Fear of Choking or Drowning

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Written by the Dental Fear Central Web Team
Last updated on January 17, 2021

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 might suffocate and die.

Fear of drowning or suffocating

Here you’ll find some of the most common choking fears and possible solutions!

Choking or drowning in water or in your own saliva

Dental visits can involve lots of water. Handpieces (drills) and ultrasonic instruments used for cleanings spray a stream of water towards your teeth. This is done to reduce the heat that’s generated, thus protecting your teeth. So what feels like saliva pooling in the back of your throat may actually be water that hasn’t been suctioned away properly. 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 and the high-volume suction.

The saliva ejector

Saliva ejectors

This looks like a bendable see-through straw. It’s great for removing saliva that’s pooling in the back of your throat. Saliva ejectors come in packs of 100 and cost next to nothing. They have a wire reinforcement which allows them to be bent into any shape you want.

The high volume suction

Cannula attachments for high volume suction
Cannulas (disposable attachments) for the high volume suction tool

The high volume suction is so strong that the dental nurse simply holds it close to where the dentist is working. 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

Top Tips

  • A great dental assistant who is skilled with the high-volume suction tool 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, ask if they’ll be assisting that day when making your appointment.
  • Agree on hand signals with your dental team: one for when you need to take a break, and one to slip in the saliva ejector or to clear away any fluid.
  • Holding the saliva ejector yourself can be very helpful. You curve it so it goes in at the corner of your mouth. You can then move it about where needed.
  • A dental dam will prevent water from going down your throat. This can be used during fillings for example. When you’re using a dental dam, saliva (rather than water) is the likely culprit should you still get a drowning feeling. The amount of saliva you can produce tends to be relatively small, just use the saliva ejector.
  • No one likes the drowning feeling so do let your dentist (or hygienist) know what’s happening!

I have a fear of choking and gagging. Recently I 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. – from our message board

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 dentist Mike Gow:

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 dental 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 rolls

  • Be upfront about your fear. Maybe your dentist can use an alternative.
  • Tell 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. – from our message board

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 Sensitive 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.

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).

Visit our support forum to get help with this and other fears, or to simply get things off your chest!

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