Dental Anxiety and Expectation of Pain: Cognitive Modulation of the Pain Experience of Dental Patients

Pain is a multidimensional concept composed of sensory and cognitive components. Modulation of cognitive factors (e.g., attention, memory, and emotion) plays a key role in our perceived pain experience during dental treatment. Among these factors, denial anxiety is the most common emotional disturbance in dental patients. Clinical research has shown that patients with high dental anxiety expect a bad pain experience during treatment. Cognitive theory suggests that an increase in the uncertainty of a stimulus-outcome association may contribute to one's anxiety level. Based on clinical data and a theoretical framework, we suggest that techniques for modulating pain expectations, such as graduated exposure to a stimulus or correcting patients' faulty dental beliefs, are effective ways of managing pain and anxiety in dental practice.