NON-PHARMACOLOGICAL METHODS FOR REDUCING DENTAL ANXIETY IN CHILDREN AND ADULTS: A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6338Keywords:
Dental Anxiety, Non-pharmacological Methods, Cognitive Behavioral Therapy, Music Therapy, Virtual Reality, Hypnosis, AromatherapyAbstract
Dental anxiety is a significant clinical problem that may lead to avoidance of dental care, deterioration of oral health, and reduced quality of life. The aim of this study was to present current evidence on non-pharmacological methods for reducing dental anxiety in children and adults and to evaluate the effectiveness of the most commonly used interventions. A narrative review was conducted using the PubMed database. Keywords and Medical Subject Headings (MeSH) related to dental anxiety and non-pharmacological interventions, including cognitive behavioral therapy, music therapy, hypnosis, virtual reality, and aromatherapy, were used in the search strategy. English-language publications published between 2016 and 2026 were included, comprising randomized controlled trials, clinical study, systematic reviews, meta-analyses, and narrative reviews. The findings indicate that the strongest scientific evidence supports cognitive behavioral therapy, which effectively reduces anxiety, decreases avoidance behaviors, and improves patient cooperation during dental treatment. Beneficial effects have also been reported for music therapy, hypnosis, virtual reality, and aromatherapy; however, for some of these interventions, the available evidence remains limited and findings are not always consistent. Non-pharmacological approaches may represent valuable adjuncts to the routine clinical management of dental anxiety. The choice of intervention should be tailored to the patient’s age, severity of anxiety, and individual needs.
References
Appukuttan, D. P. (2016). Strategies to manage patients with dental anxiety and dental phobia: Literature review. Clinical, Cosmetic and Investigational Dentistry, 8, 35–50. https://doi.org/10.2147/CCIDE.S63626
Piechal, A., Siekierska, E., & Blecharz-Klin, K. (2026). Etiology of dental anxiety and dental phobia: Review. European Journal of Dentistry, 20(1), 13–22. https://doi.org/10.1055/s-0045-1809146
Hoffmann, B., Erwood, K., Ncomanzi, S., Fischer, V., O'Brien, D., & Lee, A. (2022). Management strategies for adult patients with dental anxiety in the dental clinic: A systematic review. Australian Dental Journal, 67 Suppl 1(Suppl 1),, S3–S13. https://doi.org/10.1111/adj.12926
Shahnavaz, S., Hedman, E., Grindefjord, M., Reuterskiöld, L., & Dahllöf, G. (2016). Cognitive behavioral therapy for children with dental anxiety: A randomized controlled trial. JDR Clinical & Translational Research, 1(3), 234–243. https://doi.org/10.1177/2380084416661473
Stan, D., Voicu, D., Zainea, P., Toma, A., & Ciubară, A. (2025). Reframing dental anxiety: Cognitive behavioral therapy and its role in phobia Treatment—A narrative review. Diseases, 13(11), 377. https://doi.org/10.3390/diseases13110377
Quek, J. S., Lai, B., Yap, A. U., & Hu, S. (2022). Non-pharmacological management of dental fear and anxiety in children and adolescents: An umbrella review. European Journal of Paediatric Dentistry, 23(3), 230–242. https://doi.org/10.23804/ejpd.2022.23.03.11
Steenen, S. A., Linke, F., van Westrhenen, R., & de Jongh, A. (2024). Interventions to reduce adult state anxiety, dental trait anxiety, and dental phobia: A systematic review and meta-analyses of randomized controlled trials. Journal of Anxiety Disorders, 105, 102891. https://doi.org/10.1016/j.janxdis.2024.102891
Kong, X., Song, N., Chen, L., & Li, Y. (2024). Non-pharmacological interventions for reducing dental anxiety in pediatric dentistry: A network meta-analysis. BMC Oral Health, 24(1), 1151. https://doi.org/10.1186/s12903-024-04919-x
Wolf, T. G., Schläppi, S., Benz, C. I., Campus, G., & Frese, C. (2022). Efficacy of hypnosis on dental anxiety and phobia: A systematic review and Meta-Analysis. Brain Sciences, 12(5), 521. https://doi.org/10.3390/brainsci12050521
Matsuoka, H., Chiba, I., Sakano, Y., Toyofuku, A., & Abiko, Y. (2017). Cognitive behavioral therapy for psychosomatic problems in dental settings. BioPsychoSocial Medicine, 11, 18. https://doi.org/10.1186/s13030-017-0102-z
Tellez, M., Dunne, E. M., Konneker, E., Zhao, H., & Ismail, A. I. (2025). Online Cognitive-Behavioural intervention to manage dental anxiety: A 12-Month randomised clinical trial. Community Dentistry and Oral Epidemiology, 53(4), 543–555. https://doi.org/10.1111/cdoe.13049
van der Weijden, F. N., Hussain, A. M., Tang, L., & Slot, D. E. (2022). The effect of playing background music during dental treatment on dental anxiety and physiological parameters: A systematic review and meta-analysis. Psychology of Music, 50(2), 365–388. https://doi.org/10.1177/0305735621998439
Tan, K., Liu, H., Huang, S., & Li, C. (2023). Efficacy of music intervention for dental anxiety disorders: A systematic review and Meta-Analysis. Medicina (Kaunas, Lithuania), 59(2), 209. https://doi.org/10.3390/medicina59020209
Aravena, P. C., Almonacid, C., & Mancilla, M. I. (2020). Effect of music at 432 hz and 440 hz on dental anxiety and salivary cortisol levels in patients undergoing tooth extraction: A randomized clinical trial. Journal of applied oral science : revista FOB, 28, e20190601. https://doi.org/10.1590/1678-7757-2019-0601
Wazzan, M., Estaitia, M., Habrawi, S., Mansour, D., Jalal, Z., Ahmed, H., Hasan, H. A., & Al Kawas, S. (2022). The effect of music therapy in reducing dental anxiety and lowering physiological stressors. Acta bio-medica : Atenei Parmensis, 92(6), e2021393. https://doi.org/10.23750/abm.v92i6.11668
Venkiteswaran, A., & Tandon, S. (2021). Role of hypnosis in dental treatment: A narrative review. Journal of International Society of Preventive and Community Dentistry, 11(2), 115–124. https://doi.org/10.4103/jispcd.JISPCD_320_20
Butrón-Téllez Girón, C., Ramírez-Carrasco, A., Sánchez-Armass Cappello, O., Pozos-Guillén, A., & Pierdant-Pérez, M. (2024). The efficacy of hypnosis compared with the tell/show/do technique for the reduction of anxiety/pain in children undergoing pulpotomies: A randomized controlled trial. Journal of Clinical Pediatric Dentistry, 48(1), 69–77. https://doi.org/10.22514/jocpd.2024.009
Ramírez-Carrasco, A., Butrón-Téllez Girón, C., Sanchez-Armass, O., & Pierdant-Pérez, M. (2017). Effectiveness of hypnosis in combination with conventional techniques of behavior management in Anxiety/Pain reduction during dental anesthetic infiltration. Pain Research and Management, 2017, 1434015. https://doi.org/10.1155/2017/1434015
Hao, T., Pang, J., Liu, Q., & Xin, P. (2023). A systematic review and network meta-analysis of virtual reality, audiovisuals and music interventions for reducing dental anxiety related to tooth extraction. BMC Oral Health, 23, 684. https://doi.org/10.1186/s12903-023-03407-y
Trusculescu, L.-M., Pitic, D. E., Sălcudean, A., Popovici, R. A., Forna, N., Badoiu, S. C., Enache, A., Enasoni, S., Kiș, A., Cosoroabă, R. M., Cozma, M. M., & Todor, L. (2025). Virtual reality as a Non-Pharmacological aid for reducing anxiety in pediatric dental procedures. Children, 12(7), 930. https://doi.org/10.3390/children12070930
Purohit, A., Singh, A., Purohit, B., Shakti, P., & Shah, N. (2021). Is aromatherapy associated with patient's dental anxiety levels? A systematic review and meta-analysis. Journal of Dental Anesthesia and Pain Medicine, 21(4), 311–319. https://doi.org/10.17245/jdapm.2021.21.4.311
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Copyright (c) 2026 Zuzanna Kucia, Gabriela Pilch, Agnieszka Ciepiela, Małgorzata Berowska, Jakub Sagan, Michał Zemowski

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