Do psychological attachment styles influence dental anxiety and dental attendance?

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.