Nervous Patients: Dental Care When You Are Anxious About the Dentist

Dental anxiety is fear or apprehension about dental treatment, ranging from mild nerves to a level that stops people attending at all.

Clinical guidance distinguishes trait anxiety, which you carry generally, from state anxiety, which rises in the moment. That distinction explains something most anxious patients recognise. You can book an appointment calmly on a Tuesday and feel your heart racing in the waiting room on the Thursday. Those are two different things happening, and they respond to different kinds of help.

The numbers say being scared of the dentist is ordinary rather than unusual. In the Adult Oral Health Survey 2021, published in January 2024, 42% of adults in England with natural teeth scored in the moderate range on the Modified Dental Anxiety Scale, and a further 12% scored in the range indicating extreme anxiety. The same survey found that specific moments provoke it more than others: among those adults, 28% reported feeling very or extremely anxious about having a tooth drilled, and 25% about a local anaesthetic injection.

Dental phobia is a narrower clinical term. It describes an anxiety disorder involving a marked, specific fear that is out of proportion to the situation, where the person avoids it wherever possible. If your anxiety has reached the point where you cancel appointments you have made, or avoid booking at all, that avoidance behaviour is worth naming rather than working around.

Dr Ijaz’s approach to a first appointment starts with understanding the person in front of him rather than the mouth.

Anxious patients at Deepcar Dental Care can have longer appointments, and treatment can be staged across visits starting with whatever you find least difficult.

Longer appointment times are a recognised approach for people with moderate anxiety, because the techniques that actually reduce anxiety need time to work. Rushing them defeats them. As anxiety settles over a series of visits, appointment length can come back down.

Treatment staging works the same way. Rather than booking the thing you dread most, we sequence treatment from what feels manageable towards what does not, so that trust is built on completed visits rather than promises. Because this is a single practice with an in-house principal, that sequence is with the same clinician throughout, which is the part that makes staging meaningful.

If it helps to set out your concerns before you arrive, write them down and hand them in. Putting your triggers in writing is an established technique, and it means you do not have to say the difficult part out loud in a waiting room.

We use topical numbing gel and local anaesthetic for dental treatment that needs it, and we do not begin until you confirm the area is numb.

The gel is applied to the gum before an injection is given, so the injection itself is not the first thing you feel. Controlled breathing and progressive muscle relaxation have an established evidence base for reducing anxiety, and evidence suggests they work better if you practise them before the appointment rather than trying them for the first time in the chair. If you are someone who feels faint at injections, tell us, because applied tension is a recognised technique for that specific response.

Sedation is available at the practice, and it is different from being put to sleep under general anaesthetic. Whether it is appropriate depends on an individual assessment of your health, your anxiety and the treatment planned.

Some dental anxiety sits alongside wider mental health difficulties, and in that case a dental practice is not the only place to address it.

For phobia-level anxiety, what we can offer is a slower entry: a visit with no treatment, a second visit that goes no further than an examination if that is as far as you want to go, and treatment only once you decide. We do not provide cognitive behavioural therapy at the practice. CBT is advocated by NICE for a range of conditions including specific phobia, is well documented for dental phobia, and typically runs to six to ten sessions.

Where anxiety is bound up with other mental health conditions, national guidance advises that CBT delivered by dental professionals is not the right route and that input from psychological services is needed. If that sounds like your situation, speak to your GP as well as to us. We can still see you, and we would rather work alongside that support than pretend it is not needed. Being told honestly where a dental practice can help and where it cannot is part of the same principle: you get the real recommendation and all the options, not the easiest answer.