Dental Radiophobia: A Narrative Review of Prevalence, Associated Factors, and Public Health Consequences of Dental Radiography Fear in the Community — With a Focus on Both Patient and Clinician-Level Fear

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Fatemeh Pourmohammadi-Nejad,1 Negar Nourizadeh,1 Ali Mehdipour,2,3 Aliakbar Yousefi-Ahmadipour4,51Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; 2Faculty of Health and Life Sciences, INTI University, Nilai, Negeri Sembilan, Malaysia; 3Department of Radiology and Medical Physics, Faculty of Paramedical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 4Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 5Department of Laboratory Sciences, Faculty of Paramedicine, Rafsanjan University of Medical Sciences, Rafsanjan, IranCorrespondence: Ali Mehdipour, Email mehdipour312@yahoo.com Aliakbar Yousefi-Ahmadipour, Email Aliakbar.yousefi92@yahoo.com; A.yousefi@rums.ac.irBackground: Dental radiography is an indispensable diagnostic tool, yet many patients experience fear specifically associated with radiographic examinations. This phenomenon—dental radiophobia—represents an exaggerated fear of ionizing radiation in the dental setting. This review examines both patient-level fear and clinician-level radiophobia, which manifests as unfounded concern about low-dose radiation that impedes CBCT adoption.Methods: A narrative review was conducted using PubMed, Scopus, and Web of Science (2000– 2025). Search terms included "dental radiophobia”, "fear of dental X‑rays”, and "dental radiography anxiety” combined with "prevalence”, "risk factors”, and "public health”. Peer‑reviewed English‑language studies on human subjects were included. Data extraction was thematic.Results: General dental fear affects 10– 20% of children/adolescents. In adults, meta‑analyses report a pooled prevalence of high dental anxiety of 18% (95% CI 10– 30%) and dental phobia of 3%. For dental radiography, mean fear scores are low (0.8 ± 1.8 on a 0– 10 visual analogue scale) but with high variance, and pain during intraoral procedures is a significant predictor. Key associated factors include female sex, younger age, lower education, prior painful radiographic experiences, limited radiation knowledge, and reliance on internet information. Clinician radiophobia (unfounded concern about low‑dose radiation) impedes CBCT adoption. Public health consequences include patient refusal of radiographs, avoidance of care, delayed diagnosis, increased oral disease burden, and medico‑legal liability.Conclusion: Dental radiophobia is a clinically relevant phenomenon with measurable prevalence, identifiable risk factors, and tangible public health implications. Effective management includes non‑pharmacological behavioral techniques, improved patient communication, and evidence‑based radiation risk communication. Future research should focus on validated instruments and targeted interventions.Keywords: dental radiophobia, dental fear, dental anxiety, dental radiography, radiation fear, X-Ray anxiety, avoidance behavior, public health, ALARA principle

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