Abstract

Dental fear and anxiety (DFA) in children remains a key barrier to successful pediatric dental care and is often shaped by parental emotional and behavioral patterns. This study aims to synthesize recent evidence regarding the influence of parental anxiety on children's dental treatment outcomes, with an exploration of neurobehavioral mechanisms underpinning the transmission of dental fear. A literature search was systematically conducted in PubMed, ScienceDirect, and Google Scholar using PICO-based Boolean strategies, identifying 29 eligible studies between 2015 and 2025 assessing both parental and child anxiety with validated measures, involving a total of over 7,900 child-parent pairs. The findings consistently showed that higher parental anxiety is linked to increased DFA and reduced cooperation in children. Key contributing factors include parental emotional regulation, coping style, and behavioral modeling. Neurobiological pathways, such as HPA axis dysregulation, suggest anxiety transmission may occur via both psychological and physiological routes. Screening caregivers and incorporating familycentered approaches may improve children's behavior during treatment and reduce dental fear. Integrating neurobehavioral insights can enhance empathy and effectiveness in clinical practice.