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Dental anxiety

Dental anxiety is feeling nervous or fearful about visiting a dentist. It can sometimes prevent you from getting dental treatment.

Dental anxiety is common and affects people of all ages. There are different levels of dental anxiety, ranging from slight nervousness to a severe phobia (an illogical fear that makes you stay away from certain situations).

Dental anxiety affects people in different ways. You may be anxious about specific aspects of dental treatment or about being in close contact with someone you don't know very well. You may have had unpleasant experiences at the dentist as a child and are frightened that these will be repeated.

No matter how nervous or fearful you are of having dental treatment, there are a number of things that can help you to overcome your anxiety.

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  • Getting support Getting support

    The first step is to get in touch with your dentist and talk about your anxiety. It’s important to remember that he or she will understand if you’re anxious about having treatment.

    One way of finding a supportive dentist is to ask around – you may be able to get a recommendation from a friend or family member. Alternatively, you could find out which dentists in your area specialise in treating people with anxiety. Most dentist clinics have websites that may say they specialise in treating people who are nervous or phobic. If you feel able, phone the practice to find out more and to explain your worries. For more information, see our frequently asked questions.

    To begin with, you may be able to book an appointment just to talk about your anxiety. This way you can meet with your dentist in person and discuss your worries. You may find it helps to take a friend or family member with you.

    There are a number of things to bear in mind when you go to see your dentist for an appointment. Although you may feel embarrassed or anxious, it’s important that you’re open with him or her so that you get the support you need.

    • Timing. Ask your dentist to let you go at your own pace. For example, you might choose to have just an examination at your first appointment, or even just sit in the chair. Once the first stage doesn't frighten you any more, you can move on to the next. This way you may be able to overcome your anxiety gradually.
    • Control. Talk to your dentist about having some control over the amount of treatment you're getting. It's important that you don't feel pushed further or faster than you can cope with. You may feel more in control if you have a signal, such as raising your hand, that lets your dentist know that you would like him or her to stop.
    • Specific concerns. If there are particular things that you're worried about, or if you have had a traumatic experience in the past, tell your dentist about them.
    • Choice. There are a number of treatment options that may help you to relax. Ask your dentist to explain which options may be most suitable for you.

    If your phobia is so severe that you can't even consider approaching a dentist for support, see your GP who may be able to recommend treatment to help you.

    Bupa Dental Services

    You don’t need to have Bupa insurance to enjoy a range of dental services. Find out more today.

  • Sedation Sedation

    You may find treatment easier if you have some form of sedation. This relieves anxiety and helps you to relax. You will still be awake but you probably won't be able to remember much about the procedure afterwards.

    For oral and intravenous sedation you must have someone to accompany you to and from your dental appointment. Sedation temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you’re in any doubt about driving, contact your motor insurer so that you’re aware of their recommendations, and always follow your dentist’s advice.

    There are three main types of sedation used in dentistry.

    Oral sedation

    Your dentist may prescribe you a medicine, such as diazepam, to help reduce your anxiety. You take this as a tablet, usually about an hour or two before your appointment. Alternatively, you may take it the night before your appointment. You must take these medicines exactly as directed by your dentist.

    Inhalation sedation

    This is also known as 'gas and air'. It's a mixture of the gas nitrous oxide and oxygen. You breathe it in through a mask placed over your nose that has a tube attached to a machine. You will be able to understand what your dentist is saying throughout the treatment, but the sedation should reduce your anxiety.

    When your treatment is finished, the sedation will wear off after a few deep breaths and the gases will leave your body after a few minutes. However, you’re likely to need to stay in the clinic for up to 30 minutes for the effects of the sedation to wear off fully. Your dentist may ask you to bring a friend or family member to accompany you home.

    Intravenous sedation

    If you have intravenous sedation, a medicine will be injected through a fine plastic tube (cannula) into a vein (usually on the back of your hand). The medicine will make you feel relaxed, but you will still be able to understand and talk to your dentist although you may not remember anything afterwards.

  • General anaesthesia General anaesthesia

    Occasionally, people who have severe dental phobia, young children and people with special needs may need general anaesthesia to have dental treatment. This means that you will be asleep during the treatment. All possible alternatives should be explored first.

    You will have to go into hospital for your dental treatment if you’re having a general anaesthetic and you will need to arrange for someone to take you home. Try to have a friend or relative stay with you for the first 24 hours after your dental treatment. General anaesthesia also temporarily affects your co-ordination and reasoning skills, so you should take the same precautions as described for sedation.

  • Treatment for dental anxiety

    Our Bupa Dental Centres offer a range of routine, specialist and cosmetic treatments including dental anxiety management. Find out more.

  • Psychological techniques Psychological techniques

    You may wish to try using a psychological technique to reduce your anxiety. This may mean you don’t need to have sedation for your treatment.

    Distraction techniques

    You may find that distracting your attention from your dental treatment helps you to relax. For example, it may help to:

    • listen to music or an audio book
    • watch a video or DVD (this may not be an option in all dental clinics)
    • concentrate on relaxing each part of your body in turn
    • think about something that you’re looking forward to
       

    Hypnotherapy

    Hypnosis uses suggestions put to you by your hypnotherapist to bring about relaxation and help you change the way you feel about situations and ideas. You will stay awake and in total control. See our frequently asked questions for more information.

    Although hypnotherapy may help some people to relax, there is little scientific evidence to show that it can reduce anxiety.

    Cognitive behavioural therapy (CBT)

    Cognitive behavioural therapy is a type of talking therapy that helps you to address negative thoughts and behaviours. A behavioural therapist may be able to teach you ways of reducing your anxiety about going to the dentist. Your GP may be able to recommend a therapist.

  • FAQs FAQs

    If I have a dental check-up under hypnosis, how will I know if my dentist carries out other treatment while I'm asleep?

    Answer

    If you’re hypnotised, you will stay in a state of consciousness and you will usually remember what happens. Also, your dentist must never do treatment that you haven't agreed to – this is true whether you're hypnotised or not.

    Explanation

    You will usually be able to remember everything that happened when you were hypnotised. The idea that a hypnotist can make you fall asleep suddenly isn't an accurate description of clinical hypnotherapy, which is practised by fully qualified health professionals such as dentists. Rather than being asleep, hypnosis is usually described as being in a daydream-like trance, similar to being immersed in a book or film.

    Your session should be carried out by a fully qualified hypnotist or a dentist who has done further training in hypnotherapy. Your dentist will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the treatment. This will help you to be informed, so you can give your consent for the treatment to go ahead, which you may be asked to do by signing a consent form.

    You’re always free to say no or to ask for more information before you make up your mind. If you have agreed to have a check-up only, your dentist isn't allowed to do other treatment without your permission. Being hypnotised doesn't mean you will agree to do anything against your will.

    I've just had several fillings done in one session under intravenous sedation. Will I always need to have my treatment done this way?

    Answer

    Not necessarily. It depends on how much your anxiety affects you when you go for dental treatment. With the right care and support, you may be able to overcome your anxiety and not need intravenous sedation in the future.

    Explanation

    Intravenous sedation can help to reduce your anxiety if you're very nervous or have a phobia about getting dental treatment. However, it won't necessarily help you to address your phobia because you may have been unaware of what happened during your treatment session, and you may even have forgotten about most of it.

    If you feel ready to overcome your fear of having dental treatment without sedation, talk to your dentist about what to do next. For example, you may find it helpful to make a few appointments over the following weeks to familiarise yourself with the dental clinic and the staff, to learn about brushing and flossing properly or to have your teeth polished.

    If you don't manage to overcome your nervousness or phobia, you may still need to have sedation for future dental treatment. However, with regular check-ups and advice on diet and oral hygiene, you should be able to keep your teeth healthy and build up a good relationship with your dentist and hygienist.

    Where can I find details of dentists who specialise in treating anxious patients?

    Answer

    Seeking help can sometimes be daunting if you have dental anxiety, but finding a dentist who specialises in treating nervous people is a positive first step. There are a number of websites that may help you to find out more information.

    Explanation

    The British Dental Association has set up a directory known as 'Find a dentist'. This allows you to search for dentists in your area and to find out what special services they offer, such as treating people with dental phobia, sedation or hypnosis.

    You could also try looking at patient group websites. Some of these websites list details of dentists and dental clinics that have been recommended by people with anxiety. However, it's important to remember that these are people’s personal experiences and so may be misleading. It isn't possible to confirm the accuracy of information on websites such as these.

    The General Dental Council (GDC) regulates all dental professionals and you can check any dentist’s qualifications on the GDC website.

  • Resources Resources

    Further information


    Sources

    • What is dental phobia? Dental Fear Central. www.dentalfearcentral.org, accessed 20 June 2013
    • Common dental fears. Dental Fear Central. www.dentalfearcentral.org, accessed 20 June 2013
    • Fear of going to the dentist. BDA Smile. www.bdasmile.org, accessed 21 June 2013
    • Sedation dentistry. Dental Fear Central. www.dentalfearcentral.org, accessed 21 June 2013
    • Donaldson M, Gizzarelli G, Chanpong B. Oral sedation: a primer on anxiolysis for the adult patient. Anesth Prog 2007; 54(3):118–29. doi:10.2344/0003-3006(2007)54[118:OSAPOA]2.0.CO;2
    • Inhalation sedation (laughing gas). Dental Fear Central. www.dentalfearcentral.org, accessed 21 June 2013
    • Conscious sedation in dentistry. Scottish Dental Clinical Effectiveness Programme. www.sdcep.org.uk, published May 2006
    • IV (intravenous) sedation. Dental Fear Central. www.dentalfearcentral.org, accessed 21 June 2013
    • Standards for dental professionals. General Dental Council. www.gdc-uk.org, published 2009
    • Conscious sedation. Society for the Advancement of Anaesthesia in Dentistry. www.saad.org.uk, accessed 21 June 2013
    • Hypnotherapy. University of Maryland Medical Center. www.umm.edu, published September 2011
    • Coelho HF, Canter PH, Ernst E. The effectiveness of hypnosis for the treatment of anxiety: a systematic review. Prim Care Community Psychiatr 2007; 12(2):49–63. doi:10.1080/17468840701680678
    • Cognitive behavioural therapy. Royal College of Psychiatrists. www.rcpsych.ac.uk, published February 2012
    • Hypnotherapy training courses at the Hypnotherapy Training Institute of Britain (HTI). The Hypnotherapy Training Institute of Britain. www.hypnotherapytraininginstitute.org, accessed 21 June 2013
    • Complementary and alternative medicines 2. Royal College of Psychiatrists. www.rcpsych.ac.uk, published December 2010
    • Find a dentist. British Dental Association. www.bda-findadentist.org.uk, accessed 21 June 2013
    • Welcome to the GDC. General Dental Council. www.gdc-uk.org, accessed 21 June 2013
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    Produced by Polly Kerr, Bupa Health Information Team, August 2013.

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