*1.3.4. Cultural issues*

reaction to an unknown danger, and *dental phobia* is basically the same as fear, only much stronger, whereby the "fight-or-flight" response occurs when just thinking about or being reminded

Dental anxiety is extremely common, and most people experience some degree of the anxiety especially if they are about to have a certain dental procedure done which they have never experienced before. Moreover, someone with a dental phobia will avoid dental care at all costs until either a physical problem or the psychological burden of the phobia becomes overwhelming. In

Dental anxiety is reported to be a global public health concern due to its effects on individual's oral health and quality of life. The prevalence of the condition in children ranges from 5 to 61% [2, 3] and in adults from 1 to 52% [4–12], inclusive of participants with both moderate and

A majority of studies done reveal that females of all age groups, younger age and people who are classified to have low level of education are at more risk of having dental anxiety [2, 11]. The main reasons cited for the observed differences are more linked to environmental factors rather than biological makeup among children. However, Folayan and coworkers [13] revealed no differences in the prevalence of dental anxiety with sociodemography in children, while

Individuals with poor oral health status are reported to perceive dental anxiety than their counter parts with good oral health status. Clinically, these patients are observed to have high number of decayed and missing teeth and less restored teeth [14–16]. DeDonno [17] revealed an association between participants' dental anxiety and oral hygiene, whereby individuals with dental anxiety were seen to have poor oral hygiene. Furthermore, patients who are den-

Population studies show that individuals with dental anxiety have difficulties to attend to a dentist [19]. Dental anxiety has also been reported to impact on individuals' daily living including modification of eating habits, such as avoidance of hard to chew and foods that cause sensitivity. Further to this, individuals with dental anxiety are reported to have a high

Minja et al. [11] showed no sex difference in their study among adults.

tally anxious are usually least satisfied with the appearance of their teeth [18].

tendency to self-medication so as to avoid visiting a dentist [20].

of the threatening situation [1].

36 Anxiety Disorders - From Childhood to Adulthood

**1.2. Prevalence of dental anxiety**

high dental anxiety.

*1.3.1. Sociodemographics*

*1.3.2. Oral health status*

*1.3.3. Oral health-related behaviors*

this chapter, the term dental anxiety is employed.

**1.3. Factors associated with dental anxiety**

The role of culture and norms in modifying individual's perception of dental fear and anxiety is also of prime importance when explaining these phenomena. Culture has been reported to have influence on perceiving dental anxiety [21]. Studies have shown that dental anxiety expression significantly varied according to ethnicity as well as religion due to the engraved dental anxiety coping mechanisms and expression among different cultures [22]. Generally, it has been reported that societies with cultures that emphasize on greater self-control, emotional restraint, and compliance to social rule (such as some Asian and African countries) were more likely to score higher in their fears/anxiety [23].
