New research explores the prevalence of dental fear and memories underlying it, underscoring the need for accessible treatment
Nearly three out of four adults fear going to the dentist, according to a new study published in the Journal of the American Dental Association.
While dental fear is common, the study-led by researchers at NYU College of Dentistry-also found that most individuals are interested in treatment to overcome it.
People who are anxious about going to the dentist often avoid routine cleanings and care, only visiting a dentist when issues arise. This creates a cycle of fear, as the lack of preventive care can compromise oral health, leading to more fear-inducing pain, infections, and dental work.
"A better understanding of dental fear-and how to increase access to effective treatments for it-holds promise for improving oral and overall health," said Richard Heyman, a professor in the NYU Dentistry Center for Oral Health Policy and Management and co-director of the NYU Dentistry Family Translational Research Group.
High rates of dental fear
Earlier research shows that more than a quarter of the US population is anxious about going to the dentist, but many of these studies were conducted decades ago. To assess the current state of dental fear, researchers at NYU College of Dentistry surveyed a group of 1,003 adults that was representative of the US population based on age, gender, race, education level, region, and household income.
They found that dental fear is even more widespread than previously thought: 72.6 percent reported some amount of dental fear, with 45.8 percent saying they have moderate fear and 26.8 percent reporting severe fear.
When those with moderate or severe fear were asked whether they would be interested in a free, brief treatment for dental fear that could be completed at home, the majority (71.2 percent) expressed interest. (Those who were not interested indicated skepticism about whether the treatment would be effective, reported satisfaction with their current coping strategies, or had concerns about time.)
"While dental fear is highly treatable, few professionals have received relevant training or offer treatment. Brief, virtual dental fear treatments using apps and telehealth have the potential to reach many people, regardless of where they live," said Heyman.
Heyman and his colleagues have developed a program called Dental FearLess that uses an app and, if needed, a one-on-one telehealth session, to treat dental fear using principles of cognitive behavioral therapy and mindfulness. In a pilot study, half of participants were no longer fearful after completing the program, which continues to be studied in an ongoing clinical trial.
"While the widespread prevalence of dental fear suggests it may actually be growing in the general population, we are making progress in expanding the access to treatment," added Heyman.
The role of memory in dental fear
Given how common dental fear is, NYU Dentistry researchers are also working to better understand how it emerges. Prior research shows that more than half of those who have high levels of dental fear have had negative experiences at the dentist, often as a child or adolescent, but little attention has been paid to the role of memory in developing and maintaining these fears.
"Memories of traumatic dental care can be remarkably vivid and tend to have lifelong implications," said Kelly Daly, an assistant research scientist in NYU Dentistry's Family Translational Research Group.
To explore the connection between memory and dental fear, Daly and her colleagues analyzed survey data and written reflections from parents about their own dental fear as well as their children's fear; the findings are published in the journal Oral.
They found that many people with dental fear have memories of pain and negative interactions with dentists-including some behaviors that have since fallen out of favor, such as a dentist putting a hand over a child's mouth to stop disruptive behavior, a technique that has been removed from clinical guidelines. Patients also recounted experiences that led them to perceive dentists as untrustworthy, whether they felt humiliation, that they were not being listened to or believed, or that dentists were recommending unnecessary treatments.
"The salience of these memories-particularly ones from childhood-and ways that lifelong oral healthcare can be compromised are important lessons for practicing dental providers," said Daly. "Many of these negative experiences can be avoided with open and transparent communication between providers and patients."
In addition to Heyman, authors of the JADA study include Daly, Salomi Aladia, Sarah Harris, Nicole Roitman, Annette Kim, and Amy Smith Slep of NYU Dentistry. In addition to Heyman and Daly, authors of the Oral study include Jennie Ochshorn, Ronni Lipnitsky, Adrianna Rozbicka, and Sidhant Athilat of NYU Dentistry, as well as Suher Baker of the Brooker Memorial Institute Pediatric Dental Center and Allan Pike, a leader in pediatric dentistry. Data analyses for and writing of the two papers were supported by the National Institute of Dental and Craniofacial Research (UH3DE029453), part of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
