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. A 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

What's the best time of day to schedule a dental appointment?

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!

Most 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 the dentist greet you?
  • How do they treat the staff? Does the staff seem comfortable around the 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: It’s not uncommon to have very low standards when it comes to dentists, especially if you’ve had bad experiences in the past. Make sure you feel very comfortable with the dentist – just because someone isn’t downright horrible to you doesn’t mean they’re right for you!

It is really important that the dentist is personable and approachable. If you feel intimidated (or even bullied) by them, do yourself a favour and give them a miss.

Don’t tough it out!

Pretty much the worst mistake you can make. Why act tough when 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.

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 quite 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.

Fill in our dental fear questionnaire to give to your potential dentist!

If you reckon you cannot do this verbally (many 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 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.
  • Control: Discuss with your dentist that you want to have some control over the dental work. It’s important that you don’t feel pushed further or faster than you can cope with. Agree on a signal that lets the dentist know you need to stop for a break.
  • Specific concerns: Let your dentist know if there are specific things that make you anxious, or if you’ve 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 you don’t feel comfortable with the first dentist you meet, don’t feel obliged to push on. Instead, arrange to visit another dentist on your shortlist.

Some Common Doomsday Concerns

The Chair

Your first appointment should start off with a chat away from the chair, if at all possible. Let your dentist know that you’d prefer to sit somewhere else. Or let your dentist know beforehand, in writing or by e-mail. If there are no spare seats 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 Exam

You may find it easier to have your dentist have a first look outside the chair, without a mirror or a light. Let your dentist know you’re embarrassed and ashamed, and that you’re worried about what they will say. Once you get over the embarrassment of a quick look outside the chair, it will be easier to let them have a closer look.

The Numbers

Many people are scared of the dentist calling out numbers to their nurse. On a psychological level, the numbers may make you feel like you’re a set of teeth. 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. They may be able to quietly note them down. Or ask them to explain what the numbers mean as they say them.

The Poker

Luckily, the days when dentists used the poker (aka explorer) to randomly prod around are gone. Nowadays, we know that sticking in the poker and giving it a good shove can compromise the tooth structure of an early lesion that has the potential to remineralise. As a result, dentists use it much more gently nowadays. Do let your dentist know though if you’ve had bad experiences with the poker and you’d rather it wasn’t used!

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 (just yet).

The Diagnosis

If you feel that you cannot deal with “hearing the bad news”, let your dentist know. Ask them if they 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

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
  • the alternatives, 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 or mouth. They should also tell you the costs for each option. Sometimes, it’s difficult to estimate the cost in advance. In this case, they should give you both the cheapest and the most expensive scenario.

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. Also, it helps to prevent gum problems and makes sure that any other work is built on solid foundations. There can be exceptions to the usual order of treatment.

If a treatment plan isn’t in the usual order, your dentist should be able to explain to you why. What’s more, 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 they may leave the cleaning till last because they want to max out insurance and don’t care about long-term results.

It’s actually quite rare for this to happen nowadays. But it’s something you should be aware of because it can and does happen occasionally, especially in the U.S.

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.

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:

Step 5: The Aftermath

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

“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.

You may also like:

Common Fears Questionnaire – you can print this out, fill it in and give it to your potential dentist (or email it to them beforehand)

How much should I tell my new dentist? – dentist Fraser Hendrie on how much you can safely disclose to your new dentist.