Causes of Dental Fear Among Adults and their Associations with Oral Hygiene Habits

Abstract

Dental fear and anxiety are common and may lead to avoidance of dental care and poorer oral health. This study aimed to identify the causes of dental fear among adults and their associations with sociodemographic characteristics and oral hygiene habits. An anonymous online questionnaire survey was conducted in February–March 2025 among 175 adults aged 18 years and over. The questionnaire covered sociodemographic data, oral hygiene and dietary habits, and items from modified MDAS and Corah scales. Data were analysed using SPSS 30.0 (descriptive statistics, chi-square test, correlation analysis). Most respondents brushed their teeth twice a day (71.4%), yet 30.3% did not use dental floss and 52.5% did not use interdental brushes. Mean anxiety scores across dental situations were low (2.02–2.32 on a 5-point scale), with the highest scores for local anaesthetic injection and tooth filling. The most frequently reported causes of fear were pain (53.2%) and treatment costs (48.0%). Women reported fear of pain (57.2% vs 32.4%; p = 0.007) and of a poor treatment outcome (26.1% vs 8.1%; p = 0.020) more often than men. Fear of medical instruments and of unpleasant sounds, smells and surroundings was significantly associated with age group (p = 0.032 and p = 0.018, respectively), being reported almost exclusively by respondents aged 18–50 years. Toothbrushing frequency was significantly associated only with anxiety during professional cleaning and polishing (r = 0.173; p = 0.022). Dental fear is driven largely by factors that can be managed in the clinic, and its pattern differs by sex and age; fear reduction strategies should therefore be tailored and address pain control, transparency of treatment costs and empathic communication.