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*
PhD (Psychologist) Department of
Psychology, Ağrı Training and
Research Hospital, Ağrı, Turkey
Email: mlkyzc.04@gmail.com
ORCID: 0009-0005-3819-6007

*Corresponding Author: Melik YAZICI, PhD

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

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.

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