pharmacological approaches. Cognitive behavioural therapy features prominently, alongside exposure techniques, relaxation strategies and communication-based behavioural management. More recently, research has explored adjunctive methods such as virtual reality distraction, music and aromatherapy, used alongside anxiety management strategies, signalling a move towards low-cost, patient-friendly interventions that can be embedded in routine practice.

The fifth major theme, paediatric dentistry stands out as a consistently strong and distinct research area. Children’s dental anxiety is framed as both a clinical challenge and a preventive opportunity. Studies emphasise early positive dental experiences, parental involvement and behaviour guidance techniques such as tell–show–do. The enduring focus on paediatric populations reflects consensus that preventing anxiety in childhood may be the most effective long-term strategy for reducing its burden in adult dentistry.

Taken together, these five themes illustrate a field that has matured rapidly. Dental anxiety research has expanded beyond describing and quantifying anxiety; it now informs how clinicians screen, communicate and intervene across diverse patient groups. Publication output in dental anxiety research continues to rise globally. For practitioners, an ongoing challenge will be translating this growing evidence base into everyday, anxiety-sensitive dental care.

The article, titled “Publication performance and trends in dental anxiety research: A comprehensive bibliometric analysis”, was published online on 19 January 2026 in the International Journal of Dentistry.