# Orthodontic and General Dentistry Fear in 8–73-Year-Old Patients at a Large, Urban U.S. Orthodontic Clinic: Self-Reported Point Prevalences and Clinical Implications

## TL;DR

This study finds that about one in six patients at an urban U.S. orthodontic clinic experience significant fear of both general dentistry and orthodontic care.

## Contribution

The study provides the first U.S.-based prevalence data for orthodontic fear and highlights its strong correlation with general dentistry fear.

## Key findings

- 22.1% of patients had clinically significant fear of general dentistry.
- 17.2% of patients had clinically significant fear of orthodontic care.
- Fear of dentists and orthodontists was strongly correlated (r = 0.67).

## Abstract

Background/Objectives: Dental fear affects about one in four general dentistry patients in the U.S. and other high-income countries. However, the prevalence of fear in orthodontic practice has received scant attention, with no studies in the U.S. The aim of this study was to investigate the prevalence of orthodontic and general dentistry fear and the relationship between the two among patients at a large, U.S. urban university orthodontic clinic serving a culturally and ethnically diverse population. Methods: Patients (N = 186) rated their general dentistry and orthodontic fear using a validated single-item scale. Results: A substantial proportion of patients experienced clinically significant fear of dentists (22.1% [95% CI 16.31–28.69%]) and orthodontists (17.2% [95% CI 11.61–22.82%]). There was a strong effect size (r = 0.67) between ratings of fear of dentists and orthodontists. Our prevalences were nearly identical to the weighted prevalences in the literature for general dentistry and orthodontic fear (22.90% [95% CI: 20.73–25.22%] and 17.65% [95% CI: 15.09–20.53%], respectively) among orthodontic patients. Conclusions: Despite orthodontic procedures being generally less fear-inducing than general dentistry, orthodontists should assume that over one in six patients will be fearful. Further research is needed to create an assessment of the most feared orthodontic stimuli and to broaden the application of evidence-based dental fear treatments. We recommend screening all orthodontic patients using a single, validated question; if patients are fearful, providers should use empathic communication and accommodate patient needs in treatment sessions.