Guides · General
Overcoming dental anxiety: practical advice for nervous patients
The causes of dental anxiety, the consequences of letting fear delay treatment, methods that work before and during the appointment, agreeing with the dentist, the approach in children and sedation options.
Fear of the dentist is common and usually stems from a bad past experience or a feeling of losing control. Telling us about your anxiety in advance, starting with a short introductory visit, agreeing on a 'stop' signal, learning the steps of the procedure beforehand and breathing exercises reduce anxiety markedly. For severe anxiety there is the option of treatment under sedation.
Why does the fear arise?
- A painful or rough experience in childhood or adulthood
- Loss of control: lying back, being unable to speak, not seeing what is being done
- Triggers such as needles, sounds and smells
- Embarrassment: not having been for a long time, the state of the teeth
- Negative stories heard from others
The price of fear is delay: a root canal instead of a small filling, an extraction instead of a root canal. Delay feeds the anxiety; early, small steps break the cycle.
Before the appointment
- Mention your anxiety when booking. The clinic plans the time and approach accordingly.
- Ask for an introductory visit: Just an examination and a talk; getting to know the setting without any procedure.
- A morning appointment: So you don't spend the day thinking about it.
- Cut caffeine and eat something light; anxiety rises on an empty stomach.
- A companion: Someone you trust can be in the waiting area or the room.
- Write down your questions: What will be done, how long will it take, what will I feel, can I take a break?
In the chair
- A stop signal: Agree that the dentist will stop when you raise your hand. Knowing you are in control resolves most of the anxiety.
- Tell-show-do: Ask the dentist to explain each step briefly beforehand; no surprises.
- Breathing: In through the nose for 4 seconds, out through the mouth for 6; drop the shoulders, relax the hands.
- Distraction: Music or a podcast through headphones, focusing on a point on the ceiling.
- Topical anaesthetic: Gel before the injection; the sensation of the needle is greatly reduced. Ask that treatment not start until the anaesthetic has taken effect.
- Short sessions: Appointments of no more than 20–30 minutes for the first treatments.
If anxiety is severe
In some patients the fear is beyond what behavioural methods can manage. Then treatment under sedation (with an anaesthetist, awake but relaxed) or, in selected cases, under general anaesthesia can be discussed with your dentist. For a long-term solution, a short course of cognitive-behavioural therapy is also effective; your dentist can refer you.
In children
A child's fear is mostly learnt from the parent's anxiety. Neutral phrases such as "they'll count your teeth" instead of "it won't hurt" or "don't be scared"; a first visit limited to an examination and introduction; play instead of reward-and-punishment language. More: A child's first dental visit.
About embarrassment
Dentists see mouths in every condition; the aim is to make a plan, not to judge. Not having been for a long time does not mean it is too late to start. In this clinic the first meeting for anxious patients can be limited to an examination and a conversation; simply mention it in the note on the appointment request form.
This article is for general information only; diagnosis and treatment tailored to you require a dental examination.
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