title: Toward a genetic understanding of dental fear: evidence of heritability.
abstract: OBJECTIVE
  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, ρG= 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.
authors.affiliation: Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV, USA.|Center for Oral Health Research in Appalachia, Pittsburgh, PA, USA.
authors.forename: Cameron L
authors.initials: CL
authors.lastname: Randall
authors.affiliation: Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Shaffer
authors.affiliation: Center for Oral Health Research in Appalachia, Pittsburgh, PA, USA.|Department of Psychology and Department of Dental Practice and Rural Health, West Virginia University, Morgantown, WV, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: McNeil
authors.affiliation: Center for Oral Health Research in Appalachia, Pittsburgh, PA, USA.|Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Crout
authors.affiliation: Center for Oral Health Research in Appalachia, Pittsburgh, PA, USA.|Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Weyant
authors.affiliation: Center for Oral Health Research in Appalachia, Pittsburgh, PA, USA.|Center for Craniofacial and Dental Genetics, Departments of Oral Biology, Human Genetics, Clinical and Translational Science, and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Marazita
keywords: anxiety; behavioral sciences; dental anxiety; fear; genetics; heredity; pain