Dental Fear Remains a Widespread Issue in the U.S.

By Genni Burkhart

As sedation dentists are all too familiar with, dental fear isn't just a rare occurrence that only a handful of patients struggle with. In fact, a new national study published in the September issue of The Journal of the American Dental Association (JADA) discovered that an astounding 72.6% of U.S. adults report being afraid of going to the dentist. Almost half (45.8%) described their fear as moderate, with 26.8% (more than 1 in 4 surveyed) stating it as severe.

These numbers confirm what many providers already see in their daily work: Fear is a major barrier that influences how patients continue to approach oral healthcare.

The Role of Memory in Dental Fear

The NYU College of Dentistry team behind this study highlighted how memories fuel this ongoing cycle of dental fear. For these patients, many can still recall their first painful dental visit or a time they felt dismissed in the chair. Some even remember outdated practices that would never be used today, such as the use of physical restraints as a child. Those experiences permeate into adulthood and don't fade easily. According to this research, these memories attach to a sense of fear and can shape every dental interaction moving forward.

From a neuroscience perspective, this connection makes sense. Emotional memories are reinforced through the amygdala and hippocampus. When pain and fear are linked, the memory becomes sharper and more resistant to fading. That is why negative childhood dental experiences often echo into adulthood and create lifelong barriers to care. It seems the proverbial phrase, "Old habits die hard," is a fitting explanation for the widespread occurrence of dental phobias seen in the U.S.

The Cycle of Avoidance

When fear is left unaddressed, it creates a cycle. Patients avoid preventive care, issues escalate, and by the time they return to the chair, treatment is more invasive and often more uncomfortable. That reinforces their fear, locking them into a loop of anxiety and neglect.

Beyond oral health, this avoidance has systemic consequences since untreated infections and inflammation affect overall wellbeing. The new JADA study also makes it clear that this fear doesn't belong to one demographic group alone. It cuts across age, income, education, and background.

Patients Want New Solutions

One of the most surprising findings from the study was that more than 70% of fearful patients said they would try a free, brief, digital program designed to reduce dental fear. This shows that patients are open to help, especially when it is easy to access. Programs like Penn & NYU’s Dental FearLess, which combine app-based tools with optional telehealth sessions, have shown real promise. In one early pilot, half of the participants reported a significant reduction in fear after completing the program.

However, these digital approaches aren't a complete replacement for in-office care. Yet, they do seem to make dental visits more approachable for patients who otherwise might stay away. For dental teams, being aware of these tools adds another option for care planning and extends the support they can offer patients beyond pharmacology.

Sedation, Trust, and Communication

Sedation remains an important clinical tool, but this study also reinforces the value of trust and communication. Many patients with strong negative memories say they felt dismissed, unheard, or not believed. That's incredibly poignant. For those patients, validation and transparency can be just as effective as medication. Explaining treatment steps, addressing concerns, and involving patients in decisions all help counteract the sense of helplessness that often lies at the root of dental fears.

For practices that frequently care for anxious patients, adding a screening question about dental fear to intake forms can be an easy first step. Furthermore, combining sedation with positive, pain-free experiences may help break the cycle over time. When every member of the dental team, from front desk staff to clinical providers, uses empathetic communication, it creates an environment that feels safe and non-threatening for all patients.

This Research Matters

This new census-matched, demographically representative study shows dental fear is far more common than older research has suggested. Nearly three out of four adults are affected, and many are open to treatment if it's accessible, which makes the digital approach so effective. This situation poses both challenges and opportunities. On one hand, fear continues to prevent millions from seeking preventive care. On the other hand, patients are showing strong interest in solutions that dental professionals can offer or recommend.

Key Takeaways for Dental Practices:

• Acknowledge fear openly: Asking about fear normalizes it and gives patients permission to share their concerns.
• Leverage digital tools: Explore resources such as cognitive behavioral therapy (CBT) or mindfulness-based apps that can help patients prepare before their arrival.
• Pair sedation with communication: Sedation addresses immediate anxiety, but trust and empathy build long-term confidence.
• Train your team: Consistent, supportive communication from every staff member helps create a safe environment.
• Think long term: Helping patients overcome fear is not just about today’s appointment. It's about breaking the cycle of avoidance and improving lifelong health.

Building Teams That Truly Understand

Dental fear is a complex issue that often shapes a patient’s entire lifetime of oral health decisions. For dental providers and their teams, it's crucial to recognize the "invisible weight" these patients have been carrying long before their first step into your practice. A patient who appears calm in the waiting room may still be recalling a negative childhood memory that colors every aspect of their visit with you.

Sedation practices are often more attuned to this reality, given the population they serve. Yet all providers can benefit from incorporating the lessons of psychology, communication, and behavioral science into daily practice. Creating a culture of empathy and understanding does more than ease fear in the moment. It strengthens long-term relationships, improves compliance, and ultimately leads to better outcomes.

As this study clearly identifies, dental fear is a widespread issue across all demographics in the US. As such, recognizing it as a psychological and neurological reality gives dental teams more options to help patients feel safe and supported. When your team understands that patients bring with them past experiences you can't always see, and perhaps cannot imagine, you move closer to reshaping how millions of people positively experience dentistry.

References

Heyman, R. E., et al. (2025). A census-matched survey of dental fear and fear-treatment interest in the United States. The Journal of the American Dental Association. doi.org/10.1016/j.adaj.2025.07.004

Fajín-Riveiro, L., Mitchell, S. (2024). Empathetic Communication Matters. Johns Hopkins University Blog. https://imagine.jhu.edu/blog/2024/10/15/empathetic-communication-matters/ 

Versaci, M. B. (2025, September 2). September JADA finds dental fear still prevalent in US. ADA News. 

New York University. (2025, September 2). Most adults experience dental fear and show interest in virtual fear-treatments. News-Medical. 

Author: With over 15 years as a published journalist, editor, and writer, Genni Burkhart's career has spanned politics, healthcare, law, business finance, technology, and news. She resides in Northern Colorado, where she works as the editor-in-chief of the Incisor at DOCS Education.