As most dental professionals are well aware, dental fear and no-show patients often go hand in hand. But did you know new survey results reveal that dental fear is much higher than previously believed?
According to a recent article in the Journal of the American Dental Association, 72.6% of patients report fear of visiting the dentist—45.8% have moderate, and 26.8% report severe fear.1
Yet most dentists have no idea dental fear is this prevalent, or that it may be why their patients cancel, don’t show, or don’t schedule an appointment in the first place. Most patients don’t display signs that they’re apprehensive, and most dental professionals do not bring up the subject with their patients.
This leads to dentists rating patient fear as much lower than it actually is. But an honest conversation can help dental professionals understand patient fears, which can open doors and lead to solutions, and this will lead to happier patients and a decrease in no-shows.
“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, PhD, a professor in the NYU Dentistry Center for Oral Health Policy and Management and codirector of the NYU Dentistry Family Translational Research Group, which conducted the new study.
What causes dental fear?
Dental fear is often the result of past bad experiences at the dentist, many from childhood and teen years. But little attention has been given to the role of memory in developing and maintaining these fears. Negative memories often involve recalling pain, and upsetting dentist behaviors, such as acting impatient, scolding, and even placing their hand over a child’s mouth, a behavior that has long since fallen out of favor.
A large-scale study about specific phobias (the most severe, debilitating manifestation of fears) indicated that “individuals with dental phobia reported more frequent and severe intrusive recollections of fear-related events than did individuals with all other common phobias.”2
“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.
Patients show interest in overcoming their dental fear
The JADA study reveals that among fearful patients, 71.2% would be interested in pursuing a way to overcome their fear, namely, a digital treatment they would be able to undergo at home.1
This digital treatment is now available and is showing promise in the form of Dental FearLess, a joint effort between the Family Translational Research Group at New York University and the University of Pennsylvania.
According to the Dental FearLess website, cognitive behavioral therapy has been tested in dozens of clinical trials and used in specialty clinics for more than 20 years. The study is an ongoing nationwide randomized controlled trial of a brief stepped-care approach.3 Stepped-care means that people receive only as much of an intervention as they need.
There are two steps for this study:
- Step 1: a self-administered mobile app to treat dental fear.
- Step 2: a virtual session with a dental fear specialist.
Throughout the study, participants may be randomized to the stepped-care treatment or asked to give feedback about their past experiences with dentists. All participants will be able to get the full treatment, free of cost, by the end of their participation. Participation may take up to three months.
A dentist shares success stories
Tricia Quartey-Sagaille, DMD, FAGD, who owns Nobel Dental Care in Brooklyn, New York, says that her patients who have used Dental FearLess have seen “tremendous” results. She says that dental fear can lead to patients postponing care and eventually needing more complex treatment, which is uncomfortable and often compounds their fear of the dentist.
She reminds dentists that their terrific dental skills really won’t mean anything if patients don’t show up to have the work done in the first place.
Dr. Quartey-Sagaille’s patients who have had success with Dental FearLess learned new tools to cope and were equipped with questions to ask at the dentist to set their minds at ease. She shared that one of her patients went from never wanting to come to the dentist to successfully having a mouth full of work done. Another with a phobia of needles who once took hours to numb now takes only minutes to numb and no longer dreads visiting the dentist.
She said some of her most fearful patients are now some of her best patients because they’re grateful they could overcome their fears and receive much-needed oral care. Dr. Quarey-Sagaille recommends FearLess to her patients as well as to her peers who don’t realize that fear may be what makes their patients difficult, or keeps them from the dentist altogether.
“While the widespread prevalence of dental fear suggests it may actually be growing in the general population, we’re making progress in expanding access to treatment,” Richard Heyman said.
Along with Heyman, those who conducted the research are Kelly Daly, PhD, Salomi Aladiam MA, Sarah Harris, BA, Nicole Roitman, BA, Annette Kim, BA, and Amy Smith Slep, PhD.
References
1. Heyman RE, Daly KA, Aladia S, et al. A census-matched survey of dental fear and fear-treatment interest in the United States. Joural of the American Dental Association. September 2025. https://jada.ada.org/article/S0002-8177(25)00402-7/abstract
2. Daly KA, Ochshorn J, Heyman R, et al. Trauma, terror, and toothpaste: Exploring memories for dental visits across a range of patient fear. Oral. September 1, 2025. https://www.mdpi.com/2673-6373/5/3/65
3. Dental FearLess. https://www.dentalfearless.org/for-dentists
