Worries about visiting the dentist

If you or a family member feels anxious about visiting your dentist, we’re here to help.

Don’t let anxiety stop you from looking after your teeth

Being anxious about visiting a dentist is common for both adults and children, but it’s important to look after your dental health.

Our research shows that anxiety can be caused by fear of the unknown, so we’ve partnered with JAAQ to help answer any questions you might have before you book.

Our teams are trained to support all of our patients, so if you feel worried about visiting, just let us know. There’s plenty we can do to make you feel comfortable, including explaining your treatment step by step or discussing sedation options.

Answering your questions about dental worries

Dr. Shaila Patel-Buxton answers common questions about visiting a clinic or practice.

Transcript

Who are you and what do you do?

Hi, I am Shaila.

I'm a Bupa dentist, and I have a lot

of experience in looking

after nervous, anxious

patients coming to the dentist,

or patients who have a dental phobia.

How common is dental anxiety?

So dental anxiety is really common.

It's thought that it affects almost half

of the adult population.

It's about 4 in 10 people.

Is there something a patient can do prior to a dentist appointment to help?

So before you come to the dentist, if you know

that you are nervous or you are anxious,

or you have a phobia about coming,

that's really, really helpful.

The more information you can actually give to us,

the more we can work with it.

So the first thing I'd say is please definitely

let the dental team know.

So either you let the receptionist know, which is

probably the first port of call, or you let the nurse

or the dentist know

and then we can work with you to try

and find a way to make you comfortable

and make the treatment

and the whole process, the whole journey, much more

comfortable for you.

What is dental anxiety?

Dental anxiety occurs when

patients feel either nervous

or anxious about coming to the dentist.

I think a little bit of apprehension

or nervousness is- it's normal.

It becomes a problem if it stops you from attending the

dentist or going through with your treatment.

Will my dentist judge me?

So when you go to the dentist, the dentist is

definitely not going to judge you.

As dentists, we are trained

to, if you like meet

the patient where they are, meet them halfway,

especially to be non-judgmental, keep things confidential

and we understand that patients have had all sorts

of experiences before we actually see them.

How do I know if I have dental anxiety?

So you'll know if you have it

because you might recognise that you've got some symptoms of

anxiety or you're feeling quite nervous

about coming to the dentist.

I like to think of it as the signs

that you might encounter.

I split them into three groups really.

They might be emotional, they might be physical signs

or more intellectual mind symptoms.

So some emotional signs can be really obvious,

like you feel tearful,

you start crying at the thought of it.

Physical signs you often feel in your body, so

very common heart palpitations, feeling faint,

feeling dizzy, feeling like you need

to keep pacing around the room.

You might feel angry. Start sweating.

Often patients say, I can feel like my mouth's really dry.

I need some water. In fact,

I'm feeling a bit like I have a dry mouth at the moment.

And then one of the things I

see quite often is sometimes nervous patients

will ask lots of questions.

Is everything clean? Is it safe in here?

What are you going to do? How long is it going to take?

So often patients want

to intellectualise "What's really going to happen?".

Who can help me from the dental practice with my dental anxiety?

So in the Bupa Dental clinics, the whole team

are involved in helping you with your dental anxiety

or nervousness, phobia, around going to the dentist.

So what I mean by that is your first port

of call is the reception team,

and they can guide you as to

who might be the right dentist to look after you.

After that, we have treatment coordinators.

We have the nursing team as well as the dentist themselves.

So we find that it's a whole team approach really.

Do all Bupa dental practices have someone who can help with dental anxiety?

So this is a really good question.

I think most dental practises,

so most Bupa Dental practices will have a team

that either can help you at that particular practise

or they can refer you to the best team that can help you.

Most dental practises will be really familiar with

seeing patients who have signs of dental anxiety

or nervousness or phobia, dental phobia.

What are the most common treatments people fear?

The treatments that people most commonly fear

are things like having to have root canal treatments.

I get asked a lot of questions about that,

having your wisdom teeth taken out

and loads of people are a little bit needle phobic,

so they're scared of injections

and especially dental injections.

Do all Bupa practices have a dentist who has additional training in dental anxiety?

So your particular Bupa dental practice

that you're used to going to,

or that's close to you, may not have a dentist that

particularly supports dental anxiety,

but it is really worth contacting the reception team

because they will be able to advise you.

So either they will point you to the right dentist

or point you to another clinic or team that can support you.

Can someone who isn't usually afraid of the dentist get dental anxiety for certain treatments?

Yes, absolutely.

Especially if you've heard some negative stories

about someone else's experience.

I would say if you're getting nervous,

and especially if you're about to have some treatment,

then come and have a chat with us

and we'll do everything we can to make it as comfortable

as possible for you.

Can Valium help dental anxiety?

So for some patients, Valium can be really helpful.

In the dental practice, we

normally need to carry out an assessment

and then arrange for patients to have Valium.

We like to give it to you almost like a pre-medication,

so it's something you would take before your appointment.

Normally it's about half an hour, 45 minutes

before your appointment.

Now, if you're going to take some Valium,

we do prefer it if you have

an escort or somebody to take you home afterwards.

Does dental anxiety affect all ages?

Yes, yes it does.

It affects all ages from young children to

adults, and we will change our approach according

to the age of the patient

and what we feel is really appropriate

and what will help them.

How can I support my dental anxiety if I have a fear of needles?

So I find it's really common to be

scared of having injections.

I'm in that category. I hate having injections.

What I find is really helpful

is having some numbing gel

or spray on the gum

before the dentist gives you the actual dental injection.

So definitely letting the dentist know

or speaking to the dental team about your needle phobia in

advance is really helpful.

Also, sometimes having another distraction technique,

so it could be having some music

or a podcast on your headphones or in the background.

Also, we have the dental wand, which

is another technique we can use

to make the dental injections more comfortable.

What is the wand?

So the dental wand

or the wand is a computerised system

for delivering dental injections,

and what it really helps with is

reducing the flow of the anaesthetic

going into your gum.

So the technique is a lot more gentle

and precise in terms of

the dentist giving you an injection.

So most patients find this more comfortable

than a normal dental injection.

Are nervous patients and dental anxiety the same thing?

Yes, nervous patients and dental anxiety is the same.

I have a partner with dental anxiety, what can I do?

So the best thing you can do is, I guess, support them

and encourage them to reach out

and make a dental appointment.

And if they're open to it, come with them

to the dental appointment.

It's really common to have patients come in with

a partner, friend, relative, their mom,

for example.

What can Bupa dentists do to support dental anxiety?

So as Bupa dentist, we can support you

in terms of the following,

there's a few points actually.

I guess the first one is

we create a safe space for you to

talk about what your main concerns are in the

first or second meeting.

When we have the dental check up, we always leave time

for some discussion,

and I like to find out what are your main concerns,

really, what's made you

so anxious about coming to the dentist?

The second point I'd say is making sure then when we plan

dental treatment, making sure we've got enough time for you,

that you're not rushed.

We've got time for

the numbing to work, for example.

We've got time for you to get settled.

Another point that I think is really helpful is

I really like to take time

to frame up what's going to happen.

So some patients I find really want to know

and want an explanation of each step as it happens,

or kind of want to know in advance what's going

to happen at the next appointment.

Sometimes we find the opposite.

Some patients will say, look, next time, just get on

with it, but please don't tell me what's happening.

So it's really good to kind check in with you beforehand

and find out what really works for you.

I guess the next thing in my mind is quite obvious

in the sense of making sure that

any treatment we carry out is as comfortable as possible,

that we've got really good pain control

and we've got you as comfortable as possible

during your treatment.

If there's anything that we can do that helps

in terms of distract you from the noise.

For example, I always like

to have music on in the background

unless a patient doesn't want

to have anything on in the background,

but there's also podcasts, there's talk radio,

there's all sorts of things we can do nowadays.

Protocol is really important, so making sure that

you can signal to us whenever you want to stop treatment.

So putting your hand up is really, really common.

Yeah, it's really those sorts of things.

Is treating dental anxiety different for kids compared to adults?

Yeah, so a lot of things are really similar in that we try

to create a relaxed, friendly atmosphere.

We try and make sure there's plenty of time,

and for children, we'll try

and explain things in a child-friendly way

and use, where possible, fun language

that they can understand.

For example, I might say Mr.

Tickle or Mr.

Mirror for the Dental Mirror,

or the Hoover for the Aspirator.

So we try and ultimately create a really relaxed atmosphere.

Does general anxiety management support dental anxiety?

Oh yes, yes it does.

Absolutely. So any techniques you have to manage your

anxiety, your general anxiety, will definitely help you

with your dental anxiety.

And in fact, I use that for myself.

So if I've got to have some dental treatment, I will

definitely use my yoga breathing and try

and relax myself with deep breathing in that way.

How can you recognise dental anxiety in a partner?

So often you'll find that your partner may put off going

to the dentist, avoid having their treatment appointments,

not booking for a checkup,

or they might actually display signs of anxiety.

You might notice a change in their behaviour.

Are receptionists experienced to support nervous patients?

Yeah, absolutely.

I think most receptionists are experienced in,

I guess, being the first port of call, dealing

with patient queries, so they can often spot the signs

of dental anxiety.

So it might be things like your

expression, your body language.

Sometimes patients are in tears and they're crying,

or they feel a little bit faint, so there's many, many signs

that they will spot, and then they can tell you

what the best support will be.

They can help guide you.

What kind of options are available to dental anxiety patients?

There are a number of options available.

Some things are really simple, like having your friend

or partner with you or family member holding your

hand to help calm you initially.

So we did that the other day for a patient.

Another thing that's really helpful if you like listening

to music or listening to things, bringing your headphones

with you, having your own music playing or podcast

or whatever it is that you love listening to,

or we can play it in the surgery for you.

And then when it comes to actual treatments, we can offer,

for example, if you're needle phobic,

we can offer numbing gels,

we can use the dental wand to try

and make the technique as comfortable as possible for you.

Sometimes explaining the steps of a treatment

and making sure that you really know what's going on can be

really helpful to patients.

The more we communicate the better.

And of course there are options like offering sedation

or a sedative tablet as a pre-medication

can really help some patients.

I think the main thing is that you come

and have a chat with us, have a conversation so we can work

with you to find out what's really going to work for you.

Can you overcome / cure dental anxiety?

Oh, this is a great question.

Yes, I believe you can! I can think

of a lovely lady who's in her eighties now,

who we treat, who comes in

and is able to have all sorts of dental treatment now.

But she has told me the story

of being a real dental

phobic patient when she was a lot younger

and she really used to struggle

to get any sort of dental treatment.

So she's amazing. She's really overcome her dental phobia.

And in fact, I think when we see

patients overcoming their anxiety

or their, I guess their phobia, their nervousness

and transform the way they

approach their dental appointments, it's so inspiring.

It is so rewarding to see. It makes our day, always.

What typically causes dental anxiety?

So this is a big question

because there's all sorts of

reasons why patients might get anxious.

So one

of the most common ones is growing up hearing negative stories.

So you might've heard stories from your parents,

from your grandparents, especially about things like

root canal treatments

or if you have to have a wisdom tooth taken out,

you might have had a bad experience yourself when you were a

child or as an adult.

A lot of patients recall

having braces when they were little,

having lots of dental appointments as a child for that,

and then it's put them off going as an adult.

It could be that- it is thought that genetically,

some patients are generally much more anxious.

Another big area is if you've got other health problems.

So for example, I'm going

to talk about a personal story.

My mom, unfortunately, a few years back, was diagnosed

with a brain tumour

and I started to notice that she was far more anxious about

all sorts of things, and especially if she had to have

any sort of medical or dental treatment.

So for sure,

health problems, whether they're physical

or mental health problems can definitely trigger a

lot more anxiety.

What can I do if I struggle to even call up the dentist?

So, yeah, if you're really struggling with this, I think

see if you can find somebody in your support network

that can help you through the process, especially initially,

to help you: make that initial call,

perhaps attend the first appointment with you

or simply drop us an email.

For example, I've had a few occasions where I have

spoken to the patient on the phone

before they've even made an appointment and come

and seen me face to face.

Does mindfulness or meditation help with dental anxiety?

Yes, absolutely.

I find that if I get really nervous,

then I'll certainly use my breathing techniques

to help calm me.

We actually have a link to some really great

mindfulness and breathing exercises.

What is sedation?

So sedation is something that you can take

in conjunction to normal dental treatment.

So there are three main types.

You can either take a sedative tablet, we normally give this

as a pre-medication, so it's something you would take

about half an hour, 45 minutes

before your dental treatment appointment.

You could have what we call gas

and air, which is actually nitrous oxide,

and you normally have a little mask

and you will breathe through the mask.

It's something that's often used in hospitals as well.

Or the third way is having

a sedative injection,

and this is normally administered either by an anaesthetist

that comes to the dental practice

or by the dentist themselves.

So for all three of these, normally the best thing is

to have a chat with the dentist at one of the Bupa practices

and they can carry out a pre-assessment for you.

Can I get sedation?

So yes, you can get sedation

for certain dental treatments.

Normally what would happen is a Bupa dentist

would assess you for sedation.

I guess the first thing is to find out, well, what sort

of dental treatment do you actually need,

and is there a case for you to have sedation?

So we also want to assess your level of anxiety,

of your dental anxiety, whether you have a phobia,

what the state of your mouth is,

what the oral health problems might be,

and whether we feel that,

whether you really need a sedation.

Interestingly, I find that some patients come in

and they think that they need a sedation,

but often with a few simple steps

and protocols in place, they can manage to have treatment

without sedation.

Or they might

start off with simpler, more gentle dental treatments,

and then perhaps have sedation for the final stages.

For example, if you've got to have a wisdom tooth taken out.

Do nervous patients stress out dentists?

We're really used to looking after nervous patients

and people with dental anxiety.

So I'd say, no, not really,

but the best thing you can do is tell us about it,

so then we know how to, well, we've got better idea of how

to look after you and how to accommodate you.

How do I go about finding a dentist who specifically supports nervous patients?

Call up the dental practice, maybe the one closest to you

or the one you've heard about,

and ask the reception team

so they will know if they've got a dentist at the practice

who is experienced in dealing with dental anxiety,

or they will signpost you to the most helpful nearest

Bupa dental practice.

Does CBT help with dental anxiety?

Yes, it does.

And nowadays you can also have CBT apps,

which I find incredibly useful.

Is dental anxiety the same as a phobia?

A dental phobia is like an extreme version

of dental anxiety. It's when the anxiety gets so bad

that you can't face going to the dentist at all.

Can I calm dental anxiety?

Ah, yes, absolutely.

You can calm dental anxiety.

There are lots of tools that you can use.

Things like mindfulness apps.

I use yoga breathing techniques, relaxation

breathing techniques.

If you don't have your own tools, you could work

with a therapist or a counsellor.

I often get patients referred to me

from other therapists.

Can I get put to sleep if I'm really nervous?

Yeah.

So this is a really common question,

and the answer is yes,

but normally in the dental

practices at Bupa, we would need to carry out a careful

assessment and examination

and before we can arrange this for you.

So I guess the best thing is that you reach out to us

and make an appointment, come and see us.

Does dental anxiety come from a fear of pain?

So often if patients have had a bad experience

before and they've felt pain during the treatment,

or they've heard negative stories

about an upcoming treatment being painful, then

that can often trigger dental anxiety.

Is there a scale of dental anxiety?

So there is a scale for dental anxiety

that we can use to assess patients

for sedation, but I would say don't worry about

where you are on that scale

and just reach out to us

and have a conversation about it.

Because I find that sometimes patients come in

and they think that they will definitely need a sedation,

but actually they can manage to have dental treatment

with just a few really simple techniques.

Does dental anxiety get worse over time?

So the earlier that you

deal with your dental anxiety, the better it is.

As with any anxiety, the more that you leave it,

the worse it can get.

I guess another really important point to make here is,

especially if you haven't been to the dentist

for a long time, reaching out

and having a checkup will help you look

after your oral health

because you'll get an assessment of where you're at,

how healthy you are, and any problems

or any issues can be picked up early

before they become really painful.

Do I have to get treatment straight away?

This is a great question.

No. So normally what happens is on your first appointment,

you'll come in for a dental checkup.

So this gives us a chance to meet you,

to find out a little bit more about your dental anxiety

and to have a look in the mouth

and carry out a proper examination.

Often we're taking either some

dental photos, call these two selfies,

and we'll take some X-rays so we can really have a good look

and assess what's happening.

But what's really important is that at this appointment,

we've got a chance to discuss with you what's going on

in your mouth, and also

what treatment we recommend

and how might we manage your dental anxiety.

So this is a really important time for you

to ask any questions and express how you're feeling.

How can Bupa support my dental anxiety if I have a fear of needles?

So having a fear of needles is actually really common,

and I find that most patients

can manage having a dental injection with

simple techniques like putting some numbing gel on

or numbing spray onto the gum

before you have your injection.

Or we can use the dental wand, which is a computerised way

of giving you an injection.

Other techniques that can really help are techniques

that we would use for dental anxiety.

So it may be distraction methods like using music

to help relax you or breathing exercises.

Sometimes working with a therapist

or CBT can be really helpful.

So the best thing is that you have a chat with us

or with your dentist at Bupa

and explore what options are available to you.

What can go wrong if you don't see the dentist except when something hurts?

So there's lots of things

that could be happening in your mouth

that you can't necessarily see in the mirror yourselves.

For example, you might have tooth decay in

between the teeth, or you might have some gum inflammation

or maybe the start of some gum disease

that you won't necessarily be able to see

or notice any symptoms from.

So we pick up all of these things in a dental checkup,

but if you don't go for a check until something hurts,

then often, I guess, small issues

that can be reversed

or dealt with much more easily,

become far more complex issues

and problems that need to be dealt with.

How does dental anxiety affect oral health?

So I find that patients who have a lot of dental anxiety

will avoid going to the dentist

or avoid completing their treatment plans.

So they won't come in necessarily

and have all the recommended treatment.

So we find that over time, over months, over years,

their dental and oral health will decline.

So studies have actually shown that patients

with dental anxiety

and dental phobia, I guess, have a lower level

of oral health.

Can I pass my dental anxiety on to my kids?

Yeah, so for sure you can pass dental anxiety onto kids.

I guess kids will pick up on any

negative words or phrases that you might use

around going to the dentist.

So if you are avoiding going to the dentist

or you've had a bad experience

or you are scared of going, they will

for sure certainly pick up on this.

For example, I have had over the years, quite a lot of

children and young adults

who have never had any dental treatment

but are really frightened.

And when I ask them why, often it's

because they've heard some negative stories

from their parents

or grandparents, friends, about

dental experiences and that's really put them off.

I feel ashamed of my dental anxiety. What can I do?

This feeling of shame

or being ashamed about,

I guess your dental anxiety

or fear of going to the dentist is really, really common

and it's often really difficult to talk about.

I feel as a society, we don't really often talk about what's

behind this fear of the dentist,

and the more that

you can open up about it

or even let the dental team know that this is going on

for you, really helps in this situation.

Do you have any tips for reducing sensory stimuli like the sound of the drill?

Yeah.

So for the sounds of the drill,

I think one really useful thing is nowadays it's quite easy

for patients to bring in headphones.

So I'd say you're welcome to bring your headphones in

and listen to your favourite music or podcast,

or the other day we put on

a radio station for a patient.

So you could always ask, if you don't have headphones,

you could always ask the dentist to

play something, play some music.

That's an obvious way of blocking out the noise.

And if that's not quite enough,

or if you're able to, you could use

some meditation, some relaxation through breathing,

or use your imagination

and focus to help also manage

that sensory stimulation.

I feel helpless in the chair. Do you have any advice?

Yeah, so the feeling of helplessness

is really, really common.

It's really common for people

to feel powerless in the situation

because you can't really see what's going on.

What I find is really helpful is often having a chat

with patients beforehand.

So we can try and create a protocol

and find out what might be more helpful to you.

So, for example, you could bring in your own headphones,

listen to music or podcasts

or something that helps relax you.

We can agree a little protocol where

whenever you want to stop and have a break,

you can raise your hand

or give me a signal so that I know to let you have a break.

I often check in with patients, especially at the beginning,

to make sure that you're comfortable,

that any pain relief is working

and that we are working at a pace that suits you.

Sometimes patients will tell me that they really want

explanations as we go along, or it might be vice versa,

and you don't want to know anything.

So what we are trying to do is give you as much control

as possible over the things that

will make a difference to you.

So I think here communication is really important,

so letting us know how you feel will really help both of us.

I am paranoid I will be causing an inconvenience to my dentist if I am nervous during my procedure.

Firstly, I want to say actually having dental anxiety

is really common,

and as dentists, we're trained to

support patients who are anxious

and nervous about coming to the dentist

and who have dental phobia.

I guess what we really want to do is support you

through this journey, so if you are able

to let us know in advance, then we can work with you

to really help you through this journey.

On a personal note, I find that actually,

if we've managed to support you through

or support patients through this journey

and over time

they can overcome their dental anxiety

and get their treatment done, then

that's a huge transformation

and that's really- not only is it really rewarding

for the dental team, it's just such a wonderful thing

to see.

Lived experience and expert insight

Being sedated at the dentist

If you’re worried about visiting the dentist, we have lots of options available to you, including sedation.

You can find information about the different types of sedation we offer, and other techniques that could help with a visit to a dental clinic.

More about dental sedation

Get dental treatment from Bupa

Check-ups, orthodontics and more.

How Bupa can help you and your family

^{^} We may record or monitor our calls.

Bupa Dental Care is a trading name of Oasis Dental Care Limited. Registered in England and Wales No: 00478127. Registered office: Bupa Dental Care, Vantage Office Park, Old Gloucester Road, Hambrook, Bristol, United Kingdom BS16 1GW.

Oasis Dental Care Limited has a number of trading names including Bupa Dental Care. For a list of all our different trading names please follow this link.