DENTAL FEAR AND ANXIETY IN CHILDREN AND ITS ASSOCIATION WITH ORAL HEALTH OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstracts: Objectives: Dental fear and anxiety (DFA) are common in children and can significantly hinder oral health by reducing dental attendance, oral hygiene practices, and engagement with preventive care. This review consolidates evidence on the association between DFA and oral health outcomes, focusing on caries indices, dental visitation, and treatment avoidance.Methodology: PubMed, Scopus, Web of Science, and the Cochrane Library were searched up to May 2025. Studies assessing children aged 3–18 years using validated DFA instruments and reporting oral health outcomes were included. Data were synthesized narratively and semiquantitatively; Meta-analysis was performed for studies with comparable data. Results: Eighteen studies met inclusion criteria, with most showing that higher DFA was associated with poorer oral health, including increased caries (DMFT/deft) and reduced dental visits. Meta-analysis of two studies demonstrated that children with elevated DFA had over twice the likelihood of developing caries (OR: 2.35; 95% CI: 1.28–4.34). Conclusion: DFA in children is linked to poorer oral health outcomes and reduced engagement in preventive dental care. Early detection and child-focused interventions are essential to mitigate these effects. Keywords: Avoidance, caries, children, dental anxiety, Dental fear, oral health.