How to manage dental anxiety

Gemma Forsythe shares what dental anxiety looks like and her top tips for supporting patients who suffer with it.

Gemma Forsythe shares what dental anxiety looks like and her top tips for supporting patients who suffer with it.

Regular dental visits are important for oral health, but for some patients their dental anxiety can lead to them postponing or avoiding dental appointments. 

Dental anxiety is very common and can be caused by several factors including a previous bad experience in the dental chair, helplessness/lack of control while in the dental chair or a lack of understanding from the dental team amongst others.

What does dental anxiety look like?

It is important that dental teams consider a patient’s dental anxiety level and treat that patient accordingly to make their dental visit as comfortable and easy as possible for them. Patients that suffer from dental anxiety can often present as irritable or rude, but this can often be a defence mechanism from the patient.

For patients who suffer from dental anxiety, they can experience some distressing symptoms prior to/during their dental appointments such as:

  • Feeling faint
  • Excessive sweating
  • Nausea
  • Heart palpitations
  • Panic attacks
  • Feeling upset/crying.

An empathetic and understanding approach is needed when discussing with patients their level of dental anxiety and what it is that causes their dental anxiety if anything. It can also be supportive to ‘normalise’ their anxiety, letting them know that dental anxiety is very common and that you regularly treat patients daily that present with exactly the same symptoms as themselves.

How you support anxious patients will differ from person to person and should be tailored to the individual. What helps to ease one person’s anxiety will not necessarily work for everyone.

How to manage patient anxiety

Here are some ways in which you can support your patients that suffer from dental anxiety…

Stop signal

Ensure that you have agreed to a stop signal with the patient, such as raising their hand if they need a break. This will allow the patient to feel some kind of control in a situation where they feel that they have none at all.

Explaining the procedure

Ask your patient whether they want you to explain what is happening and when, or whether they would prefer to just have the treatment done without explanation. 

Obviously, there has to be some degree of explanation for consent reasons, but some patients would rather not know what is going on throughout treatment – they just want to close their eyes and get on with it. For those patients who do want to know what is happening, the tell, show, do approach can be really useful for these patients.

Local anaesthetic

For patients who are nervous about local anaesthetic (LA), placing numbing gel prior to injecting can help to put them at ease slightly about this, as can counting down the seconds until administering the LA is over.

Stress ball

What I find useful for anxious patients, especially for local anaesthetic and extractions, is giving them a stress ball to squeeze. 

If they find this works for them, I leave a pop-up note on their chart to remind myself to give it to them on the next visit.

Open conversations

Asking the patient if there are any ways in which we can make their visit more comfortable is a good idea. This also shows the patient that you are committed to making their visits a more positive experience for them.


Distractions can also relieve anxiety. Encouraging your patients to bring their headphones to treatment appointments can be useful so they can listen to their own choice of music.

This can also help to drown out unpleasant sounds such as the handpieces.

Instrument display

Be aware of what instruments and materials that you have sitting on display when the patient enters the surgery. Items like LA syringes and needles should be covered up so as not to cause the patient any further distress.

Catch up with previous Nursing Matters columns:

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