In a national telephone survey of more than 7,000 Australians, about 16% reported high dental fear (Armfield and colleagues, Australian Dental Journal, 2006). People with high fear tended to have gone longer since their last dental visit and to have more missing teeth. Fear of the dentist is common, it has real effects on health, and it usually responds to the right kind of help.
What follows is a practical guide: how to work out what is driving your fear, what to arrange before the appointment, what can change in the chair, and when sedation or psychological support makes sense.
The fix depends on what you are afraid of
“Dental anxiety” covers several different fears, and the most useful first step is naming yours. Someone frightened of pain needs something quite different from someone who cannot bear feeling trapped. The Better Health Channel lists traumatic dental or healthcare experiences, earlier injury to the head and neck, and fear of losing control among the common causes, and notes that conditions such as generalised anxiety, depression and post-traumatic stress can play a part.
| If the main fear is | What often helps |
|---|---|
| Pain, or a painful visit in the past | Numbing gel before injections, time for the local anaesthetic to work fully, checking the area is numb before starting |
| Losing control, lying back unable to speak | An agreed stop signal, sitting up for discussions, short breaks |
| Not knowing what is coming | “Tell, show, do”: each step explained and the instrument shown before it is used |
| Sounds, smells, the bright light | Headphones, tinted glasses, a few minutes to settle in the room first |
| Being judged after a long gap | A first visit that is only a conversation, and a plan written in plain language |
| Fear strong enough to stop any visit | Sedation, and support from a psychologist |
Most of the work happens before you sit down
Mention the anxiety when you book. A line on the booking form or a sentence on the phone lets the clinic allow extra time and brief the dentist or OHT (oral health therapist) before you walk in. You do not have to explain why.
Ask for the first visit to be a conversation only. Sitting upright, talking through your history and worries, with nothing done to your teeth unless you decide you are ready. For many people, one appointment where nothing bad happens does more than any amount of reassurance.
Choose the time carefully. An early slot means less waiting and less time to dwell on it. A day without other pressures either side gives you room to settle afterwards. A friend or family member in the waiting room can help too; if you are having sedation, someone to take you home is required anyway.
What can change once you are in the chair
A stop signal. Agree on one, usually a raised hand, and expect it to be honoured immediately. The Better Health Channel recommends this, and knowing you can stop often means you do not need to.
“Tell, show, do.” Borrowed from children’s dentistry, it works just as well for adults. The step is described, the instrument shown, and only then is it used. Surprises cause most of the sudden spikes in fear.
Slow breathing. Breathing out for longer than you breathe in, for a couple of minutes before you go in and again as you start, helps calm a racing heart. The Better Health Channel lists deep breathing, meditation and distraction among useful coping techniques.
Distraction. Music or a podcast through headphones is the simplest. Ask what the clinic has available.
Breaks. Longer treatment can be split into shorter visits, and even within one visit you can ask for a pause to sit up and rinse.
Sedation helps the anxiety, not the numbness
When communication and pacing are not enough, sedation can make treatment possible. It does not replace local anaesthetic: the tooth is still numbed in the usual way. What sedation does is lower the anxiety response so that the injection and the treatment feel manageable.
At Lumi Dental, the options are happy gas (relative analgesia, nitrous oxide breathed through a small nose mask), inhaled pain relief, oral sedation taken as a tablet before the visit, and IV sedation, given through a fine cannula in the arm or hand. Ask us which, if any, suits your health and the treatment planned. Lumi Dental does not provide general anaesthetic. That is given by an anaesthetist in a hospital or day surgery, and where it is the right choice, the team can refer you.
The Better Health Channel notes that not every dentist offers sedation, and advises that you should not drive home after any sedation. Our guide to sedation options for anxious adults compares them in more detail.
When the fear needs more than a dental appointment
For some people the strategies above are not enough. That is more likely if you have tried several times and could not get through a visit, if just thinking about the dentist brings on panic, or if the fear is part of a wider anxiety condition or post-traumatic stress.
Psychological treatment has good support here. A systematic review of randomised trials (Wide Boman and colleagues, European Journal of Oral Sciences, 2013) found that cognitive behavioural therapy and behavioural therapy reduced dental anxiety in adults, though the authors rated the quality of the evidence as low and called for better studies. These approaches often use graded exposure: small, predictable steps towards a full visit, so the body slowly learns that the dental chair is not a threat. Your GP is the place to start if you would like a referral to a psychologist, and short, low-pressure dental visits can run alongside.
Questions to ask when you ring a clinic
A short phone call tells you a lot about whether a practice is set up for nervous patients. Useful questions include:
- Can my first visit be a conversation with no treatment?
- How long is a first appointment?
- What sedation do you offer, and what happens if I need more than that?
- Can I bring someone with me?
- How do you usually look after people who are anxious?
If you have stayed away for a long time, there may be several things to address. A clear plan that separates what is urgent from what can wait makes that far less overwhelming. A routine scale and clean is often a gentle place to restart, and our article on sensitive teeth may help if sensitivity is part of what puts you off.
What patients ask about dental fear
Will the dentist judge me for not coming in for years?
A good dental team will not. Long gaps are common among anxious patients, and the conversation should be about what to do next, not about the past.
My child is scared of the dentist too. Is that common?
Yes. A systematic review (Cianetti and colleagues, European Journal of Paediatric Dentistry, 2017) found dental fear and anxiety in roughly 10 to 20 per cent of children and adolescents, depending on the questionnaire used. Short first visits, “tell, show, do” and age-appropriate language usually help. Eligible children aged 0 to 17 may be covered under the Child Dental Benefits Schedule for basic services, which can make several short, low-pressure visits easier to arrange.
Does private health insurance cover sedation?
Cover varies between funds and policies, and the dental treatment and the sedation may be claimed differently. Ask the clinic for item numbers with your quote and check them with your fund before treatment.
Is sedation safe?
For suitable patients, sedation given by trained clinicians with proper assessment and monitoring is generally considered safe. Your medical history and medicines are reviewed first, and the risks for you specifically should be explained before you agree to anything.
A first step without pressure
Fear of the dentist rarely matches what actually happens, but you only find that out by going, and the first step does not have to involve any treatment. If you would like a calm first conversation, Lumi Dental in Melrose Park offers free consults for nervous patients. See our approach to dental anxiety, or visit current deals to book your first visit when you are ready.
