Community Honors PennSmiles Mobile: Factors Influencing Pediatric Dental Anxiety

Tamar Brown

Ami Gadhia

Nathaniel Lamson

Marina A. Shamoun

Shirley Zhang

Brown, Tamar, Gadhia, Ami, Lamson, Nathaniel, Shamoun, Marina A., Zhang, Shirley
University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences, Division of Community Oral Health


Materials and Methods: Cross- sectional, case control, and cohort studies published from 2004 to 2019 and published from various countries that measured dental fear and anxiety in children and adolescents (aged 0-19 years) in the general population, or when visiting dental clinics with specific operator behaviors or dental operatory environments, were searched with specific keywords in the PubMed electronic database. Data collected from these articles using specific dental fear questionnaires of demonstrated reliability and/or validity were extracted and analyzed.

Project Overview

Rationale: Early childhood dental fear and anxiety has been recognized as a key hindrance to successful long-term patient management, resulting in avoidance of dental care and overall decreases in lifetime oral health. Since the mobile care unit provides a different environment in comparison to the traditional clinic atmosphere, this juxtaposition allowed us to hypothesize environmentally-influenced variations in response to dental stimuli. Through our work in the Mobile Care Unit via the PennSmiles Honors Program, we aim to investigate how environmental factors may play a role in children’s dental fear and anxiety and how we can reliably measure and further assuage these anxieties in our patients on the PennSmiles bus. The purpose of this review of literature is to determine if specific operator behaviors or dental operatory environmental cues can help alleviate children’s dental anxiety.


Conclusions: Dental fear and/or anxiety occurs commonly amongst children and adolescents, and subsequently influences future dental behavior. Creating a comfortable dental environment can help alleviate dental anxiety in children and improve overall quality of care.