Developing an Ontology for Dental Care-Related Fear and Anxiety: Toward an Understanding of Problems in Dental Care Utilization

Project Summary/Abstract Dental care-related fear, anxiety, and/or phobia (hereafter, DFA) traditionally refers to the emotional, behavioral, and/or physical responses that may occur when thinking about or engaging in dental care. There is ample evidence in the scientific literature that DFA is associated with greater prevalence of oral conditions and diseases, including dental caries, tooth loss, and periodontal disease, leads to avoidance of both preventive and restorative dental care, and impairs oral health-related quality of life. Moreover, these observed associations appear to pervade populations and are global in nature, and, although significant advances in pain management and anxiety control, society-wide estimations of the prevalence of dental care-related fear/anxiety have remained relatively constant for over half a century. Despite the impact of DFA on oral health, the scientific literature is replete with terminology that refers only to dental fear or only to dental anxiety, yet in the broader psychological literature, fear and anxiety are known to be separate constructs with unique manifestations. This lack of consistency and interoperability between the medical and dental care communities in defining and classifying such phenomena has contributed to the current stalemate in scientific progress as it relates to understanding the etiology and implications of such phenomena in the dental care context. Without a consensus on the definition, types, scope, and etiology of DFA, the associated individual, clinical, and population impacts, and viable strategies for intervening to mitigate or manage such impacts the impact of DFA cannot be adequately studied. To address these terminological shortcomings, we have created the Ontology of Dental care-related Fear, and Anxiety, and/or Phobia (ODFA). By more precisely representing the types of fear and/or anxiety experienced by individuals, the ODFA’s concepts and relations facilitate the development of tools and resources capable of enhancing our understanding of the individual, clinical, and population impacts of dental care-related fear and anxiety. When applied to study data, the ODFA enables the integration and interoperability of data from multiple studies, which, in turn, provides a means to perform rigorous analysis on larger datasets in order to gain an in-depth understanding of the phenomenon and treatments for DFA.