Trauma, Terror, and Toothpaste: Exploring Memories for Dental Visits Across a Range of Patient Fear.

Background/Objectives: Emotional fear memories are increasingly recognized as contributors to the development of specific fears and phobias. Despite this, relatively little dental fear research has specifically focused on patient memories or their potential role in the etiology of dental fear. Methods: This two-study paper employs qualitative thematic analysis of memories for dental visits among traumatized patients (study 1) and the general patient population (ranging from endorsing no dental fear to severe fear). Recollections were evaluated based on the characteristics (i.e., sensory descriptors, affectively laden, intrusive) of emotional fear memories (studies 1 and 2) and according to a modified cognitive vulnerability model of dental fear (study 2). Results: Characteristics of emotional fear memories were ubiquitous across recollections of individuals who endorsed traumatic dental visits in childhood. Among the general patient population, these characteristics and cognitive vulnerability themes (particularly perceptions of the visit and dentist as dangerous and untrustworthy) were more prevalent in the earliest remembered visits for fearful individuals. When individuals were asked to recall their worst dental visits, emotional fear memory characteristics and vulnerability perceptions were evident across the spectrum of current fear (none to severe). Conclusions: This study contributes to nascent work examining memory in specific fears and phobias and suggests that worst recollections across a general sample share many of the characteristics that might otherwise imply vulnerability for anxiety. We recommend that dental practices universally screen patients for fear, inquire about past negative experiences, partner with patients to minimize evoking their specific vulnerabilities, and diligently implement these personalized care plans.