Endodontic therapy aims at preventing or curing apical periodontitis. To conduct this, the cleaning and shaping of the canals are essential. By using an irrigant, such as sodium hypochlorite (NaOCl), practitioners attempt to wash out debris, dissolve organic and inorganic tissue, lubricate the canals, prevent smear layer formation, and disrupt biofilms. Different methods have been developed to optimise the effectiveness of irrigants, including manual or passive techniques (the conventional method used worldwide) and active techniques (the irrigant is activated by certain devices to improve its flow in the root canal system). Some techniques included in the active category are ultrasonic and sonic methods, apical negative pressure irrigation, and multisonic activation. These active techniques appear to have higher effectiveness when compared to the conventional syringe method during the root canal treatment procedure. However, it is unclear whether they also have a higher influence on the treatment outcome and healing of apical periodontitis. There is a consensus on the need for endodontic studies with standardized protocols and methods to reach a standardized clinical protocol when using active irrigation.

Dental fear and anxiety (DFA) serve as a significant obstacle to oral healthcare, affecting approximately 15% of the adult population. In endodontics, misconceptions regarding procedural pain and complexity often lead to treatment avoidance or a preference for extraction over tooth-preserving therapy. Currently, there remains a notable information gap regarding the efficacy of modern educational modalities in mitigating these barriers. The purpose of this scoping review is to map the existing research on DFA, socioeconomic barriers to endodontic care, and the relative effectiveness of new educational tools, particularly multimedia and Artifical Intelligence (AI) -driven interventions, in raising patient awareness and lowering DFA. Following the Arksey & O’Malley guidelines and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), a systematic search was carried out for the years 2015–2025 using PubMed/MEDLINE, ScienceDirect, Cochrane, and Wiley. Two reviewers conducted independent data charting and study selection. Joanna Briggs Institute (JBI) critical assessment techniques were used to evaluate methodological quality. Notably, there was no pre-registered review protocol, which is recognised as a methodological limitation. Ten studies met the inclusion criteria, representing diverse geographic cohorts, including Saudi Arabia, India, Pakistan, Brazil, and Turkey. The findings indicate that previous negative dental experiences, fear of pain and limited knowledge regarding root canal treatment are major contributors to DFA. Educational interventions, particularly video-based and animated materials, were associated with improved patient understanding and reduced anxiety levels. Recent studies also suggest that AI-generated educational content may enhance clarity and trust while reducing patient anxiety, although further validation is required. Socioeconomic factors, including treatment cost and access to specialised care, were also identified as important determinants influencing treatment decisions. Emerging digital and AI-driven educational tools show promise in reducing DFA but require further expert validation and ethical oversight before widespread implementation to avoid misinformation and ensure clinical safety. Future research should prioritise longitudinal and multi-centre studies to evaluate the long-term impact of digital education on patient decision-making and treatment outcomes.