Much more than a catchphrase, dental anxiety is a reality for many people. It has no respect for age or social standing.
People who deal with significant dental anxiety account for anywhere from 8-19% of the population.
In this article, I want to help you discover:
- How to recognize the signs of dental anxiety
- How to cope with dental anxiety
- How proper treatment can lead to less anxiety and a more positive experience in the dental chair
What is dental anxiety?
Dental anxiety is extreme nervousness associated with the thought of visiting the dentist for preventive care and dental procedures. Essentially, it is a fear, stress, or panic caused by any dental setting.
Dental anxiety can be evidenced by an elevated pulse rate, sweating, a nervous stomach, and a general feeling of dread over going to a dental practice.
Also referred to as dental phobia, this fear can be triggered by needles, drills, or even the thought of going to a dental appointment. Many anxious patients report past bad experiences, often from childhood, as the cause of their fear of the dentist.
When seeking the right dental office for you, be sure to ask questions about the way the dentist approaches patients with dental anxiety. At Rejuvenation Dentistry, your overall physical and emotional well-being are as important to us as your oral health.
We don’t act as your only health care professional, but we recognize and address that many health problems stem from poor oral health.
Signs & Symptoms of Dental Anxiety
Dental phobia can trigger physical, emotional, cognitive, and behavioral responses in anxious patients. If this goes unchecked, the patient may use any excuse to skip a dental appointment, promising themselves they will reschedule.
The longer they can put off a trip to the dental office, the better (at least in their own mind). They will likely find it difficult to undergo dental treatment regardless of whether it is simple or complex — even a dental cleaning is likely to lead to significant concern.
People with dental anxiety may experience:
- Racing heartbeat (tachycardia) or palpitations
- Low blood pressure and possible -fainting (syncope)
- Increased blood pressure
- An upset stomach
- Visible distress, crying, or signs of panic
- Using humor or aggression to mask anxiety
What causes dental anxiety & phobia?
A traumatic experience from our past is the most common cause of dental anxiety. Whether the bad experience happened to a family member or to us personally, it only takes one to trigger a lifetime of dental phobia.
Let’s take a deeper dive into some of the reasons that even simple dental procedures can produce anxious patients.
Fear of Pain
Fear of pain is the most likely reason patients avoid the dentist.
It may seem almost too obvious to mention; however, fear of pain (whether related to dental experience or not) is a serious issue humans have faced forever.
In a Stanford News article entitled, “People who fear pain are more likely to suffer it,” the author explores a research study about how pain and anxiety occur and how it’s processed in the brain.
The researchers noted “insanely strong” correlations between the subjects’ responses to an Anxiety Sensitivity questionnaire and the ensuing brain activity in the medial prefrontal gyrus (the area of the brain that searches for things that are wrong).
In conclusion: There are significant differences in perception of pain from person to person. Some people can take pain in stride (even though they don’t enjoy it).
But for many individuals, the anxiety produced by pain, or even the thought of pain, can actually cause them to experience pain even more often.
If we consider this finding related to fear of the dentist, it’s easy to see how a person’s oral health could suffer significantly from avoiding dental visits.
Fear of Injections
Fear of injections, also known as needle phobia or trypanophobia, is a recognized phobia that affects approximately 50 million Americans. Full-blown reactions can include racing heartbeat, nausea, dizziness, and chest pain.
For the dental patient who fears injections, receiving a novocaine shot can be a traumatic experience all by itself. Even if you know the purpose is to prevent pain/feeling during the dental procedure, your brain may fixate on the needle (not the benefit).
Fear of Anesthesia
Along with the fear of injections comes the fear of receiving an anesthetic. It is a less common concern but no less important when considering dental care.
In a 2011 study, the fear of anesthesia, numbness, and sedation were significant factors to overall dental health. This fear encompasses the fear of receiving medicine and the fear of the numbness that occurs with the injection.
This concern often prevents patients from seeking relief from oral pain, including asking for medical advice, recommendations, etc.
The end result is often years of oral health issues, including cavities, discolored or cracked teeth, gum disease, and other oral hygiene issues.
Past Dental Trauma
As I stated above, past painful experience is the number one cause of dental anxiety. The worst part about this phobia is that it often turns an irrational fear into a much more severe problem.
Left unchecked, a vicious cycle of avoiding the dentist begins and keeps you from achieving the healthiest mouth (and body) possible!
One negative dental experience from childhood can affect a patient’s oral health over their lifetime and even temper how they handle their children’s dental experience.
Address these fears with your dentist and the dental office staff when calling to schedule a dental appointment.
Feeling Out of Control or Helpless
Sitting in the dental chair may not be stressful in and of itself. But for many patients, leaning back with a light over the face, a shield or covering under the chin, and the dentist, plus an assistant, standing over them, can cause a feeling of loss of control or helplessness.
Even realizing that you’re in a safe, open environment, the experience of feeling out of control can be daunting. It will be nearly impossible to endure the dental visit, much less relax and remain still.
Lack of Personal Space
The most obvious concept of personal space is the physical proximity of people, objects, or things around you. There is a private, unseen territory around us which nobody should invade. We each set these boundaries according to who we are; the amount of personal space will differ from person to person.
Even the most stress-free individual has a limit to how close others can come.
Whether your dental treatment involves an invasive procedure or is a routine cleaning/hygiene visit, it will involve someone standing over you — in your personal space.
Other causes of anxiety due to lack of personal space include:
- Previous trauma to the head and neck
- Other traumatic experiences like being closed in a small space for some time
- Generalized anxiety, depression, or post-traumatic stress disorder
- The view that the mouth is a personal area and accessing the mouth is an invasion of personal space
- Trust issues
- Anxiety associated with other conditions such as agoraphobia (fear of being in situations where you feel you cannot escape), claustrophobia (fear of closed spaces), or obsessive-compulsive disorder (patterns of obsessions and compulsions, often related to cleanliness)
Dental Anxiety & Oral Health
By avoiding going to the dentist, not only are you more likely to need more involved treatments when you do finally attend, but you are also missing out on learning how to better care for your oral health.
Dental anxiety can lead to individuals avoiding the dentist altogether, which can severely impact more than your oral health. The mouth is the gateway to the body.
Healthy mouth = healthy body = optimal immunity
Who can be affected by dental anxiety?
Dental anxiety can affect anyone at any age. People who do not experience dental fear or phobia often cannot understand the stress this brings to the sufferers.
I founded Rejuvenation Dentistry to be more than a dental practice that merely suppresses symptoms. Our staff works with each patient to discover the root cause of symptoms and treat that cause, so it doesn’t progress and cause even more harm to your overall health.
Our aim is to provide high-quality, stress-free dental care for each person who visits our offices.
How to Ease Dental Anxiety in 3 Steps
1. Talk to your dentist (speak up!).
Anyone who suffers from dental anxiety will attest that sharing your feelings is very therapeutic and can put the mind and heart at ease. When you call for a dental appointment, you should be upfront about your hesitation and concerns.
Consider these opportunities for sharing your concerns with your dental practice:
- When you make an appointment, speak with the receptionist about your nervousness. The more your dentist knows about you, the more they can put your mind at ease.
- When you arrive, don’t be afraid to share your anxiety with the dental staff, hygienist, or dentist. This includes sharing past dental experiences that caused you distress.
A great practice/dental clinic should be focused on providing you with a calm, pleasant atmosphere where your fears are heard.
- Ask about coping strategies you might use to address your dental phobia.
- Agree on a signal you can use if you feel overwhelmed at any time during your treatment; a raised hand, a thumbs up, etc.
- If at any time you have pain, whether you receive local anesthesia or are under conscious sedation, let your dentist know.
2. Distract yourself.
There are several ways to distract yourself during your dental visit that shouldn’t hinder your treatment quality.
- Keep something in your hands, such as a fidget spinner or a stress ball, to squeeze.
- Wear headphones or earbuds. Listening to your favorite music or an audiobook can be a welcome distraction from the sounds of instruments. Be sure to set a volume that allows the dental team to still communicate with you. You can use this technique even while in the waiting room before your dental appointment.
- If available, take advantage of a TV or video setup. Some dental offices have local channels to choose from, but you can also take a tablet or other mobile device to set up in your line of sight.
- Visualize a pleasant place. Thinking about a setting that puts you at ease can bring great peace and comfort.
3. Use coping mindfulness techniques.
The journey to relaxation starts in your mind. Here are a few coping strategies you can do silently, from the waiting room to the dental chair:
- Controlled breathing. Take slow, measured breaths. For example, inhale as you slowly count to 4, then exhale for the same length of time. This can be repeated any time during your visit — when you are waiting for dental treatment to begin, after you receive an injection/anesthesia, or while x-rays are being processed.
- Body scan. Focus attention on relaxing your muscles, beginning with your forehead, then moving down to cheeks, neck, arms, etc., all the way to your toes.
Other Dental Anxiety Treatments
At Rejuvenation Dentistry, we recognize that a calm mind is key to effective treatment. We believe your mental health and head-to-toe health are as important as your oral health. Our staff recognizes that your total body health can be adversely affected when you associate fear or pain with a dental visit.
Your comfort is our top priority, which is why we offer comprehensive sedation dentistry.
We will explain each step of your treatment, including possible side effects of any prescribed medications and what to expect from start to finish. From cleaning to root canals to restorative care and oral surgery, your comfort means our success.
Our goal is to help you experience:
- Minimal if any pain during procedures
- Fear-free, stress-free treatment
- A more relaxed state of mind about your care
- The confidence to have regular dental appointments
- Reduced gag reflex
We use local anesthesia, the foundational level of sedation, to numb treatment sites before a minor procedure. You remain alert under its effects.
We’ll prescribe a medication for you to take either before your visit or during it. The level of anxiety you have will determine the kind of medication we provide and the level of comfort you experience.
We administer nitrous oxide, sometimes referred to as laughing gas, through a mask. Nitrous oxide keeps you alert but relaxed throughout your treatment, and its effect wears off quickly after the mask is removed.
Administered intravenously, IV sedation puts you in a sleep-like state, though you’re not actually asleep. You won’t feel any sensation during your procedure, nor will you remember anything about it afterward.
Usually reserved for use during the most complex dental and medical procedures, general anesthesia is a combination of medications that renders you entirely unconscious for your procedure’s duration.
Outlook on Dental Anxiety
Remember this important fact: if you feel gripped by dental fear, you are not alone. Between 8-19% of people experience some level of trepidation around dental visits. There is no need to feel embarrassed or ashamed.
One of my greatest goals is to provide an anxiety-free approach to dentistry, where patients can turn fear of the dentist into a positive experience.
Whether your visit is for a dental check-up or cleaning or your treatment plan involves more invasive procedures, we listen to you and work with you to offer the best dental care you’ll ever receive.
Why is this important?
It’s important because your oral health is key to not just your mouth but to your whole body. We take an approach grounded in bio-regulatory medicine – an evidence-based system that addresses the whole person: Medically, emotionally, physically, and spiritually.
- Armfield, J. M. (2010). The extent and nature of dental fear and phobia in Australia. Australian dental journal, 55(4), 368-377. Abstract: https://pubmed.ncbi.nlm.nih.gov/21174906/
- Appukuttan, D. P. (2016). Strategies to manage patients with dental anxiety and dental phobia: literature review. Clinical, cosmetic and investigational dentistry, 8, 35. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790493/
- Armfield, J. M., & Milgrom, P. (2011). A clinician guide to patients afraid of dental injections and numbness. SAAD digest, 27, 33-39. Abstract: https://pubmed.ncbi.nlm.nih.gov/21323034/