**2.1. Dental anxiety pathway**

Five theories are thought to better explain the pathways of dental anxiety: *Pavlovian cognitive conditioning, informative pathway, vicarious conditioning, verbal transmission/threat, and parental pathway* [24].

*Pavlovian cognitive conditioning* is the most commonly utilized pathway of dental fear and anxiety used by the patients, whereby past painful dental experience may negatively impact an individuals' future dental attendance.

*Informative pathway* is an indirect pathway to phobia that involves learning about fearful dental events as told by other individuals.

*Vicarious conditioning* is another indirect pathway, whereby individuals may acquire dental phobia by learning indirectly through observing the responses of others attending a dentist.

In *Verbal transmission/threat*, there is no direct observation of traumatic/fearful event, but through hearing or reading about dangerous or threatening information about a stimulus irrespective of an actual presence of the threating stimulus. In this pathway, dental visit is used as a disciplinary measure for misbehaving.

*Parental pathway* refers to a situation where a fearful behavior displayed by a parent becomes a pathway of acquiring dental anxiety by a child. A stronger relationship is observed when it is the mother who expresses intensified fearful behavior.
