Dental Anxiety Prevalence, Correlates, and Patient-Preferred Management Strategies in Romanian Adults: A...

Background: Dental anxiety constitutes a prevalent barrier to oral healthcare utilization, yet patient-centered data on its prevalence, symptom profile, and preferred management strategies remain scarce in Romanian adult populations. Objectives: This study aimed to assess the prevalence and demographic correlates of self-reported dental anxiety, identify the most anxiety-provoking procedures, evaluate the perceived efficacy of anxiety-reduction strategies, and characterize patient preferences for improved anxiety management in the dental setting. Methods: A cross-sectional observational study was conducted using an anonymous 18-item online questionnaire (Google Forms) among 223 Romanian adults (≥18 years), recruited via convenience sampling between May and June 2025. Descriptive statistics, Pearson's chi-square tests, Fisher's exact test, Cramér's V, and ordinal logistic regression (proportional odds model) were applied (Python 3.11; pandas, scipy, statsmodels). Results: Any degree of self-reported pre-procedural anxiety was endorsed by 60.5% of respondents, with 11.7% reporting moderate-to-severe levels. In the fully adjusted multivariable model (Model 2), female sex (OR = 1.80, 95% CI: 1.04-3.14, p = 0.037) and chronic medical conditions (OR = 3.84, 95% CI: 1.21-12.20, p = 0.022) were independent predictors of higher anxiety severity, although the chronic disease estimate was based on a small subgroup (n = 13) and its wide confidence interval indicates limited precision. Tooth extractions (49.8%) and periodontal surgery (39.5%) were the most anxiety-provoking procedures. Despite this high prevalence of self-reported anxiety, 66.4% of participants had never employed any coping strategy. Detailed procedural explanations provided by the clinician were consistently identified as the dominant patient-preferred intervention across four independent survey items (endorsed by 24.7-77.6% of respondents). A highly significant association was observed between anxiety status and perceived inadequacy of staff anxiety management (χ² = 22.406, p < 0.001). Conclusions: Self-reported dental anxiety affects the majority of this Romanian adult sample, with communication-based strategies representing the primary patient-centered priority. These findings support integrating structured communication training and standardized anxiety screening into routine dental practice.