Prevalence of Dental Anxiety in Children and Adolescents Globally: A Systematic Review with Meta-analyses

Background: Dental anxiety (DA) negatively impacts oral health-related quality of life, and patients with DA usually require more dental treatment time.

Aim: To describe the global prevalence of DA in children and adolescents and to examine the influence of individual factors (age, sex, and caries experience) and variables related to DA measurement on pooled prevalence.

Design: Systematic review with meta-analyses of observational studies published between 1985 and 2020 (PROSPERO CRD42014013879).

Results: Searches yielded 1207 unique records; 224 full-text articles were screened, and 50 studies were used in the qualitative and quantitative synthesis. No study was considered as having high methodological quality according to 'The Joanna Briggs Institute assessment tool'. Overall pooled DA prevalence was 23.9% (95% CI 20.4, 27.3). Pooled prevalence in preschoolers, schoolchildren, and adolescents was as follows: 36.5% (95% CI 23.8, 49.2), 25.8% (95% CI 19.5, 32.1), and 13.3% (95% CI 9.5, 17.0), respectively. DA was significantly more prevalent in preschool children (one study) and schoolchildren (two studies) with caries experience and in female adolescents (one study). The scale used for DA assessment was shown to influence pooled prevalence in preschoolers and adolescents.

Conclusion: DA is a frequent problem in 3- to 18-year-olds worldwide, more prevalent in schoolchildren and preschool children than in adolescents.