Home
Bupa members

Support and offers for individual members and customers

Dental anxiety

Published by Bupa's health information team, June 2009.

This factsheet is for people who are worried about going to the dentist or who would like information about overcoming dental anxiety.

Many people feel understandably anxious about dental treatment. This factsheet describes some of the techniques available to help overcome this anxiety and make it easier for people to get the dental treatment they need.

Dental anxiety

People of all ages and backgrounds are affected by dental anxiety. This doesn't stop most people visiting the dentist, but others would prefer to suffer from toothache than have dental treatment.

If you don't go to the dentist, it can cause serious problems. Tooth decay and gum disease don't get better without treatment. You may not know that you have these conditions until it's too late. This could result in you losing your teeth.

Also, dentists screen patients for mouth cancer, so regular check-ups can save lives.

Teeth play an important part in physical appearance. If you have unsightly, uncared-for teeth, it can lead to problems with your confidence and self-esteem. Regular visits to the dentist will help you to keep a healthy, bright smile.

Taking lots of painkillers for dental problems rather than going to a dentist can have serious side-effects, and taking more than the recommended dose can even be fatal. If you're taking over-the-counter painkillers such as paracetamol, ibuprofen or aspirin, it's very important that you read the patient information leaflet that comes with the medicine. It's also crucial to make an appointment with a dentist as soon as possible.

Types of anxiety

Being nervous about going to the dentist affects people in different ways. Some people are anxious about specific aspects of dental treatment. Others may dislike being in close contact with someone they don't know very well. Many people had unpleasant experiences as a child and are frightened that these will be repeated.

There are also different levels of dental anxiety, ranging from slight nervousness to a severe phobia (an out-of-proportion fear that makes you avoid a certain situation).

However anxious you are, it's likely there will be ways of dealing with the problem one step at a time.

Getting support

The first step is to get in touch with a dentist to discuss your anxiety. However, if your phobia is so severe that you can't even consider approaching a dentist for support, try your GP who may be able to recommend a counsellor.

Finding a supportive dentist

Dentists are aware that many patients are anxious, and are trained to take your fears seriously and deal with them sensitively. Some dentists specialise in treating nervous patients.

One way of finding a supportive dentist is by word of mouth. You may be able to get a recommendation from someone that has been to a dentist who was sympathetic to his or her needs.

If this isn't possible, you could ask a friend to make some phone calls to find out which dentists in your area specialise in treating nervous patients. Make a shortlist of suitable dentists and then call some yourself to see which one feels right for you. When you call, be open about your worries; by sharing them, the staff will be better able to arrange the support that you need.

It's often possible to book an appointment where no treatment is planned. This way you can meet the dentist and discuss your anxieties. If possible, arrange it for a time when you won't have to sit and wait at reception - perhaps first thing in the morning - as waiting can be stressful. You may find it helps to take a reassuring friend or family member with you.

A number of things that you may wish to bear in mind and raise with your dentist at your first appointment are described below.

  • Timing - ask your dentist to let you go at your own pace. For example, you might choose to just have an examination at your first appointment, or even just to sit in the chair. Once the first stage doesn't frighten you any more you can move on to the next, slightly harder one. This way you are facing your fear and gradually overcoming it step by step.
  • Control - talk to your dentist about having some control over the amount of treatment that you're having done. It's important that you don't feel pushed further or faster than you can cope with. You may feel more in control if you have a signal (raising your hand for example) that lets the dentist know that you would like him or her to stop.
  • Specific concerns - if there are particular things that you're worried about, or if you have had a traumatic experience, you should tell your dentist about them. If you have any questions your dentist will be able to answer them. Dentistry has advanced a great deal in recent years and there are numerous methods for controlling and relieving pain.
  • Choices - there are other treatment options that may help you relax, such as sedation and hypnotherapy. Your dental practice may offer these services, or it may be able to refer you to one that does.
  • If you don't feel comfortable with the first dentist you visit, you don't have to go back to them again. Instead, try another one from your shortlist.

Sedation

You may find treatment easier if you have some form of sedation. You will still be awake but you will feel very relaxed and probably won't be able to remember much about the procedure afterwards. There are three main types of sedation used in dentistry.

Inhalation sedation

This is also known as 'gas and air'. It's a mixture of nitrous oxide (laughing gas) and oxygen. You breathe it in through a mask that is placed over your nose by your dentist. People experience different feelings while breathing inhalation sedation, including 'pins and needles', ringing ears and sleepiness. You'll be able to understand what your dentist is saying throughout the treatment, but the sedation should reduce your anxiety. When your treatment is finished, the sedation will wear off after a few deep breaths and the gases leave your body within about 20 minutes.

Oral medicines

Your dentist may prescribe you a medicine (eg temazepam or diazepam) to take an hour or two before your appointment, to reduce your anxiety. The pills must be taken exactly as directed by your dentist, and will have marked sedative effects. So you must have someone to accompany you to and from your dental appointment, and you mustn't drink alcohol while taking the pills. You won't be able to drive or go to work until the following day.

Intravenous sedation

For intravenous sedation, a sedative drug is injected through a fine plastic tube (cannula) into a vein (usually on the back of your hand) before the dental treatment begins. This type of sedation is very effective. The medicine used will make you very relaxed, but you will still be able talk and listen to your dentist (though you may not remember any of it). You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours. Again, you won't be able to drive or go to work for at least 24 hours.

General anaesthesia

There are greater risks with general anaesthesia, so it's not commonly used for dental treatment. However, it's an option for complex dental surgery, young children and people with special needs. Occasionally, people with severe dental phobia may have general anaesthesia so that they can receive dental treatment, but all possible alternatives should be explored first. General anaesthetic has to be given in hospital, so you will need to be referred and may have to stay overnight.

If you have a general anaesthetic, it means you will be asleep during the procedure. You won't feel or remember anything about the treatment when you wake up. For more information, see Related topics.

Psychological techniques

There are some psychological techniques that you can try to reduce your levels of anxiety.

Distraction techniques

You may find it helpful to distract your attention away from your dental treatment. There are many ways that you can do this.

  • Listening to music or audio books.
  • In some dental surgeries, you may be able to watch a video or DVD.
  • Concentrating on relaxing each part of your body in turn.
  • Thinking about something you are looking forward to.

Hypnotherapy

Hypnotherapy is known to help people relax and can be used to treat anxiety. You may find that this is something that works for you, although not everyone is susceptible to its effects. You can't be made to do anything you don't want to while you are hypnotised.

Behavioural psychotherapy

Behavioural psychotherapists teach you ways to reduce your anxiety. Regular meetings and homework exercises aim to help you to change the way you feel about something you're scared of. If you are interested in trying this treatment, ask your GP if services are available in your area.

Related topics

Further information

Sources

  • Phobias. The Mental Health Foundation. www.mentalhealth.org.uk, accessed 27 February 2009
  • Chestnutt IG, Gibson J. Churchill's pocketbook of clinical dentistry. 3rd ed. Elsevier, 2007: 103
  • Mitchell DA, Mitchell L. Oxford handbook of clinical dentistry. 4th ed. Oxford: Oxford University Publications, 2007
  • Hypnotherapy. MIND. www.mind.org.uk, accessed 27 February 2009
  • Psychotherapy. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed 27 February 2009

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: June 2009

 

Rate this page

Feedback

Have you found the information in this factsheet helpful? Do take a couple of moments to give us your feedback.

Click here to give us your feedback

Up to £100 off a Bupa Health assessment

Bupa health insurance

Free online health check

Bupa Care Homes

Bupa travel cover