As a result, many don't go for care until they have a toothache or abscess, Porac says.
With older patients, the hesitation may be caused by childhood memories of painful dental visits, says Dr. Kim Harms, consumer adviser for American Dental Association.
Dentistry 30 years ago was different from today, as the emphasis was on taking care of the tooth and less attention was given to the patient's comfort, says Harms, a general practitioner at River's Edge Dental Clinic in Farmington, Minn.
"The good news is that dentistry has progressed tremendously," Harms says. "Dentists are far more focused on the patient, and dentistry is pretty much pain free."
Dentists assume that all patients have some apprehension, Porac says.
"Who doesn't get nervous with any kind of health treatment?" he says.
The fears can be extreme.
"A lot of people say, `I'd rather have a baby than be here,' " Porac says.
Some say they are bothered by the noise and vibration from the dental equipment, Porac says. Others cite the lack of dental insurance or not having time for the appointment as reasons for avoiding the dentist's chair.
High on the list of feared procedures is the root canal, which cleans out and treats the diseased nerve in the center of a tooth.
For many people, feeling out of control for a long period of time is a problem, Harms says.
Telling your dentist about your fears can help.
"The most important tool we have is good communication between patient and dentist," Harms says. "Some come in with sweaty palms, but the majority look nice and calm on the outside."
Those who simply cannot tolerate having work done on their teeth can be given nitrous oxide or anesthesia that makes them sleep, Porac says. Prescriptions such as Valium can be taken an hour before the appointment, he says.
One way to relax is to put on stereo headphones and listen to music, Harms says.
Virtual reality glasses, which fit over the head like a sun visor and have a movie screen inside, provide another option. Patients can block out their fears by getting caught up in the movie.
For those with a needle phobia, an electronic anesthetic can be used, Harms says. Two sticky pads that transmit electronic stimulation are attached to the outside of the cheeks. The procedure works well for small fillings, and when the pads are removed, the patient doesn't feel numb, Harms says.
Porac advises both adults and children to visit the dentist every six months. People with healthy mouths and gums can go once a year, but it's not wise to wait much longer, he says.
Those with gum disease should see a dentist more frequently, he says.
It's important to overcome your fears, as the people who tend to lose their teeth are those who fail to visit the dentist, Harms says.
"People can have healthy teeth their entire life," Harms says. "We can maintain them indefinitely."