Level Of Dental Anxiety Research Articles

Exploring the Variations in the Use of Modified Dental Anxiety Scale (MDAS) in Literature: A Survey of Studies Published from 2014 to 2023.

Modified Dental Anxiety Scale (MDAS) is a frequently used psychometric tool to evaluate the dental anxiety level of dental patients or the general population. However, it was largely unclear if MDAS was consistently administered in the original format in the academic literature. This work aimed to survey the literature published in the last 10 years to reveal the current usage of MDAS. Web of Science and Scopus were queried to identify papers that mentioned the use of MDAS. Among a total of 260 analyzed papers, 101 papers included comprehensive information regarding both the questions posed and the response format employed. Two papers only used an explicitly renamed MDAS with modified contents. Among the 258 papers that used MDAS that were supposed to be standardized, many discrepancies from the original version were discovered. There were only 39 papers that strictly followed the recommended scoring scheme: if a participant had a score of ≥ 19, he or she might be highly dentally anxious. Notable modifications included the use of a cut-off score different from the original recommendation, the use of multiple cut-off scores, modifications of the response format or descriptors, and modifications to the question items especially adding extra questions. These modifications would create confusion when researchers and clinicians tried to compare data across studies. Researchers are recommended to administer MDAS in its original format.

Glass ionomer fissure sealants versus fluoride varnish application on children's behaviour: a randomised controlled trial.

Glass ionomer fissure sealant (GIS) and fluoride varnish (NaFV) are two preventive interventions applicable to pre-school children. However, their application effects on young children's behaviour are understudied. The study compared the effects of GIS and NaFV applications on dental anxiety (DA), cooperativeness and pain level in pre-school children when applied to primary second molars in outreach settings. Four hundred and thirteen children were recruited for the study, out of which 228 were allocated to NaFV group whilstand 185 allocated to the GIS group. One calibrated examiner screened and randomly allocated the children into either group. Another calibrated examiner recorded the children's DA level and cooperativeness with Frankl Behaviour Rating Scale (FBRS) and Venham Behaviour Rating Scale (VBRS) throughout the treatment period. Subjects self-reported their pain levels using Wong-Baker Faces Scale (WBFS). Significant difference in postoperative anxiety was found using VBRS, with children in NaFV group having more positive scores post-treatment (p = 0.016). Only the type of preventive interventions significantly affected postoperative DA and patient cooperation (p = 0.032), whereas no other clinical findings and socio-demographic factors significantly influenced the children's behaviour postoperatively. NaFV application is associated with less DA and more cooperative behaviour in pre-school children compared to GIS application although similar pain levels were recorded.

Assessing Dental Anxiety Among Children In A Dental Clinic Waiting Room: An Observational Study

Background: Dental anxiety among children can significantly impact their overall oral health and well-being. This study aims to assess the levels of dental anxiety among children age 7 to 12 in a dental clinic waiting room using the Modified Dental Anxiety Scale (MDAS). The aims of this observational study were to evaluate the impact of the dental waiting room and previous dental visits on dental anxiety among children aged 7 to 12 who were waiting for their treatment. Materials & Methodology: A total of 234 children aged 7 to 12 years were included in the study, and their dental anxiety levels were assessed using the MDAS. The scale, comprising a questionnaire of five items related to dental anxiety, was administered to each participant in the dental clinic waiting room. Result : Results shows Females exhibited a significantly higher median MDAS score compared to males and the extraction of tooth Procedure had a significantly higher MDAS score than those receiving restoration or scaling. Conclusion: This observational study provides insights into the prevalence and factors associated with dental anxiety among children in a dental clinic waiting room. Understanding the levels of dental anxiety in this age group is crucial for developing targeted interventions and strategies to alleviate anxiety and promote positive dental experiences

Comparative evaluation of three different behavior management techniques among children aged 6-12 years in dental practice: A single-center, double-blind, randomized controlled trial.

Dental anxiety is characterized by distress in anticipation of dental visits, which may result in a child's refusal to undergo treatment and, ultimately, lead to parents' reluctance towards dental care. The aim of this study was to evaluate and compare the effectiveness of the tell-show-do technique, modeling technique and yogic relaxation technique in the reduction of dental anxiety among children aged 6-12 years. The study was an interventional, parallel-group, single-center, double-blind, randomized controlled trial conducted on 120 children who required restorative treatment without the use of local anesthesia. The participants were selected based on specific inclusion and exclusion criteria and were randomly divided into 3 groups: group 1 - tell-show-do technique; group 2 - modeling technique; group 3 - yogic relaxation technique. The dental anxiety levels were evaluated 4 times using both physiological (oxygen saturation and pulse rate) and behavioral parameters (facial image scale (FIS) and the Face, Legs, Activity, Cry, and Consolability scale (FLACC)). The data was assessed by 2 blinded and calibrated specialists. Statistically significant differences were observed in all 4 parameters among the 3 groups. During both the intraoperative and postoperative periods, the oxygen saturation levels were significantly higher in the yogic relaxation technique group. Moreover, the yogic relaxation technique group exhibited lower pulse rates, FIS and FLACC scores compared to the tell-show-do and modeling technique groups. The practice of yoga has a positive influence on the general health of the individual. Consequently, it can be considered one of the alternative behavioral modification techniques for the reduction of dental anxiety in children.

DENTAL ANXIETY LEVEL IN DENTAL STUDENTS AND STUDENTS FROM OTHER FACULTIES

Currently, dental anxiety affects up to 50% of the population and represents the emotional and physical response to an anticipated experience, which the individual perceives as threatening. Background: The objective of this study was to compare the level of dental anxiety in a group of students of Dental Medicine compared with a group of students from other faculties. Methods: The study was carried out over a period of 6 months, on 148 participants, who were divided into two study groups and assumed the completion of a questionnaire related to the state of anxiety they have in the dental office as a patient. Results: Of the students with a high level of anxiety, 68.75% are women and only 31.25% are men. The high level of anxiety is present only in 3.57% of the students of the faculty of dental medicine, these being female. For students of other faculties, the situation is significantly different: 15.21% have a high level of anxiety, 56.25% of them are women, and 31.25% are men. Conclusions: Anxiety towards dentistry considerably influences the dental treatment plan of patients with a high level of anxiety. Through the adequate management of anxious patients, the dentist manages to control their stress, thus obtaining the prerequisites for the success of the dental treatment.

Uncovering Oral Health Concerns: Exploring dental anxiety within Transgender community- A systematic review

Dental fear and anxiety (DFA) have substantial implications for oral health, often resulting in the avoidance of dental care and negative consequences. Despite facing unique health challenges and discrimination, there is a lack of research on the prevalence of DFA among transgender individuals. This paper seeks to synthesize evidence regarding the prevalence of DFA within this population. We searched multiple databases, including PubMed, Google Scholar, Cochrane Database, Web of Science, and LILACS, for studies published up to May 2024. We included observational studies, cross-sectional studies, surveys, and cohort studies that provided data on DFA prevalence among transgender individuals. Eligible studies were screened, and data extraction was performed according to predefined criteria. The risk of bias was evaluated using the ROBINS-E tool, while the level of evidence and quality were assessed following the Oxford Centre for Evidence-Based Medicine guidelines. Among the 20 studies assessed for eligibility, only 2 met the inclusion criteria and were thus included in the review. These studies reported varying prevalence rates of DFA among transgender individuals, with both exhibiting a moderate risk of bias. However, the quality of evidence was deemed low due to the limited number of studies and their observational nature. The available evidence indicates that transgender individuals experience notable levels of dental fear and anxiety, which contribute to disparities in accessing oral health care and achieving positive outcomes. This review underscores the imperative for further high-quality research to comprehensively understand and address the oral health needs of transgender individuals, ensuring equitable and effective dental care.

Uncovering Oral Health Concerns: Exploring Dental Anxiety within Transgender Community: A Systematic Review

Dental fear and anxiety (DFA) have substantial implications for oral health, often resulting in the avoidance of dental care and negative consequences. Despite facing unique health challenges and discrimination, there is a lack of research on the prevalence of DFA among transgender individuals. This paper seeks to synthesize evidence regarding the prevalence of DFA within this population. We searched multiple databases, including PubMed, Google Scholar, Cochrane Database, Web of Science, and LILACS, for studies published up to May 2024. We included observational studies, cross-sectional studies, surveys, and cohort studies that provided data on DFA prevalence among transgender individuals. Eligible studies were screened, and data extraction was performed according to predefined criteria. The risk of bias was evaluated using the ROBINS-E tool, while the level of evidence and quality were assessed following the Oxford Centre for Evidence-Based Medicine guidelines. Among the 20 studies assessed for eligibility, only 2 met the inclusion criteria and were thus included in the review. These studies reported varying prevalence rates of DFA among transgender individuals, with both exhibiting a moderate risk of bias. However, the quality of evidence was deemed low due to the limited number of studies and their observational nature. The available evidence indicates that transgender individuals experience notable levels of dental fear and anxiety, which contribute to disparities in accessing oral health care and achieving positive outcomes. This review underscores the imperative for further high-quality research to comprehensively understand and address the oral health needs of transgender individuals, ensuring equitable and effective dental care.

The Parental Concern and Acceptance of Silver Diamine Fluoride Treatment in Preschool Children: A Cross Sectional Study

Abstract Aim: Silver diamine fluoride (SDF) is a minimally invasive treatment with proven efficacy for managing early childhood caries. However, the dark staining associated with SDF treatment remains a major concern that affects parental acceptance. This study examines the level of parental acceptance of SDF treatment for preschool children in Laos and explores associated factors such as parental anxiety, previous dental experience, and demographic data. Materials and Methods: A cross-sectional survey was conducted with 324 parents of children aged 2–5 years enrolled in preschools in Vientiane Capital, Laos. Participants provided demographic information, details on their children’s dental history, and their own dental anxiety levels. Following a video demonstration of the effectiveness and application of SDF, parents completed a survey assessing their acceptance of and concerns about SDF using a 5-point Likert scale. Parental dental anxiety was measured with the modified dental anxiety scale. Data were analyzed using chi-square tests, independent t tests, and multiple logistic regression (P ≤ 0.05). Results: Eighty percent of the parents accepted SDF treatment for their children. Those highly concerned about SDF staining were significantly less likely to accept it as a treatment option (P < 0.01). Increased acceptance correlated with reduced concern about staining (95% confidence interval = 15.57–1095.88). Additionally, 84.9% of parents reported some level of dental anxiety, with older parents showing higher acceptance of SDF. Conclusions: Parents were highly receptive of the SDF treatment for their children’s primary dentition. Parents who were older tended to be less concerned about the staining, and those who had a high level of dental anxiety were more likely to accept SDF treatment.

The effect of dental treatment using conscious sedation therapy on patient satisfaction

Objectives: This study aimed to investigate the effects of conscious sedation on patient satisfaction with dental treatment. Methods: The survey included questions on the patients’ general characteristics, dental treatment fear, anxiety, and satisfaction, and patient evaluation by an observer. Statistical analyses were performed using SPSS 20.0 ver. and data were analyzed using frequency analysis, independent t-test, Pearson’s correlation coefficient, and multilinear regression analysis. Results: Patients who received conscious sedation therapy showed significantly lower levels of dental fear and anxiety, whereas their dental treatment satisfaction was significantly higher than that of patients who received regular dental treatment (p<0.05). Dental treatment fear, anxiety, satisfaction, and conscious sedation depth were significantly correlated in patients who received conscious sedation therapy (p<0.05). Factors influencing dental treatment satisfaction included age, weight, use of medication, smoking habits, use of conscious sedation therapy, dental treatment fear and anxiety, and conscious sedation depth (p<0.05). Conclusions: Conscious sedation therapy can be an effective method to reduce dental treatment fear and anxiety and improve patient satisfaction.

The level of dental fear and anxiety is higher in children with both severe Molar-Incisor Hypomineralisation and active dental caries lesions compared to children without these conditions

PurposeTo assess levels of dental fear and anxiety (DFA) in children with and without Molar-Incisor Hypomineralisation (MIH) and dental caries lesions.MethodsIn this cross-sectional observational study, 159 children between 8 and 12 years of age were included. For the evaluation of DFA, children responded to the validated version of the Children’s Fear Survey Schedule-Dental Subscale. MIH was assessed using the MIH Index. To evaluate the activity of dental caries lesions and dental caries experience, the Nyvad criterion and the dmft/DMFT index were used, respectively. Dental hypersensitivity was evaluated using air stimulation and a Visual Analogue Scale. The association between MIH and dental caries with DFA was assessed using the generalised linear model with Poisson family, identity link function and robust variance estimation. The significance level was set at 5%.ResultsThe mean DFA score was 28.3 (SD = 13.4) with scores ranging from 15 to 64. Amongst children presenting both MIH and dental caries, the perception of DFA was notably higher compared to those with either MIH or dental caries alone. The activity of caries lesion in patients with MIH also influenced DFA levels (diff: 18.6; 95% CI: 12.0–25.2; p < 0.001). Dental caries experience in the primary dentition also demonstrated statistical significance concerning DFA (95% CI: 0.8–13.3; p value = 0.027).ConclusionChildren with MIH exhibit higher levels of DFA than children without MIH. The experience of dental caries and the activity of caries lesions significantly influence the perception of DFA in children with MIH.

Evaluation of Dental Anxiety Levels on Oral and Dental Health Quality of Life in Patients with Hashimoto Thyroiditis

Aim: This study aimed to evaluate the effect of anxiety level, dental fear, anxiety on oral health quality of life oral, and dental health in Hashimoto's thyroiditis patients. Materials and Methods: Ninety adult individuals were included from Gaziantep University Faculty of Dentistry. All participants were asked about demographic parameters (age, gender), socio-economic status (education, marital status), and oral hygiene habits. The OHIP-14 and OHRQoL-UK questionnaires were used to asses the effect of individuals' oral health on their quality of life. Dental anxiety levels were evaluation with the Modified Dental Anxiety Scale (MDAS). Statistical analysis was performed using IBM SPSS Statistics 22.0. Result: There were no significant differences for Sociodemographic data, dental habits, age, marital status, educational status, smoking, frequency of brushing tooth, frequency of visiting the dental clinic in OHIP-14, OHRQoL, and MDAS survey scores (p &gt; 0.005). However, there was a statistically moderate positive correlation between the total OHIP-14 scores and the MDAS scores (r = 0.309; p &lt; 0.003). Additionally, a moderate negative correlation was showed between the total OHRQoL and the MDAS scale (r = 0.307; p &lt; 0.003). Conclusion: In conclusion, this study showed that patients' quality of life regarding oral and dental health was low, regardless of individual factors. It was found that dental anxiety was lower in patients with HT, and a significant correlation betwen the quality of life and anxiety level was observed.

Associations between Dental Anxiety Levels, Self-Reported Oral Health, Previous Unpleasant Dental Experiences, and Behavioural Reactions in Dental Settings: An Adult E-Survey.

Background and Objectives: The aim of this study was to investigate the prevalence of dental anxiety, its association with self-reported oral health, and sociodemographic factors in adults that are critical for improving oral health and well-being. Materials and Methods: An online survey was conducted via social media, with 1551 adults (76.5% women, 23.5% men) participating nationwide. Data collected included demographic data, Modified Dental Anxiety Scale (MDAS) scores, and associations between dental anxiety, negative experiences, and self-reported oral health. The analysis included psychophysiological, behavioural, and emotional responses and avoidance of dental visits, using descriptive and generalised linear regression models. Results: This study found that the mean score of the MDAS was 9.70 ± 5.11 out of 25, 19.1% of the participants reported no dental anxiety, and 7.8% suffered from dental phobia. Gender, age, and socioeconomic status had no significant effect on the prevalence of anxiety. Although more than half of the participants reported negative dental experiences, particularly in childhood, anxiety levels were unaffected. However, those who rated their oral health as excellent or very good had lower anxiety scores (p = 0.008, p = 0.024). Among the dental procedures, oral surgery (58.7%) and prosthetic (restorative) dental treatments (15.2%) caused the most anxiety. Avoidance behaviour correlated with increased anxiety (p ≤ 0.001), as did postponing dental visits until severe pain occurred (p = 0.011). Conclusions: These results emphasise the significant prevalence of dental anxiety in adults, particularly for surgical procedures and drilling, posing challenges in patient management. Tailored strategies are essential to reduce anxiety, improve patient well-being, and optimise dental service delivery and treatment efficacy.

Evaluation of The Role of Music and Bach Flower Remedies in The Management of Anxious Pediatric Dental Patients: A Randomised Clinical Trial

Objective: Dental fear and anxiety describe negative feelings towards the dental environment, particularly significant in pediatric dentistry due to their cognitive, behavioral, and physical impacts on children. Managing this anxiety through positive dentist-child relationships and behavioral guidance techniques is crucial. This study aims to evaluate the effectiveness of passive distraction using music and Bach flower remedy in reducing dental fear and anxiety in children aged 6-8 years. Methods: This randomized controlled clinical study included 12 children (n=4 for each group) aged 6-8 years, randomly assigned to Group 1 (control), Group 2 (Bach flower remedy), or Group 3 (passive distraction with music) for treating superficial dentin caries in primary teeth without local anesthesia. Dental fear and anxiety levels were assessed using objective (heart rate, oxygen saturation, systolic and diastolic blood pressure) and subjective (Facial Image Scale and Venham’s Picture Test) measures before and after treatment. Results: The study included 12 children (6 female, 6 male) with a mean age of 7.3±0.8 years. In Group 2, heart rate significantly decreased after treatment (97.8 ± 10.1 to 90.5 ± 8.8, p.05). Conclusion: In this study, although passive distraction with music and Bach flowers did not have a significant effect on physiological and projective measurement tools in children with dental fear and anxiety, a decrease in heart rate was observed in children exposed to Bach flowers.

Analysis of dental anxiety levels and oral health-related quality of life of patients attending a periodontology clinic

Analysis of dental anxiety levels and oral health-related quality of life of patients attending a periodontology clinic

Dental anxiety and oral health in American Indian and Alaska natives.

American Indian and Alaska native (AI/AN) individuals report distrust of the healthcare system. This study explored associations between having either high levels of dental distrust or high levels of dental care-related fear and anxiety ("dental anxiety") and oral health outcomes in AI/AN adults. The 2022 State of Oral Health Equity in America survey included the Modified Dental Anxiety Scale and asked to what extent respondents agreed with the statement, "At my last oral health visit, I trusted the oral health provider I saw", and asked about self-rated oral health and presence of a dental home. AI/AN individuals (N = 564) who reported low dental trust (n = 110) or with high dental anxiety (MDAS≥19; n = 113) reported significantly worse overall and oral health and were significantly less likely to have a dental home (p < 0.05 used for each analysis). Dental distrust and dental anxiety can significantly impact oral health and dental utilization in AI/AN communities and are important intervention targets to improve AI/AN oral health.

The psychological impact of coronavirus disease 2019 pandemic on parents’ knowledge, attitudes, and children’s anxiety during pediatric dental practice

Abstract Purpose This study’s goal was to assess the impact of the coronavirus disease 2019 (COVID-19) outbreak on parent’s knowledge, attitude, and children’s anxiety during dental treatment. Patients and methods A structured questionnaire was applied to a sample of 400 parents of children aged from 8 to 15 years and from different socioeconomic backgrounds. The children’s dental anxiety level was assessed using the Facial image scale. The accompanied parent’s and dentist’s dental anxiety level was also evaluated using a Likert scale, 1–6. Results In total, 71.5% of parents answered that their children could be infected with COVID-19 during dental treatments and that they were concerned about their children receiving such treatment due to the outbreak. When asked about the transmission of COVID-19, 90% of participants believed it was due to aerosol-generating procedures during dental treatment. Conclusion The COVID-19 pandemic has had an impact on parental attitudes about dental care and oral health management.

Is serum BDNF level relıable parameter ın detectıng of dental anxıety before ımpacted thırd molar surgery?

Brain-derived neurotrophic factor (BDNF) is a factor that implicate in the pathophysiology and treatment of depression and anxiety. The aim of this study was to determine the relationship between dental anxiety and BDNF serum level through impacted third molar surgery. In this randomized, double-blind, cross-sectional study, the sample included patients who had been admitted for the impacted third molar extraction under local anesthesia between January to November 2020. The primary predictor variable was serum BDNF level and the second predictor variable was dental anxiety scores before and after operation in patients. The primary outcome variable was the correlation between anxiety scores (APAIS, MDAS, STAI, VAS) and serum BDNF level. The sample included 55 patients (22 Male, 33 Female) aged 18 to 42 (24,2+5,55). Comparison of pre-operative scores (APAIS, MDAS, STAI, VAS and BDNF) and post-operative scores were statistically significant (P < .05). Post-operatively, MDAS and VAS scores decreased, while BDNF levels and STAI scores increased compared to the preoperative scores. BDNF was not correlated with APAIS, MDAS, STAI, and VAS preoperatively and postoperatively. There may be a relationship between serum BDNF level and dental anxiety scale, but, no correlation was found between them.

Analysis of Psychological Distress and Dental Anxiety in Patients Attending Dental Care During the COVID-19 Pandemic.

The COVID-19 epidemic has affected all facets of patient care, including dentistry services, and placed hitherto unheard-of demands on healthcare systems throughout the world. More and more emphasis is being paid to psychological discomfort and dental anxiety that epidemic patients face when seeking dental care. The purpose of this research was to examine the psychological distress and dental anxiety levels of patients receiving dental care during the COVID-19 pandemic in a tertiary care setting between 2021 and 2022. For this study, 300 patients with regular dental checkups were selected as a convenience sample. Self-report questionnaires measuring dental anxiety and psychological discomfort were filled out by participants. Descriptive and inferential statistics were used to analyze the data once demographic information was gathered. The majority of participants experienced psychological anguish (66.7%) and dental anxiety (73.3%) at moderate-to-severe levels. When compared to pre-pandemic values, there was a substantial increase in psychological distress (P < 0.001) and dental anxiety (P < 0.001) throughout the pandemic period. Current research shows how the COVID-19 pandemic significantly affected the mental health of patients receiving dental care, underscoring the need of catering to patients' mental health needs in dental practices during public health emergencies.

Influence of Education on Dental Anxiety and Fear in Mental Disorders after Viewing a Molar Extraction in Three Types of Mental Disorder Compared to Persons with No Mental Disorder.

Objective: The goal of this study is to validate the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Scale (DFS) at three different times: seven days before, immediately after, and seven days after watching a video of surgical extraction of a lower third molar in a sample with four strata: anxiety disorder, adjustment disorder, mixed anxiety-depressive disorder, and no mental disorder ages 18-70 in a psychiatric clinic in Malaga. Methods: The Research Ethics Committee of the Virgen Macarena-Virgen del Rocío Hospitals approved the study. After being interviewed by a psychiatrist and subsequently completing the Hamilton Rating Scales for Anxiety and Depression, the participants were divided into 4 strata (60 persons in each). The influence of education level was then analyzed. Results: The scales demonstrated good psychometric properties, with higher MDAS and DFS scores for lower levels of education and mixed anxiety-depressive disorder. Conclusions: Patients who show higher levels of dental anxiety and dental fear will be those with lower education levels, as well as those who suffer from mixed anxiety-depressive disorder.

Investigating the Relationship Between Parenting Styles and Levels of Social Anxiety and Dental Anxiety in Adolescents

Background: Dental anxiety is a challenge faced by dental professionals when treating young children and adolescents. It is caused by several complex factors. This study aimed to investigate the association between different parenting styles and the levels of social anxiety and dental anxiety in adolescents. Methods: The present cross-sectional study was conducted on 126 adolescents aged 12-19 and their mothers at a private pediatric dental clinic in Zahedan in 2021. The convenience sampling method was used to select participants. The Dental Anxiety Scale (DAS) and Beck Anxiety Inventory (BAI) were employed to measure dental anxiety and social anxiety, respectively. Mothers completed the Baumrind Parenting Styles Questionnaire. Statistical analyses included variance tests, post hoc (Tukey) tests, Pearson’s correlation coefficient, and multiple linear regression analysis. Results: According to the findings of this study, the number of mothers with permissive, authoritarian, and authoritative parenting styles was 4 (3.2%), 9 (7.1%), and 113 (89.7%), respectively. The means±standard deviations (SD) of dental anxiety in the authoritative, permissive, and authoritarian parenting styles were 45.80±28.0%, 45.31±11.83%, and 35.42±18.49%, respectively. In addition, the mean scores±SD of social anxiety in the authoritative, permissive, and authoritarian parenting styles were 22.61±17.71%, 48.81±5.24%, and 38.72 ±11.93%, respectively. According to the results, social anxiety and maternal parenting styles were significant and influential factors in dental anxiety in adolescents (P&lt;0.001). Conclusion: This study highlights the significant relationship between dental anxiety, social anxiety, and parenting styles in adolescents. Addressing social anxiety and understanding the impact of parenting styles can help reduce dental anxiety. Interventions should prioritize creating a supportive environment and attending to psychological well-being alongside dental care.