Initial Steps in Developing an Ontology of Dental
                         Care-Related Fear, Anxiety, and Phobia – Abstract
                         William D. Duncan1,∗ , Astha Singhal1 , Olga S. Enz1 , Alexander D. Diehl2 , Brenda Heaton3
                         and Daniel W. McNeil1
                         1
                           Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, Gainesville, USA
                         2
                           Department of Biomedical Informatics, University at Buffalo, Buffalo, USA
                         3
                           Department Epidemiology & Health Services Research, University of Utah School of Dentistry, Salt Lake City, UT, USA


                                      Abstract
                                      Dental care-related fear, anxiety, and phobia (DFA) broadly refer to negative emotional, behavioral, or physical
                                      responses that occur when thinking about or being a patient receiving professional dental care. These responses
                                      pervade societies globally and significantly impact population oral health through patterns of dental care utilization
                                      and avoidance. Avoidance stemming from DFA often manifests as eschewing preventive or restorative care, often
                                      until pain or dysfunction necessitates it, and involves late cancellations or appointment no-shows, the latter
                                      leading to empty chair time which has significant societal costs. Moreover, despite advances in pain management
                                      and anxiety control, society-wide estimations of the prevalence of DFA have remained high for over half a century
                                      with phobic levels relatively unchanged. Currently, DFA research is stymied by the absence of an agreed-upon
                                      and controlled vocabulary. The scientific literature on DFA constructs is replete with inconsistencies and includes
                                      terminology that refers to only dental fear or dental anxiety and these terms are often used interchangeably. In
                                      the broader psychological literature, however, fear and anxiety are treated as separate constructs with unique
                                      manifestations. The lack of consistency/interoperability between the medical and dental care communities in
                                      defining and classifying such phenomena has contributed to the current stalemate in scientific progress as it
                                      relates to understanding the etiology and implications of DFA. To address these shortcomings in DFA terminology
                                      and classification, we are developing the Ontology of Dental care-related Fear, Anxiety, and/or Phobia (ODFA).
                                      By addressing these weaknesses, the ODFA will facilitate the development of tools and resources capable of
                                      enhancing our understanding of the individual, clinical, and population impacts of dental care-related fear and
                                      anxiety. Specifically, we aim to develop an ontology that garners acceptance from the scientific and clinical
                                      communities and that represents the types of fear and/or anxiety experienced by individuals to predict the
                                      likelihood of dental care avoidance, including emergency-only care, delay of treatment, cancellation of dental
                                      care appointments, or not showing up for scheduled appointments (i.e. no- shows).

                                      Keywords
                                      Ontology, Dental Care-Related Fear, Anxiety, and Phobia, DFA




                          15th International Conference on Biomedical Ontologies 2024, July 17-19, 2024, Enschede, The Netherlands
                         ∗
                              Corresponding author.
                          Envelope-Open wdduncan@gmail.com (W. D. Duncan); ASinghal@dental.ufl.edu (A. Singhal); OEnsz@dental.ufl.edu( (O. S. Enz);
                          addiehl@buffalo.edu (A. D. Diehl); brenda.heaton@hsc.utah.edu (B. Heaton); DMcneil@dental.ufl.edu (D. W. McNeil)
                          Orcid 0000-0001-9625-1899 (W. D. Duncan); 0000-0001-9191-6978 (A. Singhal); 0000-0002-3943-6819 (O. S. Enz);
                          0000-0001-9990-8331 (A. D. Diehl); 0000-0002-3097-4717 (B. Heaton); 0000-0002-0766-8455 (D. W. McNeil)
                                      © 2024 Copyright for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).


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