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Much research has gone into finding the causes underlying dental anxiety in adults. Findings of one study, of adults living in the Detroit tricountry area was published in an article, titled Factors Associated with Dental Anxiety, in the Journal of the American Dental Association.

The study showed a dental anxiety prevalence of 10 percent among the 455 adults—those over 18—participants. Six factors were associated with dental anxiety:

• Unfavorable attitudes toward dentists

• Infrequent checkups

• Dissatisfaction with one’s mouth

• Small numbers of filled surfaces

• Being female

• Lower income levels.

These are just some of the factors dentists should be aware of when dealing with and assessing the levels of dental anxiety in their patients. However, there are other factors too which you need to consider. And some studies have shown results that are not entirely in agreement with those of the Detroit study.

We set out below some findings you may find useful in your dental practice.

• Dental anxiety prevalence changes from country to country. For example, a study in Sweden showed 5.4 percent; another showed 10.2 percent prevalence in Denmark; 18.9 percent prevalence was shown in a study Michigan area adults. The wide range in prevalence may be attributable to cultural differences.

• Varies according to age. A Canadian study showed an 8.4 percent prevalence among adults 50 and older. Another study on American adults over 65 found a 14 percent prevalence rate. There are conflicting results from various studies on whether anxiety increases or decreases with age, among adults. Some show decreases while others found no differences due to age.

• No clear relationship has been established between dental anxiety and socioeconomic status—as measured by education or income level. Some studies found higher levels of dental anxiety among those with low education and income levels while others failed to find such a link.

• Levels of anxiety vary by sex. While multiple studies have shown higher levels of dental anxiety among women compared with men; but one study on adults 50 and older found no differences.

• Prevalence by race may vary. Not many studies have been conducted to establish the racial differences. But a study in 1975 found no differences between white and African-American dental patients.

• Dental attendance and seeking treatments less likely. Those with dental anxiety are more likely to avoid seeking treatment, delay setting up dental appointment and more likely to skip, cancel or postpone appointments. Some may not have visited a dentist in even five years because of fear.

• Dental anxiety is associated with poor oral health. Not surprising in the least was that those with higher levels of anxiety have more decayed surfaces and fewer filled surfaces compared to those who do not suffer from anxiety. They also tend to have more missing teeth and fewer filled teeth.

• Satisfaction with appearance matters. The Detriot study showed that participants who were less satisfied with the way their mouths looked were more likely to be dentally anxious compared to others.

• Self reported pain or distress from teeth or gums. Again from the Detroit study, those who were suffering in this way were more likely to be anxious.

• Attitudes towards dentists. There is a direct correlation between dental anxiety and negative attitudes towards dentists. While the cause for this is unknown, it is likely affected by the dentist-patient relationship. People’s perception of the competence of dentists decreased together with rising levels of anxiety.

Other studies have shown that people who reported seeing a dentist angry or making condescending remarks were more likely to have higher levels of anxiety. Also, according to other studies, anxiety-prone patients have complained that dentists fail to take their worries seriously or were likely to make them feel guilty about how they feel.

The above provides a number of insights into working effectively with dentally anxious patients or potential patients. Better sensitivity to anxieties from both you, the dentist and from staff in your practice, and using effective methods of alleviating anxiety are likely to improve patient outcomes and satisfaction.