Oral health is an important part of an individual's overall health; however, dental care is not included in the Canadian public healthcare system. Many Canadians struggle to access dental care, and six million Canadians avoid visiting the dentist each year due to cost.1 The most vulnerable groups include children from low-income families, low-income adults, seniors, indigenous communities, and those with disabilities.1–5 The lack of affordable, equitable, and accessible dental care puts undue strain on emergency departments across the country, as patients desperately seek the care of a physician when they actually need the care of a dental professional.6 Emergency physicians do not have the same expertise or equipment as dentists and, in most cases, are only able to provide temporary symptom relief. This results in an increased reliance on prescription opioids that would otherwise be unnecessary if patients could access the dental care they required.

The aetiology of dental anxiety is multifactorial. Psychologically traumatising events associated with dental treatment have been shown to be of particular importance. The present investigation examines the role of memory in relation to these traumatic episodes and investigates their influence on the patient's response to dental treatment.

The study has shown that patients with dental anxiety have had more experience of “traumatic dental events” (p<0.001), relate the cause of their dental anxiety to specific dental procedures and report more fear of dental treatment than controls. The memories of such traumatic dental events are important indicators of anxiety in the clinical setting, with dentally anxious patients having significantly higher scores for dental anxiety (p<0.001) compared with controls. Furthermore, the memories of these events have a special relevance to the patient's subjective experience of dental anxiety in the here and now. The past event sensitises the susceptible patient and maintains and intensifies the anxiety through a feed-back mechanism, resulting in a vicious circle of anticipatory dental fear.