Top ten tips for caring for nervous patients

nervous patientsAndrew Davies gives his top 10 tips for caring for nervous patients, and how to establish trust and develop into the ‘ideal dentist’.

Patients will always be nervous or anxious in some shape or form, even if they don’t always relay this to us.

A fear of the dentist comes in a wide range of emotions and complexities – from the fear of feeling pain or a loss of control, to embarrassment or even sometimes just a general fear of the surgery environment.

Anxious and nervous patients do take up a lot of time, however this an investment in the practice for the future. Once the fear is overcome, these patients turn into your normal cooperative patient and go on to spread the word of how wonderful you are.

Most nervous patients have never been regular attenders and sometimes require more work completed than your regular patient list.

The main aim is to establish trust. Trust then develops into the ‘ideal dentist’ and the result is a loyal returning patient. We must educate patients that pain-free, minimally invasive dentistry is now the norm.

Make the first appointment non-clinical

We speak to patients in our consultation room to try to pinpoint what exactly they are nervous about. Isolating the actual cause of this feeling will enable a solution to the problem.

I usually ask: ‘What bothers you’ or ‘What would your dream appointment be like?’

Scheduling of the appointment

Offer an appointment for when it would suit the patient best with no ‘rushing to attend’. This creates less stress and more comfort.

Typically, the best times are either first thing in the morning so there is no thinking about it all day. Or in the afternoon to allow time to get into their normal frame of mind.

Always advise the patient to eat before attending.


Distraction is your best friend! We offer noise cancelling headphones to all our patients and reassure them that it isn’t being rude. Stress balls and fidget spinners are excellent for all ages.

Ask the patient to say in their head what they can see and smell. Combine these with bringing a friend and the magic happens.

Offer sedation if possible

Patients can feel that treatment is more readily achieved if they are sedated. Discuss it and, if possible, offer it.

Just discussing it relaxes patients and makes them feel you care.

Topical, topical, topical!

Numbing gels prevent the pain from anaesthetic. This in turn stops the feeling of any pain from your treatment.

Always keep tissues taut, slow advancement of the needle with slow delivery of the aesthetic. Over inform all details of what the patient will feel once it is effective and working – the feeling of being numb can be a huge surprise if not correctly explained beforehand.

Tell, show, do

Playing with a dental imitation toy and using euphemisms instead of demonstrating on a model or observing one provides a better explanatory concept of the dental procedure. This leads to greater understanding of a procedure (but only if the patients would like to be shown).

Use simple language with the team and keep instruments out of the patient’s sight

We use four-handed dentistry and all instruments are on the nurse’s side in drawers. We never use ‘instrument words’ and instead have head gestures.

After a discussion, my team now understands what the gestures mean and we are on the same wavelength.

Be honest

I always say to the patient about pain/discomfort that will be felt after procedures. You would be surprised at the number of patients that return saying ‘there was no pain after at all’. This makes you a hero and their trust is instantly put more into you.

Go buy a reward after treatment

It doesn’t just have to be children who get something special after the dentist. Something as simple as suggesting a post-dentist visit to a spa, a gift or a wonderful experience.

By associating these treats, your patient may start to think about visiting the dentist even more positively and less of a chore.

Choose a stop signal

Your patient feeling comfortable and in control is the ultimate game-changer. Agree on a stop signal together before starting any treatment.

We have a small button on the arm of the dental chair that rings when pressed – it is just a portable, wireless doorbell, but it works very well.

This article was first commissioned for Clinical Dentistry magazine. To sign up and receive Clinical Dentistry magazine, visit

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