Fear of Choking or Drowning

A fear of choking at the dentist is not unusual. For example, you may worry about drowning in your own saliva, choking on dental instruments, or choking on gauze. You may be genuinely concerned that you may die. Here are some of the most common choking fears and possible ways of dealing with them:

Choking or drowning in water or in your own saliva:

Dental visits can involve lots of water. Handpieces (also known as ‘drills’) as well as ultrasonic instruments used for cleanings spray a stream of water towards your teeth, in order to reduce the heat that’s generated. What may feel like saliva pooling in the back of your throat may actually be water that hasn’t been properly suctioned away. This can happen especially if the dental nurse or dental assistant is a bit inexperienced.

There are two main types of suction instruments: the saliva ejector (which looks like a bendable see-through straw), and the high volume suction. The high volume suction is so strong that the dental nurse simply holds it close to where the dentist is working and when held in the right spot, it will suck away any nearby debris and water:

“In the past, it was not uncommon for patients to feel as though their mouths were filled with debris and water when the dentist was working, this lead often to patients feeling as though they may struggle to breathe. The truth is there are many ways around this problem now, modern suction systems allow dentists to use the water that they need while working and remove it from your mouth again almost immediately. There are many systems that dentists can use to achieve this and very often it is just a case of finding out what works for you. If you have this fear, ask your dentist how they would deal with it for you.” (Fraser Hendrie, BDS)

When you’re using a rubber dam, saliva (rather than water) is the more likely culprit. The amount of saliva you can produce tends to be relatively small, and all that is usually required is a saliva ejector.

Here are some tips:

  • A great dental nurse or assistant who is skilled with the high volume suction can make all the difference between a visit where you feel as if you’re drowning and choking on water and a comfortable visit. If you have a preferred dental nurse or assistant, ask if they’ll be assisting that day when making your appointment.
  • If you feel that your mouth is overflowing with saliva, remind your dental team about your concern and ask them when you lift up your left hand to slip in the saliva ejector to clear the fluid.
  • You may be able to curve the plastic saliva ejector so it goes in at the corner of your mouth, allowing you to hold it yourself and move it about where needed.
  • No one likes the drowning feeling so do let your dentist (or hygienist) know what’s happening!
  • Depending on the type of treatment, you and your dentist may be able to use a rubber dam, which prevents water from going down your throat.

“I have a fear of choking and gagging. I recently had a filling in a top molar, all the way in the back next to my wisdom tooth… I’ll tell you what helped me get through it. LOTS OF SUCTION. I held one, and the assistant held another one. This way everything stayed very dry in my mouth, because I can’t handle it when even water runs down my throat. Even that makes me gag at the dentist. Also if you feel a gag moment coming on, concentrate on breathing through your nose, instead of your mouth. That also helps a lot.”

Feeling unable to swallow with your mouth open:

This is quite a common complaint. Most of us are not really used to swallowing with our mouths open. The following tip comes from Mike Gow, BDS:

“I teach my patients to practice swallowing with their mouths open in the run up to the next appointment. Try this yourself at home. Once you have done this for a few days, you can progress to holding a small amount of water in your mouth (and keeping it there), while allowing the swallowing reflex to take place. Obviously the trick is not to swallow any of the water – just to allow the natural reflex within the throat to take place, keeping the water in the mouth. (I hope that makes sense!) It is a very effective and useful thing to learn to do.”

Fear of choking on dental instruments:

  • Ask your dentist if you can use a rubber dam. This is a thin sheet of latex which protects your throat from anything going into it.

Fear of choking on gauze or cotton wool:

  • Be sure to mention your concern to your dentist if you are worried about having gauze in your mouth after tooth removal. From our message board:

“I thought there would be a big wad of cotton in my mouth. Not so. The first tooth was extracted by an oral surgeon, and he used a gauze pad that sat at the side of my mouth. It gave me no problem. I just had to change it every so often the first day. For the last three teeth, my dentist used an absorbable Gelfoam pad that fit right into the hole of the extraction. I never had to take it out nor change it. It filled the hole, and made the bleeding stop almost instantly. And I never knew it was there…hence no gagging possible.”

Fear of choking due to local anaesthetic:

The local anaesthetic may make you feel as if you’re unable to breathe and make you choke as a result. If this is the case for you, please have a read of our page on Fear of Feeling Numb.

Choking and gagging:

The words “choking” and “gagging” are sometimes used interchangeably – again, we’ve got a separate page for dealing with a sensitive gag reflex: How to Deal With a Bad Gag Reflex.

Feeling of choking when the chair is too far back:

Some people feel as if they are going to choke if the chair is tipped too far back.

You could ask your dentist to only put the chair back as far as necessary – on our fear of loss of control page, you’ll find tips for dealing with dental chair position.

Choking due to past abuse:

The feeling of choking may also be associated with past sexual abuse. You can find tips for abuse survivors and their dentists on this page: Tips for Abuse Survivors and Their Dentists (warning: may trigger).

Related pages:

Fear of Feeling Numb

Fear of Gagging

Fear of Panic Attacks

The information on this page has been provided by the Dental Fear Central Web Team. Last reviewed on January 4, 2019. We welcome your feedback on our information resources.