Overcoming Dental Anxiety: 5 Strategies for a Stress-Free Appointment

Dental Anxiety.

Dental Anxiety is a physical or psychological reaction of fear that a person associates when visiting a dentist or a dental office. It can be caused by any item present in a dental office such as needles, drill, dental chair or fear of getting a dental procedure etc., sometimes even the thought of a dental office can trigger an anxiety attack.

Dental fear and Dental anxiety are not the same. Usually, dental fear is when a person knows exactly what particular item in the dental office makes them afraid, but Dental Anxiety is more of a generalized fear of the unknown that a person associates with the dental office.

Dental phobia is a severe, extreme terror that a person feels going to a dentist.

Patients having any of the above three conditions usually end up avoiding or skip going to dental appointments regardless of whether the procedure is simple or complex.

How Dental Anxiety Affects Oral Health.

Avoiding dental appointments can cause a simple dental condition to eventually turn into a complicated one that may require a more extensive complex treatment which in turn worsens the anxiety problem.

A lot of dental issues can be avoided by getting regular dental checkups, getting cleaning done and diagnosing minor dental issues early before they grow into bigger conditions. A simple cavity if left untreated could require a root canal treatment or need for extraction or a simple routine cleaning if neglected could turn into severe periodontal problems causing severe bone loss. Thus, anxiety disorders lead to neglect or delay in seeking dental care, causing increase in cavities and diseases of the gum. Certain lifestyle factors such as alcohol, smoking, diabetes, lead to conditions like oral cancer, mouth lesions, ulcers, mobile teeth due to bone loss which are usually diagnosed by a dentist during a routine examination.

What Causes Dental Anxiety?

Dental anxiety can be caused by any of the following reasons

One of the most common reasons for dental anxiety is a previous traumatic dental experience or other health care experience that left an agonizing or fearful impression in a person’s mind.

  1. Any trauma or abuse that was previously inflicted in the Oro-facial area or in the head and neck region.
  2. Any form of depression, anxiety or post-traumatic stress disorder.
  3. The belief or view that the mouth is a personal area and accessing the mouth is an invasion of personal space.
  4. The fear or phobia of loss of control and not being able to see the dental procedure while being operated.
  5. Anxiety due to Trust issues.
  6. Fear of Needles and dental instruments.
  7. White coat syndrome, Anxiety in the presence of a doctor or health care provider.
  8. Anxiety from traumatic dental experiences shared by friends and family and belief in hearsay.
  9. 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, where there is an obsession around cleanliness.

Who can be affected by dental anxiety

Dental anxiety is very common and can affect people of any age group.

Children who have had bad dental experiences in most cases can overcome their fears if the situation is managed well and they are well cared for and supported during further dental visits.

Adults who are anxious about dental care tend to remain anxious throughout life.

Many anxious dental patients can find a dentist who is sympathetic to their situation and will provide measures to minimize or alleviate their dental anxiety, so they are able to cope with going to the dentist.

How to manage dental anxiety or phobia

There are several ways to help manage dental anxiety or phobias. It is important to let the dentist know if you experience any level of dental anxiety. Open discussion around the individual triggers of anxiety can help the dentist work with you to tailor a management plan that works for you and mitigates the anxiety levels.

People with dental anxiety may experience

  • sweating
  • palpitations or increased heartbeat
  • panic attacks
  • aggression
  • low blood pressure
  • fainting

Some psychological techniques include:

Deep Breathing

Deep breathing helps relax and feel calm and reduce anxiety during dental appointments.


meditation helps reduce anxiety that a patient feels as soon as they enter a dental office of sit on a dental chair. Meditating before or after an appointment helps to remain calm and focused.


Such as listening to music or the use of devices/headphones or watching television while the dentist performs the procedure.

Guided Imagery

This technique involves thinking happy thoughts or recollecting funny memories which in turn help calm and relax the mind.

Bring a friend

Bringing a relative or friend helps calm the anxiety by creating a sense of safety and comfort thus bringing down anxiety.

Using hand signals

Agreeing with your dentist on a signal to stop during the treatment for a break (Such as raising your left hand).

Other psychological techniques to help reduce anxiety are

  • Using a weighted blanket or soft toy.
  • Use of compression toys or balls.
  • Hypnosis.
  • Creating a relaxing atmosphere in the operatory.

Referral to a psychologist can be helpful too. Short, targeted therapies including cognitive behavioral therapy can be very successful.


Certain analgesics work to relieve pain but can also reduce mild to moderate anxiety.

Most commonly used analgesic and mild sedative used in dentistry is NITROUS OXIDE or LAUGHING GAS.  It is safe and effective and involves the inhalation of laughing gas alongside oxygen in a mixture. It is a colorless, odorless gas that is not only a sedative but also an analgesic and hypnotic. When administered it gives the patient feel relaxed throughout the procedure, thus allowing the dentist to better care for the patient.

Inhaling laughing gas does not put one to sleep and wears off quicky allowing the patient to drive themselves after the dental procedure.

Who are not a candidate for laughing gas are

  • allergies to latex
  • vit B12 deficiency
  • severe emotional disturbances
  • pregnant women
  • drug-dependencies
  • middle ear problems

Anxiety relieving medication (oral anxiolytic tablets)

The patient’s anxiety becomes worse when they enter a dental office, In such cases medication helps to reduce stress and anxiety and helps make the patient calm. Certain oral anxiolytic medications (Such as Triazolam/Halcion) are sometimes prescribed by dentists and medical doctors pre-operatively to relieve anxiety and relax during the course of the procedure. A single dose is usually taken one hour before the dental appointment.

The Medication should only be taken following a discussion with your doctor. You will need someone to accompany you to drive you to and from the dental office as you cannot safely drive a car under the influence of a sedative medication.

Conscious Sedation / IV Sedation

Another form of sedation involves receiving medication through a drip placed into a vein of the arm or hand, also known as IV sedation. The Intra-Venous sedation is administered by a certified Dentist (who has an advanced training in sedation) or a registered nurse who is certified in sedation or anesthetist. It can be undertaken at a dental practice that has additional equipment, or in a hospital setting.

While under IV sedation (commonly known as Twilight Sedation) you may drift off into sleep like state but can respond to verbal commands and prompts. Transitional amnesia, nausea and drowsiness are the most common side effects of IV sedation. A driver is needed to and from the clinic as the patient remains under the influence of sedation for some time post-operatively.

Not every dentist provides IV sedation. Certain preexisting medical conditions, pregnancy and co-morbidities may dictate the type of sedation that you may require.

General Anesthesia

In general anesthesia the patient is made to be completely unconscious or fully asleep during the procedure. A patient is given general anesthesia only in the case of severe dental anxiety.

General anesthesia is usually done in a hospital setting by an anesthesiologist and then the dentist proceeds with the treatment. General anesthesia can also be provided by a dentist in a dental clinic provided the dentist has been trained to administer the same.

There are certain side effects associated with post general anesthesia like nausea and vomiting hence a patient is advised to bring a friend or a relative along to help drive home safely.

Managing Dental Anxiety at SkyView Dentistry.

At SkyView Dental we use the latest in dental technology to make sure our patients have the best and pain free dental experience. It is of utmost importance to us to not only efficiently identify dental anxious individuals but also to treat them appropriately when they arrive at our dental office. Our team of experienced dentists have the appropriate training and experience to care for patients suffering from dental anxiety and to make sure you have the best experience in the dental chair.

Schedule your appointment today with our dentist, call SkyView Dental team at (317) 886-9500.