A2 Refereed review article in a scientific journal
Dental Anxiety as a Potential Bottleneck in Oral-Systemic Health Pathways: A Conceptual Mapping Review of Review Articles
Authors: Kajita, Mika; Pohjola, Vesa; Humphris, Gerald; Lahti, Satu
Publisher: MDPI AG
Publication year: 2026
Journal: Dentistry Journal
Article number: 227
Volume: 14
Issue: 4
eISSN: 2304-6767
DOI: https://doi.org/10.3390/dj14040227
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Open Access publication channel
Web address : https://doi.org/10.3390/dj14040227
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/523193144
Self-archived copy's licence: CC BY
Self-archived copy's version: Publisher`s PDF
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.
Downloadable publication This is an electronic reprint of the original article. |
Funding information in the publication:
Mika Kajita’s (M.K.) contribution to this manuscript was co-funded by the European Union’s Horizon Europe Framework Programme for Research and Innovation 2021–2027 under the Marie Skłodowska-Curie grant agreement no. 101126611, as part of the SYS-LIFE postdoctoral programme.