A comprehensive approach to reducing dental anxiety in children: collaboration between the dentist, parents, and psychologist
https://doi.org/10.36377/ET-0196
Abstract
Dental anxiety in children remains one of the main barriers to preventive dental care and successful treatment. Although behavioral management techniques are widely used in pediatric dentistry, their application is often unsystematic and rarely incorporates the potential of the educational environment. This review summarizes current national and international studies addressing the factors involved in the development of dental anxiety in children and approaches to its prevention. Dental anxiety is shown to be influenced by individual psychological characteristics, family-related factors, and social context. Particular attention is given to the role of mental health professionals. While the involvement of medical psychologists in dental settings is limited by organizational constraints, school psychologists have significant potential for early identification of anxiety-related risks and the development of emotional self-regulation skills. The integration of school psychologists into interdisciplinary preventive models may improve the effectiveness of pediatric dental care.
About the Authors
I. A. NikolskayaRussian Federation
Irina A. Nikolskaya – Cand. Sci. (Med.), Professor of the Department of Therapeutic Dentistry, Institute of Dentistry
1 Ostrovityanova Str., Moscow 117997, Russian Federation
Competing Interests:
The authors declare no conflict of interests.
I. D. Kondratenko
Russian Federation
Irina D. Kondratenko – Pediatric Dentist, Assistant of the Department of Therapeutic Dentistry, Institute of Dentistry
1 Ostrovityanova Str., Moscow 117997, Russian Federation
Competing Interests:
The authors declare no conflict of interests.
E. N. Anisimova
Russian Federation
Evgenia N. Anisimova – Cand. Sci. (Med.), Associate Professor, Professor of the Department of Dentistry and Maxillofacial Surgery
11 Volokolamskoe Highway, Moscow 125080, Russian Federation
Competing Interests:
The authors declare no conflict of interests.
V. A. Katyukhina
Russian Federation
Valeria A. Katyukhina – Assistant of the Department of Therapeutic Dentistry at the Institute of Dentistry
1 Ostrovityanova Str., Moscow 117997, Russian Federation
Competing Interests:
The authors declare no conflict of interests.
I. S. Kopetskiy
Russian Federation
Igor S. Kopetskiy – Dr. Sci. (Med.), Professor, Head of the Department of Therapeutic Dentistry at the Institute of Dentistry
1 Ostrovityanova Str., Moscow 117997, Russian Federation
Competing Interests:
The authors declare no conflict of interests.
D. O. Svistunov
Russian Federation
Danila O. Svistunov – Student of the Institute of Dentistry
1 Ostrovityanova Str., Moscow 117997, Russian Federation
Competing Interests:
The authors declare no conflict of interests.
References
1. Grisolia B.M., dos Santos A.P.P., Dhyppolito I.M., Buchanan H., Hill K., Oliveira B.H. Prevalence of dental anxiety in children and adolescents globally: A systematic review with meta-analyses. Int J Paediatr Dent. 2021;31(2):168–183. https://doi.org/10.1111/ipd.12712
2. Cianetti S., Lombardo G., Lupatelli E., Pagano S., Abraha I., Montedori A. et al. Dental fear/anxiety among children and adolescents. A systematic review. Eur J Paediatr Dent. 2017;18(2):121–130. https://doi.org/10.23804/ejpd.2017.18.02.07
3. Klingberg G., Broberg A.G. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent. 2007;17(6):391–406. https://doi.org/10.1111/j.1365-263X.2007.00872.x
4. Sarapultseva M., Yarushina M., Kritsky I., Ibragimov R., Sarapultsev A. Prevalence of dental fear and anxiety among russian children of different ages: the cross-sectional study. Eur J Dent. 2020;14(4):621–625. https://doi.org/10.1055/s-0040-1714035
5. Clow J., Northstone K., Hardwick C., Dermont M., Dudding T. Are childhood oral health behaviours and experiences associated with dental anxiety in adolescence? Int J Paediatr Dent. 2023;33(4):372–381. https://doi.org/10.1111/ipd.13058
6. Wu L., Gao X. Children’s dental fear and anxiety: exploring family related factors. BMC Oral Health. 2018;18(1):100. https://doi.org/10.1186/s12903-018-0553-z
7. Coric A., Banozic A., Klaric M., Vukojevic K., Puljak L. Dental fear and anxiety in older children: an association with parental dental anxiety and effective pain coping strategies. J Pain Res. 2014;7:515–521. https://doi.org/10.2147/JPR.S67692
8. Henedy S.S., Khalil A.M., Mahmoud S.H., El-Habashy L.M. The effect of different parenting styles on the child behavior during the dental visit: observational longitudinal study. BMC Oral Health. 2025;25(1):342. https://doi.org/10.1186/s12903-025-05659-2
9. ten Berge M., Veerkamp J.S., Hoogstraten J., Prins P.J. Childhood dental fear in relation to parental child-rearing attitudes. Psychol Rep. 2003;92(1):43–50. https://doi.org/10.2466/pr0.2003.92.1.43
10. Vygotsky L.S. Developmental Psychology. Selected Works. Moscow: Yurait; 2024. 281 p. (In Russ.) Available at: https://urait.ru/bcode/538602 (accessed: 30.04.2026).
11. Dubrovina I.V. Psychological service in the education system as a phenomenon. Lomonosov Pedagogical Education Journal. 2024;22(4):9–28. (In Russ.) Available at: https://msupedj.ru/articles/article/11321/ (accessed: 30.04.2026).
12. Bochaver A.A., Akhmedjanov, D.R., Bayramyan R.M., Polivanova K.N. Parental stress scale: adaptation on the Russian-speaking sample of schoolchildren’s mothers. Social Psychology and Society. 2024;15(3):202–221. (In Russ.) https://doi.org/10.17759/sps.2024150312
13. Armfield J.M., Heaton L.J. Management of fear and anxiety in the dental clinic: a review. Aust Dent J. 2013;58(4):390–407. https://doi.org/10.1111/adj.12118
14. Morgan A.G., Rodd H.D., Porritt J.M., Baker S.R., Creswell C., Newton T. et al. Children’s experiences of dental anxiety. Int J Paediatr Dent. 2017;27(2):87–97. https://doi.org/10.1111/ipd.12238
15. Modabber M., Campbell K.M., McMurtry C.M., Taddio A., Dempster L.J. Children’s perceptions of dental experiences and ways to improve them. Children. 2022;9(11):1657. https://doi.org/10.3390/children9111657
16. Cademartori M.G., Costa V.P.P., Corrêa M.B., Goettems M.L. The influence of clinical and psychosocial characteristics on children behaviour during sequential dental visits: a longitudinal prospective assessment. Eur Arch Paediatr Dent. 2020;21(1):43–52. https://doi.org/10.1007/s40368-019-00444-6
17. Prikhozhan A.M. Anxiety in children and adolescents: psychological nature and age dynamics. Moscow: Moscow Psychological and Social Institute; Voronezh: MODEK; 2000. 304 p. (In Russ.)
18. Aleksandrov Yu.I. (ed.) Psychophysiology. 3 rd ed. Saint Petersburg: Piter; 2007. 464 p. (In Russ.) Available at: https://djvu.online/file/6ITN5wEsxdiHl (accessed: 30.04.2026).
19. Themessl-Huber M., Freeman R., Humphris G., MacGillivray S., Terzi N. Empirical evidence of the relationship between parental and child dental fear: a structured review and meta-analysis. Int J Paediatr Dent. 2010;20(2):83–101. https://doi.org/10.1111/j.1365-263X.2009.00998.x
20. Šimunović L., Špiljak B., Radulović M., Vlahovljak A., Ostojić M., Krlev J. et al. Relationship between children’s and parents’ dental anxiety: a cross-sectional study on the six European countries. Dent J. 2022;10(11):209. https://doi.org/10.3390/dj10110209
21. Versloot J., Veerkamp J.S., Hoogstraten J., Martens L.C. Children’s coping with pain during dental care. Community Dent Oral Epidemiol. 2004;32(6):456–461. https://doi.org/10.1111/j.1600-0528.2004.00187.x
22. Van Meurs P., Howard K.E., Versloot J., Veerkamp J.S., Freeman R. Child coping strategies, dental anxiety and dental treatment: the influence of age, gender and childhood caries prevalence. Eur J Paediatr Dent. 2005;6(4):173–178.
23. Suprabha B.S., Rao A., Choudhary S., Shenoy R. Child dental fear and behavior: the role of environmental factors in a hospital cohort. J Indian Soc Pedod Prev Dent. 2011;29(2):95–101. https://doi.org/10.4103/0970-4388.84679
24. Vinogradova A.V., Kolesnikova L.R., Vinokurova T.S. Evaluation of effectiveness of psychological training of children to dental intervention. Vestnik of the Smolensk State Medical Academy. 2018;17(3):103–107. (In Russ.)
25. Kobiyasova I.V. Psychology in dentistry: aspects correct communication with patients. Saratov Journal of Medical Scientific Research. 2011;7(1):297–300. (In Russ.) Available at: https://ssmj.ru/2011/1/297 (accessed: 30.04.2026).
26. Boyko V.V. Recognition and overcoming of fear at the dental appointment. Institut Stomatologii. 2003;(4):6–9. (In Russ.) Available at: https://instom.spb.ru/catalog/article/8476/ (accessed: 30.04.2026).
27. Kiseleva E.G. Formation of long-term relationships between dentists, children, and parents for the prevention and treatment of dental diseases [abstract dissertation Dr. Sci. (Med.)]. Moscow; 2006. 44 p. (In Russ.)
28. Nelson J.A., O’Brien M., Blankson A.N., Calkins S.D., Keane S.P. Family stress and parental responses to children’s negative emotions: tests of the spillover, crossover, and compensatory hypotheses. J Fam Psychol. 2009;23(5):671–679. https://doi.org/10.1037/a0015977
29. Soares F.C., Lima R.A., de Barros M.V.G., Dahllöf G., Colares V. Development of dental anxiety in schoolchildren: A 2-year prospective study. Community Dent Oral Epidemiol. 2017;45(3):281–288. https://doi.org/10.1111/cdoe.12290
30. Newton T., Asimakopoulou K., Daly B., Scambler S., Scott S. The management of dental anxiety: time for a sense of proportion? Br Dent J. 2012;213(6):271–274. https://doi.org/10.1038/sj.bdj.2012.830
31. Dogan M.C., Seydaoglu G., Uguz S., Inanc B.Y. The effect of age, gender and socio-economic factors on perceived dental anxiety determined by a modified scale in children. Oral Health Prev Dent. 2006;4(4):235–241. https://doi.org/10.3290/j.ohpd.a11638
32. Ogorodnikova A.V. The role of a psychologist working at school. Molodoy Uchenyi. 2022;(1):57–59. (In Russ.) Available at: https://moluch.ru/archive/396/87680 (accessed: 30.04.2026).
33. Darvish O.B. Developmental psychology. Moscow: Vlados-Press; 2003. 264 p. (In Russ.)
34. Eremeeva V.D., Khrizman T.P. Boys and girls are two different worlds: neuropsychologists for teachers, educators, parents, and school psychologists. Saint Petersburg: Tuskarora; 2000. 180 p. (In Russ.)
35. Shlegel Ju.V., Akimova S.E., Sarap L.R., Tupikova L.N. Psychology of the relationships in the dentist’s practice. Endodontics Today. 2013;11(2):27–30. (In Russ.) Available at: https://www.endodont.ru/jour/article/view/563 (accessed: 30.04.2026).
Review
For citations:
Nikolskaya I.A., Kondratenko I.D., Anisimova E.N., Katyukhina V.A., Kopetskiy I.S., Svistunov D.O. A comprehensive approach to reducing dental anxiety in children: collaboration between the dentist, parents, and psychologist. Endodontics Today. 2026;24(2):361-366. https://doi.org/10.36377/ET-0196

























