Sedation alternatives, behavioral therapy, and patient experience design in modern dentistry: A comprehensive review

Dental anxiety is a significant barrier to optimal oral healthcare, affecting millions worldwide. Traditional pharmacologic sedation methods such as nitrous oxide, oral benzodiazepines, and intravenous sedation are effective but carry potential risks, high costs, and accessibility issues. In this comprehensive review, literature was selected through systematic searches in PubMed, Scopus, and Web of Science databases, covering publications from January 2000 to June 2025, using keywords such as dental anxiety, sedation alternatives, behavioral therapy, and patient experience. The review includes randomized controlled trials, meta-analyses, and clinical reports in English. The research gap lies in the limited integration of multidisciplinary, technology-driven, and behavior-based approaches as mainstream dental anxiety management strategies, despite growing evidence of their effectiveness. This article explores non-pharmacologic interventions including cognitive behavioral therapy (CBT), exposure therapy, virtual reality (VR), music therapy, aromatherapy, biofeedback, and patient experience are designed to address anxiety, enhance comfort, and improve treatment adherence. The paper also discusses implementation challenges, comparative outcomes, and limitations, concluding with future directions for integrating these methods into modern dentistry. By bridging psychology, technology, and environmental design, this review aims to guide practitioners toward safe, cost-effective, and patient-centered care models.