Prevalence and Risk Factors for Dental Anxiety and Dental Fear in Nigeria: A Systematic Review and Meta‐Analysis

Abstract

ABSTRACT Objective In Nigeria, the burden of dental anxiety and dental fear (DFA) remains poorly characterized despite its possible contribution to poor dental service utilization and treatment avoidance. This study aimed to estimate the pooled prevalence of dental anxiety in Nigerian populations and identify associated risk factors. Methods This systematic review and meta‐analysis was registered in PROSPERO: (CRD420261373453). A search was conducted in PubMed/MEDLINE, Embase, Web of Science, EBSCOhost, and African Journals Online from inception to March 2026. Studies were included if they were cross‐sectional, cohort, or case–control studies conducted in Nigerian populations of any age that reported prevalence estimates of DFA using validated instruments. Two independent reviewers extracted data and assessed the risk of bias using the Joanna Briggs Institute checklists. The primary outcome was the pooled prevalence of dental anxiety, calculated using random‐effects meta‐analysis with the Freeman‐Tukey double arcsine transformation. The associations between DFA and age, sex, and educational levels were also determined. Heterogeneity was assessed using I 2 statistics. Results Of 237 records identified, 30 studies met the inclusion criteria, comprising 7920 participants. The pooled prevalence of DFA was 61% (95% CI: 41%–79%; I 2 = 97%). Severe to extreme DFA prevalence was 18% (95% CI: 12%–27%). The pooled mean dental anxiety score was 11.9 (95% CI: 10.6–13.2). Females had higher DFA scores than males (mean difference 1.3, p = 0.0003) although the certainty of evidence was low. Participants under 30 years had higher scores than those 30 years and older (mean difference 1.6, p = 0.0002). Education level showed no significant association. Most studies (86.7%) had a moderate risk of bias. No publication bias was detected. Conclusion Dental anxiety and dental fear affect approximately three‐quarters of the Nigerian population, with a possible higher burden among females and younger adults. These findings highlight the possible value of routine anxiety screening and integration of behavioural management into Nigerian dental practice.