Patterns and influencing factors of dental implant anxiety in China

To investigate the anxiety pattern and its association with perceived pain at different perioperative stages of dental implant surgeries in China, and identify key influencing factors of anxiety. A prospective observational perioperative study was conducted on 506 implant patients in Changsha Stomatological Hospital from January 2025 to June 2025. Patients assessed their current level of dental anxiety at each of five time points: pre-surgery night (T1), hospital waiting period (T2), local anesthesia administration (T3), implant placement procedure (T4), and post-surgery (T5). Pain perception was evaluated by patients using the Numerical Rating Scale (NRS) on the night before surgery, during surgery, and after surgery. Repeated-measures ANOVA, independent sample t-tests, binary logistic regression, and Kruskal-Wallis test were used for analysis. Anxiety levels peaked at T3 (2.61 ± 0.98) and T4 (2.51 ± 1.05), then decreased significantly at T1 (2.38 ± 1.06), T2 (2.21 ± 0.97), and T5 (1.43 ± 0.72). Predicted pain, intraoperative pain, and postoperative pain were significantly correlated with anxiety. Preoperative pain was not significantly associated with anxiety. Female (OR = 2.60), elderly patients (36-50 years old, OR = 2.40 51-72 years old, OR = 2.19), mandibular implant (OR = 1.81), and bimaxillary implant (OR = 9.63) are factors associated with increased odds of anxiety. The model showed acceptable discrimination (AUC = 0.704, 95% CI 0.658-0.750) and calibration (Hosmer-Lemeshow p = 0.42). Dental anxiety peaks during invasive procedural phases. Gender, age, implant location, and perceived pain degree are key influencing factors. Targeted interventions for high-risk groups and effective pain management can help mitigate anxiety and improve perioperative care quality.