Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Daniel W McNeil

Committee Co-Chair

Melissa Blank

Committee Member

Richard Jurevic

Committee Member

Kevin T Larkin

Committee Member

John R Shaffer


Fear of pain is experienced in acute and chronic pain populations, as well as generally, and impacts numerous aspects of the pain experience, including pain intensity, pain-related disability, and pain behavior (e.g., avoidance). A related but separate construct, dental care-related fear, also is experienced in the general population, and impacts dental treatment-seeking behavior and oral and systemic health. Very minimal work has addressed the role of genetics in the etiologies of fear of pain and dental care-related fear. Limited available data suggest that variants of the melanocortin-1 receptor (MC1R) gene may predict greater levels of dental care-related fear. The MC1R gene also may be important in the etiology of fear of pain. This study aimed to confirm that MC1R variant status predicts dental care-related fear and to determine, for the first time, whether MC1R variant status predicts general fear of pain. Participants were 817 Caucasian adults (62.5% female, M age = 34.7 years, SD = 8.7) who were part of a larger, cross-sectional project that sought to identify determinants of oral diseases at the community-, family-, and individual levels (Center for Oral Health Research in Appalachia, cohort 1; COHRA1). Participants were genotyped for SNPs on MC1R and completed self-report measures of fear of pain and dental care-related fear. Variation on MC1R predicted higher levels of dental care-related fear and fear of pain. Importantly, fear of pain mediated the relation between MC1R variant status and dental care-related fear, B = 1.60, 95% CI [0.281, 3.056]. MC1R variants may influence orofacial pain and, in turn, predispose individuals to develop fears about pain. Such fears influence the pain experience and associated pain behaviors, as well as fears about dental treatment. This study provides support for small genetic contributions to the development/maintenance of fear of pain and dental care-related fear. These findings suggest directions for future research to identify potential targets for intervention in the treatment of fear of pain and dental care-related fear.