Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Daniel W. McNeil.


Avoidance of dental care, resulting from fear and anxiety, has major implications for oral and overall health. For instance, untreated oral disease may exacerbate cardiovascular disease and diabetes, among other systemic health concerns (Williams et al., 2008). In the USA, 5-10% of adults avoid necessary dental treatment because of dental care-related fear (Milgrom et al., 2009). The long-term goal of this project was to improve our understanding of psychosocial barriers to oral health care. Specifically, the study aimed to examine the relation between dental care-related fears, fear of pain, and dental beliefs in a rural, Appalachian population and to determine the impact and mechanism of the role of dental care-related fear and anxiety in the long-term utilization of an emergency dental clinic. For this retrospective cohort study, participants were 80 (40 female) adults visiting the West Virginia University School of Dentistry emergency clinic. A decade ago, these patients completed the Dental Fear Survey, the Fear of Pain Questionnaire, and the Dental Beliefs Scale in addition to a demographic questionnaire. Ten-year follow-up of these patients was completed by way of dental chart review. Abstracted information about the frequency and nature of emergency clinic visits was compared to the previously completed measures of dental care-related fear and anxiety using multiple linear regression analysis; neither dental care-related fear, fear of pain, nor negative beliefs about dentistry predicted total number of clinic visits or extractions for this sample of symptomatic treatment seekers. Interestingly, patients who received restorative dental treatment versus extractions had completed a significantly greater number of years of education than those who did not receive restorative treatment. Future work should continue to address symptomatic treatment-seeking patients, as they are a unique population whose dental attendance patterns may benefit from psychosocial intervention.