Primacy vs. recency effects: the dominant role of recent over past dental experience in dental anxiety

TL;DR

Recent dental experiences have a stronger impact on dental anxiety than past or childhood experiences.

Contribution

This study highlights the dominant role of recent dental experiences in predicting dental anxiety.

Findings

Pain and distress during the most recent dental visit was the strongest predictor of dental anxiety.

Women reported higher dental anxiety levels than men.

Childhood dental problems were associated with dental anxiety, but less strongly than recent experiences.

Abstract

Dental fear and anxiety (DFA) is a prevalent problem with multifactorial origins, including past traumatic experiences, cognitive vulnerabilities, and sociodemographic factors. Since most previous studies have focused on early or cumulative dental trauma and so, the relevance and significance of the most recent dental experience in shaping DFA is less explored. This study aimed to examine how recent, past, and childhood dental experiences, along with pain-related fear and demographic variables, predict DFA severity.

A cross-sectional online survey was conducted with 802 Hungarian adults (mean age = 28.74; 78% women). Dental fear and anxiety (DFA) was assessed using three validated instruments: the Dental Anxiety Question (DAQ), the Short Dental Fear Question (SDFQ), and the Modified Dental Anxiety Scale (MDAS). Participants reported past dental experiences categorized by life stages into childhood, adulthood, and the past year. Hierarchical linear regression models were constructed for each DFA measure across the three temporal dimensions, adjusting for age, sex, and pain/distress during the last dental visit.

In all three timeframes, DFA was significantly associated with painful or traumatic dental experiences. However, pain and distress during the most recent dental visit was found to be the strongest predictor of DFA across all models (p < .001). Sex was a consistent predictor, with women reporting higher DFA levels (p < .001), and age showed a negative association in some models. Dental problems in childhood were also associated with DFA, but the predictive power decreased when recent experiences were also considered.

DFA develops based on early or cumulative experiences but is also significantly influenced by the most recent dental visit, highlighting a dynamic interaction between trait-like and state-like anxiety processes. Our findings underscore the importance of ensuring positive, pain-free dental care to disrupt the reinforcement of DFA and prevent avoidance behavior.

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