Dental anxiety, sometimes referred to as odontophobia, prevents many people from seeking necessary care. Up to 75% of adults experience some degree of fear related to visiting the dentist. This apprehension ranges from mild nervousness to a severe phobia that causes treatment avoidance. Understanding this fear is common is the first step toward managing it. This overview provides practical strategies to reduce stress and increase comfort before and during dental procedures.
Preparing Mentally and Logistically Before the Visit
Planning before the patient enters the building can significantly reduce the time spent anticipating the procedure. Scheduling the appointment strategically is key. Many anxious patients find it helpful to book the first appointment of the morning, which limits the hours spent waiting and worrying about the visit.
Manage your physical state by avoiding stimulants in the hours leading up to the appointment. Caffeine and similar substances increase heart rate and intensify feelings of nervousness. Substitute coffee with water or a calming herbal tea to maintain a relaxed baseline.
Practicing mental rehearsal, or visualization, in the days before the visit is an effective preparatory tool. Find a quiet space to imagine the entire appointment in a calm, positive manner. Mentally walk through the process of arriving, sitting in the chair, and completing the procedure successfully.
Active Relaxation Techniques During the Procedure
Once seated, behavioral strategies focus on managing the body’s physical response to stress. Diaphragmatic breathing is a fundamental technique that shifts the body from a “fight or flight” response to a relaxed state. This method involves inhaling slowly through the nose, ensuring the abdomen rises more than the chest, and then exhaling slowly through pursed lips.
To maximize the calming effect, the exhale should be noticeably longer than the inhale (e.g., breathing in for four and out for six or eight). This pattern stimulates the vagus nerve, which helps to lower heart rate and blood pressure. Focusing on the rhythm of the breath provides a grounding anchor, diverting attention away from the dental environment.
Progressive muscle relaxation (PMR) uses the contrast between tension and release to achieve deep physical calm. This technique involves deliberately tensing a specific muscle group for about five to ten seconds and then immediately releasing the tension for a longer period. Starting with the feet and moving up to the face is a common approach, but beginning with the hands and arms is often easier in a dental chair.
For example, a patient can squeeze their hands into fists for a few seconds and then consciously let all the tension drain out. This technique can be modified to target easily accessible muscle groups like the shoulders, by shrugging them up toward the ears before letting them drop. Consciously relaxing the jaw, forehead, and neck muscles is particularly helpful, as these areas often hold unconscious tension during stressful procedures.
Distraction is a simple yet powerful technique that engages the mind’s resources elsewhere. Wearing headphones and listening to music, audiobooks, or podcasts can mask the sounds of the dental environment, such as the high-pitched whir of the drill. Patients can also use visual distraction by focusing on a specific spot on the ceiling or counting patterns in the texture of the wall, or by engaging in a complex mental task like reciting a poem or listing capital cities.
Establishing Communication and Control with the Dental Team
Establishing clear communication with the clinical team mitigates the lack of control that contributes to dental anxiety. Before the procedure begins, agree upon a non-verbal “stop signal,” such as a simple raise of the hand. This signal gives the patient the immediate power to stop the procedure at any time, providing significant psychological comfort.
Patients should request that the dentist explain each step before performing it. Knowing what sensation to expect, even if it is a brief description like “I am going to place the small suction tip now,” prevents sudden jolts of fear caused by unexpected actions. This verbalization helps transform the unknown into a predictable sequence of events.
Requesting accommodations for sensory input improves the experience. Beyond bringing personal headphones, patients can ask for sunglasses to shield their eyes from bright overhead lights. Requesting a blanket or sweater is also helpful, as feeling cold can heighten the body’s stress response.
Understanding Medically Assisted Relaxation Options
When behavioral techniques alone are not enough to manage moderate to severe anxiety, pharmacological options are available. Nitrous oxide, or “laughing gas,” is inhaled through a small mask over the nose. It provides a light level of relaxation, and its effects wear off almost immediately, allowing the patient to drive themselves home shortly after the appointment.
Oral conscious sedation involves taking a prescription pill, such as a benzodiazepine, about an hour before the procedure. This medication creates a deeper state of drowsiness and relaxation, and the patient may remember very little of the procedure. Due to lingering effects, a responsible adult must drive the patient to and from the appointment and remain with them for the rest of the day.
Intravenous (IV) sedation is the deepest form of conscious sedation available outside of a hospital setting and is used for longer or more complex procedures. The medication is administered directly into a vein, allowing the dental team to precisely control the level of sedation throughout the visit. As with oral sedation, IV sedation requires a designated driver and a period of monitoring at home afterward. These options must be discussed with the dental team in advance to ensure they are appropriate for the patient’s health status and procedure.