• Research
• Expressions Winter 2024

Revealing Roots of Dental Anxiety

Faculty researchers call for more attention to patient mental health

From left: Professor Mike Leung, Professor Colman McGrath, Ms Natalie Wong, and Dr Andy Yeung.

Two peer-reviewed journal articles published by a research team at the HKU Faculty of Dentistry offer new insights into feelings of anxiety that may lead to avoidance of dental visits, and recommend how dentists can tackle the problem and improve public understanding of dental anxiety, fear, and phobia.

Professor Mike Leung, Clinical Professor in Oral and Maxillofacial Surgery and principal investigator of the team, said: “Our aim was to enhance awareness of the significance of different factors in evaluating and addressing dental anxiety, inspire more research, and foster interdisciplinary cooperation to help individuals overcome their fears and be able to get access to the essential dental care they need.” The co-investigators were Ms Natalie Wong, Research Assistant and PhD candidate in Oral and Maxillofacial Surgery; Professor Colman McGrath, Clinical Professor in Dental Public Health; and Dr Andy Yeung, Tutor in Radiography.

In their first article, published in Frontiers in Psychology,1 the team surveyed 171 Chinese adults in Hong Kong and found that negative early-life experiences were associated with having dental anxiety in adulthood. Specific adverse childhood experiences, such as emotional and physical neglect, sexual abuse, and household substance abuse, were linked to high levels of dental anxiety. Accordingly, dentists need to demonstrate empathy during dental appointments and personalise treatment after finding out about their patients’ adverse childhood experiences, the researchers conclude.

Our aim was to enhance awareness of the significance of different factors in evaluating and addressing dental anxiety, inspire more research, and foster interdisciplinary cooperation to help individuals overcome their fears and be able to get access to the essential dental care they need.

In their second article, published in the International Journal of Environmental Research and Public Health,2 the team evaluated 145 educational videos on YouTube on the topics of dental fear, anxiety, or phobia. About two-thirds of the videos had been produced by health professionals, reporting triggers and causes, patients’ symptoms and behaviours, and both medical and non-medical interventions. Some patients shared testimonials about their own negative dental experiences or recounted anecdotes of other people’s negative experiences. However, information on the specific definitions and diagnostic criteria of dental fear, anxiety, and phobia was often missing. Observing that the most popular videos contained the most misinformation, the researchers advise dentists to collaborate with mental health experts to create reliable and accurate online videos.

The research team’s publications highlight the need for dentists to consider both dental-related and non-dental factors when examining causes of dental anxiety, fully appreciate psychological aspects, develop appropriate targeted interventions, and enhance the quality of relevant online public education.