How to Tackle Dental Anxiety – An Overview

Written by the Dental Fear Central Web Team and reviewed by Lincoln Hirst BDS
Last updated on January 17, 2021


A dentist’s technical competence is important, and it’s well worth checking their qualifications and any further training they’ve done. But that aside, above all else, it really boils down to… personality!

Some dentists are just naturally good at making their nervous (or terrified) patients feel at ease. Of course, if they’re trained in using a wide range of tools to help people with dental fears, all the better.

If you don’t get that feeling from the first dentist you choose to meet, try another. Just because a dentist says on their website that they welcome anxious patients doesn’t always mean they’re good at it. It’s also true that a dentist may be great for some people, but not a good match for others. Go with your gut instinct.

If at all possible, find someone you really like !

The assistant or dental nurse can also make a major difference to how well looked after you feel. If the nurse and dentist work well as a team and show mutual respect to each other, this harmony rubs off and makes everyone feel more relaxed. For some people, the assistant is a major source of moral support, and they will only book in when they are sure that “their” nurse will be present.

What else can help with overcoming dental phobias and fears?

1. psychological strategies – the way your dentist communicates, techniques dentists can use to help, and ideas you can easily use yourself

2. technology and gadgets – new and not-so-new inventions which can make dental treatment more enjoyable

3. sedation – using drugs to make you feel relaxed

4. comfortable and effective numbing – if dental treatment is painful, then all the psychology in the world is not going to help:

CBT is good but CBT won’t work unless you have the right dentist. I mean really you can CBT for months but if you aren’t numb then forget it. – comment from a dentist on our support forum

The way you tackle your fears needs to be tailored to you as an individual. But generally speaking, we can look at tackling fears (or “dental anxiety management”) as being a bit like a pyramid, where the layers closer to the bottom are needed to support the layers further up the pyramid:

The Environment

The environment be of huge importance when it comes to dental anxiety. It sets the tone for the whole dental experience – first impressions do count! While we cannot do away with modern dental equipment, it’s important that the reception areas and treatment rooms don’t have a hospital vibe. This means, for example,

  • a friendly interior design scheme,
  • instruments being hidden from sight as much as possible,
  • artwork instead of photos of smile makeovers,
  • perhaps music playing in the background or other distractions,
  • dentists and staff not dressing in traditional medical outfits – the proverbial white coat can be a trigger for many people (luckily, they’ve gone out of fashion in recent years),
  • thoughtful little touches like a water dispenser or tea and coffee machine, and
  • doing away with the “typical” smells associated with dentistry as far as possible.


The foundation of the pyramid is communication. Your dentist should be someone who is supportive, caring, and easy to talk to. They should use non-threatening language that you can understand.

Good rapport is essential. Rapport (a harmonious connection) implies a relationship of equals, where you don’t perceive your dentist as a threatening or a condescending figure, but as a partner in your care. It’s about doing things together with your dentist, rather than your dentist doing things to you.

Psychological Strategies

You may find it helpful to bring someone along to hold your hand for a bit of support (though this may not always be possible during COVID-19 times!).

It is also essential that you and your dentist agree a stop signal, and ideally also a coping signal.

Coping styles: Monitoring vs. Blunting

The choice of psychological strategies that you and your dentist use depends on your personal preferences. Coping strategies fall into two broad categories:

  • monitoring: you prefer being given detailed information and actively participating (enhancing control)
  • blunting: you prefer less information/detail and may prefer being distracted or unaware.

Some people have a general preference for knowing exactly what is going to happen before and during a procedure, while others prefer only a brief explanation, and cope best by being distracted (or unaware of what is happening).

However, things are rarely that straightforward. For example, you may prefer distraction or minimal information during certain situations or procedures, but still like to be given detailed knowledge and the opportunity to participate in other situations. Or you may simultaneously seek information and distraction (for example, being informed about what is happening while music is playing in the background).

Preferences can also change over time, for example because of changes in your general stress levels or mental health issues. The key is to remain flexible – there are plenty of options in the toolbox.

Psychological strategies include:

Some of these strategies are aimed at enhancing control, such as signalling or tell-show-do, while others are aimed at diverting attention.

Of course, you can also choose to enlist the help of a therapist, such as a psychologist, psychotherapist, counsellor, or hypnotherapist. Cognitive-behavioural therapy tends to be the method of choice for tackling dental phobia and specific dental fears.

Technology and Gadgets

There have been some exciting technological advances and innovations which can really help with specific fears. For example, The Wand has been a real blessing for people with needle phobia. Handpieces (drills) have become quieter (especially the electric versions), and digital scanners for taking impressions are becoming more commonplace.

You can find out more on these pages:


If you feel they would help you, there are various sedation options available.

Premedication and oral sedation are a low-cost way of making you feel more calm and relaxed.

Inhalation sedation (laughing gas) is great for making you feel more relaxed, and can be very much a “participation technique” also suited to people who like to feel in control of situations.

IV (intravenous) sedation may be better suited to those who are more willing to entrust control to another person. It can produce a level of sedation so deep that you may not remember much, or even nothing at all, of what happens during treatment.

IV sedation can also be a good option if you need lots of work doing and you are really worried about it. You could get things under control using IV sedation, and then experiment with other methods when you require just a bit of maintenance work.

Visit our forum for help and support, or to simply get things off your chest!