Why People Delay Dental Visits, and What It Means for Their Health

Los Angeles Times

5 days ago

Missing or putting off dental appointments may seem harmless in the short term but over time those delays can have long term consequences – not just for your teeth but for your overall health. From cavities in toddlers to infections in cancer patients, understanding why people put off treatment is the first step to changing those habits. Research shows those delays are rarely about laziness – they're more often about cost, anxiety, lack of support and access barriers with lack of dental insurance or not being covered by a dental plan being a common reason for delay.
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Dental delays are more common than you think. A 2025 cross-sectional study found that over 71% of preschoolers with cavities didn't get treated right away. The average delay? Nearly four months—117.5 days [1]. Reasons ranged from financial hardship and logistical challenges to caregivers not knowing their child had a problem until it got worse. Dependents like children rely on caregivers to find the right dental care and meet the requirements for timely treatment.
And it's not just kids. During the COVID-19 pandemic, nearly half of U.S. adults admitted to putting off dental care [4]. What's interesting is that urban residents—despite having more dentists nearby—were more likely to delay treatment than those in rural areas. That means it's not just about distance; stress, work schedules and transportation logistics may be just as big of a factor.
Fear is a powerful barrier. A 2023 study found that dental anxiety and low self-efficacy—the belief that one can't handle the stress or logistics of dental treatment—were stronger predictors of delay than simple procrastination [3]. In plain terms, some people aren't avoiding the dentist because they don't care—they're overwhelmed, nervous, or unsure how to take the first step.
In older adults, social support can make all the difference. Research from China on oral cancer patients found that those who lived with their adult children were less likely to delay treatment [2]. When people feel supported, they're more likely to seek care promptly.
We hear all the time about the importance of early dental visits for kids but the data tells a more complicated story. A 2012 Medicaid study found no significant difference in outcomes between kids who had their first dental visit before 18 months and those who started later [5]. Early care is important but maybe not as early as some programs suggest. Dental benefits and dental coverage for kids are based on state Medicaid policies and kids have to qualify for these services according to specific criteria. That could help us target our prevention efforts more effectively.
Meanwhile dental neglect—intentional or not—remains a big problem. States vary in how they provide dental services and preventive services to kids through Medicaid. A global review found 34-56% of kids and teens are affected by dental neglect [8]. Whether it's financial strain or caregivers not knowing the signs of dental disease, the takeaway is clear: education and access matter just as much as timing.
Dental health doesn't exist in isolation. For patients undergoing cancer treatment, a minor dental issue can be life threatening. If a dental problem is left untreated it can complicate or delay cancer therapy. A 2018 systematic review found a high rate of untreated dental infections like pericoronitis in oncology patients [9]. These infections can delay or complicate chemotherapy and radiation. That's why cancer care teams are working more closely with dental professionals – often involving a dental practice to treat emerging oral health issues as they arise – to catch problems early and avoid preventable setbacks.
If a tooth has been neglected for too long many people assume the only option is to extract and replace. But is that always the best choice? The goals of dental treatment should include both preserving natural teeth whenever possible and patient preferences for long term outcomes. A 2013 review compared long term outcomes of preserving compromised teeth vs replacing them with implants. Surprisingly well maintained natural teeth lasted longer than implants [10]. This finding supports the value of early conservative treatment – acting sooner means saving teeth rather than replacing them.
Not directly related to delays but a 2022 Cochrane review on full-mouth disinfection for periodontitis brings up a related question: timing matters but so does method. Not all periodontitis cases need antibiotics and overtreatment should be avoided. Full-mouth treatment is meant to be aggressive but the evidence didn't show it was superior to step-by-step scaling and root planing [6]. It raises the question of overtreatment especially when antibiotics are involved.
This applies outside of dentistry too. A 2025 study on statin therapy in diabetic patients found that delays in preventive care even when not related to teeth led to worse outcomes [7]. The lesson applies across all medical disciplines: proactive care is better.
Delaying dental care isn't about being lazy—it's about fear, finances, logistics and sometimes just lack of information. What's clear is that delays are costly in dollars and in health. Fixing this requires a multi-faceted approach:
Timely dental care doesn't just save smiles it saves overall health and quality of life.
[1] Huang, J., Sun, J., Ji, Y., Chen, C., Yang, Z., & Zhao, H. (2025). Analysis of factors influencing delayed treatment seeking for dental caries in preschool children: a cross-sectional study. BMC public health, 25(1), 1669. https://doi.org/10.1186/s12889-025-22936-5
[2] Yang, Y., Ning, H., Liang, B., Mai, H., Zhou, J., Yang, J., & Huang, J. (2024). Exploring Factors Influencing Patient Delay Behavior in Oral Cancer: The Development of a Risk Prediction Model in Western China. Healthcare (Basel, Switzerland), 12(22), 2252. https://doi.org/10.3390/healthcare12222252
[3] Steinvik, L. M., Svartdal, F., & Johnsen, J. K. (2023). Delay of Dental Care: An Exploratory Study of Procrastination, Dental Attendance, and Self-Reported Oral Health. Dentistry journal, 11(2), 56. https://doi.org/10.3390/dj11020056
[4] Kranz, A. M., Gahlon, G., Dick, A. W., & Stein, B. D. (2021). Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic. JDR clinical and translational research, 6(1), 8–14. https://doi.org/10.1177/2380084420962778
[5] Beil, H., Rozier, R. G., Preisser, J. S., Stearns, S. C., & Lee, J. Y. (2012). Effect of early preventive dental visits on subsequent dental treatment and expenditures. Medical care, 50(9), 749–756. https://doi.org/10.1097/MLR.0b013e3182551713
[6] Jervøe-Storm, P. M., Eberhard, J., Needleman, I., Worthington, H. V., & Jepsen, S. (2022). Full-mouth treatment modalities (within 24 hours) for periodontitis in adults. The Cochrane database of systematic reviews, 6(6), CD004622. https://doi.org/10.1002/14651858.CD004622.pub4
[7] Shah, N., Lan, Z., Brown, C. J., Martin, S. S., & Turchin, A. (2025). Impact of Statin Nonacceptance on Cardiovascular Outcomes in Patients With Diabetes. Journal of the American Heart Association, 14(11), e040464. https://doi.org/10.1161/JAHA.124.040464
[8] Khalid, G., Metzner, F., & Pawils, S. (2022). Prevalence of dental neglect and associated risk factors in children and adolescents-A systematic review. International journal of paediatric dentistry, 32(3), 436–446. https://doi.org/10.1111/ipd.12923
[9] Hong, C. H. L., Hu, S., Haverman, T., Stokman, M., Napeñas, J. J., Braber, J. B., Gerber, E., Geuke, M., Vardas, E., Waltimo, T., Jensen, S. B., & Saunders, D. P. (2018). A systematic review of dental disease management in cancer patients. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 26(1), 155–174. https://doi.org/10.1007/s00520-017-3829-y
[10] Levin, L., & Halperin-Sternfeld, M. (2013). Tooth preservation or implant placement: a systematic review of long-term tooth and implant survival rates. Journal of the American Dental Association (1939), 144(10), 1119–1133. https://doi.org/10.14219/jada.archive.2013.0030