Increased Dental Anxiety, Fear & Care Avoidance in Red Heads

Objectives: Red hair is a reliable phenotype for mutations of the melanocortin-1 receptor gene (MC1R) and is associated with increased general anesthetic requirement and resistance to local anesthetics. We thus tested the hypothesis that redheads fear dental care and local anesthesia, and avoid dental care more than people with other hair colors.

Methods: Sixty-nine red-heads and seventy-seven dark-haired participants (aged 18 to 40 years) were genotyped for MC1R alleles. Each also completed validated survey instruments designed to measure psychological symptomatology, global and dental-specific anxiety, constructs associated with dental fear, fear of local anesthesia, and previous dental history including dental care avoidance. Bivariate and multivariate analyses were conducted.

Results: Ninety-six percent of red-haired subjects had deleterious MC1-R mutations compared to twenty-seven percent of dark-haired subjects. Red-heads were more than more than twice as likely to exhibit substantial dental anxiety and avoidance of dental care than participants with dark hair, even after controlling for state, trait, and generalized anxiety sensitivity (p = 0.02). Fear of dental treatment and fear of local dental anesthesia administration was significantly higher in subjects with red hair even after controlling for state, trait, and generalized anxiety sensitivity (p = 0.04). Results were similar when the analyses were conducted based on deleterious MC1-R mutations rather than hair color.

Conclusion: The results support our hypothesis that red hair and mutations of the MC1-R gene are associated with dental anxiety, dental fear, fear of local anesthesia, and avoidance of dental treatment. Patients with MC1-R mutations may thus require special encouragement to obtain dental care, as well as additional local anesthesia for procedures. Funded by NIDCR grant R21DE016064.