Fear of the dentist

Mild to moderate dental nerves are very common. Good communication from the dental team can make a big difference.

People with very high dental fear visit less often, and their visits are more likely to be for a problem or for pain relief rather than check-ups.

It can feel like

• Dread for days before an appointment
• Feeling faint, sick or shaky
• Panic or tears in the waiting room
• Racing heart and fast breathing
• Trouble sleeping the night before

The numbing injection is often the most feared part. For some people, lying back in the chair or having a strong gag reflex adds to the fear.

Shame and embarrassment about the state of your teeth can also keep people away.

Direct bad experiences are a key cause. Children who had more invasive treatment, like having teeth pulled, tend to be more afraid. Being scolded or treated harshly by dental staff as a child is also linked to more fear.

Children who had more routine check-ups early on tend to be less afraid.

Parents’ dental fear predicts their children’s fear. Teasing from parents, and friends’ stories of bad visits, are also linked to fear in young people.

Phobias in general can be learned from people around us.

Twin research suggests dental fear is partly inherited. People who tend to feel worry and stress more strongly are also more likely to have dental anxiety.

Dental anxiety is linked to other distressing life experiences, including sexual assault. Lying back, someone close to your face, and not being able to speak can bring up strong feelings.

Highly anxious dental patients make up about one in seven people. Dental teams see this every day.

Shame can keep people away for years. Research on dental fear stresses empathy, clear explanation and reassurance from dental staff.

Experts recommend a phased approach for fearful patients, starting with simple steps and building up.

A review of 38 studies found people who took part in behavioral treatment for dental fear reported much less fear afterwards, and the effect generally lasted.

A later review of randomized trials also found CBT reduced dental anxiety, though more high-quality studies are needed.

• Ask what coping ideas they suggest
• Mention it when you book
• Remind the dentist and staff on arrival
• Share any past bad experiences, if you want to

Agree that raising your hand means “please pause.” Knowing you can stop can make it much easier to start.

Ask what will happen and how long it will take. Knowing what’s coming can ease fears of the unknown.

Many dentists use “tell-show-do”: they explain a step, show you the tool, then do it. You can ask for this too.

Discuss pain before treatment starts, and speak up if you feel pain during it. Don’t be embarrassed about your pain tolerance.

Bottom to top (yours may differ)

• 1. Look at photos of a dental office
• 2. Look up local dentists who welcome nervous patients
• 3. Call and book a “just talk” visit
• 4. Sit in the waiting room for 10 minutes
• 5. Meet the dentist without any treatment
• 6. Sit in the chair and let it tilt back
• 7. Let the dentist look with a small mirror
• 8. Have a cleaning
• 9. Have a filling or other treatment

Therapists who treat phobias can guide your ladder and help with the worried thoughts behind it. Behavioral treatments for dental fear reduce fear and help most people keep visiting the dentist.

Some people need only a few sessions. Others need more, depending on how strong the fear is.

• Bring headphones for music or an audiobook
• Hold a stress ball or small fidget
• Watch TV if the office has one

Breathe in and out slowly for the same count. Do this five times while you wait and again in the chair.

Move your attention from your head down to your toes, relaxing each muscle group as you go.

Imagine yourself somewhere calm and pleasant, like a beach or garden, and fill in the details.

Some people feel faint around needles. Tell the team at once. The applied tension skill in the “Fear of needles, blood & medical procedures” guide was designed for this.

A parent’s dental fear predicts their child’s fear, and teasing about the dentist is linked to fear in children.

• Keep your own worries out of earshot
• Never use the dentist as a threat
• Share good dental stories, not scary ones
• Try not to become overprotective or anxious yourself

Children’s dentists use gentle techniques like tell-show-do, positive pictures before the visit, distraction, specific praise, and gradual getting-used-to.

Kind, clear communication matters. Harsh or punishing behavior from dental staff is linked to more fear in children.

• Listen to their worries without dismissing them
• Play “dentist” with a toothbrush and mirror
• Practice three slow, deep breaths together
• Talk about the visit in simple, calm words

• Celebrate each step, like booking or showing up
• Help them find a dentist who welcomes nervous patients
• Offer to make the call with them
• Offer to drive them or sit in the waiting room

• Commenting on their teeth or breath
• Lecturing about how long it’s been
• Sharing your own dental horror stories

Many dental teams are trained in ways to help fearful patients, from good communication to a step-by-step approach.

A therapist who treats phobias can help with dental fear using CBT and gradual exposure. The “CBT, DBT & other talk therapies” guide explains what to expect.

In the U.S., SAMHSA’s findtreatment.gov can help you find local mental health services.

Delaying care can lead to bigger problems and harder treatment later. If you are in pain, call a dentist now and tell them about your fear.

Find A Helpline (findahelpline.com) lists free, confidential helplines by country. The International Association for Suicide Prevention points people to it. If someone is in danger, call your local emergency number.