Overcoming Dental Anxiety: Understanding and Conquering Your Fears 

Overcoming Dental Anxiety

If you find it unnerving to visit the dentist and suffer from dental anxiety due to past experiences or preconceptions, you’re not alone. Although some sources cite higher figures, recent research indicates 36% of people avoid going to the dentist due to dental anxiety or fear. And an estimated 12% of those patients suffer from dental phobia, a type of mental health disorder. 

  • According to a 2017 study, more than 20% of people with dental anxiety avoided visiting the dentist regularly, and an estimated 9–15% never visited the dentist at all.

Opening your mouth for a long period of time during a professional tooth cleaning can certainly be a little uncomfortable and the sounds of drills aren’t exactly music to your ears! Most people wouldn’t rank a dental visit as a fun activity, however, getting regular preventive dental care is essential for maintaining your oral health and smile beauty.

How Dental Anxiety Affects Your Health 

Avoiding the dentist can lead to pain, oral and general health problems, worsening anxiety, and the need for more complex and costly dental procedures. Allowing dental anxiety to take control of your oral health and well-being can increase the risk of: 

  • Bad oral bacteria
  • Extensive tooth decay
  • Early gum disease (gingivitis)
  • Advanced gum disease (periodontitis)
  • Early tooth loss
  • Temporomandibular joint dysfunction pain 

When dentally anxious patients do seek dental care, they experience more pain than other patients due to their dental anxiety. Untreated periodontal disease and tooth decay can result in the need for more expensive treatments including crowns and bridges, root canals, and dental implants

Over time, oral health issues can affect your ability to eat, drink, speak, and socialize, thereby causing a hit to your self-esteem and quality of life. And advanced gum disease is associated with worsening symptoms in people with diabetes, respiratory disease, and heart disease. 

Why is Dental Fear So Common? 

Fifth Most Common Fears

Dental fear has been ranked fifth among the most common fears. It’s completely understandable that sitting in a dental chair with your mouth open and somebody’s hands inside it isn’t high on the list of pleasurable activities! 

Studies indicate the perception that dental treatment is uncontrollable, unpredictable, risky, and unpleasant strongly correlates to dental anxiety. The idea of being treated by a dentist in a cold or uncaring manner, as well as the anticipation of pain during dental treatment also play a role. 

Recognizing Your Unique Fears 

Just as every patient has unique oral health concerns and goals, you may have slightly different reasons for feeling anxious about visiting the dentist than the next patient who walks in the door. The first step to resolving any type of anxiety is to recognize the underlying cause(s). 

Procedural-Related Pain 

Many people assume that dental treatment will be painful, which can lead to dental anxiety. In some cases, it may not be the fear of the actual procedure, but getting stuck with a needle that causes stress. This type of fear isn’t limited to dentistry and impacts any medical treatment involving needles, such as vaccines. Advances in minimally-invasive dental technology have led to more comfortable procedures. A few examples include digital X-rays, composite fillings, and laser dentistry. Lasers can lessen sensitivity and speed recovery for cavity preparation, cosmetic gum contouring, and gum disease treatment. 

Root canals have a particularly bad and unfounded reputation. The truth is root canal treatment doesn’t cause pain, it relieves it. The perception that a root canal is painful began decades ago, but thanks to modern technologies and anesthetics, root canal treatment is no more uncomfortable today than having a filling placed. 

Loss of Control and Fear of the Unknown 

In a 2022 study, nearly 63% of respondents said dental anxiety was related to fear of the unknown. The thought of sitting back in a dental chair is the sum of all fears—pain, needles, doctors, confined spaces, loud noises, and not being in control. If you’ve avoided going to the dentist for years, the fear of the unknown can be worse because you likely have some oral health issues that need to be taken care of. 

Embarrassment about Dental Health 

Many people avoid the dentist because they fear their teeth will be the worst the dentist has ever seen. In fact, in the same 2022 study, more than 60% said dental anxiety was related to concerns about having bad teeth. 

Of course, avoiding dental care often leads to numerous dental problems that could have been prevented with routine dental visits. Some people would rather pretend these problems don’t exist or will resolve on their own, which reinforces dental anxiety and leads to worsening oral health. 

Bad Past Experiences 

As with any health-related service, all dentists aren’t created equal, in terms of both clinical expertise and chairside manner. Not all dentists understand that to build a foundation of trust and a long-term relationship, every patient needs to be treated like a unique individual in a positive and relaxing setting. But you shouldn’t let a bad past experience impact your well-being because most dentists today are caring and skilled. 

How to Overcome Dental Anxiety 

Overcoming Dental Fears

1. Find the Right Dentist 

It’s important to find a safe, comfortable, and trusted dental home, whether you require routine care, a restorative procedure, or experience a dental emergency. If you have any degree of dental anxiety, it’s essential to find a compassionate and caring dentist who can guide you through your fear. 

To find the right dentist, don’t be shy about calling or visiting dental practices before making a decision, asking friends and family for recommendations, and scheduling an initial “meet and greet” consultation. Whether you call the practice or visit in person, ask how they address dental anxiety. As a general rule, look for a dental practice that meets the following criteria: 

  • Distracting technology
  • Wide range of sedation options
  • Proven experience with anxious patients
  • Personality that fits with yours
  • Convenient location and office hours
  • Excellent online patient reviews and testimonials 

2. Embrace Distraction Technology 

One of the best ways a dental practice can improve patient comfort is to create a welcoming and relaxing environment. This starts with a comfortable, clean, and serene waiting room with amenities such as magazines, television, and complimentary tea or bottled water. Comforting chairside measures including pillows, blankets, and headphones with soothing music. These amenities can help you feel more relaxed during your visit. 

And don’t hesitate to bring your own comfort tools from home. For example, young children can bring their favorite small stuffed animal or toy and adults can bring a tension-relieving squeeze ball. 

3. Consider Sedation Options 

Sedation dentistry is a game changer because it can be customized to your unique level of dental fear and the procedure you’re undergoing. The benefits of sedation dentistry include: 

  • Minimal pain or discomfort
  •  Enhanced relaxation during dental visits
  •  Decreased dental anxiety and fear
  •  Reduced gag reflex and tooth sensitivity
  •  Fewer appointments and ability to combine treatments
  •  Lasting health benefits of receiving necessary care 

Types of Dental Sedation 

Local Anesthesia: Lidocaine, articaine, prilocaine, mepivacaine, or bupivacaine are used to prevent oral pain in the area being treated. In some cases, a topical anesthetic is used to numb an area before injecting the local anesthetic into your gum tissue or cheek. These medications work by blocking nerves that sense or transmit pain, thereby numbing the treatment site and sometimes the adjacent tissue. 

Local Anesthesia:

Oral Sedation: This type of sedation involves taking a prescribed medication orally, usually an hour before treatment or arrival at your dentist’s office. Depending on the type of medication and its potency, you may feel anything from a moderate decrease in anxiety to feeling so relaxed you fall asleep in the chair. With this type of dental anesthesia, a friend or family will need to provide transportation home. 

Oral Sedation

Nitrous Oxide: Often referred to as laughing gas, nitrous oxide is a colorless gas mixed with oxygen that is ideal for alleviating mild to moderate dental anxiety. It is inhaled through a nasal mask and makes you feel relaxed or even giddy during treatment. With this type of sedation, you’ll remain conscious, relaxed, and responsive throughout your procedure. After treatment is complete, nitrous oxide is stopped and any residual amount is flushed out of your system by breathing in pure oxygen for a few minutes. Because the effects wear off quickly, you can drive yourself home. 

Nitrous Oxide

IV Sedation: This type of sedation involves intravenous administration of a sedative medication through an IV needle placed in your arm or hand. Due to its amnesic effects, many patients who receive IV sedation forget parts of or the entirety of treatment. IV sedation is an ideal choice if you have more severe anxiety or require complex treatments, like full mouth dental implants. With some lasting effects, you’ll need someone to drive you home after your visit. 

IV Sedation

General Anesthesia: As the strongest form of sedation dentistry, general anesthesia is usually reserved for complex oral surgery procedures or severe dental anxiety. General anesthesia is a drug-induced loss of consciousness during which you can’t feel pain and stay asleep until the sedative medication is slowly reversed. It requires advanced training and careful monitoring of all your vitals during treatment to ensure your safety. General anesthesia side effects can last up to 12 hours, therefore a designated adult must accompany you to our office, stay during your procedure/recovery and drive you home. 

General Anesthesia

4. Use Relaxation Techniques and Medications 

Relaxation techniques that are easiest to implement include distraction therapy in the form of music, meditation including guided imagery, muscle relaxation, and aromatherapy. 

Music involves listening to neutral, relaxing music with a slow tempo, repetitive rhythm, gentle contours, and string instruments. Research shows the right kind of music reduces blood pressure, heart rate, respiratory rate, and cardiac output in anxious patients during dental treatment. 

Sedative medications used in oral and IV sedation are a class of drug called benzodiazepines. While slightly different, diazepam, triazolam, and alprazolam all decrease activity in the parts of your brain that control fear and anxiety. 

5. Get Support from Friends or Family 

Asking a friend or family member to stay in the room with you can be reassuring and reduce anxiety. Most dentists won’t have an issue with this for routine visits, especially if you tell them that it will help alleviate your dental anxiety. 

6. Arrive Early to Your Visit 

Arriving early to your dentist appointment is advised, especially if you’re feeling anxious. Doing so allows you to talk to the team about fears or issues prior to being treated. If you arrive late, your dentist may feel rushed and not take as much time to listen to your concerns, which can worsen anxiety. In addition, writing things down in advance and bringing them with you helps ensure you won’t forget what you wish to discuss. 

7. Talk to Your Dentist About Your Anxiety 

Be open and honest with your dentist about your current oral health concerns and dental anxiety. It also helps to ask ahead of time how long a procedure will take and what to expect. A caring dentist typically discusses this without the patient asking, especially for more involved procedures like gum disease treatment or dental implants. 

8. Ask for Breaks if Needed 

Studies show many patients feel like they can’t ask a dentist or hygienist to stop and don’t know ahead of time how long the procedure will take, thereby causing anxiety. There is no reason to feel compelled to keep your mouth open continuously during cleanings and most other procedures. Doing so can increase saliva production, the urge to swallow, and exacerbate dental anxiety. 

Healthy Teeth

9. Take Proper Care of Your Teeth 

Many people don’t realize receiving regular dental care can help prevent more serious dental issues, as well as systemic conditions. Regular dental care is essential for maintaining good oral health and identifying oral and dental diseases at an early stage. Although proper oral hygiene at home is essential, regular professional cleanings are needed to prevent bad bacteria from wreaking havoc on your teeth and gums. 

Be Proactive About Your Dental Health and Well-Being 

Individuals with high levels of dental anxiety often self-perpetuate the cycle of fear by avoiding regular dental treatment. Seeking dental care only when you’re in pain results in greater anxiety and the need for invasive and extensive treatment. 

If you’re suffering from dental anxiety, there’s no reason to feel embarrassed or postpone receiving essential dental care. Everybody deserves the benefits of a fully functional and beautiful smile!

AUTHOR
Dr. David A. Sabourin, D.D.S.

Dr. Sabourin relocated to San Diego from Ann Arbor, Michigan where he earned a Bachelor of Science degree from the University of Michigan. He graduated at the top of his class with High Honors from the University of Detroit School of Dentistry where he received his Doctor of Dental Surgery degree.

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