Dental Anxiety, Cognitive Processes, and Neuropsycho- logical Factors Affecting Patient Compliance in Restorative Dentistry: Current Evidence and Clinical Recommendations

dental anxiety, cognitive processes, neuropsychological factors, patient compliance, attentional bias, cognitive bias, executive function, cognitive behavioral therapy

Melik YAZICI1*
1*
PhD (Psychologist) Department of
Psychology, Ağrı Training and
Research Hospital, Ağrı, Turkey
*Corresponding Author: Melik
YAZICI, PhD
Email:
[email protected]
ORCID: 0009-0005-3819-6007

European Journal of Prosthodontics and Restorative Dentistry (2026) 34 (4s), 221–224

Dental
Anxiety,
Cognitive
Processes, and Neuropsychological
Factors
Affecting
Patient
Compliance
in
Restorative Dentistry: Current
Evidence
and
Clinical
Recommendations

Dental anxiety is one of the most common psychological barriers in restorative dentistry and significantly impairs patient compliance. This narrative review examines the neuropsychological foundations of dental anxiety, the influence of cognitive processes on patient compliance, and clinical outcomes in restorative and prosthodontic treatments. Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science databases from 2015 to 2026 using the Boolean operators: (“dental anxiety” OR “dental fear” OR “dental phobia”) AND (“cognitive” OR “neuropsychological” OR “attentional bias” OR “executive function”) AND (“patient compliance” OR “adherence”) AND (“restorative dentistry” OR “prosthodontics”). Thirty relevant English-language peer-reviewed studies involving adult patients were included. Results: Dental anxiety is strongly associated with attentional bias, interpretational bias, and deficits in executive functions. These factors contribute to avoidance behaviors, reduced cooperation during treatment, and difficulties in prosthesis adaptation. Cognitive Behavioral Therapy (CBT) and attentional bias modification have been shown to significantly reduce anxiety levels and improve patient compliance. Conclusions: Routine evaluation of cognitive and neuropsychological factors is crucial for enhancing treatment success in restorative dentistry. Dentists can improve patient-centered care by incorporating anxiety screening and simple cognitive techniques into daily practice. Clinical Relevance: Dentists can provide more patient-centered care by incorporating routine anxiety screening using tools such as the Modified Dental Anxiety Scale (MDAS) and implementing simple cognitive techniques into daily practice. Such approaches are expected to improve treatment outcomes, patient satisfaction, and long-term adherence to restorative and prosthetic treatments.

Received-19-05-2026 Revised-22-06-2026 Accepted-26-06-2026

Dental anxiety remains one of the most prevalent psychological barriers in restorative dentistry, significantly affecting patient compliance.¹ Approximately 10–20% of adults experience clinically significant dental anxiety, with higher rates reported in specific populations.² This condition contributes to missed appointments, delayed treatments, prosthesis adaptation difficulties, and a progressive decline in oral health.³ Recent research has moved beyond the traditional emotional fear model to highlight the critical role of neuropsychological and cognitive processes.⁴ Amygdala hyperactivity, attentional bias, interpretational bias, and executive function deficits are •••••••••••••••••••••••••••••••• ejprd.org - Published by Riset Publishing Services LLC

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