Afraid of the dentist? The cause may be something different from what you think

Young people who have experienced bullying, divorce, violence or abuse are significantly more likely to be anxious in the dentist’s chair. 

This angst may cause some people to avoid going to the dentist, while others feel an intense urge to flee once they are there.

A major risk factor is painful experiences at the dental clinic.

Between 8 – 20 per cent of children and adolescents are so afraid of dental treatment that they meet the criteria for being diagnosed with dental fear.

Now, new research shows that dental fear occurs more often in those who have been exposed to stressful childhood experiences.

In other words, painful experiences in life can affect how you feel in the dentist's chair.

Lying on your back can make you feel vulnerable

The study, with responses from more than 5800 adolescents aged 13 -17 years, shows that adolescents who have experienced stressful experiences during childhood, such as violence, divorce, abuse or bullying are significantly more likely to have dental fear than adolescents who do not have such experiences.

The study is based on data from HUNT, The Trøndelag Health Study, which is one of the largest health studies ever performed. It is a unique database of questionnaire data, clinical measurements and samples from a county’s inhabitants since 1984.

The more stressful experiences the young people had, the great was the likelihood that they would have dental fear. The study also shows that the association was stronger in girls than in boys.

"For many people who have experienced a lot of insecurity in childhood, dental treatment can be demanding. The patients lie on their backs in a vulnerable position while an authority figure works inside the mouth. It's no wonder that dental treatment can be difficult," says Lena Myran, a specialist in psychology. She works on a daily basis at the Competence Center Tannhelse Midt (TkMidt).

Not been to the dentist for 40 years

This centre includes several specialist services where dentists and psychologists work together in teams to help children and adults who have severe dental anxiety. Myran works with adult patients. She is also working on a doctoral thesis at the Norwegian University of Science and Technology (NTNU) on the connections between painful childhood experiences and health, related to the oral cavity and teeth.

"I have patients who haven't been to the dentist for 40 years," Myran said.

The study she recently published is only about young people and looks at the connections between painful childhood experiences and dental fear. The researchers looked at different types of stressors, but painful experiences at the dental clinic were not included in this material.

"It is also important to note that this is a cross-sectional study that does not provide a basis for saying what is cause or effect. We can only see if there is a connection," says Myran.

The study found a clear link between dental fear and various types of painful childhood experiences, including bullying.

Girls most at risk

"Bullying means being systematically rejected and ridiculed. If you have experienced bullying, you may have a hypersensitivity to other people's intentions. There may be periods during dental treatment where it is silent, and you do not quite know what the dentist is thinking. This may be similar to situations where these individuals have felt insecure. For people who have been bullied, saying what you think and feel may have felt dangerous," says Myran.

Myran was surprised that the correlation between painful childhood experiences and dental fear was stronger in girls than in boys.

"We know that dental fear is more common among girls and that more girls than boys have experienced sexual abuse. There are also more girls than boys who develop anxiety and depression in adolescence, but the fact that we found such a clear difference in our material was still surprising," Myran said.

She believes the findings should have consequences for how the dental health service treats young people.

"When dental professionals meet frightened patients, they can ask about the cause. Patients often find it safe for the dentist to ask. Patients know that the dentist is not a psychologist, so it does not have to be a long conversation. But by taking the patient’s experiences and fears into account, dental professionals can contribute to better dental health and safer patient experiences," says Myran.

Tell the dentist

Inspired by other initiatives in Norway, TkMidt established a service for children and adolescents who suffer from dental fear called “Trygge Barn i Tannbehandling” (Safe Children in Dental Treatment) (TBiT) eight years ago. This offer is now being rolled out nationally.

As part of the effort, training is being offered to dental professionals on how to deal with young patients who are afraid.

"It’s important to talk to your dentist or dental hygienist about how you feel. Just telling your dentist that you are afraid can help an incredible amount. Even a short sentence about your fears will lead many dentists to be more sensitive. The dentist is a good friend who should help, and you don't have to ask in any specific way, but just say that you are afraid," says Myran.

She emphasizes that many children may have had painful childhood experiences without developing dental fear, and that the anxiety about the dentist is generally greatest when you are a child, and that it often decreases as the child matures.

Children who have been in dental treatment a lot have an extra vulnerability to developing dental fear.

"Our study and other research show that, overall, there are many ways to develop intense fear of going to the dentist. Fortunately, there is good help available," says Myran.

It is possible for adult patients throughout Norway to seek help from one of Norway's Centres of Expertise in the Dental Health Service (in Norwegian).

References:
Myran, L., Sun, YQ., Dahllöf, G. et al.Associations of adverse childhood experiences with dental fear, and the mediating role of dental fear on caries experience: the Young-HUNT4 Survey. BMC Oral Health 25, 1141 (2025). https://doi.org/10.1186/s12903-025-06486-1

Laura Beaton, Ruth Freeman, Gerry Humphris; Why Are People Afraid of the Dentist? Observations and Explanations. Med Princ Pract 1 July 2014; 23 (4): 295–301. https://doi.org/10.1159/000357223

Raadal M, Strand GV, Amarante EC, Kvale G. Relationship between caries prevalence at 5 years of age and dental anxiety at 10. European Journal of Paediatric Dentistry. 2002 Mar;3(1):22-26. PMID: 12871013