Perceived barriers, applied strategies, and typology of dentists treating patients with dental anxiety: a qualitative study

Dental anxiety (DA) represents a significant challenge for patients and dental practitioners alike. While previous research has mainly focused on patients’ perspectives, less is known about how dentists themselves perceive and manage DA. This study aimed to explore interpersonal barriers, strategies, and experiences of dentists in the treatment of anxious patients and to develop a typology of dentists’ approaches. Semi-structured interviews with 60 dentists (15 specialized in DA treatment, 45 general practitioners) were conducted. The interview guide included 22 open-ended questions addressing definitions of DA, barriers, strategies, and personal experiences. Interviews were audio-recorded, transcribed verbatim, and analysed using qualitative content analysis. A typology of dentists was developed by clustering recurring response patterns across attitudes, strategies, emotional effects, and perceived helplessness. Dentists recognized DA as a prevalent and clinically relevant problem that affects both patients and dental staff. Barriers included patient unreliability, limited financial reimbursement, time constraints, and lack of psychological support structures. Analysis revealed four distinct types of dentists: Understanders, Demanders, Improvisers, and Unguided. These groups differed systematically in their motivation, strategies, and openness to change. Successful concepts were often linked to continuing education or psychotherapeutic collaboration and were associated with reduced practitioner stress and improved patient–dentist relationships. This study suggests the presence of several interpersonal barriers in the management of DA and highlights substantial heterogeneity among dentists. The proposed typology offers a basis for tailored continuing education, curricular integration, and policy measures aimed at improving care for anxious patients while reducing practitioner burden.