Dental Anxiety: 17 Ways to Cope With a Fear of Dentists

What Is Dental Anxiety?

Dental anxiety is fear, stress, or unease associated with visiting the dentist and undergoing dental procedures. It can manifest as obsessive thoughts about what could happen at the dentist, anxiety when at appointments, or even avoiding going to the dentist altogether. Not surprisingly, one of the consequences of fearing the dentist is avoiding necessary dental treatment.

Dental anxiety is estimated to affect about 36% of the population to varying degrees.¹ Therefore, it is likely that either you or someone you know suffers from this condition.

Having anxiety about a medical appointment can lead to avoidance. And this avoidance can actually increase any already-present health conditions because they are not being treated. Then, it becomes an anxiety cycle of avoidance and worsening health that could have been avoided by just making the appointment in the first place. However, this is easier said than done when anxiety is affecting you.

17 Ways to Cope With Dental Anxiety

Coping with dental anxiety requires properly preparing before appointments and developing skills to cope with anxiety during appointments. Before the appointment, familiarize yourself with the dentist, ask questions about the procedure, and communicate what your fears are. Controlling your dental anxiety during the appointment might mean having a safety person, using relaxation/distraction techniques, or taking rescue medications.

Here are seventeen ways to cope with dental anxiety:

1. Find the Right Dentist

Finding the right dentist is crucial to overcoming dental anxiety. The right dentist will listen to your fears and work with you to develop an oral health routine that takes care of your teeth while taking into account your anxiety.

Here are some tips for how to find the right dentist:

• Before you begin your dental practice search, factor in logistics like location, hours, cost, and insurance.
• Then, consider factors that might affect your comfort with someone. These might include finding someone of the same gender, someone who utilizes humor, or someone who is the same race as you. Although this may not guarantee a positive experience, it can encourage you to feel more comfortable.
• Advocate for yourself by calling different dental offices, letting them know you have dental anxiety, and asking if they would recommend a particular dentist at their practice. Staff often know the dentists they work with well and may be able to recommend someone with a good bedside manner.
• If you are still feeling uncomfortable, read reviews of the dental practice and dentists. Search for terms like “dental anxiety” to see if other patients recommend a particular dentist.

2. Schedule Wisely

Many dentists recommend that anxious patients schedule their appointments during the morning. By strategically scheduling in the morning, anxious patients can avoid having to deal with anticipatory anxiety while waiting for an afternoon or evening appointment.² If you schedule an appointment as the first patient of the day, you can also avoid having to spend additional time in the waiting room.²

If you are unable to schedule a morning appointment, at least consider picking a time when you know you will be less likely to feel rushed by other priorities.² This can at least give you extra time to pace your appointment according to any anxiety flares. Additionally, you may want to bring a loved one for support and expect to schedule around their needs.

3. Communicate Your Fears

Anxiety can worsen in situations where the people around you are unaware of your internal experiences. Developing a trusting relationship with your dentist and their staff is the foundation for conquering dental fears.² It can be especially helpful to identify your exact fears and communicate these fears to staff, as they may have strategies to help you cope.

Here are some common fears someone might communicate:²

• Fear of experiencing pain
• Fear of being judged for the condition of one’s teeth
• Fear of choking during a procedure
• Fear of the numbness caused by an anesthetic
• Fear of needles, injections, or dental instruments

4. Decide on a Signal Beforehand

One of the most common causes of dental anxiety is the fear of not being in control during a procedure. By agreeing on a signal to ask your dentist to stop, you are giving some control back during the procedure. Using the signal can help you feel more in control of pacing during the appointment. Signals can also be used to give you a break from the procedure if needed.

5. Focus on Positive Self-Talk

Negative self-talk can contribute to catastrophizing and imagining nightmare situations at the dentist. By challenging negative self-talk and replacing it with positive self-talk, you can decrease your chances of catastrophizing and increase your confidence during the appointment. You are changing the narrative of dental anxiety and replacing it with one where you are more in control and confident about success during the appointment.

Here are some examples of how to challenge negative self-talk with positive self-talk:

• Instead of “I know I can’t do this,” try to tell yourself, “I know my fear is temporary, and I can handle it.”
• Instead of “I just know they are judging how bad my teeth are,” try to tell yourself, “The staff sees all kinds of teeth and is here to help me improve my hygiene.”
• Instead of “I know I’m going to have a panic attack,” try to tell yourself, “Even if I have a panic attack, I have coping strategies to help me move through it.”
• Instead of “I can’t handle this much pain,” try to tell yourself, “I am in control of stopping the procedure with my signal, and this pain will be temporary.”

6. Reward Yourself Afterwards

Similar to how you can bribe a child with a toy following a doctor’s visit, consider rewarding yourself afterward with a pleasant experience. Knowing that you will receive this reward following the appointment can help you connect an unpleasant experience (dental anxiety) with a pleasant experience (the reward). Rewards do not need to be big. It can be getting a coffee and pastry from your favorite coffee shop or getting a 15-minute back massage.

7. Have the Procedures Explained in Advance

Anxiety often worsens in situations where there are unknown or unexpected events. You might have the procedures explained prior to the day of your appointment by either the dentist or their staff. Some dentists may even offer the tell-show-do technique, where they describe procedures in depth, familiarize you with sensory experiences and instruments used, and finally, do the procedure.²

8. Make Yourself as Comfortable as Possible

Making yourself comfortable includes evaluating and planning for your sensory experience. We are constantly scanning the environment for feedback through our senses, so they can play a big part in increasing your level of comfort at the dentist. Some dental offices may also offer sensory ways to increase comfort, such as televisions, blankets, headphones, or pleasant photos on the ceiling above the dental chair.

Here are some strategies to increase your level of comfort:

• Bringing along a favorite blanket
• Wearing relaxing and unrestricted clothing
• Wearing sunglasses or dental glasses to decrease the discomfort of fluorescent lighting
• Listening to your favorite podcast, soothing music, or funny videos
• Holding a worry stone, fidget toy, or other comforting object during your appointment

9. Practice Relaxation Techniques

Relaxation techniques are strategies to help calm your body and mind from experiences of dental anxiety. With breathing exercises for anxiety, you can learn to control your breaths to invoke a relaxation response rather than having short and shallow breaths. You may want to experiment with different breathing techniques prior to your appointment to see which ones are most effective prior to your experience of dental anxiety.

During the appointment, progressive muscle relaxation may be used to ground and distract you from discomfort during procedures. Muscle tension is also common when anxiety peaks and progressive muscle relation can help combat the tension. Lastly, the use of guided imagery meditation for anxiety can help you re-focus your awareness toward a more pleasant experience.

10. Use Distraction Techniques

Distraction techniques are short-term solutions to experiences of dental anxiety.
You can use distraction techniques for anxiety before, during, or after an appointment to help you cope. Some dental practices may also offer distraction techniques such as massaging chairs, television access, music, fidget toys, or noise-canceling headphones.

Examples of distraction techniques to try during an appointment include:²

• Using a stress ball or fidget toy
• Listening to music through headphones or focusing on any music playing in the office
• Using visualization techniques to imagine being someplace else
• Wearing a certain fragrance that is relaxing to you, such as lavender
• Focusing on deep breathing while counting your breaths

11. Remind Yourself of Dental Advances

Reminding yourself of advances in dental practices can be mixed with CBT interventions to help you cope with your dental anxiety. You can challenge catastrophic thinking patterns by asking yourself questions like “With how far dental practices have advanced, how likely is it that my feared situation will happen?” or “What is the evidence I have that my feared situation will actually occur?”

12. Practice Good Oral Hygiene

Knowing that you have been practicing good oral hygiene can help you feel prepared to attend any dental appointments. Good oral hygiene can positively impact your dental needs, such as avoiding the need for extra procedures outside of regular cleanings.

Practicing good oral hygiene can also help you familiarize yourself with the instruments in your mouth. For example, using a water flosser can help expose you to similar sensations you might feel during an appointment.

13. Plan for How You Will Manage the Pain

Fear of pain can certainly increase experiences of dental anxiety. Creating a plan for pain management during and after an appointment can help reduce anxious thoughts about pain levels or physical discomfort during the appointment.

Most dental practices offer a variety of pain management options, such as local anesthetics, numbing gels, laughing gas, or sedation. Afterward, you can clarify if your dentist suggests certain interventions, such as over-the-counter pain medication, prescription medication, oral rinses, or ice.

14. Avoid Consuming Stimulants

For some individuals, consuming stimulants can worsen dental anxiety. Caffeine can make anxiety worse because it increases heart rate and blood pressure, which can imitate anxiety symptoms and cause racing thoughts. You may want to avoid consuming any caffeine prior to your appointment to help reduce the negative impact it could have on increasing uncomfortable physical sensations.

15. Consider Anti-Anxiety Medication

Some people may benefit from using anti-anxiety medication, such as benzodiazepines, prior to their dental appointment. These medications are known as “rescue medications” as they are taken during experiences of heightened anxiety or panic. They work by increasing the efficiency of GABA, a neurotransmitter involved with feelings of calmness. A benzo might be taken while you are in the waiting room, or your dentist may ask you to take it while under their care.

16. Bring a Friend or Family Member

Bringing a friend or family member can help you feel supported and safe during an appointment. Some offices may even allow you to bring your loved one back with you to the dental room. You may want someone to wait in the waiting room, visit with you afterward, or hold your hand during the procedure.

Here are some questions to ask yourself that can help you figure out who to take:

• Have they supported me through similar situations in the past?
• Are they able to handle seeing me anxious, seeing injections, or possibly seeing blood without becoming anxious themselves?
• Are they willing to drive me there and back if that is necessary?
• If humor is important to ease my anxiety, are they willing to use it?
• If being gentle and physically comforting is important to ease my anxiety, are they willing to do it?

17. Ask About Sedation

There are varying forms of sedation and pain management offered at dental practices. You can ask your dentist to explain the pros and cons of each type of sedation and what you might expect from using them. It can also be helpful to ask about any possible interactions with the medication you are taking, especially if you already have medications that provide a sedative effect.

Here are some sedation options to ask your doctor about:

• Topical anesthesia: Topical anesthetic is a very common type of numbing agent used to prepare an area for injection. It has very minimal risks and side effects.
• Nitrous oxide (laughing gas): Laughing gas is a somewhat common form of sedation where the patient inhales nitrous oxide through a mask to help with anxiety and pain management during the procedure. Side effects include nausea, sweating, vomiting, dizziness, and, less commonly, hallucination.
• Conscious sedation: Conscious sedation, commonly known as “twilight sleep”, is a form of anaesthesia used where you are awake but relaxed. The procedure does induce short-term forgetfulness, where you likely will not remember the procedure or some of the time afterwards.
• General anesthesia: General anesthesia is normally used during major dental procedures, such as dental implants. Side effects include nausea, headaches, dizziness, and fatigue.

Symptoms of Dental Anxiety

Symptoms of dental anxiety can range from physical to emotional issues. Identifying what symptoms you normally struggle with can help you practice and plan what coping mechanisms to use. For example, if you regularly struggle with shortness of breath prior to an appointment, learning some breathing techniques may help you feel more prepared for an upcoming visit.

Symptoms of dental anxiety include:

• Avoiding going to the dentist, even for routine exams
• Experiencing panic attacks at the thought of going to the dentist
• Problems with insomnia due to an upcoming dental appointment
• Unease when imagining attending a dental appointment
• Declining dental hygiene by not attending appointments
• Symptoms like nausea, shortness of breath, and racing heart before, during, or after appointments
• Feeling physically unable to walk into your appointment
• Anxiety, especially while in the waiting room

Health Consequences of Dental Anxiety

Health consequences of dental anxiety can easily occur when a person repeatedly avoids going to routine dental visits. Common physical health consequences of dental anxiety include damaged or missing teeth, gum disease, and tooth decay.² Your overall dental hygiene can also affect more than just your mouth. When oral bacteria accumulates, it can lead to larger issues such as diabetes and heart disease.²

Other Consequences of Dental Anxiety

In addition to affecting your physical health, there are also emotional and social health consequences of dental anxiety. A damaged smile can contribute to low self-esteem, which may impact relationships and even career choices.² Wanting to hide your smile may encourage you to avoid important events you might otherwise attend, leading to isolation and feelings of depression.²

Why Do People Have Dental Anxiety?

One common reason people have dental anxiety is because of a past painful visit or witnessing another person’s dental trauma. Other people may already have pre-existing issues like anxiety, phobias of medical offices, or difficulties trusting others that exacerbate dental anxiety. People may also have certain physical sensations or sensory issues that cause them to avoid the dentist.

Reasons a person may have dental anxiety include:²

Bad Experiences at the Dentist

A primary cause for dental anxiety is overall bad experiences at the dentist. These experiences can range from painful visits to feeling shamed or judged for the quality of their smile. Although some people have significant dental trauma, such as being manipulated into having unneeded procedures completed, there are also others who simply feel judged for the quality of their teeth.

For example, some people are scared to go to the dentist because of their bad teeth. However, with strategies like challenging negative thinking patterns, they can realize that the majority of dentists do not judge them for the quality of their smiles; they actually want to help them improve their conditions.

Association With Pain

Dental visits have long been associated with pain. In previous generations, it was difficult or even impossible to have a painless visit. However, advances in medical and dental technology have changed that, so it is possible to have a completely painless or only slightly painful visit.

Sensory Processing Issues

There are many intense sounds, smells, and sensations at the dentist’s office, and for people with sensory issues, this can be overwhelming. For example, the sound or feeling of the drill and suction tube is often anxiety-provoking. Like many medical offices, dentists often have a particular smell, such as fluoride or cleaning products. Additionally, dentist offices are often cold or have uncomfortable chairs.

Other Specific Phobias

A phobia of the dentist can stem from many other phobias. For example, a phobia of blood can often be the cause of, or increase worries of, dental anxiety. A phobia of needles is another phobia that the dentist’s office can trigger. While not all dental visits will have needles, it is often just the thought or fear of them that can cause enough anxiety to provoke avoidance behaviors. Finally, the fear of the dentist has been shown to be linked to a phobia of germs for some people.³

Obsessive-Compulsive Disorder

Someone with OCD may develop dental anxiety when their compulsions are in conflict with dental visits. For example, someone with contamination OCD may avoid going to the dentist for fear of contracting bacteria from the staff.⁴ They use avoidance of “contaminated” items or people as their primary compulsion. Contamination OCD can also commonly present with over-brushing teeth, which can lead to inflammation and gum damage.⁴

Another example might be someone with just right OCD who fears being judged for the quality of their smile. Sometimes, physical compulsions can even cause dental damage, such as tapping on one’s teeth, which might be found in symmetry OCD.⁴

Bulimia Nervosa

Bulimia can cause significant erosion of someone’s teeth, which may cause dental anxiety. Individuals with bulimia may worry about being judged for the quality of their teeth or worry that someone may figure out they have an eating disorder based on their dental erosion. Frequent vomiting can also cause significant pain that might be worsened during dental procedures, leading individuals with bulimia to experience dental anxiety.⁵

When to Seek Professional Support

Dental anxiety is a very common type of situational anxiety, and for most people, developing a few coping skills for anxiety is enough to handle it. However, if your dental anxiety is making it difficult for you to ever go to the dentist, or you notice that your anxiety begins to creep into other areas of your life and get in the way of functioning day-to-day, it may be time to seek professional support for your mental health.

To find help, you can ask your general practitioner for a recommendation for a therapist or counselor specializing in anxiety. Alternatively, you can use a local therapist directory to search for a therapist who takes your insurance. If you prefer to see a therapist remotely, an online therapy service that takes insurance can match you with the right therapist.

Here are some effective types of anxiety treatments to explore:

• Exposure therapy: Exposure therapy for anxiety involves slowly exposing yourself to the situations that trigger your anxiety in a slow manner with a lot of support from the therapist. Over time, this will desensitize you to the object/person/situation that makes you anxious, and you will no longer have a fear response. Exposure therapy is the gold-standard treatment for phobias.
• Cognitive behavioral therapy (CBT): CBT for anxiety focuses on challenging your negative thoughts to test how true they actually are. The therapist will then offer an alternative, more positive thought to focus on. For example, replacing “Last time I went to the dentist it was unbearable, and I know it will be horrible this time too” with “Last time I went to the dentist it was awful, but I have learned a lot of coping skills now so it can be different this time.”
• Dialectical behavior therapy (DBT): DBT for anxiety teaches how to tolerate the distress that you cannot avoid and how to change your circumstances to avoid the distress that you don’t need to experience. For example, the therapist will teach you coping skills for when you are at the dentist and teach you skills for how to stop ruminating about the dentist and making your anxiety worse.