4 Ways Dentists Can Stop Dental Phobia and Anxiety

Dental anxiety is one of the most common reasons for people to avoid their dental check-up. The problem is, while you’re putting the dentist off, you’re not avoiding them altogether. Research has shown that if you have dental anxiety, you’re less likely to visit the dentist regularly, which puts you at higher risk of dental disease.

Once you don't visit for long enough, dental diseases like tooth decay, gum disease, and even crooked teeth in children can progress beyond the point of fixing. That is, your dental phobia is having serious implications for your smile. People with dental anxiety often end up presenting when things are too late, or after they’ve experienced extreme pain.

A man getting his teeth cleaned
XiXinXing / Getty Images

The good news is that dentists deal with people with dental anxiety every day in their clinics. In fact, dentistry has changed to make people with dental phobia feel better in their dental surgery.

Do You Have a Dental Phobia?

The first step to getting over any phobia or anxiety is to acknowledge that it exists in the first place. If you are avoiding the dentist there’s a good chance you have some level of dental anxiety.

Here are some of the most common reasons for dental phobias:

  • Childhood dental experience: the most formative dental memories are created during childhood years.
  • Painful dental experience: The mouth is one of the most heavily nervous areas in the body.
  • Dental related poor self-esteem: Some people fear going to the dentist because they feel embarrassed due to their mouth. This may be due to aesthetic problems and embarrassment with teeth, bad breath, gag reflexes, or chronic pain.

All of these conditions can cause a general fear of people looking at or being close to your mouth, which of course, is the very nature of dental treatment itself.

Here are 4 strategies for beating your dental phobia.

Overcome Fear of the Dental Needle

The number one part of a dental appointment that results in dental phobia is fear of the dental needle.

Firstly, it’s important to note that this isn’t just a dental phobia. Needle phobia is part of a group of specific phobias of blood-injection-injury. People who have needle phobia experience a loss of blood pressure and fainting response.

You should inquire about the following options for dental injections.

Topical anesthesia: Also known as “numbing gel,” it is a cream or gel used to numb your gums before your dental injection so that you can’t feel the needle glide in.

The term topical anesthetic means an anesthetic agent that is simply applied externally to the outside (like skin and gums). If you fear the dental needle ask your dentist to leave the topical anesthetic on for longer.

Painless injections: While you may be afraid of the needle, it’s important to remember that a dental needle is very small in diameter.

A recent innovation in dental surgeries is painless injections. Generally, these refer to using a local anesthetic device called the wand.

The dental wand uses a small handpiece that looks like a pen. It is designed to give a supply of anesthetic in a slow, comfortable manner. The delivery works at a low pressure and a slow rate that gives an improved anesthesia.

Does it work? Most people report a lower amount of pain associated with dental injections using the wand. You can inquire whether a dentist uses the wand before booking your appointment.

Additional anesthetic options: While nearly all dentists will use local anesthetic for most treatments (although it’s not necessary for all), they also employ a range of other anesthetic options.

Relative anesthetic: Happy gas is a term for nitrous oxide used as an anesthetic gas. However, using the small quantities employed with happy gas the patient does not become unconscious but merely sedated.

Nitrous oxide mixed with pure oxygen and air is used to produce relaxation and even a feeling of floating for the patient. It is applied in the dental surgery using a nasal inhaler, which is gently placed over the patient’s nose.

The system is very comfortable and can be adjusted by the patient if they desire. The dental practitioner allows the patient to breathe the nitrous oxide mixture for two to three minutes. Once a feeling of a general relaxation is experienced, the dental treatment can then commence.

Happy gas isn’t a replacement for local anesthetic injections. However, they quite often allow them to be applied together and the patient feels no discomfort. Once local anesthetic is used, the entire dental procedure is completely pain-free.

IV sedation: IV sedation (intravenous sedation) is when a drug, usually of the anti-anxiety or sedative variety, is administered into the blood system during dental treatment. IV sedation is typically administered by a trained dentist (such as oral surgeon) with a specific license. Often times, a nurse anesthetist is required to administered the IV sedation.

IV sedation induces a state of deep relaxation and a feeling of not being bothered by what’s going on. The drugs used for IV sedation produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in until it wears off.

As a result, time will appear to pass very quickly and you will not recall much of what happened. Many people remember nothing at all. So it may, indeed, appear as if you were “asleep” during the procedure.

Generally, patients report remembering nothing about what happened. It can be referred to as "twilight aleep." The advantages of IV sedation for dental phobias is that patients often feel absolutely fine during treatment.

For IV sedation, you will need someone to accompany you and bring you home afterward.

General anesthetic: General anesthesia (GA) refers to being “put to sleep.” During GA, you are unconscious. It is performed in a hospital setting with an anesthetist.

GA requires intubation as patients are unconscious and not breathing. The breathing tube isn't inserted to prevent debris from entering the airway. Intubation can occur via the nasal passage or oral passage. When dental work is required, nasal intubation is typically the preferred route to allow easy access to the oral cavity. The oral pharynx is blocked with gauze.

Apart from the risk of serious complications (which are very small, but still much higher than for conscious IV sedation), general anesthesia has a few major disadvantages:

  • It’s known that GA depresses the cardiovascular and respiratory systems. For some groups of medically compromised patients, it’s unsuitable for elective dental procedures.
  • Much higher cost than general dental treatment.

It’s not recommended for routine dental work like fillings. The potential risk involved is considered too high to warrant the use of GA. For general dental treatment, a breathing tube must be inserted, because otherwise, little bits of tooth, other debris, or saliva could enter the airway and produce airway obstruction or cause illnesses like pneumonia.

Dental Hypnosis

The exact way that hypnosis works is something that experts can’t quite agree on. However, you could describe it as controlling or ‘quieting’ the conscious mind. In dental phobia, the perception of harm is the hardest factor to overcome and hypnosis has been shown to be effective in even achieving overcoming dental phobia.

Hypnotists can help you achieve a state where you can more readily access your subconscious mind. From here they are able to give suggestions to help you visualize what it is you want to accomplish. Hypnosis may be described as a trance state.

Some dental applications of hypnosis include a strong gag reflex, treating chronic facial pain and addressing unwanted habits such as teeth grinding.

Hypnotism isn’t as common as other anesthetic options in dental surgeries. Some dentists have trained in dental hypnosis however you may need to find a hypnotist who specializes in overcoming dental fear.

Laser Dentistry

The fear of the sound of a dental drill can be a major factor in dental phobia. Drill-less dentistry sounds like a breeze, right?

Dental lasers work by delivering high energy light. More recently, lasers have been applied for surgical and dental procedures. They’re useful as a cutting instrument for hard or soft tissues in the mouth.

There are a number of uses for dental lasers:

  • Replacing the dental drill to treat tooth decay. Lasers can be used to remove decay within a tooth and prepare the surrounding enamel for receipt of the filling.
  • Periodontal treatment is the specialized treatment of gum disease. Many people avoid addressing their gum disease because of the relative discomfort of mechanical removal of plaque or calculus from beneath the gums. Periodontal conditions are caused by chronic inflammation so the longer they are left, the more difficult they are to treat.
  • Root canal treatment is definitely not the most favorite dental procedure. The use of metal files to clean canals can be a source of dental phobia. Dental lasers can be used to reshape gums and remove bacteria during root canal procedures.
  • Teeth whitening. Lasers are used to speed up in-office teeth whitening procedures. A peroxide bleaching solution, applied to the tooth surface, is ''activated" by laser energy, which speeds up the whitening process.

Pediatric Dentists

Dental phobia is often formed by a negative experience during childhood years. Children especially can experience intense dental anxiety due to the perception and unfamiliarity of a dental office and relative discomfort experienced in the mouth.

In certain situations, and to prevent long-term dental anxiety or phobia, it’s best that some children be seen by a specialist in kids' dentistry.

Pediatric dentists are registered as specialist dentists and must have completed additional study after their general dentistry training. The additional training is provided under the supervision and direction of specialist dental and medical staff in various hospitals and university clinics. They provide a pediatric dentist with a broad range of experience in managing the diverse oral health care needs of children.

A pediatric dentist must register their specialist qualification with the Dental Board in their jurisdiction and restrict their practice to pediatric dentistry.

Here’s generally what pediatric dentists specialize in and why they are helpful for dental phobias.

  • Identify causes of dental disease and teach children and their families have healthy teeth and mouths.
  • Work in a completely kid-focused and friendly environment.
  • Deliver specialized techniques for managing anxious and/or young children, including using special approaches for giving local analgesia and dental sedation as well as providing dental treatment under general anesthesia.
  • Treat children who have medical, physical, and intellectual conditions including those with behavioral challenges such as autism and ADHD.

Pediatric dentists play an important role in not only helping kids to get over dental fear, but to apply important treatment that will impact the growth and development of a child’s oral cavity.

Don’t let your dental phobia ruin your smile. Enquire with your dentist about options to address your dental health right away!

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature reviewClin Cosmet Investig Dent. 2016 Mar;8(1):35-50. doi:10.2147/CCIDE.S63626

  2. Kassem El Hajj H, Fares Y, Abou-Abbas L. Assessment of dental anxiety and dental phobia among adults in LebanonBMC Oral Health. 2021 Feb;21(1):48. doi:10.1186/s12903-021-01409-2

  3. Zümcü E, Uluç S. Cognitive behavioral treatment of blood-injection-injury phobia: a case reportJCBPR. 2018;7(3):144. doi:10.5455/JCBPR.291081

  4. Riba-Roca A, Figueiredo R, Malamed SF, Arnabat-Dominguez J. A randomized split-mouth clinical trial comparing pain experienced during palatal injections with two different computer-controlled local anesthetic delivery systemsJ Clin Exp Dent. 2020 Dec;12(12):e1139-e1144. doi:10.4317/jced.57506

  5. Mohan R, Asir V, Shanmugapriyan, et al. Nitrousoxide as a conscious sedative in minor oral surgical procedureJ Pharm Bioall Sci. 2015;7(5):250. doi:10.4103/0975-7406.155939

  6. Harris M, Chung F. Complications of general anesthesiaClinics in Plastic Surgery. 2013 Oct;40(4):503-513. doi:10.1016/j.cps.2013.07.001

  7. Yadav R, Yadav H, Chandra A, Yadav S, Verma P, Shakya V. Accidental aspiration/ingestion of foreign bodies in dentistry: A clinical and legal perspectiveNatl J Maxillofac Surg. 2015 Dec;6(2):144. doi:10.4103/0975-5950.183855

  8. Allison N. Hypnosis in modern dentistry: Challenging misconceptionsFDJ. 2015 Oct;6(4):172-175. doi:10.1308/rcsfdj.2015.172

  9. U.S. Department of Health and Human Services. Periodontal gum disease.

By Steven Lin, DDS
Steven Lin, DDS, is a dentist, TEDx speaker, health educator, and author.