Worried about visiting the dentist?
Don’t let anxiety stop you from looking after your teeth
Being anxious about visiting a dentist is common for both adults and children, but it’s important to look after your dental health.
Our research shows that anxiety can be caused by fear of the unknown, so we’ve partnered with JAAQ to help answer any questions you might have before you book.
Our teams are trained to support all of our patients, so if you feel worried about visiting, just let us know. There’s plenty we can do to make you feel comfortable, including explaining your treatment step by step or discussing sedation options.
Answering your questions about dental worries
Dr. Shaila Patel-Buxton answers common questions about visiting a clinic or practice.
Transcript
Who are you and what do you do?
Hi, I am Shaila.
I'm a Bupa dentist, and I have a lot
of experience in looking
after nervous, anxious
patients coming to the dentist,
or patients who have a dental phobia.
How common is dental anxiety?
So dental anxiety is really common.
It's thought that it affects almost half
of the adult population.
It's about 4 in 10 people.
Is there something a patient can do prior to a dentist appointment to help?
So before you come to the dentist, if you know
that you are nervous or you are anxious,
or you have a phobia about coming,
that's really, really helpful.
The more information you can actually give to us,
the more we can work with it.
So the first thing I'd say is please definitely
let the dental team know.
So either you let the receptionist know, which is
probably the first port of call, or you let the nurse
or the dentist know
and then we can work with you to try
and find a way to make you comfortable
and make the treatment
and the whole process, the whole journey, much more
comfortable for you.
What is dental anxiety?
Dental anxiety occurs when
patients feel either nervous
or anxious about coming to the dentist.
I think a little bit of apprehension
or nervousness is- it's normal.
It becomes a problem if it stops you from attending the
dentist or going through with your treatment.
Will my dentist judge me?
So when you go to the dentist, the dentist is
definitely not going to judge you.
As dentists, we are trained
to, if you like meet
the patient where they are, meet them halfway,
especially to be non-judgmental, keep things confidential
and we understand that patients have had all sorts
of experiences before we actually see them.
How do I know if I have dental anxiety?
So you'll know if you have it
because you might recognise that you've got some symptoms of
anxiety or you're feeling quite nervous
about coming to the dentist.
I like to think of it as the signs
that you might encounter.
I split them into three groups really.
They might be emotional, they might be physical signs
or more intellectual mind symptoms.
So some emotional signs can be really obvious,
like you feel tearful,
you start crying at the thought of it.
Physical signs you often feel in your body, so
very common heart palpitations, feeling faint,
feeling dizzy, feeling like you need
to keep pacing around the room.
You might feel angry. Start sweating.
Often patients say, I can feel like my mouth's really dry.
I need some water. In fact,
I'm feeling a bit like I have a dry mouth at the moment.
And then one of the things I
see quite often is sometimes nervous patients
will ask lots of questions.
Is everything clean? Is it safe in here?
What are you going to do? How long is it going to take?
So often patients want
to intellectualise "What's really going to happen?".
Who can help me from the dental practice with my dental anxiety?
So in the Bupa Dental clinics, the whole team
are involved in helping you with your dental anxiety
or nervousness, phobia, around going to the dentist.
So what I mean by that is your first port
of call is the reception team,
and they can guide you as to
who might be the right dentist to look after you.
After that, we have treatment coordinators.
We have the nursing team as well as the dentist themselves.
So we find that it's a whole team approach really.
Do all Bupa dental practices have someone who can help with dental anxiety?
So this is a really good question.
I think most dental practises,
so most Bupa Dental practices will have a team
that either can help you at that particular practise
or they can refer you to the best team that can help you.
Most dental practises will be really familiar with
seeing patients who have signs of dental anxiety
or nervousness or phobia, dental phobia.
What are the most common treatments people fear?
The treatments that people most commonly fear
are things like having to have root canal treatments.
I get asked a lot of questions about that,
having your wisdom teeth taken out
and loads of people are a little bit needle phobic,
so they're scared of injections
and especially dental injections.
Do all Bupa practices have a dentist who has additional training in dental anxiety?
So your particular Bupa dental practice
that you're used to going to,
or that's close to you, may not have a dentist that
particularly supports dental anxiety,
but it is really worth contacting the reception team
because they will be able to advise you.
So either they will point you to the right dentist
or point you to another clinic or team that can support you.
Can someone who isn't usually afraid of the dentist get dental anxiety for certain treatments?
Yes, absolutely.
Especially if you've heard some negative stories
about someone else's experience.
I would say if you're getting nervous,
and especially if you're about to have some treatment,
then come and have a chat with us
and we'll do everything we can to make it as comfortable
as possible for you.
Can Valium help dental anxiety?
So for some patients, Valium can be really helpful.
In the dental practice, we
normally need to carry out an assessment
and then arrange for patients to have Valium.
We like to give it to you almost like a pre-medication,
so it's something you would take before your appointment.
Normally it's about half an hour, 45 minutes
before your appointment.
Now, if you're going to take some Valium,
we do prefer it if you have
an escort or somebody to take you home afterwards.
Does dental anxiety affect all ages?
Yes, yes it does.
It affects all ages from young children to
adults, and we will change our approach according
to the age of the patient
and what we feel is really appropriate
and what will help them.
How can I support my dental anxiety if I have a fear of needles?
So I find it's really common to be
scared of having injections.
I'm in that category. I hate having injections.
What I find is really helpful
is having some numbing gel
or spray on the gum
before the dentist gives you the actual dental injection.
So definitely letting the dentist know
or speaking to the dental team about your needle phobia in
advance is really helpful.
Also, sometimes having another distraction technique,
so it could be having some music
or a podcast on your headphones or in the background.
Also, we have the dental wand, which
is another technique we can use
to make the dental injections more comfortable.
What is the wand?
So the dental wand
or the wand is a computerised system
for delivering dental injections,
and what it really helps with is
reducing the flow of the anaesthetic
going into your gum.
So the technique is a lot more gentle
and precise in terms of
the dentist giving you an injection.
So most patients find this more comfortable
than a normal dental injection.
Are nervous patients and dental anxiety the same thing?
Yes, nervous patients and dental anxiety is the same.
I have a partner with dental anxiety, what can I do?
So the best thing you can do is, I guess, support them
and encourage them to reach out
and make a dental appointment.
And if they're open to it, come with them
to the dental appointment.
It's really common to have patients come in with
a partner, friend, relative, their mom,
for example.
What can Bupa dentists do to support dental anxiety?
So as Bupa dentist, we can support you
in terms of the following,
there's a few points actually.
I guess the first one is
we create a safe space for you to
talk about what your main concerns are in the
first or second meeting.
When we have the dental check up, we always leave time
for some discussion,
and I like to find out what are your main concerns,
really, what's made you
so anxious about coming to the dentist?
The second point I'd say is making sure then when we plan
dental treatment, making sure we've got enough time for you,
that you're not rushed.
We've got time for
the numbing to work, for example.
We've got time for you to get settled.
Another point that I think is really helpful is
I really like to take time
to frame up what's going to happen.
So some patients I find really want to know
and want an explanation of each step as it happens,
or kind of want to know in advance what's going
to happen at the next appointment.
Sometimes we find the opposite.
Some patients will say, look, next time, just get on
with it, but please don't tell me what's happening.
So it's really good to kind check in with you beforehand
and find out what really works for you.
I guess the next thing in my mind is quite obvious
in the sense of making sure that
any treatment we carry out is as comfortable as possible,
that we've got really good pain control
and we've got you as comfortable as possible
during your treatment.
If there's anything that we can do that helps
in terms of distract you from the noise.
For example, I always like
to have music on in the background
unless a patient doesn't want
to have anything on in the background,
but there's also podcasts, there's talk radio,
there's all sorts of things we can do nowadays.
Protocol is really important, so making sure that
you can signal to us whenever you want to stop treatment.
So putting your hand up is really, really common.
Yeah, it's really those sorts of things.
Is treating dental anxiety different for kids compared to adults?
Yeah, so a lot of things are really similar in that we try
to create a relaxed, friendly atmosphere.
We try and make sure there's plenty of time,
and for children, we'll try
and explain things in a child-friendly way
and use, where possible, fun language
that they can understand.
For example, I might say Mr.
Tickle or Mr.
Mirror for the Dental Mirror,
or the Hoover for the Aspirator.
So we try and ultimately create a really relaxed atmosphere.
Does general anxiety management support dental anxiety?
Oh yes, yes it does.
Absolutely. So any techniques you have to manage your
anxiety, your general anxiety, will definitely help you
with your dental anxiety.
And in fact, I use that for myself.
So if I've got to have some dental treatment, I will
definitely use my yoga breathing and try
and relax myself with deep breathing in that way.
How can you recognise dental anxiety in a partner?
So often you'll find that your partner may put off going
to the dentist, avoid having their treatment appointments,
not booking for a checkup,
or they might actually display signs of anxiety.
You might notice a change in their behaviour.
Are receptionists experienced to support nervous patients?
Yeah, absolutely.
I think most receptionists are experienced in,
I guess, being the first port of call, dealing
with patient queries, so they can often spot the signs
of dental anxiety.
So it might be things like your
expression, your body language.
Sometimes patients are in tears and they're crying,
or they feel a little bit faint, so there's many, many signs
that they will spot, and then they can tell you
what the best support will be.
They can help guide you.
What kind of options are available to dental anxiety patients?
There are a number of options available.
Some things are really simple, like having your friend
or partner with you or family member holding your
hand to help calm you initially.
So we did that the other day for a patient.
Another thing that's really helpful if you like listening
to music or listening to things, bringing your headphones
with you, having your own music playing or podcast
or whatever it is that you love listening to,
or we can play it in the surgery for you.
And then when it comes to actual treatments, we can offer,
for example, if you're needle phobic,
we can offer numbing gels,
we can use the dental wand to try
and make the technique as comfortable as possible for you.
Sometimes explaining the steps of a treatment
and making sure that you really know what's going on can be
really helpful to patients.
The more we communicate the better.
And of course there are options like offering sedation
or a sedative tablet as a pre-medication
can really help some patients.
I think the main thing is that you come
and have a chat with us, have a conversation so we can work
with you to find out what's really going to work for you.
Can you overcome / cure dental anxiety?
Oh, this is a great question.
Yes, I believe you can! I can think
of a lovely lady who's in her eighties now,
who we treat, who comes in
and is able to have all sorts of dental treatment now.
But she has told me the story
of being a real dental
phobic patient when she was a lot younger
and she really used to struggle
to get any sort of dental treatment.
So she's amazing. She's really overcome her dental phobia.
And in fact, I think when we see
patients overcoming their anxiety
or their, I guess their phobia, their nervousness
and transform the way they
approach their dental appointments, it's so inspiring.
It is so rewarding to see. It makes our day, always.
What typically causes dental anxiety?
So this is a big question
because there's all sorts of
reasons why patients might get anxious.
So one
of the most common ones is growing up hearing negative stories.
So you might've heard stories from your parents,
from your grandparents, especially about things like
root canal treatments
or if you have to have a wisdom tooth taken out,
you might have had a bad experience yourself when you were a
child or as an adult.
A lot of patients recall
having braces when they were little,
having lots of dental appointments as a child for that,
and then it's put them off going as an adult.
It could be that- it is thought that genetically,
some patients are generally much more anxious.
Another big area is if you've got other health problems.
So for example, I'm going
to talk about a personal story.
My mom, unfortunately, a few years back, was diagnosed
with a brain tumour
and I started to notice that she was far more anxious about
all sorts of things, and especially if she had to have
any sort of medical or dental treatment.
So for sure,
health problems, whether they're physical
or mental health problems can definitely trigger a
lot more anxiety.
What can I do if I struggle to even call up the dentist?
So, yeah, if you're really struggling with this, I think
see if you can find somebody in your support network
that can help you through the process, especially initially,
to help you: make that initial call,
perhaps attend the first appointment with you
or simply drop us an email.
For example, I've had a few occasions where I have
spoken to the patient on the phone
before they've even made an appointment and come
and seen me face to face.
Does mindfulness or meditation help with dental anxiety?
Yes, absolutely.
I find that if I get really nervous,
then I'll certainly use my breathing techniques
to help calm me.
We actually have a link to some really great
mindfulness and breathing exercises.
What is sedation?
So sedation is something that you can take
in conjunction to normal dental treatment.
So there are three main types.
You can either take a sedative tablet, we normally give this
as a pre-medication, so it's something you would take
about half an hour, 45 minutes
before your dental treatment appointment.
You could have what we call gas
and air, which is actually nitrous oxide,
and you normally have a little mask
and you will breathe through the mask.
It's something that's often used in hospitals as well.
Or the third way is having
a sedative injection,
and this is normally administered either by an anaesthetist
that comes to the dental practice
or by the dentist themselves.
So for all three of these, normally the best thing is
to have a chat with the dentist at one of the Bupa practices
and they can carry out a pre-assessment for you.
Can I get sedation?
So yes, you can get sedation
for certain dental treatments.
Normally what would happen is a Bupa dentist
would assess you for sedation.
I guess the first thing is to find out, well, what sort
of dental treatment do you actually need,
and is there a case for you to have sedation?
So we also want to assess your level of anxiety,
of your dental anxiety, whether you have a phobia,
what the state of your mouth is,
what the oral health problems might be,
and whether we feel that,
whether you really need a sedation.
Interestingly, I find that some patients come in
and they think that they need a sedation,
but often with a few simple steps
and protocols in place, they can manage to have treatment
without sedation.
Or they might
start off with simpler, more gentle dental treatments,
and then perhaps have sedation for the final stages.
For example, if you've got to have a wisdom tooth taken out.
Do nervous patients stress out dentists?
We're really used to looking after nervous patients
and people with dental anxiety.
So I'd say, no, not really,
but the best thing you can do is tell us about it,
so then we know how to, well, we've got better idea of how
to look after you and how to accommodate you.
How do I go about finding a dentist who specifically supports nervous patients?
Call up the dental practice, maybe the one closest to you
or the one you've heard about,
and ask the reception team
so they will know if they've got a dentist at the practice
who is experienced in dealing with dental anxiety,
or they will signpost you to the most helpful nearest
Bupa dental practice.
Does CBT help with dental anxiety?
Yes, it does.
And nowadays you can also have CBT apps,
which I find incredibly useful.
Is dental anxiety the same as a phobia?
A dental phobia is like an extreme version
of dental anxiety. It's when the anxiety gets so bad
that you can't face going to the dentist at all.
Can I calm dental anxiety?
Ah, yes, absolutely.
You can calm dental anxiety.
There are lots of tools that you can use.
Things like mindfulness apps.
I use yoga breathing techniques, relaxation
breathing techniques.
If you don't have your own tools, you could work
with a therapist or a counsellor.
I often get patients referred to me
from other therapists.
Can I get put to sleep if I'm really nervous?
Yeah.
So this is a really common question,
and the answer is yes,
but normally in the dental
practices at Bupa, we would need to carry out a careful
assessment and examination
and before we can arrange this for you.
So I guess the best thing is that you reach out to us
and make an appointment, come and see us.
Does dental anxiety come from a fear of pain?
So often if patients have had a bad experience
before and they've felt pain during the treatment,
or they've heard negative stories
about an upcoming treatment being painful, then
that can often trigger dental anxiety.
Is there a scale of dental anxiety?
So there is a scale for dental anxiety
that we can use to assess patients
for sedation, but I would say don't worry about
where you are on that scale
and just reach out to us
and have a conversation about it.
Because I find that sometimes patients come in
and they think that they will definitely need a sedation,
but actually they can manage to have dental treatment
with just a few really simple techniques.
Does dental anxiety get worse over time?
So the earlier that you
deal with your dental anxiety, the better it is.
As with any anxiety, the more that you leave it,
the worse it can get.
I guess another really important point to make here is,
especially if you haven't been to the dentist
for a long time, reaching out
and having a checkup will help you look
after your oral health
because you'll get an assessment of where you're at,
how healthy you are, and any problems
or any issues can be picked up early
before they become really painful.
Do I have to get treatment straight away?
This is a great question.
No. So normally what happens is on your first appointment,
you'll come in for a dental checkup.
So this gives us a chance to meet you,
to find out a little bit more about your dental anxiety
and to have a look in the mouth
and carry out a proper examination.
Often we're taking either some
dental photos, call these two selfies,
and we'll take some X-rays so we can really have a good look
and assess what's happening.
But what's really important is that at this appointment,
we've got a chance to discuss with you what's going on
in your mouth, and also
what treatment we recommend
and how might we manage your dental anxiety.
So this is a really important time for you
to ask any questions and express how you're feeling.
How can Bupa support my dental anxiety if I have a fear of needles?
So having a fear of needles is actually really common,
and I find that most patients
can manage having a dental injection with
simple techniques like putting some numbing gel on
or numbing spray onto the gum
before you have your injection.
Or we can use the dental wand, which is a computerised way
of giving you an injection.
Other techniques that can really help are techniques
that we would use for dental anxiety.
So it may be distraction methods like using music
to help relax you or breathing exercises.
Sometimes working with a therapist
or CBT can be really helpful.
So the best thing is that you have a chat with us
or with your dentist at Bupa
and explore what options are available to you.
What can go wrong if you don't see the dentist except when something hurts?
So there's lots of things
that could be happening in your mouth
that you can't necessarily see in the mirror yourselves.
For example, you might have tooth decay in
between the teeth, or you might have some gum inflammation
or maybe the start of some gum disease
that you won't necessarily be able to see
or notice any symptoms from.
So we pick up all of these things in a dental checkup,
but if you don't go for a check until something hurts,
then often, I guess, small issues
that can be reversed
or dealt with much more easily,
become far more complex issues
and problems that need to be dealt with.
How does dental anxiety affect oral health?
So I find that patients who have a lot of dental anxiety
will avoid going to the dentist
or avoid completing their treatment plans.
So they won't come in necessarily
and have all the recommended treatment.
So we find that over time, over months, over years,
their dental and oral health will decline.
So studies have actually shown that patients
with dental anxiety
and dental phobia, I guess, have a lower level
of oral health.
Can I pass my dental anxiety on to my kids?
Yeah, so for sure you can pass dental anxiety onto kids.
I guess kids will pick up on any
negative words or phrases that you might use
around going to the dentist.
So if you are avoiding going to the dentist
or you've had a bad experience
or you are scared of going, they will
for sure certainly pick up on this.
For example, I have had over the years, quite a lot of
children and young adults
who have never had any dental treatment
but are really frightened.
And when I ask them why, often it's
because they've heard some negative stories
from their parents
or grandparents, friends, about
dental experiences and that's really put them off.
I feel ashamed of my dental anxiety. What can I do?
This feeling of shame
or being ashamed about,
I guess your dental anxiety
or fear of going to the dentist is really, really common
and it's often really difficult to talk about.
I feel as a society, we don't really often talk about what's
behind this fear of the dentist,
and the more that
you can open up about it
or even let the dental team know that this is going on
for you, really helps in this situation.
Do you have any tips for reducing sensory stimuli like the sound of the drill?
Yeah.
So for the sounds of the drill,
I think one really useful thing is nowadays it's quite easy
for patients to bring in headphones.
So I'd say you're welcome to bring your headphones in
and listen to your favourite music or podcast,
or the other day we put on
a radio station for a patient.
So you could always ask, if you don't have headphones,
you could always ask the dentist to
play something, play some music.
That's an obvious way of blocking out the noise.
And if that's not quite enough,
or if you're able to, you could use
some meditation, some relaxation through breathing,
or use your imagination
and focus to help also manage
that sensory stimulation.
I feel helpless in the chair. Do you have any advice?
Yeah, so the feeling of helplessness
is really, really common.
It's really common for people
to feel powerless in the situation
because you can't really see what's going on.
What I find is really helpful is often having a chat
with patients beforehand.
So we can try and create a protocol
and find out what might be more helpful to you.
So, for example, you could bring in your own headphones,
listen to music or podcasts
or something that helps relax you.
We can agree a little protocol where
whenever you want to stop and have a break,
you can raise your hand
or give me a signal so that I know to let you have a break.
I often check in with patients, especially at the beginning,
to make sure that you're comfortable,
that any pain relief is working
and that we are working at a pace that suits you.
Sometimes patients will tell me that they really want
explanations as we go along, or it might be vice versa,
and you don't want to know anything.
So what we are trying to do is give you as much control
as possible over the things that
will make a difference to you.
So I think here communication is really important,
so letting us know how you feel will really help both of us.
I am paranoid I will be causing an inconvenience to my dentist if I am nervous during my procedure.
Firstly, I want to say actually having dental anxiety
is really common,
and as dentists, we're trained to
support patients who are anxious
and nervous about coming to the dentist
and who have dental phobia.
I guess what we really want to do is support you
through this journey, so if you are able
to let us know in advance, then we can work with you
to really help you through this journey.
On a personal note, I find that actually,
if we've managed to support you through
or support patients through this journey
and over time
they can overcome their dental anxiety
and get their treatment done, then
that's a huge transformation
and that's really- not only is it really rewarding
for the dental team, it's just such a wonderful thing
to see.
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