When you think about personality, it’s likely you regard it as an interesting quality to ponder but one that has relatively limited impact on what happens to your health as you get older. So, you’re an extravert, and you like to be around other people. Why might it possibly impact your likelihood of regularly seeing a dentist?
Pondering this strange question, you might come up with your own hypotheses. People who are extraverted smile a lot, and they want their teeth to look good. Or perhaps they’re lucky enough to have jobs that are well-paying (because they’re so likeable) leading them to be able to carry decent dental insurance?
The field of health psychology is littered with attempts to understand not just such apparently strange questions but also how personality affects behavior, which in turn, affects physical well-being. The issue of who sees a dentist doesn’t normally come up as part of this whole question, but it’s a reasonable issue to address. Good dental health is related to good physical health overall, and can also affect mental health. Anyone who’s had a root canal or tooth extraction can almost certainly attest to that. However, people with poor dental health (such as gum disease) also can be at risk of developing serious, life-threatening cardiac conditions.
Personality and Health-Seeking Behaviors
Dental care is just one aspect of health-related behaviors, of course. It’s an interesting one to examine just because it’s not one that people usually think about when they reflect on the personality-health relationship. More commonly, health psychologists tend to look at the behaviors that affect chronic conditions involving heart disease and cancer, or accidental injuries requiring hospitalization.
In a newly published study, Northwestern University’s Emily Willroth and a team of international colleagues (2023), analyzed the data from 15 large-scale longitudinal studies involving over 350,000 individuals to address the question of whether personality can make a difference in health care use. There is no underestimating the importance of this work, they argue, noting that “understanding who uses different kinds of health care services has important implications for individuals who receive care as well as for the societal systems that provide care. This information can be used to promote effective, efficient, and equitable health care”. In other words, the world could stand to reap great benefits from knowing who’s most likely to engage in the type of health care that prevents chronic disease. If indeed extraverts are more likely to seek dental care, then the implication is that introverts might need more prodding to go for their regular cleanings.
Health care utilization also depends on the availability of services, as the authors rightly point out. According to what is called the “Anderson behavioral model of health care utilization” personality is only part of the equation. As noted above, you need to have adequate resources to pay for health care as well as have health care providers and facilities within physical or virtual access.
Testing Personality’s Role in Health Care Utilization
Although clearly, it’s not possible to carry out experiments testing the personality-health care use relationship, there are ways to test possible causal links. To do so, Willroth and her extensive co-author team used coordinated data analysis, a process in which the same hypotheses are tested using identical methods across samples. Following this set of analyses, the authors then went on to use a variant of a method known as meta-analysis in which the results are systematically summarized across studies. The samples included some of the most well-known longitudinal investigations in the world, including the Midlife in the United States (MIDUS) study, the Seattle Longitudinal Study, and the Midlife in Japan study, among others.
Across all of these studies, the team could draw from personality data collected within the Five Factor Model tradition (openness to experience, conscientiousness, agreeableness, neuroticism/emotional stability, and extraversion). The key outcome measures available to them regarding health care utilization were dental visits, general medical practitioner visits, and hospitalizations. Variations across samples in the way the health care questions were asked had to be taken into account, leading Willroth et al. to settle on the use of each type of health care at least once (in a 12-24 month interval) rather than on number of visits. Importantly, the authors also controlled statistically for such possible influences of age, sex, number of chronic health conditions, and ability to access health care (income and insurance).
So, did the findings stack up to predictions? Across all samples, those more likely to see their dentist were low on neuroticism, they were indeed high on extraversion, and they were also more likely to be high on conscientiousness and agreeableness. Although the authors predicted high neuroticism to be predictive of more dental visits (due to their tendency to fret), the results were in the opposite pattern, suggesting instead that anxiety over seeing a dentist (called “dental anxiety”) stopped the highly neurotic in their tracks before they would even schedule a visit.
As much as they didn’t seem to like seeing a dentist, those high in neuroticism were actually more likely to visit a general medical practitioner. You might expect the conscientious to make sure that they saw a medical professional on a regular basis, but this did not show up in the findings, nor was agreeableness a factor either.
This surprising finding about conscientiousness can be somewhat explained when looking at number of hospital visits. Those high in this trait were less likely to be admitted to a hospital, suggesting that they actually took pretty good care of themselves. As a result, they managed to avoid hospitalization. In the words of the authors, “This suggests that people higher in conscientiousness are more likely to manage their health by using some types of routine health care services such as dentists but are less likely to require hospitalization.”
From Findings to Practice
As you read about these results, you might understandably be wondering what they mean for you and your health. Obviously, you’d like to avoid hospitalization, and you probably would like your teeth to be in good shape. But if your personality is opposite to what was shown by the findings (i.e. you’re high in dental anxiety), what can you do to turn things around?
Luckily, there is ample evidence that personality can change especially if you become aware of how it’s affecting your life. You’re low in conscientiousness so you don’t really pay that much attention to your blood pressure and weight, and you don’t usually floss your teeth. Start with the simplest behavioral change you can make, and then reward yourself for accomplishing that small goal (flossing every other day, for example). Keep a chart or use one of the available health trackers on your smartphone or smartwatch. Those little accomplishments that pop up can eventually become quite motivating. If low extraversion is the culprit, find a dentist who allows you to feel comfortable without requiring that you keep up the patter in between their probes of your mouth.
The main point is that you don’t need to give in to what your personality might lead you to do, if that path is toward poorer health-related behaviors. You also don’t have to give in to the factors that impede health care access (and there are many). Prevention starts with your own behavior, and it’s cheaper (and easier) to avoid those hospitalizations. If you hate visiting the dentist, is this because your hygiene is so bad? Again, prevention can take the misery out of those potentially frightening encounters.
To sum up, your personality can do a lot for you in maintaining your physical health. And with better physical health comes better mental health and, ultimately, a straighter path toward fulfillment.
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