치과 불안(dental anxiety)이란 치과 진료 시 또는 치과 진료와 관련된 자극에 노출되었을 때에 예상되는 주관적인 불안이나 두려움을 의미한다. 이전 연구에 따르면 상당히 많은 비율의 사람들이 치과 불안을 경험하고 있으며 치과 불안으로 인해, 제 때 적절한 치료를 받지 못해 실제 구강 건강이 저해되고, 이러한 구강 건강의 저하는 개인의 안녕감 및 삶의 만족감에도 부정적인 영향을 주고 있다. 치과 불안은 그 원인이 매우 다양하고 매우 이질적인 인구 집단에서 방대하게 나타나고 있다. 여러 가지 개인의 신체적, 인지적, 성격적 측면과도 관련이 있음이 여러 연구를 통해 검증되어 왔다. 그럼에도 불구하고 현재 정신장애 진단 체계로는 치과 불안을 정확하게 진단하기 어려운 실정이고 특히 국내 연구에서는 심리학자들의 관심을 많이 받지 못해왔다는 한계를 가진다. 이에 본 논문에서는 기존 논문의 개관을 통해 치과 불안을 이해해 보았고 치과 불안과 관련된 여러 요인과 관련된 국내외 연구들을 살펴보았다. 또한, 기존의 연구에서 제안하는 치과 불안을 설명하는 모형, 치과 불안을 평가하는 도구와 치료 방법까지 살펴보았다. 아울러, 치과 불안을 활발히 연구하기 위해 치과계와 심리학계의 협업을 통해 국내에서도 많은 연구가 이루어지고 실제 치과 불안을 경험하는 환자들이 적절한 심리학적 서비스를 받게 되기를 기대한다.
Dental anxiety is referred to as expected anxiety or fear when one receives dental treatments or is exposed to dental treatment-related stimuli. Previous studies have proven that a high rate of people have been experiencing dental anxiety in the community, and dental anxiety plays an crucial role in people’s hesitation to seek adequate treatment, leading to people’s oral health and life satisfaction to worsen as time passes. Dental anxiety has multi-causality and is shown to very heterogeneous to people. Also, dental anxiety has been proven to be related to individuals’ physical, cognitive, and personality traits. However, dental anxiety cannot be diagnosed precisely with the current diagnostic system, and attracts less attention from psychologists. Thus, this paper reviews previous studies to understand the related variables, models, assessments, and interventions of dental anxiety. Additionally, it is expected that all related researchers such as dental experts and psychologists collaborate on various and useful studies, and that patients with dental anxiety seek practical assistance via appropriate psychological services.
강희양, 손정락 (1999). 한국판 치과 불안 검사의 타당화 연구. 한국심리학회 학술대회 자료집, 1999(1), 184-186.
고부일, 송연미, 배수명 (2017). 인지행동치료를 통한 치과불안 감소에 대한 질적 연구. 치위생과학회지, 17(1), 46-55.
권수진, 최유진 (2010). 경남지역 청소년들의 치과진료형태가 치과공포감에 미치는 영향. 한국콘텐츠학회논문지, 10(2), 277-285.
박미성, 한경수 (1998). 치과외래환자에서 공포, 불안, 우울 및 구강안면부 스트레스증상에 관한 연구. Journal of Oral Medicine and Pain, 23(4), 387-401.
신재원, 김선일 (2019). 치과불안척도(DFS)에 근거한 치과공포 연관선 연구. 대한심리치과학회지, 28(1). 54-60.
심연수, 김아현, 안소연 (2013). 청주시 일부 중학생들의치과공포도와 치과공포 요인. 한국콘텐츠학회논문지, 13(9), 295-304.
이든샘, 김정호, 김제중 (2017). 이완을 유도한 가상현실프로그램이 치과불안에 미치는 효과. 한국심리학회지: 건강, 22(2), 257-269.
임은정, 임순연 (2017). 한국어판 치과 불안 및 공포 지수의 타당도와 신뢰도. 치위생과학회지, 17(1), 20-29.
홍진실, 김영삼, 이해진, 김주연, 장기완 (2015). DFS 에근거한 치과공포 및 치과불안 유래 요인에 대한 문헌고찰. Journal of Korean Academy of Oral Health, 39(4), 229-236.
황혜림, 이수영, 조영식 (2010). 일부 대학생의 치과불안과 치과의료이용 형태. 치위생과학회지, 10(5), 357-363.
Aartman, I. H. (1998). Reliability and validity of the short version of the Dental Anxiety Inventory. Community Dentistry and Oral Epidemiology, 26(5), 350-354.
Al Absi, M., & Rokke, P. D. (1991). Can anxiety help us tolerate pain? Pain, 46(1), 43-51.
Alshoraim, M. A., El-Housseiny, A. A., Farsi, N. M., Felemban, O. M., Alamoudi, N. M., & Alandejani, A. A. (2018). Effects of child characteristics and dental history on dental fear: Cross-sectional study. BMC Oral Health, 18, 1–9.
American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition: Washington D. C:American Psychiatric Publishing.
Appukuttan, D. P. (2016). Strategies to manage patients with dental anxiety and dental phobia:literature review. Clinical, Cosmetic and Investigational Dentistry, 8, 35-50.
Armfield, J. M. (2006). Cognitive vulnerability: a model of the etiology of fear. Clinical Psychology Review, 26(6), 746-768.
Armfield, J. M. (2010a). Development and psychometric evaluation of the Index of Dental Anxiety and Fear (IDAF-4C+). Psychological Assessment, 22(2), 279-287.
Armfield, J. M. (2010b). How do we measure dental fear and what are we measuring anyway? Oral Health and Preventive Dentistry, 8(2), 107-115.
Armfield, J. M., & Heaton, L. (2013). Management of fear and anxiety in the dental clinic: a review. Australian Dental Journal, 58(4), 390-407.
Armfield, J. M., & Ketting, M. (2015). Predictors of dental avoidance among Australian adults with different levels of dental anxiety. Health Psychology, 34(9), 929-940.
Armfield, J. M., Slade, G. D., & Spencer, A. J. (2008). Cognitive vulnerability and dental fear. BMC Oral Health, 8(1), https://doi.org/10.1186/1472-6831-8-2.
Armfield, J. M., Stewart, J. F., & Spencer, A. J. (2007). The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health, 7(1), https://doi.org/10.1186/1472-6831-7-1.
Baard, P. P., Deci, E. L., & Ryan, R. M. (2004). Intrinsic need satisfaction: a motivational basis of performance and weil‐being in two work settings 1. Journal of Applied Social Psychology, 34(10), 2045-2068.
Baus, O., & Bouchard, S. (2014). Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: a review. Frontiers in Human Neuroscience, 8, 112.
Bergdahl, M., & Bergdahl, J. (2003). Temperament and character personality dimensions in patients with dental anxiety. European Journal of Oral Sciences, 111(2), 93-98.
Berggren, U., & Linde, A. (1984). Dental fear and avoidance: a comparison of two modes of treatment. Journal of Dental Research, 63(10), 1223-1227.
Bessell, A., Clarke, A., Harcourt, D., Moss, T. P., &Rumsey, N. (2010). Incorporating user perspectives in the design of an online intervention tool for people with visible differences: Face IT. Behavioural and Cognitive Psychotherapy, 38(5), 577-596.
Boka, V., Arapostathis, K., Kotsanos, N., Karagiannis, V., van Loveren, C., & Veerkamp, J. (2016). Relationship between child and parental dental anxiety with child's psychological functioning and behavior during the administration of local anesthesia. Journal of Clinical Pediatric Dentistry, 40(6), 431-437.
Boyle, C. A., Newton, T., & Milgrom, P. (2010). Development of a UK version of CARL: a computer program for conducting exposure therapy for the treatment of dental injection fear. SAAD Dig, 26(8), 11.
Bradt, J., & Teague, A. (2018). Music interventions for dental anxiety. Oral Diseases, 24(3), 300-306.
Burghardt, S., Koranyi, S., Magnucki, G., Strauss, B., & Rosendahl, J. (2018). Non-pharmacological interventions for reducing mental distress in patients undergoing dental procedures: Systematic review and meta-analysis. Journal of Dentistry, 69, 22-31.
Buunk-Werkhoven, Y. A., Dijkstra, A., & van der Schans, C. P. (2009). Oral health-quality of life predictors depend on population. Applied Research in Quality of Life, 4(3), https://doi. org/10.1007/s11482-009-9081-y.
Buunk‐Werkhoven, Y. A., Dijkstra, A., Schaub, R. M., Van Der Schans, C. P., & Spreen, M. (2010). Oral health related quality of life among imprisoned Dutch forensic psychiatric patients. Journal of Forensic Nursing, 6(3), 137-143.
Cademartori, M. G., Rosa, D. P. D., Brancher, L. C., Costa, V. P. P., & Goettems, M. L. (2020). Association of Dental Anxiety with Psychosocial Characteristics among Children Aged 7-13 Years. Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 20, https://doi.org/10.1590/pboci.2020.028.
Carlsen, A., Humphris, G. M., Lee, G. T., & Birch, R. H. (1993). The effect of pre-treatment enquiries on child dental patient's post-treatment ratings of pain and anxiety. Psychology and Health, 8(2-3), 165-174.
Carlsson, S. G., & Jern, S. (1982). Paradigms in psychosomatic research: A dialectic perspective. Scandinavian Journal of Psychology, 23, 151-157.
Carlsson, V., Hakeberg, M., & Boman, U. W. (2015). Associations between dental anxiety, sense of coherence, oral health-related quality of life and health behaviour–a national Swedish cross-sectional survey. BMC Oral Health, 15(1), https://doi.org/10.1186/s12903-015-0088-5.
Choi, J. S., & Kim, K. K. (2006). Relationships between dental fear and dental services utilization with respect to oral health promotion. Korean Journal of Health Education and Promotion, 23(4), 47-65.
Choi, S., Kim, J., Song, K., & Lee, S. (2004). Analysis of the related factors of dental fear among teenagers in private dental clinics. Journal of Korean Academy of Dental Health, 28(4), 495-503.
Cianetti, S., Lombardo, G., Lupatelli, E., Pagano, S., Abraha, I., Montedori, A., . . . Salvato, R. (2017). Dental fear/anxiety among children and adolescents. A systematic review. European Journal of Paediatric Dentistry, 18(2), 121-130.
Cohen, L. A., Snyder, T. L., & LaBelle, A. D. (1982). Correlates of dental anxiety in a university population. Journal of Public Health Dentistry, 42(3), 228-235.
Cohen, S., Fiske, J., & Newton, J. (2000). The impact of dental anxiety on daily living. British Dental Journal, 189(7), 385-390.
Colares, V., Franca, C., Ferreira, A., Amorim Filho, H., & Oliveira, M. (2013). Dental anxiety and dental pain in 5-to 12-year-old children in Recife, Brazil. European Archives of Paediatric Dentistry, 14(1), 15-19.
Corah, N. (1988). Dental anxiety. Assessment, reduction and increasing patient satisfaction. Dental Clinics of North America, 32(4), 779-790.
Corah, N. L. (1969). Development of a dental anxiety scale. Journal of Dental Research, 48(4), 596-596.
Coxon, J. D., Hosey, M.-T., & Newton, J. T. (2019). The oral health of dentally anxious five-and eight-year-olds: a secondary analysis of the 2013child dental health survey. British Dental Journal, 226(7), 503-507.
Dagnan, D., & Jahoda, A. (2006). Cognitive–behavioural intervention for people with intellectual disability and anxiety disorders. Journal of Applied Research in Intellectual Disabilities, 19(1), 91-97.
Dahlander, A., Soares, F., Grindefjord, M., & Dahllöf, G. (2019). Factors associated with dental fear and anxiety in children aged 7 to 9 years. Dentistry Journal, 7(3), 68-76.
Dailey, Y., Humphris, G., & Lennon, M. (2001). The use of dental anxiety questionnaires: a survey of a group of UK dental practitioners. British Dental Journal, 190(8), 450-453.
De Jongh, A., Aartman, I., & Brand, N. (2003). Trauma‐related phenomena in anxious dental patients. Community Dentistry and Oral Epidemiology, 31(1), 52-58.
De Jongh, A., Adair, P., & Meijerink‐Anderson, M. (2005). Clinical management of dental anxiety:what works for whom? International Dental Journal, 55(2), 73-80.
De Jongh, A., Schutjes, M., & Aartman, I. H. (2011). A test of Berggren’s model of dental fear and anxiety. European Journal of Oral Sciences, 119(5), 361-365.
De Jongh, A., Van den Oord, H., & Ten Broeke, E. (2002). Efficacy of eye movement desensitization and reprocessing in the treatment of specific phobias: Four single‐case studies on dental phobia. Journal of Clinical Psychology, 58(12), 1489-1503.
Deacon, B. J., & Abramowitz, J. S. (2004). Cognitive and behavioral treatments for anxiety disorders:A review of meta‐analytic findings. Journal of Clinical Psychology, 60(4), 429-441.
Dobros, K., Hajto-Bryk, J., Wnek, A., Zarzecka, J., &Rzepka, D. (2014). The level of dental anxiety and dental status in adult patients. Journal of International Oral Health, 6(3), 11-14.
Dumitrache, M. A., Neacsu, V., & Sfeatcu, I. R. (2014). Efficiency of cognitive technique in reducing dental anxiety. Procedia-Social and Behavioral Sciences, 149, 302-306.
Economou, G. C. (2003). Dental anxiety and personality: investigating the relationship between dental anxiety and self-consciousness. Journal of Dental Education, 67(9), 970-980.
Eitner, S., Wichmann, M., Paulsen, A., & Holst, S. (2006). Dental anxiety–an epidemiological study on its clinical correlation and effects on oral health. Journal of Oral Rehabilitation, 33(8), 588-593.
Farhat-McHayleh, N., Harfouche, A., & Souaid, P. (2009). Techniques for managing behaviour in pediatric dentistry: comparative study of live modelling and tell-show-do based on children's heart rates during treatment. Journal of the Canadian Dental Association, 75(4), 283a-283g.
Farholm, A., Halvari, H., Niemiec, C. P., Williams, G. C., & Deci, E. L. (2017). Changes in return to work among patients in vocational rehabilitation:a self-determination theory perspective. Disability and Rehabilitation, 39(20), 2039-2046.
Felemban, O. M., Alshoraim, M. A., El-Housseiny, A. A., & Farsi, N. M. (2019). Effects of familial characteristics on dental fear: A cross-sectional study. The Journal of Contemporary Dental Practice, 20(5), 609-615.
Firat, D., Tunc, E., & Sar, V. (2006). Dental anxiety among adults in Turkey. Journal Contemporary Dental Practice, 7(3), 75-82.
Flammer, E., & Bongartz, W. (2003). On the efficacy of hypnosis: a meta‐analytic study. Contemporary Hypnosis, 20(4), 179-197.
Garcia-Palacios, A., Hoffman, H. G., Kwong See, S., Tsai, A., & Botella, C. (2001). Redefining therapeutic success with virtual reality exposure therapy. Cyber Psychology and Behavior, 4(3), 341-348.
Getka, E. J., & Glass, C. R. (1992). Behavioral and cognitive-behavioral approaches to the reduction of dental anxiety. Behavior Therapy, 23(3), 433-448.
Gisler, V., Bassetti, R., Mericske‐Stern, R., Bayer, S., & Enkling, N. (2012). A cross‐sectional analysis of the prevalence of dental anxiety and its relation to the oral health‐related quality of life in patients with dental treatment needs at a university clinic in Switzerland. Gerodontology, 29(2), e290-e296.
Glaesmer, H., Geupel, H., & Haak, R. (2015). A controlled trial on the effect of hypnosis on dental anxiety in tooth removal patients. Patient Education and Counseling, 98(9), 1112-1115.
Gordon, D., Heimberg, R. G., Tellez, M., & Ismail, A. I. (2013). A critical review of approaches to the treatment of dental anxiety in adults. Journal of Anxiety Disorders, 27(4), 365-378.
Goyal, A., Sharma, A., Gaur, T., Singh, J., Pachori, Y., Chhabra, K. G., & Chhabra, C. (2014). Impact of dental fear on oral health-related quality of life among school going and non-school going children in Udaipur city: A cross-sectional study. Contemporary Clinical Dentistry, 5(1), 42-48.
Grös, D. F., & Antony, M. M. (2006). The assessment and treatment of specific phobias: a review. Current Psychiatry Reports, 8(4), 298-303.
Gujjar, K. R., & de Jongh, A. (2019). Is virtual reality exposure therapy the future treatment for anxious dental patients? CDA Journal, 47(8), 513-519.
Gujjar, K. R., Sharma, R., & Jongh, A. D. (2017). Virtual reality exposure therapy for treatment of dental phobia. Dental Update, 44(5), 423-435.
Gujjar, K. R., van Wijk, A., Sharma, R., & de Jongh, A. (2018). Virtual reality exposure therapy for the treatment of dental phobia: A controlled feasibility study. Behavioural and Cognitive Psychotherapy, 46(3), 367-373.
Hägglin, C., Berggren, U., Hakeberg, M., Hallstrom, T., & Bengtsson, C. (1999). Variations in dental anxiety among middle-aged and elderly women in Sweden: a longitudinal study between 1968and 1996. Journal of Dental Research, 78(10), 1655-1661.
Hakeberg, M., Berggren, U., & Carlsson, S. G. (1992). Prevalence of dental anxiety in an adult population in a major urban area in Sweden. Community Dentistry and Oral Epidemiology, 20(2), 97-101.
Halvari, A. E. M., Halvari, H., & Deci, E. L. (2019). Dental anxiety, oral health‐related quality of life, and general well‐being: A self‐determination theory perspective. Journal of Applied Social Psychology, 49(5), 295-306.
Hamasha, A. A. H., Aldosari, R. B., Osamie, Z. M., Aldosari, M. M., Fakih, A. H., & Alonazi, A. M. (2020). Prevalence of dental fear among male students studying in National Guard schools in Riyadh: A cross-sectional study. Saudi Journal of Oral Sciences, 7(1), 24-28.
Heaton, L., Leroux, B., Ruff, P., & Coldwell, S. (2013). Computerized dental injection fear treatment: a randomized clinical trial. Journal of Dental Research, 92(7_suppl), S37-S42.
Hilbert, K., Evens, R., Maslowski, N. I., Wittchen, H.-U., & Lueken, U. (2014). Fear processing in dental phobia during crossmodal symptom provocation: an fMRI study. BioMed Research International, 2014, https://doi.org/10.1155/2014/196353.
Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. The Journal of Clinical Psychiatry, 69(4), 621-632.
Humphris, G., Freeman, R., Campbell, J., Tuutti, H., & D'souza, V. (2000). Further evidence for the reliability and validity of the Modified Dental Anxiety Scale. International Dental Journal, 50(6), 367-370.
Humphris, G. M., Dyer, T. A., & Robinson, P. G. (2009). The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age. BMC Oral Health, 9(1), https://doi.org/10.1186/1472-6831-9-20.
Humphris, G. M., Morrison, T., & Lindsay, S. (1995). The Modified Dental Anxiety Scale: validation and United Kingdom norms. Community Dental Health, 12(3), 143-150.
Jain, A., Suprabha, B. S., Shenoy, R., & Rao, A. (2019). Association of temperament with dental anxiety and behaviour of the preschool child during the initial dental visit. European Journal of Oral Sciences, 127(2), 147-155.
John, M., Hujoel, P., Miglioretti, D. L., LeResche, L., Koepsell, T., & Micheelis, W. (2004). Dimensions of oral-health-related quality of life. Journal of Dental Research, 83(12), 956-960.
Karibe, H., Koeda, M., Aoyagi-Naka, K., Kato, Y., Tateno, A., Suzuki, H., & Okubo, Y. (2019). Differences in the perception of dental sounds: a preliminary study. Patient Preference and Adherence, 13, 1051-1056.
Kleinknecht, R. A., Klepac, R. K., & Alexander, L. D. (1973). Origins and characteristics of fear of dentistry. The Journal of the American Dental Association, 86(4), 842-848.
Kleinknecht, R. A., Thorndike, R. M., McGlynn, F. D., & Harkavy, J. (1984). Factor analysis of the dental fear survey with cross-validation. Journal of the American Dental Association, 108(1), 59-61.
Klingberg, G., & Broberg, A. G. (2007). Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. International Journal of Paediatric Dentistry, 17(6), 391-406.
Kumar, S., Bhargav, P., Patel, A., Bhati, M., Balasubramanyam, G., Duraiswamy, P., &Kulkarni, S. (2009). Does dental anxiety influence oral health-related quality of life? Observations from a cross-sectional study among adults in Udaipur district, India. Journal of Oral Science, 51(2), 245-254.
Kvale, G., Berggren, U., & Milgrom, P. (2004). Dental fear in adults: a meta‐analysis of behavioral interventions. Community Dentistry and Oral Epidemiology, 32(4), 250-264.
Lahmann, C., Schoen, R., Henningsen, P., Ronel, J., Muehlbacher, M., Loew, T., . . . Doering, S. (2008). Brief relaxation versus music distraction in the treatment of dental anxiety: a randomized controlled clinical trial. The Journal of the American Dental Association, 139(3), 317-324.
Leutgeb, V., Schäfer, A., & Schienle, A. (2011). Late cortical positivity and cardiac responsitivity in female dental phobics when exposed to phobia-relevant pictures. International Journal of Psychophysiology, 79(3), 410-416.
Litt, M. D. (1996). A model of pain and anxiety associated with acute stressors: distress in dental procedures. Behaviour Research and Therapy, 34(5-6), 459-476.
Locker, D. (2003). Psychosocial consequences of dental fear and anxiety. Community Dentistry and Oral Epidemiology, 31(2), 144-151.
Locker, D., Liddell, A., Dempster, L., & Shapiro, D. (1999). Age of onset of dental anxiety. Journal of Dental Research, 78(3), 790-796.
Maples-Keller, J. L., Yasinski, C., Manjin, N., &Rothbaum, B. O. (2017). Virtual reality-enhanced extinction of phobias and post-traumatic stress. Neurotherapeutics, 14(3), 554-563.
Marci, C. D., Ham, J., Moran, E., & Orr, S. P. (2007). Physiologic correlates of perceived therapist empathy and social-emotional process during psychotherapy. The Journal of Nervous and Mental Disease, 195(2), 103-111.
McGrath, C., & Bedi, R. (2004). The association between dental anxiety and oral health‐related quality of life in Britain. Community Dentistry and Oral Epidemiology, 32(1), 67-72.
Mehrstedt, M., John, M. T., Tönnies, S., & Micheelis, W. (2007). Oral health‐related quality of life in patients with dental anxiety. Community Dentistry and Oral Epidemiology, 35(5), 357-363.
Milgrom, P., & Weinstein, P. (1993). Dental fears in general practice: new guidelines for assessment and treatment. International Dental Journal, 43(3Suppl 1), 288-293.
Milgrom P, Weinstein P, Heaton LJ. (2009). Treating fearful dental patients: A patient management handbook. Seattle: Dental Behavioral Resources.
Moore, R., Abrahamsen, R., & Brodsgaard, I. (1996). Hypnosis compared with group therapy and individual desensitization for dental anxiety. European Journal of Oral Sciences, 104(5‐6), 612-618.
Moore, R., & Brødsgaard, I. (2001). Dentists’perceived stress and its relation to perceptions about anxious patients. Community Dentistry and Oral Epidemiology, 29(1), 73-80.
Moore, R., Brødsgaard, I., & Birn, H. (1991). Manifestations, acquisition and diagnostic categories of dental fear in a self-referred population. Behaviour Research and Therapy, 29(1), 51-60.
O’Shea, R. M., Corah, N. L., & Ayer, W. A. (1986). Why patients change dentists: practitioners’views. The Journal of the American Dental Association, 112(6), 851-854.
Oosterink, F., De Jongh, A., & Aartman, I. (2009). Negative events and their potential risk of precipitating pathological forms of dental anxiety. Journal of Anxiety Disorders, 23(4), 451-457.
Opriş, D., Pintea, S., García‐Palacios, A., Botella, C., Szamosközi, Ş., & David, D. (2012). Virtual reality exposure therapy in anxiety disorders: a quantitative meta‐analysis. Depression and Anxiety, 29(2), 85-93.
Ozlek, E., Yıldırım, A., Koc, A., & Boysan, M. (2019). Socio-demographic determinants of dental anxiety and fear among college students. Eastern Journal of Medicine, 24(2), 169-175.
Parsons, T. D., & Rizzo, A. A. (2008). Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: A meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 39(3), 250-261.
Pezzini Soares, J., Cardoso, M., & Bolan, M. (2019). Demystifying behaviour and dental anxiety in schoolchildren during endodontic treatment for primary teeth—controlled clinical trial. International Journal of Paediatric Dentistry, 29(3), 249-256.
Robertson, M., Araujo, M., & Innes, N. (2019). Anxiety and fear management in paediatric dentistry using distraction techniques. Evidence-Based Dentistry, 20(2), 50-51.
Ryan, R. M., & Deci, E. L. (2000). Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary Educational Psychology, 25(1), 54-67.
Salem, K., Kousha, M., Anissian, A., & Shahabi, A. (2012). Dental fear and concomitant factors in 3-6 year-old children. Journal of Dental Research, Dental Clinics, Dental Prospects, 6(2), 70-74.
Scheier, M. F., & Carver, C. S. (1985). The Self-Consciousness Scale: A revised version for use with general populations 1. Journal of Applied Social Psychology, 15(8), 687-699.
Schuller, A. A., Willumsen, T., & Holst, D. (2003). Are there differences in oral health and oral health behavior between individuals with high and low dental fear? Community Dentistry and Oral Epidemiology, 31(2), 116-121.
Shim, Y.-S., Kim, A.-H., Jeon, E.-Y., & An, S.-Y. (2015). Dental fear & anxiety and dental pain in children and adolescents; a systemic review. Journal of Dental Anesthesia and Pain Medicine, 15(2), 53-61.
Sinha, E., Rekha, R., & Nagashree, S. R. (2019). Anxiety of dental treatment among patients visiting primary health centers. Journal of Indian Association of Public Health Dentistry, 17(3), 235-245.
Soares, F. C., Lima, R. A., de Barros, M. V., Dahllöf, G., & Colares, V. (2017). Development of dental anxiety in schoolchildren: A 2‐year prospective study. Community Dentistry and Oral Epidemiology, 45(3), 281-288.
Soares, F. C., Lima, R. A., Santos, C. d. F. B. F., De Barros, M. V. G., & Colares, V. (2016). Predictors of dental anxiety in Brazilian 5–7 years old children. Comprehensive Psychiatry, 67, 46-53.
Sohn, W., & Ismail, A. I. (2005). Regular dental visits and dental anxiety in an adult dentate population. The Journal of the American Dental Association, 136(1), 58-66.
Stouthard, M. E., & Hoogstraten, J. (1990). Prevalence of dental anxiety in the Netherlands. Community Dentistry and Oral Epidemiology, 18(3), 139-142.
Stouthard, M. E., Hoogstraten, J., & Mellenbergh, G. J. (1995). A study on the convergent and discriminant validity of the Dental Anxiety Inventory. Behaviour Research and Therapy, 33(5), 589-595.
Stouthard, M. E., Mellenbergh, G. J., & Hoogstraten, J. (1993). Assessment of dental anxiety: a facet approach. Anxiety, Stress and Coping, 6(2), 89-105.
Tefikow, S., Barth, J., Maichrowitz, S., Beelmann, A., Strauss, B., & Rosendahl, J. (2013). Efficacy of hypnosis in adults undergoing surgery or medical procedures: a meta-analysis of randomized controlled trials. Clinical Psychology Review, 33(5), 623-636.
Tellez, M., Kinner, D. G., Heimberg, R. G., Lim, S., & Ismail, A. I. (2015). Prevalence and correlates of dental anxiety in patients seeking dental care. Community Dentistry and Oral Epidemiology, 43(2), 135-142.
Tellez, M., Potter, C., Kinner, D., Jensen, D., Waldron, E., Heimberg, R., . . . Ismail, A. (2015). Computerized tool to manage dental anxiety: a randomized clinical trial. Journal of Dental Research, 94(9_suppl), 174S-180S.
Thomson, W. M., Locker, D., & Poulton, R. (2000). Incidence of dental anxiety in young adults in relation to dental treatment experience. Community Dentistry and Oral Epidemiology, 28(4), 289-294.
Tunc, E. P., Firat, D., Onur, O. D., & Sar, V. (2005). Reliability and validity of the Modified Dental Anxiety Scale (MDAS) in a Turkish population. Community Dentistry and Oral Epidemiology, 33(5), 357-362.
Unell, L., Söderfeldt, B., Halling, A., & Birkhed, D. (1999). Explanatory models for clinically determined and symptom-reported caries indicators in an adult population. Acta Odontologica Scandinavica, 57(3), 132-138.
Vainionpää, R., Pesonen, P., Laitala, M. L., Pohjola, V., & Anttonen, V. (2019). Dental fear and dental health and attendance among Finnish male prisoners. Journal of Oral and Maxillofacial Research, 10(4), e4.
Van Houtem, C., Aartman, I., Boomsma, D., Ligthart, L., Visscher, C., & De Jongh, A. (2014). Is dental phobia a blood‐injection‐injury phobia? Depression and Anxiety, 31(12), 1026-1034.
Van Wijk, A., & Hoogstraten, J. (2003). The Fear of Dental Pain questionnaire: construction and validity. European Journal of Oral Sciences, 111(1), 12-18.
Van Wijk, A., & Hoogstraten, J. (2005). Experience with dental pain and fear of dental pain. Journal of Dental Research, 84(10), 947-950.
Vermaire, J., De Jongh, A., & Aartman, I. H. (2008). Dental anxiety and quality of life: the effect of dental treatment. Community Dentistry and Oral Epidemiology, 36(5), 409-416.
Weisenberg, M., Aviram, O., Wolf, Y., & Raphaeli, N. (1984). Relevant and irrelevant anxiety in the reaction to pain. Pain, 20(4), 371-383.
Wide Boman, U., Carlsson, V., Westin, M., &Hakeberg, M. (2013). Psychological treatment of dental anxiety among adults: a systematic review. European Journal of Oral Sciences, 121(3pt2), 225-234.
Wolpe, J. (1954). Reciprocal inhibition as the main basis of psychotherapeutic effects. AMA Archives of Neurology and Psychiatry, 72(2), 205-226.