Abstract
Purpose Dental anxiety is a prevalent condition, impacting adults, adolescents and children worldwide. The purpose of this study was to evaluate the knowledge, confidence, and willingness to implement dental anxiety management techniques (DAMTs) by dental hygienists (DHs) in North Carolina (NC) as well as the types of DAMTs currently being used by DHs in NC.
Methods This cross-sectional study utilized an electronic survey of DHs licensed to practice in NC. An email list provided by the NC Dental Board was used to invite all dental hygiene licentiates (N=7,732) to participate. The 32-item survey included multiple-choice, select-all, Likert-scale, and open-ended on the following categories: demographics, knowledge, education, clinical experience, confidence to treat, and willingness to implement DAMTs. Descriptive statistics, multivariate analysis (p<0.05), and thematic analysis were used for data interpretation.
Results A total of 632 NC DHs completed the survey for a response rate of 8.17%. Most (99%, n=622) reported treating a patient with dental anxiety. Over one-third (36%, n=214) reported a lack of education on DAMTs at their educational institution and poor preparation in utilizing DAMTs post-education (4.90 on a 0-10 scale). Verbal DAMTs were more frequently learned during education by participants aged 18-34 compared to participants aged 55+ (p<0.0001). The most frequently recognized and utilized DAMTs were positive reinforcements (96.66%, n=578) and trust building (96.40%, n=536), followed by information (95.32%, n=570) and explanation (93.71%, n=521) and music (84.45%, n=505). Most reported confidence (99.45%, n=544) in treating patients with dental anxiety and willingness (99.25%, n=536) to modify care using DAMTs. Open-ended responses included trust, communication, empathy, and person-centered care.
Conclusion Although participants reported regularly treating patients with dental anxiety, there was limited knowledge and utilization of the various types of DAMTs. Respondents expressed interest in continuing dental anxiety management education.
- Received October 28, 2025.
- Accepted January 27, 2026.
- Copyright © 2026 The American Dental Hygienists’ Association
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