Determinants of Implementing the 2024 Weight Management Guidelines in Overweight Patients with Coronary Heart Disease in China: A CFIR-Based Qualitative Study of Patient and Caregiver.

Dental anxiety and dental fear are clinically important psychological variables that affect the timing of dental treatment, tolerance of dental procedures, patient-clinician communication, and subsequent dental attendance [,]. In this article, dental anxiety refers to apprehension related to the dental setting or an anticipated dental procedure, whereas dental fear refers to a response to a more identifiable stimulus, such as injections, pain, instrument sounds, or a specific dental treatment [,]. The term dental phobia is reserved for a more severe diagnostic construct requiring formal clinical criteria, and no diagnosis of dental phobia was made in this study [,]. Dental fear and anxiety are common, but their severity and clinical consequences vary between individuals. A systematic review and meta-analysis estimated the global prevalence of dental fear in adults at 15.3%, high dental fear and anxiety at 12.4%, and severe dental fear and anxiety at 3.3% []. Dental fear has been associated with female sex, younger age, previous negative dental experiences, psychological distress, and poorer perceived oral health [,]. A recent adult e-survey also linked higher dental anxiety with unpleasant dental experiences, avoidance-related behavior, and adverse emotional reactions in dental settings []. Dental fear should therefore be considered not merely a subjective discomfort but a clinical variable that may influence the use of dental services. The clinical significance of dental anxiety extends beyond transient distress during treatment. High dental fear is often conceptualized within a fear-avoidance cycle, in which fear contributes to the postponement of dental visits, symptom-driven rather than preventive attendance, the accumulation of more complex treatment needs, and the reinforcement of negative dental experiences [,]. This cycle may affect oral health-related quality of life and broader health behaviors [,]. From this perspective, the clinically relevant question is not only whether a patient is anxious, but also which cues and previous experiences maintain that fear.