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Dental anxiety

Key points

  • If you have dental anxiety, you feel nervous or fearful about seeing a dentist.
  • The condition is common and can affect anybody.
  • People who have dental anxiety are affected in different ways and to different degrees.
  • There are many ways to overcome your fear and a dentist will be able to help you with this.
  • Sedation and psychological therapies are some of the ways in which you may be able to get over your anxiety.

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

About dental anxiety

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.

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.

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

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.

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.

 

Produced by Polly Kerr, Bupa Health Information team, August 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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