Author: Dental Fear Central
Written by the Dental Fear Central Web Team
Last updated on July 24, 2020

Doomsday – The First Appointment

Feeling like a lamb being led to its slaughter? Join the club! This page explains how to figure out whether you’ve met Mr or Mrs Right, and how to communicate your needs to them.

You’re out in the car park already and don’t have a chance to prepare? Then here’s a really quick summary before you walk in that door:

  1. On your first appointment just have a chat (away from “the chair”) and discuss your fears.
  2. Arrange with your dentist that the first examination is not in-depth, just a quick look. This helps you to get over the “my teeth are disgusting and the worst the dentist has ever seen” syndrome.
  3. If you’re happy with the dentist and you’d like to see them again, arrange a stop signal (either today or during the next appointment). This puts you more in control of the situation.

Hired or fired?

Your first appointment is a get-to-know-you meeting, where you get a chance to check out your potential dentist. The only possible exception to this rule is an acute emergency.

You’re paying for the pleasure (either directly or indirectly) – treat it like you would a job interview.

In the words of dentist Mike Gow:

I will often say to the patient they believed they were coming to that first appointment to be assessed when in fact it’s the other way round. You know, it’s a job interview, they’ve come to interview me to decide if I am the right person to be their dentist and I hope they choose to employ me.

Time of Day

You should schedule the appointment at a time when you feel at your most relaxed (in the normal way, that is! Nobody feels relaxed on Doomsday).

If you’re a morning person and you dread having to wait all day, your best bet may be the first appointment of the day. This also pretty much guarantees that there’s no hanging around the waiting area for too long.

If you’re a night-owl who feels cranky in the morning, or someone who feels at their best in the late afternoon, the last appointment of the day might be best for you. The disadvantage of this is that you might have to spend some time waiting, as dentists often run late. The advantage is that your dentist won’t be worried about the next person waiting to come in.

If you find the “waiting room” bit really hard, but don’t like early mornings either, a good choice is the first appointment after the lunch break.

Bring a Friend

You may find it helpful to bring a close friend along to your first appointment, to act as an advocate for you and for moral support. Bringing a friend is not a problem (we’ve never had anyone on our support forum say that the dentist minded their partner or friend coming along). Not everyone likes this idea though – you may not want even your nearest and dearest to see you in a panicked state. Or you may want someone to come along, but only as far as the waiting area. Go with whatever feels right for you!

First impressions – trust your instincts!

The vast majority of people who have overcome a dental phobia will tell you that you will know when you have found the right dentist.

Some things to watch out for:

  • How does your dentist greet you?
  • How does s/he treat the staff? Do they seem comfortable around your dentist?
  • Is the dentist personable and approachable? Or do you feel intimidated by them?
  • Are they like a normal person, or are they “dentisty”?
  • Is the place clean? Avoid places that aren’t. Also, instruments should not be laid out in plain sight.
  • What’s the overall atmosphere like? Is it relaxed, happy, and friendly?
  • Is the dentist gentle with you?
  • Most of all, do you feel instinctively comfortable with this dentist?

Hazard Warning: People with dental phobias can have very low standards when it comes to dentists, and may be sucked in just because a dentist isn’t downright horrible. Make sure you feel very comfortable with the dentist!

It is really important that the dentist is personable and approachable. If you feel intimidated by them, then they are not a good fit for you.

Don’t tough it out!

Pretty much the worst mistake you can make. Why act tough if it’s so much easier to get treated with kid gloves if you act scared? You may think “I don’t have to ‘act’ scared, I’m scared to death anyway”, but even so, you may want to try and lay it on a bit thick. This may also take your mind off trying to fight your sense of panic. If you’re scared to death, it’s best to openly show it. Fighting panic only fuels the fire, so go with the flow. Acting brave will most likely add to your sense of panic.

Be honest and open about your fears. Your dentist can’t help you if you aren’t.

One and the same dentist may treat apprehensive patients very differently depending on whether they appear scared or not – so do make sure your dentist knows you are scared.

Be open about your fears – or be prepared

During your first appointment (or beforehand), you will need to voice your fears and concerns.

If you reckon you cannot do this verbally (some people find they’re lost for words or they “freeze”), put it into writing or use our dental fears questionnaire. Write down your fears, or alternatively, what you’d need to know from your dentist in order to be able to let them have a look, undergo treatment, or whatever else. You can then pass on this written information, either on a sheet of paper or via e-mail. Be aware though that e-mails may get lost or deleted by mistake, so do check beforehand that your dentist has received it.

Dentists who are interested in helping anxious patients are usually happy to engage in an email exchange beforehand, so you can see if they’re the right fit for you.

The only way your dentist will be able to alleviate your fears is by knowing about them. They’re not mind-readers. Be sure to mention even minor concerns – it doesn’t matter if you think they’re “stupid” or “irrational” (your concerns, that is – not your dentist!).

How much should I tell my new dentist?

You might want to find out the answer to this question from the horse’s mouth, so we asked dentist Fraser Hendrie. You can read his thoughts here:

How much can I tell my new dentist? – get tips on how much you can safely disclose.

How far should I go?

If you don’t like the dentist, not very far – you should make your excuses and leave. If you think this would be impossible for you to pull off, it’s a good idea to ensure, as far as possible, that you meet the right dentist first time round. Or bring someone you trust with you.

If you reckon you’ve found the right dentist, go as far as you feel comfortable! As a rule-of-thumb, you may want to let your dentist have a quick look (rather than a complete exam) during your first visit – this will get rid of the embarrassment factor, which is a huge hurdle for many people who are terrified of dentists. You could ask your dentist to have a look outside the chair first, without a mirror.

Plus whatever else you can manage without feeling too uncomfortable – your dentist will take the lead on that one to some extent. For example, some people might get as far as x-rays, or sitting in “the chair”, or trying out some of the equipment, but it really depends on the individual. The first appointment should really be used to build rapport with your dentist, and allow them to alleviate some of your fears.

Here are some ideas for your first visit:

  • Timing: go at your own pace. For example, you might choose to have an X-ray and examination at the next appointment, or you may only feel ready to try sitting in the chair. As you take each step and find that you can cope with it, the level of anxiety will be reduced.
  • Control: discuss with your dentist that you want to have some control over the dental work that is done. It’s important that you don’t feel pushed further or faster than you can cope with. A useful way of making sure you feel in control is to discuss a signal – such as a raised hand – that lets the dentist know you need to stop for a break.
  • Specific concerns: let your dentist know if there are specific areas that make you anxious, or if you have had traumatic experiences with dentistry in the past. Ask questions about anything that worries you, and allow the dentist to reassure you. Dentistry has advanced so much in recent years that treatments can be totally painless.

If, by the end of the session you do not feel comfortable with the first dentist you meet, do not feel obliged to proceed. Instead, arrange to visit another dentist on your shortlist.

Some Common Doomsday Concerns

The Chair

Your first appointment should always start off with a chat away from the chair. Say that you’d prefer to sit somewhere else, or if you can’t say it, let your dentist know beforehand, in writing or by e-mail. If seats aren’t available in the treatment room or if you feel you can’t cope with entering a treatment room, ask if there is another room where you can have a chat first.

The Look

You may find it easier to have your dentist have a look outside the chair first, without a mirror (only if you feel comfortable with the dentist, of course). Let your dentist know that you are embarrassed over the state of your mouth, and that you are worried about what they will say. Once you can get over the embarrassment of a quick look outside the chair, it will be much easier to let them have a closer look.

The Numbers

Many people are scared of the dentist calling out numbers to their nurse. The numbers, on a psychological level, may make you feel like you’re a set of teeth, rather than a human being with emotions. They also make the whole situation very clinical, and many people hate this clinical feel. Ask your dentist nicely if they could either not call out the numbers, or else not do it on your first visit, or to explain what the numbers mean as they say them, or listen to an mp3 player while they are doing this “charting” – depending on your and your dentist’s preference.

The Poker

Luckily, the days when dentists used the poker (or explorer, in layman’s speak) to randomly prod around are gone. It is now known that sticking in the poker and giving it a good shove (as done in the olden days) can compromise the tooth structure of an early lesion that has the potential to remineralise. It is used much more gently nowadays. Do let your dentist know though if you’ve got a problem with the poker and if you’d rather it wasn’t being used during your first visit!

The X-Ray

X-rays are usually quite easy, but if you’ve got a problem with gagging, make sure you let your dentist know. Also, do let your dentist know if you’re scared of looking at the x-ray pictures and you’d rather not see them (or at least, rather not see them straight away).

The Diagnosis

If you feel that you cannot deal with “hearing the bad news”, let your dentist know that you don’t think you can handle the bad news all at once and ask if s/he can break it to you slowly – or during the next appointment. Depending on your prior experiences, you may be the opposite and you may be especially anxious to get an honest and detailed diagnosis – again, let your dentist know!

Red Flags

During the first appointment, you may not get as far as working out a treatment plan together with your dentist. However, there are some general rules-of-thumb that dentists should follow, which you should know about:

(1) Informed Consent: your dentist should explain to you, in language that you can understand, the available treatment options, what they involve, what the various alternatives are, and what the advantages and disadvantages of each alternative are. You should always ask what they would do themselves if it was their own tooth/mouth. They should also tell you the costs for each option. (Sometimes, it’s difficult to estimate the cost in advance though, in which case both the cheapest and the most expensive scenario should be given).

If a dentist doesn’t present the treatment options, doesn’t give advice, and doesn’t let you decide, this is a red flag!

(2) The usual order of treatment is:

  1. pain relief (if necessary)
  2. cleaning / advice on prevention of problems
  3. deep cleaning (if necessary)
  4. fillings/restorations (if necessary)
  5. tooth removal (if necessary).

A cleaning usually comes first because otherwise you can’t really see what is going on, and also, it’s very important for preventing gum problems and making sure that any other work is built on solid foundations. There can be exceptions to the usual order of treatment.

If you are presented with a treatment plan that deviates from the usual order, your dentist should be able to explain to you why – and the explanation should make sense to you. Unfortunately, there are some unethical dentists who do cosmetic ($$$) treatments first in order to make more money, or who leave the cleaning till last because they want to max out your insurance and don’t care about long-term results.

It’s actually quite rare for this to happen, but it’s something you should be aware of because it can and does happen occasionally.

Give yourself a pat on the back!

If things went well – you’ve just done something incredible, maybe even something you never thought possible! You should feel really proud of yourself (and your dentist)!!

If there’s anything you feel unsure about, or if things didn’t go according to plan, please don’t hesitate to post on our forum for support and advice. Or if things went great – consider leaving a message on the forum. Your success story will really help others who are trying to work up the courage to get where you are now!

What Next?

That’s really between you and your dentist. Some people feel over the moon and completely trust their dentist immediately, and find that their dentist is able to alleviate their fears and concerns about treatments. But it is also very common to still feel fearful (or to freeze) despite being really happy with your dentist – unlearning dental fears can be a long process, but the focus should be on how much you have improved, rather than on what you cannot yet do. Other people experience feelings of guilt over the past which can be hard to resolve.

Please don’t hesitate to post on our support forum – that’s what it’s there for!

You can read more about The Aftermath (and When Things Go Wrong) here.

“I’d like to say ‘thank you’…”

If you’d like to say “thank you” to that special dentist but don’t know how – apart from saying “thank you” in person (which is always very much appreciated!), we’ve collected some gift ideas for dentists.