Work along both lines: a modified model of the vicious circle of Dental Fear and Anxiety (DFA)

Dental Fear and Anxiety (DFA) manifests as anxiety and fear symptoms specifically associated with dental treatment. This review article conducts a comprehensive analysis of the etiological factors and clinical implications of DFA, dissects the underlying vicious cycle mechanism, identifies limitations in existing theoretical models, and proposes a revised framework. The review demonstrates that patients with DFA tend to avoid dental care, leading to prolonged delays in treatment that exacerbate oral health deterioration. This progressive decline often culminates in unavoidable coercive interventions, while simultaneously generating psychological distress such as social embarrassment and perceived incompetence, thereby reinforcing the original fear response. Furthermore, this study innovatively integrates direct and indirect intervention strategies within a modified vicious cycle model. This comprehensive strategy aims to disrupt the negative feedback loop through simultaneous targeting of psychological and practical barriers.