Introduction

Of all visits to the doctor, a visit to the dentist is likely one of the most unpleasant (Willershausen et al., 1999). The very thought of the smell at a dentist's office sends a cold shiver down some people's spines, not to mention the thought of the sound of the drill. At the same time, a smile characterized by a healthy white row of teeth makes for a good first impression and may be worth the visit to the dentist. Besides the fear of going to the dentist, there are also other reasons for postponing this visit. Some tend to put off this appointment as well as other appointments in their daily routine that they know are necessary. This phenomenon is called procrastination.

Procrastination is defined as a voluntary postponing of tasks that one knows should be done (Steel, 2007) and is a well-researched phenomenon (Klingsieck, 2013; Rozental & Carlbring, 2014; Steel, 2007). One prominent explanation is that more attractive, more pleasant tasks are preferred to less attractive, more aversive tasks (Pychyl et al., 2000; Steel, 2007). If we assume that procrastinators prefer the reception of short-term rewards, or the avoidance of short-term punishment, to long-term consequences, it is understandable why a healthy smile in the long run is not sufficiently opposed to the possible pain of dental treatment. However, procrastination research was initially focused strongly on the academic domain for decades (Lee, 2005; Moon & Illingworth, 2005; Steel & Klingsieck, 2016). This is not surprising, as up to 75% of students report that they procrastinate and the negative effects of procrastination have been demonstrated especially in academia (for an overview see, Steel, 2007). Recent studies show that procrastination also has an impact on life beyond the academic sector. Hen and Goroshit (2018) identified several areas where people suffer from procrastination (e.g., health, finances, friendships). In their study, health stood out the most from the eleven different areas of life presented to the participants. In fact, 40% of the participants reported to suffer in their health care due to procrastination.

The negative influence of procrastination on health is also illustrated by Sirois (2007) in the procrastination-health model. This model postulates that procrastination might have a negative impact on health in two ways – the direct and the indirect path. In the direct path, procrastination causes stress, which results in a permanent activation of the stress response. This in turn can lead to a deterioration of the immune system due to subsequent release of cortisol, which can result in various diseases on the one side. On the other side, it provokes the arousal of the autonomous nervous system which can lead to an elevated heart rate besides other health problems. In the indirect path, procrastination leads to illness because health-promoting behaviours are poorly performed or not performed at all. For instance, exercising or eating healthy are repeatedly postponed which often does not have a negative effect on health immediately, but in the long term.

Some studies have already shown this (negative) impact of procrastination on health-promoting behaviour, e.g. going to bed on time (Kroese et al., 2014, 2016; Rapoport et al., 2023) or exercise regularly (Kelly & Walton 2021; Klingsieck & Weigelt, 2016; Rapoport et al., 2022). It has been shown that high procrastinators exercise less than they intended to, sleep less, do not keep to their scheduled bedtimes, and generally report more health problems. The importance of studying procrastination of health-related behaviours such as sleep, exercise, and healthy eating has thus already been recognised. For this reason, special questionnaires were developed in these areas to assess domain-specific procrastination. In the area of bedtime procrastination, there is the Bedtime Procrastination Scale by Kroese et al. (2014), and for sports, there are the questionnaires by Klingsieck and Weigelt (2016) and by Kelly and Walton (2021). Haghbin and Pychyl (2016) also developed the Exercise and Healthy Diet Procrastination Scales.

However, in addition to a healthy diet, regular exercise and adequate sleep, preventive check-ups with a doctor are also part of a healthy lifestyle and known to ensure healthiness. Crucially, regular check-ups at the doctors can diagnose and treat diseases more quickly, which leads to a healthy and long life in the long run (Hung et al., 2014). It is not without reason that there are recommendations for certain preventive examinations from certain age groups onwards (Virgini et al., 2015). Nevertheless, these examinations are often associated with unpleasant feelings ("What if something bad comes out?") and are therefore all the more suitable for being postponed or avoided altogether. In the surprisingly few studies on procrastination of medical examinations so far, it has been found that procrastinators tend to put off medical (Sirois, 2003) and mental (Stead et al., 2010) treatments. Crucially, Sirois (2007) presented first data that procrastination is also associated with less medical (r = -.22) and dental (r = -.30) check-ups.

Dental check-ups are a particularly interesting area. Dental hygiene is one of the few medical areas where a regular annual check-up is recommended at any age, and it represents an area of the body that is usually difficult to hide from others. However, dental hygiene simultaneously is an undeniably difficult issue. One third of the English population reports not to go to the dentist regularly (Steele et al., 2009). Globally, the number of unattended dental check-ups is estimated at 54% (Reda et al., 2018). In a recent study by Inoue et al. (2021), 63% of respondents (of the Japanese population) reported delays in their dental check-ups. This makes it obvious that this is a widespread global problem. At the same time, the study by McGrath and Bedi (2001) shows that people who have seen a dentist in the year of the survey believe that their dental health has a positive impact on their quality of life. In addition, there is a direct negative correlation between dental disease (e.g. formation of caries) and the frequency of dental visits (Aldossary et al., 2015). This is not surprising, because regular visits to the dentist are also associated with good dental hygiene (Hill et al., 2013). This in turn also determines the quality of life, for example through the absence of pain, the ability to eat as well as social factors like smiling (Spanemberg et al., 2019). Dental health is also associated with mental stability, whereas poor oral hygiene can be associated with lack of self-esteem and depression (O’Neil et al., 2014).

Until now, little attention has been paid to underlying personality factors in the research of dental attendance. When investigating the causes, most studies assume that dental anxiety (fear before and during dental treatment that leads to visiting dentists only in case of pain) is the main reason for low attendance or postponement of dental appointments (Hill et al., 2013). In response, there are efforts to remedy this problem of missed dental attendance through the use of mobile schedulers (Foley & O’Neill, 2009) or the use of rewards for regular check-ups (Xia & Song, 2016). However, these are aids that are externally controlled and do not necessarily have a long-term effect. Another possible positive influence could be self-compassion. People with high values in self-compassion are more likely to go to the doctor when they are ill and to follow the doctor's prescription (Terry & Leary, 2011).

Self-compassion means the ability to encounter oneself with goodwill, to accept one's own suffering, and to confront oneself with one's own mistakes without self-criticism (Neff, 2003a). Moreover, it means facing one's own suffering openly, whether it is self-inflicted or caused by others. It also means treating one's weakness with kindness, without judgement and critical thoughts, rather than distancing oneself (Neff, 2003a). Self-compassion helps to cope with negative situations (Leary et al., 2007), improves overall well-being and is negatively related to depression, anxiety, worry, and neuroticism (Neff, 2003a; Raes, 2010). Crucially, the available evidence points to a strong link between self-compassion and health-promoting behaviours. Studies have shown that individuals with high self-compassion are more attentive to their health, smoke less, drink less alcohol and are more likely to seek medical help when they need it (Allen and Leary, 2014). Self-compassion is associated with less stress (Sirois, 2014) and better general health condition (Brion et al., 2014; Dunne et al., 2018; Sirois, 2020; Terry et al., 2013). Furthermore, it is strongly linked to health consciousness, motivation to avoid unhealthiness, and approach health satisfaction (Terry et al., 2013). Dunne and colleagues (2018) showed that the influence of self-compassion on physical health is mediated by health-promoting behaviour.

With self-compassion having a rather positive influence on healthy behaviour (Brion et al., 2014; Dunne et al., 2018; Sirois, 2020; Terry et al., 2013), and procrastination having a rather negative influence on healthy behaviour (Kroese et al., 2014, 2016; Rapoport et al., 2022; Sirois et al., 2003), the exact impact of procrastination and self-compassion combined is not entirely clear. That is, the two factors could have an independent effect on health behaviour, or conversely, it could be that they have a joint effect on health behaviour. One possible type of this relationship could be that self-compassion offsets the influence of procrastination, in which case it would be possible that particularly strong procrastinators would benefit from high self-compassion. It is known that procrastination and self-compassion are negatively related (Sirois, 2014) and that they can influence certain parameters in different directions. For example, self-compassion has a positive effect on sleep quality and sleep satisfaction, whereas bedtime procrastination has a negative effect on these parameters (Rapoport et al., 2023). It has also been shown that self-compassion has the ability to minimise the influence of procrastination on behaviour. Rapoport and colleagues (2022) investigated the influence of sports procrastination and self-compassion on sports behaviour. They found that high sport procrastinators tend not to complete the sport activity they have planned for the week (intention-action gap, for an overview see Sheeran & Webb, 2016). However, if these high procrastinators show high values in self-compassion, the effect is cancelled out and they do as much sport as they have planned (comparable to the low sport procrastinators). Yet, these effects could only be demonstrated to a limited extent for other areas such as bedtime procrastination (Rapoport et al., 2023). The question arises in which way self-compassion and procrastination influence and possibly interact in one crucial health behaviour field, namely dental attendance. Interestingly, self-compassion is not well researched in the field of dental health. Only one study (Friis et al., 2017) has so far investigated this relationship, finding that the time spent flossing is reduced after self-compassion training. This is a contradictory result, as self-compassion is known to increase health-promoting behaviours in other areas (Brion et al., 2014; Dunne et al., 2018; Sirois, 2020; Terry et al., 2013). Yet, since flossing is a specific health behaviour and was performed under laboratory conditions, it would be important to systematically explore the interaction between self-compassion, procrastination and dental health behaviour.

Current study

The aim of this study was to explore the relationship between procrastination and dentist behaviour. In particular, we were interested in whether high procrastination leads to an unhealthy dentist behaviour. More precisely, we assumed that high levels of procrastination should lead to less dental attendance, like visiting the dentist less often or postpone appointments. At the same time, we hypothesised that self-compassion would have an opposite effect on procrastination by showing a positive impact on dental attendance. To examine this relationship more closely, we wanted to exclude another factor that may have an influence on dental attendance: dental anxiety, i.e. an increased fear before and during a dental procedure. To the best of our knowledge, there are no studies to date that relate dental anxiety to self-compassion and procrastination. However, we would assume that dental anxiety is positively related to procrastination and negatively related to self-compassion to be in line with our previous conclusions.

Methods

Participants

Overall, 348 participants took part in the study. After the exclusion of subjects under 18 years of age, data were available for 341 participants (Mage = 33.43, SDage = 14.35, range = 18 – 70; 73.90% female). 31.7 % of the participants were students, 40.2 % employees and 28.1% were either pupils, trainees, civil servants, self-employed persons, unemployed, and others. 23% of the participants reported having a university degree. The participants were recruited at the local university, yet mostly through social networks (Facebook & Instagram) and via messenger services like whatsapp groups to reach a wide range of the general population. There was no reward for participation. Data were collected via an online tool (https://www.soscisurvey.de). To find a small effect, an analysis with G-Power (Faul et al., 2009) specified a number of at least 272 subjects. To reach this number, the study link was accessible for one month (12 June 2020 - 15 July 2020). After that, participation was no longer possible. However, more persons participated in the study during this period. Before registration, participants were informed about the procedure and provided their informed consent. Participation was only possible after actively clicking on the consent, in accordance with the recommendations of the local ethics committee. The survey was conducted in accordance with the Declaration of Helsinki on ethical principles. As only non-invasive procedures were used, no permission was requested from the local ethics committee. The participants then reported their gender, age, formal education and type of employment and fulfilled the questionnaires (presented in randomized order) afterwards.

Material

General procrastination

To measure general procrastination, the short version of the General Procrastination Scale (GPS-K, German version) by Klingsieck and Fries (2018) was used. It consists of nine items such as "Even small tasks, which only require sitting down and completing them, often remain undone for days" and "Normally I start a work at a task as soon as I receive it" (inverted item). Items were scored on a 4-point Likert scale ranging from 1 = very atypical to 4 = very typical. It showed an excellent internal consistency in this study, Cronbach's 𝛼 = .93.

Self-Compassion

To assess participants’ levels of self-compassion, the German version of the Self-Compassion Scale (SCS; Neff, 2003b; translated and validated by Hupfeld & Ruffieux, 2011) was used. The SCS uses a 5-point Likert-type scale from 1 = very rarely to 5 = very often. The 26-item questionnaire includes six subscales: Self-Kindness, Self-Judgment, Common Humanity, Isolation, Mindfulness, and Over-Identification and can be combined to a total score (Cronbach's 𝛼 = .90).

Dental anxiety

To examine dental anxiety, we used the German version of the Dental Fear Survey (Kleinknecht et al., 1973; German translation: Tönnies et al., 2002). The DFS consists of 20 items divided into four scales: postponement or cancellation of a treatment appointment (two items), psychophysiological fear reactions during dental treatment (five items), anxiety or unpleasant feelings before and during the various treatment phases or situations (12 items), and an overall assessment of global dental fear (one item). The five-level answer options for the postponement or cancellation of a treatment appointment scale range from 1 = never to 5 = almost always and for the other scales from 1 = none to 5 = very much. The DFS is not designed to give a single value (for an overview, see Armfield, 2010) and was particularly chosen because it contains a scale of postponement of a dental visit. We reversed the polarity of the two items in this scale and added them to our dental attendance scale (for more details, see the results section). In order to get a value for the total dental anxiety, we also used the German version of the Dental Anxiety Scale (DAS; Corah, 1969; German translation: Tönnies et al., 2002). The DAS describes four situations in which the subjects are asked to rate how they feel, on a scale from 1 = relaxed to 5 = so anxious that I break out in sweat and feel downright ill and shows excellent internal consistency in this study (Cronbach’s 𝛼 =. 91).

Dental attendance

In the first study on procrastination and dental health by Sirois (2007), the relationship was only assessed by the statement "I see the dentist for regular check-up.”. The aim of the present study was to extend this behaviour further to include other factors such as putting off going to the doctor and not going to the dentist when in pain. Thus, we formulated questions on our own and checked by exploratory factor analysis whether they were assigned to the construct called dental attendance as a part of this study.

As mentioned above, we used the two items from the DFS-subscale postponement of a dental visit for our dental attendance scale: “Has fear of dental work ever caused you to put off making an appointment?” and “Has fear of dental work ever caused you to cancel or not appear for an appointment?”. In addition, we designed the following items to explore dental attendance in more detail: "I see the dentist for regular check-ups." (corresponding to Sirois, 2007), "I only go to the dentist if I have complaints." (inverted item), "If I have severe pain I go to the dentist immediately.", "I find it difficult to make an appointment with the dentist." (inverted item), and "My dentist behaviour is clearly affecting my life." (inverted item). Participants rated the extent to which the statements applied to them on a 5-point Likert scale ranging from 1 = does not apply at all to 5 = totally applies. The resulting scale is presented in detail in the results section.

Additionally, participants were asked to enter a time slot for the question: "How long have you not been to the dentist?” with the answering options "max. one year", "1 - 2 years", "2 - 5 years", "5 - 10 years", and "> 10 years". This item was not included in the questionnaire because it did not meet the requirement of interval scaling.

Statistical analysis

All analyses (Bayesian and frequency) were conducted with JASP (version 0.16.0). Correlations and multiple regressions were used for data analysis. All data is openly available on OSF at https://osf.io/63dpm/?view_only=2ada579c2bc242e0b72d956076ad1917.

Result

Exploratory Factor Analysis for dental attendance

Table 1 contains the intercorrelations between the dental attendance items. Exploratory Factor Analysis was performed in order to determine the factor structure of the scale by means of the obtained data. The Kaiser-Meyer-Olkin measure verified the sampling adequacy for the analysis, KMO = .849. Bartlett’s test of sphericity χ2(21) = 1006.37, p < .001, indicated that correlation structure was adequate for factor analysis. An iterated oblimin promax rotation method was used because the factors were assumed to be correlated with each other. The Kaiser’s criterion of eigenvalues greater than 1 (see Field, 2009) yielded a one-factor solution as the best fit for the data. The results of this factor analysis are presented in Table 2. The scree test also indicated one factor as the best factor solution. Item 3, “If I have severe pain I go to the dentist immediately.”, showed a low factor loading of .440, so we decided to exclude this item, resulting in the inclusion of six items.

Table 1 Descriptive statistics and intercorrelations of the dental attendance items
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Table 2 Factor loading for the seven items included in the Exploratory Factor Analysis
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After we had reversed the polarity of the five inverted items, we formed an average value from the six items which we called dental attendance. Overall, it showed a good internal consistency in this study, Cronbach's 𝛼 = .85.

Correlational analysis: General procrastination, self-compassion, dental anxiety, and dental attendance

General procrastination and self-compassion were negatively correlated in this study, r(341) = -.20, p < .001 (Table 3), as reported in other studies. Moreover, general procrastination correlated positively with all facets of dental anxiety, r’s = .14 to .20, p < .05. Interestingly, as we expected, there was also a negative correlation with dental attendance, confirming our assumption that general procrastination and dental attendance are related to each other, r(341) = -.23, p < .001. It is also interesting that self-compassion correlated positively with dental attendance, r(341) = .12, p =.031. This suggests that self-compassion is associated with positive health-behaviour.

Table 3 Descriptive statistics and intercorrelations of the main questionnaires
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Multiple regression analysis: dental anxiety, general procrastination, and self-compassion

A hierarchical multiple regression analysis was used to examine the effects of general procrastination and self-compassion on dental attendance with regard to dental anxiety. Dental anxiety was entered as Step 1. General procrastination and self-compassion scores were entered as Step 2. Dental anxiety entered at Step 1 accounted for 45.6% of the variance. The variables entered as Step 2 resulted in a significant increase of the explained variance (R2 = .47, p = .007). Interestingly, only dental anxiety, β = -.65 p < .001, and general procrastination, β = -.11, p = .007, were significant predictors in Step 2, but not self-compassion (Table 4).

Table 4 Regression results using dental attendance as the criterion
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The same Bayesian linear regression analysis revealed the model including dental anxiety and general procrastination, BFM = 14.84, to be at least two times more likely than the model with only dental anxiety, BF01 = 2.67 and at least nine times more likely than any model including self-compassion, BF01 = 9.42.

Discussion

The aim of the present study was to take a deeper look at the impact of procrastination on health-promoting behaviour in the field of dental health. The results indicated that procrastination plays a significant role in dental attendance, in the sense that high values in procrastination lead to less dental attendance. Based on previous evidence, it is known that regular dental check-ups are associated with long-term dental healthiness (Thomson et al., 2010). This result fits well with the existing literature pointing out that procrastination minimizes health-promoting behaviour in different health-related areas, like sports and sleep (e.g., Kroese et al., 2014, 2016; Rapoport et al., 2022). Thus, this study extends this relationship as our results were able to indicate another area in which procrastination can have a negative impact on health. This is important because once these areas are discovered, an accurate statement can be made about the consequences of procrastination. This is crucial because, among other things, it also shows again that the consequences of procrastination are not limited to a certain area (e.g., academia) or a certain age group (e.g., youth).

The results of our study indicated that dental health is a new field of research in which procrastination and its probable negative effects should be studied more closely. Yet, as this extends the existing procrastination literature into a new section of health, the creation of a new questionnaire was necessary. In the questionnaire we created, it was our intention to combine several factors related to dental attendance into one construct. It was important for us to capture not only the behaviour related to regular check-ups, but also more concrete behaviour, for example in the case of pain. In addition, we surveyed the extent to which participants tend to postpone appointments at the last minute or not go at all. We worked on the coherence of the questions, which is also reflected in the good fit. Furthermore, during the survey it was our aim to investigate a broad age range of participants (18 – 70 years), indicating a high representation of the general population. This made it possible to conduct a clearer statement about the influence of procrastination on dental attendance and thus also to look for factors to minimise it.

Our study was explicitly designed to allow to differentiate between any effect of procrastination and dental anxiety. Interestingly, when procrastination was included in the calculation, there was an improvement in the variance explanation compared to the model with only dental anxiety. Dental anxiety is a factor that has been studied a lot in the context of dental attendance (Hill et al., 2013). However, we were able to show that there are other personality factors that can have an influence on dental attendance. In the case of dentist anxiety, numerous types of therapy or interventions are used to try to minimise it (e.g., Appukuttan, 2016). If we consider that a part of people does not attend dentist appointments only because of procrastination, this part would not be affected by the measures of dental anxiety therapy. For these people, other solutions would have to be found.

The present study indicates a negative effect of procrastination on dental attendance, even when dental anxiety is accounted for. This opens up the question if dental procrastination needs to be considered as a domain-specific procrastination. After many years of using more general procrastination questionnaires, the need for domain-specific questionnaires has lately been increasingly emphasized (Klingsieck, 2013; Mann, 2016). For example, with regard to bedtime procrastination, Kroese et al.’ (2014) Bedtime Procrastination Scale shows much higher correlations with sleep-specific outcomes (sleep quality, sleep duration, discrepancy between planned and actual bedtime, and sleep satisfaction) than the general procrastination scale (Rapoport et al., 2023). Thus, domain-specific questionnaires are much closer to the procrastinated behaviours. This calls for the development of a domain-specific dental-procrastination questionnaire, which is beyond the scope of the present study.

While one central aim of the present study was to investigate the possible negative influence of procrastination on dental attendance, another aim was to investigate one factor which might be a counteracting force: self-compassion. The data of the present study do not provide a clear indication for this question. On the one hand, the correlation points in the direction we suspected, that high self-compassion also goes hand in hand with more dental attendance, but at the same time the values are not particularly high and are not supported by the subsequent regression analysis. We were also able to show the negative correlation between procrastination and self-compassion, which was also found in other studies (e.g., Rapoport et al., 2022; Sirois, 2014). However, it is still unclear in which way the two factors interact with each other in relation to health behaviour. Up to now, the interaction between procrastination and self-compassion on health behaviour has only been shown in the literature for sports behaviour (Rapoport et al., 2022). In this study, sports behaviour was defined as the difference between planned and actual exercises during the week. It might be possible that a high degree of self-compassion is helpful in implementing planned intentions. However, in our study we did not compare planned behaviour with actual behaviour, but only looked at actual behaviour. Moreover, sports behaviour is a regular activity, whereas a visit to the doctor is usually an exception in everyday life. Additionally, the last visit to the doctor is different in time lag between the participants and is therefore difficult to compare with a behaviour that is carried out weekly, if not daily.

Nevertheless, the positive correlation between self-compassion and dental attendance might indicate that an increase in self-compassion can also lead to an increase in dental attendance. This is particularly important because self-compassion can be learned. Targeted exercises have already led to improvements in other health-promoting areas. In the study by Kelly (2010), training in self-compassion led to a reduction in daily smoking, and in the study by Kelly and Carter (2015), binge eating was reduced. For this reason, it would be interesting to see whether dental attendance can also be improved through training in self-compassion. To the best of our knowledge, the only study in the area of self-compassion and dental health is the one by Friis et al. (2017), which pointed out that dental flossing was reduced after self-compassion training, as was motivation to improve one’s dental flossing. In this study, however, the participants were also given negative feedback on their dental flossing by a dentist. As the authors themselves note, the results may also be due to the fact that the low self-compassion group felt motivated by the negative feedback to perform even better towards the dentist (need of social approval), whereas the high self-compassion group did not feel the need to please the dentist. This could explain the result not matching other studies on self-compassion and health-promoting behaviour (e.g., Terry & Leary, 2011).

Since we cannot make a precise statement about the influence of self-compassion based on the available data, the question remains open how procrastination can be minimised in this area, so that it could also lead to a promotion in dental attendance. As more and more studies are investigating whether mobile tools could be helpful in ensuring regular dental visits (Foley & O’Neill, 2009), future studies need to analyse if such measures could help especially for high procrastinators. Thus, further studies could investigate whether continuous reminders of the appointment make it more likely that the appointment will be kept despite procrastination. Perhaps it is comparable to a deadline for a homework assignment or an exam, which is also reminded again and again during the semester. Although procrastinators tend to postpone learning, they end up taking part in exams and meeting deadlines (Svartdal et al., 2020).

A possible limitation of the study is that a large part of the sample was female. Since studies have shown that men show less regular dental attendance (Bernson et al., 2013) and slightly more procrastination (Steel, 2007), these results need to be re-examined in future studies that should include more men. In addition, the sample was partly collected at a university and through social media, which may represent a bias. Less than a third of the participants were students, yet still the sample does not reflect the demographic distribution. Further differentiation would be conceivable in future studies in order to compare different age groups and possibly develop more focused interventions.

The results of the present study open up further interesting lines of inquiry for future studies. For instance, it would be interesting to take a deeper look at the exact dental behaviour – how long/regular do participants brush their teeth or to let them rate their overall oral hygiene. As mentioned above, it is difficult to compare our data with the data from the sports study (Rapoport et al., 2022), as the results in our study do not refer to direct behaviours. For example, one could also collect desired and current dental status. In the survey of the current dental status, more objective data, such as dental recordings, could also be used. In addition, it would also be interesting to collect data on other factors that may lead people further away from their desired dental status, such as smoking and drinking sugary soft drinks. It is conceivable that self-compassion in particular would play a role in achieving these statutory goals.

In summary, this study showed that there are other factors besides dental anxiety that can reinforce postponement of dental visits. Determining these factors is important to help people lead a healthy lifestyle, which in the long run can lead not only to improved health but also to savings of money by the state and health insurance companies. The study represents a first step towards establishing domain-specific dentist procrastination.