## 4 Discussion
### Clinical Implications and Future Research Directions  
The clinical implications of the conducted research include:  
* Personalization of dental care: Developing patient anxiety and fear management strategies based on their previous experiences and individual responses.
* Optimization of clinical processes: Implementing effective technologies that simultaneously minimize patient discomfort.
* Reduction in sensory stimuli during dental visits.
* Increasing trust in dentists and dental hygienists: By better managing patient emotions.
* Enhancing the quality of dental services: Positive patient experiences and improved overall oral health.  
These implications are crucial for reducing the avoidance of hygiene visits, which could contribute to better oral health and quality of life, strongly associated with dental fear and anxiety [41].  
To summarize the conducted study, it is important to consider its limitations. One of the key limitations is the lower statistical power observed for certain variables, which may affect the ability to detect significant effects, particularly in cases where the sample size was smaller, or variability was higher. Additionally, the lack of a control group comparing GBT with traditional methods limits the conclusions we can draw regarding GBT's potential to reduce anxiety or improve comfort. Although GBT was used in this study, its impact on anxiety reduction was not directly assessed.  
The article identified some anomalies, such as unusual levels of anxiety and heart rate in patients, which may be due to individual differences or underlying medical conditions. However, these deviations did not affect the overall conclusions regarding the effectiveness of the therapy in reducing anxiety.  
There is a clear need for further research to verify the long-term effects of fear and anxiety reduction strategies, as well as to conduct a cost-benefit analysis of implementing personalized interventions and new technologies. Future studies should focus on long-term outcomes and on identifying additional factors and their connections that may influence patient experiences during dental visits. It will also be valuable to expand the research sample to diverse demographic groups to determine whether the findings are universal and to understand how various cultural, social, and economic factors affect levels of fear and anxiety. Interdisciplinary research combining dentistry with psychology should also be considered, as it could provide more comprehensive strategies for managing patient  
Figure 23: A conceptual model of the impact of sociodemographic factors, clinical factors, and patient experiences on the levels of fear and anxiety during a hygiene visit, along with strategies for their reduction (black arrows: positive correlation; red arrows: negative correlation).  
emotions, taking into account different aspects of their mental and physical health. The potential significance of patient susceptibility to anxiety, which is frequently raised in foundational research on this topic, should not be overlooked [42].  
In future studies, it would be beneficial to include more complex research designs, such as double-blind placebo-controlled trials, to more accurately assess the true impact of GBT on anxiety reduction and to limit the possibility of a placebo effect, which may have influenced anxiety reduction in patients regardless of the method used.  
In future research, it would be valuable to consider testing modifications to the Guided Biofilm Therapy (GBT) protocol, such as integrating additional anxiety reduction techniques, including relaxation techniques, or the use of virtual reality technology. These studies could provide new data on their effectiveness in further reducing patient anxiety, contributing to the continued improvement of personalized patient care in the context of dental hygiene.