Dental fear and avoidance: causes, symptoms, and consequences.

A specialized community dental unit for dental fear treatment was used to investigate 160 adult patients. The patients, predominantly women 20 to 40 years old, had avoided regular dental care for an average of 16 years. Psychosocial and psychosomatic conditions were common. Dental fear generally had started in childhood (85%) and the dominating causative factor was previous traumatic dental experiences. For fear of early origin, the dentist's professional behavior was most important, whereas for fear acquired in adult years, pain was important. The most feared events in dentistry ranked by the patients were drilling, having an anesthetic, and extraction. The most desired dentist attributes were understanding and trying to avoid pain, whereas the most undesired were being heavy-handed, critical, and remote and distant. The dental status was strongly affected by fear and avoidance, and the deterioration was significantly more pronounced in men.