Understanding the Hidden Impact of Dental Anxiety

A recent cross-sectional study conducted at an academic dental clinic in the United Arab Emirates has shed light on a pervasive issue affecting many adults: dental anxiety and its profound effects on oral health-related quality of life (OHRQoL). Published in the journal Healthcare, the research reveals that higher levels of dental anxiety are independently linked to poorer OHRQoL, even after adjusting for factors like age and gender. This finding underscores the psychosocial burden that dental fear imposes, often leading individuals to delay or avoid necessary care, exacerbating oral health problems and diminishing overall well-being.

In the UAE, where advanced healthcare infrastructure coexists with a diverse expatriate population, oral health challenges remain significant. The study, involving 138 adult patients, utilized validated tools—the Modified Dental Anxiety Scale (MDAS) and Oral Health Impact Profile-14 (OHIP-14)—to quantify these associations. With a mean MDAS score of 10.54 indicating slight anxiety on average, and OHIP-14 scores rising significantly with anxiety levels, the results highlight a moderate positive correlation (Spearman's ρ = 0.34, p < 0.001).

What is Dental Anxiety and How is it Measured?

Dental anxiety, also known as dental phobia when severe, refers to an excessive fear or apprehension about dental procedures, often rooted in past negative experiences, anticipation of pain, or sensory sensitivities like the sound of drills. The MDAS, a five-item questionnaire scoring from 5 (no anxiety) to 25 (extreme anxiety), categorizes levels as low (5-9), moderate (10-17), and high (18-25). In this UAE study, 49% reported low anxiety, 38% moderate, and 12% high.

OHRQoL, measured by OHIP-14 (scores 0-56, higher indicating worse impact), assesses seven domains: functional limitation, pain, psychological discomfort, physical disability, social disability, handicap, and psychological disability. Mean score was 14.22, with high-anxiety patients scoring nearly double those with low anxiety (24.75 vs. 12.77).

Key Findings from the RAKMHSU Study

Led by researchers at RAK College of Dental Sciences, RAK Medical & Health Sciences University (RAKMHSU) in Ras Al Khaimah, the study recruited patients from November 2024 to April 2025. Participants averaged 34.9 years old, with 55% male. Multiple linear regression confirmed MDAS as the strongest predictor of OHIP-14 scores (β = 0.69, p < 0.001), alongside older age (β = 0.11, p = 0.019) and female gender (β = 2.14, p = 0.018), explaining 52% of variance.

• Low anxiety group: OHIP-14 mean 12.77 (SD 6.92)
• Moderate: 16.72 (SD 7.18)
• High: 24.75 (SD 7.47)

These differences were statistically significant (Kruskal-Wallis p < 0.001), emphasizing dental anxiety's role in amplifying perceived oral health burdens.

Broad Implications for Daily Life and Well-Being

Dental anxiety doesn't just affect clinic visits; it permeates psychological, social, and functional aspects of life. High-anxiety individuals reported greater difficulties in eating, speaking, and maintaining relationships due to oral issues. In the UAE's multicultural society, where expatriates comprise over 88% of the population, unaddressed anxiety can compound stress from relocation and cultural adjustments.

The study's authors note that while cross-sectional, the patterns align with global evidence, suggesting anxiety contributes to avoidance behaviors, worsening conditions like caries (prevalence 35.9% in Abu Dhabi adults) and periodontitis (19.3%).

UAE's Oral Health Landscape: Challenges and Progress

Despite world-class facilities, UAE adults face high periodontal disease rates, rising despite global caries declines. A prior Dubai study found 59.3% dental anxiety prevalence among oral surgery patients, 18.2% severe. Factors include high-sugar diets, tobacco use, and irregular visits. Government initiatives like the National Oral Health Strategy aim to improve access, but psychological barriers persist.

RAKMHSU's research contributes to addressing these, training future dentists sensitive to patient fears.

The Role of UAE Universities in Advancing Dental Research

RAKMHSU's RAK College of Dental Sciences, offering a five-year BDS accredited by the Ministry of Education, emphasizes research alongside clinical training. This study exemplifies their focus on psychosocial determinants. Similarly, University of Sharjah's College of Dental Medicine conducts cutting-edge work, while NYU Abu Dhabi explores global health disparities.

These institutions produce graduates equipped for patient-centered care, integrating behavioral sciences into curricula to tackle anxiety.

Previous Studies and Global Comparisons

Prior UAE research, like a 2023 Dubai outpatient study, reported high anxiety linked to injections (41.6%) and extractions (32.7%). Globally, 10-20% suffer clinical anxiety, mirroring UAE trends. Middle Eastern studies confirm similar OHRQoL impairments.

The RAKMHSU paper calls for longitudinal research to establish causality, incorporating clinical exams.Read the full study here.

Effective Strategies for Managing Dental Anxiety

UAE clinics offer sedation dentistry (nitrous oxide, IV), tell-show-do techniques, and CBT. RAKMHSU trains students in these, promoting early intervention.

• Communication: Discuss fears openly with dentists.
• Relaxation: Deep breathing, progressive muscle relaxation.
• Technology: VR distraction, laser dentistry minimizing pain.
• Therapy: CBT reframes negative thoughts; effective alternative to sedation.

Clinics like those in Dubai provide nervous patient programs with sedation options.

🦷 Innovations in UAE Dental Education and Training

UAE universities like RAKMHSU integrate anxiety management into BDS programs from year one, with clinical exposure emphasizing empathy. University of Sharjah's advisory board focuses on research-driven curricula. This prepares graduates for diverse patients, enhancing UAE's oral health ecosystem.

Photo by Annie Spratt on Unsplash

Future Outlook: Research, Policy, and Actionable Insights

Longitudinal studies from UAE unis could inform national policies, like anxiety screening in clinics. Actionable steps: Dentists adopt MDAS routinely; patients seek university-affiliated clinics for holistic care. With UAE's Vision 2031 prioritizing health, addressing dental anxiety promises better OHRQoL.Dental Tribune coverage.

Stakeholders—from RAKMHSU researchers to policymakers—must collaborate for preventive strategies, reducing the cycle of avoidance and poor outcomes.