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Do psychological attachment styles influence dental anxiety and dental attendance?

British Dental Journal (2022)Cite this article

Abstract

Objectives Attachment style has been shown to influence patient engagement in medical settings but has been little explored in dentistry. The aim of our study was to identify whether there was a link between patients with insecure attachment styles and dental attendance and anxiety.

Methods A survey was circulated and completed by 317 participants on social media. Respondents completed the revised Adult Attachment Scale and questions about the timing of their last dental visit, anxiety levels and the perceived reasons for these.

Results Participants classed as having a secure attachment were most likely to have attended a dental appointment in the last two years (87%) and least likely to report dental anxiety (25%). Participants in the fearful attachment group had the highest levels of dental anxiety (75%) and lowest rates of attendance (63%). Both anxious attachment traits (M2.68, 2.09, z = 4.09; p <0.001) and avoidant attachment traits (M2.81, 2.51, z = -2.94; p <0.01) were associated with reduced dental attendance in the past two years. Common themes surrounding visiting the dentist included: unpleasant emotional experiences, previous psychological trauma and inaccurate beliefs about dentistry, resulting in mistrust.

Conclusion Attachment styles are related to dental anxiety and attendance. Understanding the role of attachment in service planning and education of dentists could improve the care of patients.

Key points

  • Highlights how psychological attachment style has been shown in medicine to influence engagement with healthcare services, psychological wellbeing and types of health behaviours performed by different individuals.

  • Explores whether psychological attachment style can influence self-reported dental anxiety and attendance and has found that there may be an association between these phenomena. In particular, anxious and avoidant attachment traits were associated with worse dental attendance. A fearful attachment style was associated with higher levels of dental anxiety and poorer dental attendance.

  • Proposes further research could be conducted in this field of study to improve communication skills training, service planning and the patient experience.

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Authors and Affiliations

  1. South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, TS4 3BW, UK

    Anna Beaven

  2. School of Dental Sciences, Newcastle University, Framlington Place, NE2 4BW, UK

    Pam Boullin & Chris Penlington

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  1. Anna Beaven
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  2. Pam Boullin
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  3. Chris Penlington
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Contributions

Anna Beaven: data analysis, interpretation, writing the paper and revising the paper. Pam Boullin: concept and design of the study and data acquisition. Chris Penlington: conception and design of the study, performing statistical analysis and revising the paper.

Corresponding author

Correspondence to Anna Beaven.

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All authors have given their consent for this study to be published. There are no conflicts of interests. This study had ethical approval from Newcastle University. Details of all participants were anonymised during the process of data collection.

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Beaven, A., Boullin, P. & Penlington, C. Do psychological attachment styles influence dental anxiety and dental attendance?. Br Dent J (2022). https://doi.org/10.1038/s41415-022-4353-0

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