dental aggression

Workplace Violence in the Dental Office

Violence in the dental office

According to a recent study led by researchers at NYU College of Dentistry, almost half of U.S. dentists experienced verbal or reputational aggression by patients in the previous year. Nearly one in four endured physical aggression. 

The study, published in the Journal of the American Dental Association, is the first to document aggression toward dentists in the United States. 

Aggression in healthcare 

Workplace aggression toward healthcare professionals is common, with healthcare settings second only to law enforcement in the rate of violent incidents. However, prior to this research, there had been no formal studies of aggression toward dentists in the U.S.

“Workplace violence toward healthcare professionals is both widespread and widely overlooked,” said Kimberly Rhoades, a research scientist in the Family Translational Research Group at NYU College of Dentistry and the study’s lead author. “The purpose of this study was to provide an initial estimate of rates of patient aggression in dental practices in the United States.” 

Rhoades and her colleagues surveyed 98 dentists practicing in the New York City metropolitan area. Participants had been working an average of 17 years. Participants completed a confidential online survey assessing whether they had experienced any of 21 specific types of aggressive behaviors from their patients: 

  • Physical violence (i.e., being pushed or kicked) 
  • Verbal violence (i.e., being insulted or sworn at) 
  • Reputational (i.e., threats of lawsuits or posting nasty comments on social media)  


A substantial proportion of dentists reported experiencing aggression from patients in the past year. This included physical (22.2%), verbal (55%), and reputational (44.4%) aggression.  

An even larger proportion of dentists surveyed were subjected to physical (45.5%), verbal (74%), and reputational (68.7%) aggression at some point during their career. These rates of patient aggression toward dentists are high and comparable with those reported in other healthcare settings. 

Rates of aggression did not differ by dentists’ sex, race, ethnicity, specialty, age, years practicing, or average number of patients treated per day. 

“Dentistry is rife with situations that can elicit strong negative emotions, such as fear, pain, distrust, and anger. Many patients also experience high levels of anxiety and vulnerability, which may increase negative responses or aggression,” said Rhoades. “Establishing that aggression toward dentists is a problem and how often it occurs can help us develop interventions to prevent aggression in dental practices.” 

Interventions and emergency action plans 

The American Dental Association (ADA) recommends that all dental practices include a written statement on workplace violence in their office’s employee policy manual. Part of this statement may include an Emergency Action Plan (EAP).  

For dental offices, the ADA suggests that an EAP should address workplace violence by communicating that: 

  • Every employee has a responsibility to help maintain a safe work environment 
  • A safe work environment is one that’s free of acts of physical violence, harassment, intimidation, and other disruptive behavior 
  • Workplace violence can take many forms, including:
    • worker-related violent incidents
    • incidents caused by non-employees who perpetrate acts of violence upon employees in the workplace 
  • All team members must report any violence in the practice to the dentist, including:
    • harassment and language that is threatening, insulting, or vulgar 

Find EAP templates and tools on the OSHA site here.