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Toward a genetic understanding of dental fear: evidence of heritability.

ABSTRACT: OBJECTIVES:Dental fear is a prevalent problem that impacts dental treatment-seeking behavior and thus oral, systemic, and psychological health. Among other important predictors, fear of pain has been shown to be a critical component of dental fear. While learning history (id est, past experience) is known to shape development and maintenance of dental fear and fear of pain, minimal work has addressed genetic etiological variables for these healthcare-related anxieties. With the aim of coming to a more complete conceptualization of dental fear, this study assessed the heritability of dental fear and fear of pain and elucidated the role of genetics in the relation between the constructs. METHODS:Participants (n = 1370; 827 female), aged 11-74 years (M = 29.2, SD = 12.2), in a family-based cohort study completed measures of dental fear and fear of pain. Heritability and genetic correlation were estimated using likelihood-based methods under the variance components framework. RESULTS:Dental fear was 30% heritable (P < 0.001) and fear of pain was 34% heritable (P < 0.001). Notably, there was substantial genetic correlation between dental fear and fear of pain, ?G = 0.67, suggesting they are genetically related, but likely are distinct phenotypes. CONCLUSIONS:It is clear that, in addition to environmental factors, genetic influences are important in the etiology of dental fear and anxiety and should be considered in future studies of fear and anxiety associated with dental treatment and, potentially, interventions aimed at reducing distress that is a barrier to dental treatment utilization.

SUBMITTER: Randall CL

PROVIDER: S-EPMC5388586 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Toward a genetic understanding of dental fear: evidence of heritability.

Randall Cameron L CL Shaffer John R JR McNeil Daniel W DW Crout Richard J RJ Weyant Robert J RJ Marazita Mary L ML

Community dentistry and oral epidemiology 20161011 1

<h4>Objectives</h4>Dental fear is a prevalent problem that impacts dental treatment-seeking behavior and thus oral, systemic, and psychological health. Among other important predictors, fear of pain has been shown to be a critical component of dental fear. While learning history (id est, past experience) is known to shape development and maintenance of dental fear and fear of pain, minimal work has addressed genetic etiological variables for these healthcare-related anxieties. With the aim of co ...[more]

PMID: 27730664

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Project description:Fear of pain is experienced in acute and chronic pain populations, as well as in the general population, and it affects numerous aspects of the orofacial pain experience, including pain intensity, pain-related disability, and pain behavior (e.g., avoidance). A related but separate construct-dental fear-is also experienced in the general population, and it influences dental treatment-seeking behavior and oral and systemic health. Minimal work has addressed the role of genetics in the etiologies of fear of pain and dental fear. Limited available data suggest that variants of the melanocortin 1 receptor (MC1R) gene may predict greater levels of dental fear. The MC1R gene also may be etiologically important for fear of pain. This study aimed to replicate the finding that MC1R variant status predicts dental fear and to determine, for the first time, whether MC1R variant status predicts fear of pain. Participants were 817 Caucasian participants (62.5% female; mean ± SD age: 34.7 ± 8.7 y) taking part in a cross-sectional project that identified determinants of oral diseases at the community, family, and individual levels. Participants were genotyped for single-nucleotide polymorphisms on MC1R and completed self-report measures of fear of pain and dental fear. Presence of MC1R variant alleles predicted higher levels of dental fear and fear of pain. Importantly, fear of pain mediated the relation between MC1R variant status and dental fear (B = 1.60, 95% confidence interval: 0.281 to 3.056). MC1R variants may influence orofacial pain perception and, in turn, predispose individuals to develop fears about pain. Such fears influence the pain experience and associated pain behaviors, as well as fears about dental treatment. This study provides support for genetic contributions to the development/maintenance of fear of pain and dental fear, and it offers directions for future research to identify potential targets for intervention in the treatment of fear of pain and dental fear.

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Toward a genetic understanding of dental fear: evidence of heritability.

Publications

Toward a genetic understanding of dental fear: evidence of heritability.

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