Help for Dental Anxiety

Is It Normal to Be Scared of the Dentist?

Yes. Dental anxiety is one of the most common worries people have about healthcare, and it affects people of every age and background, including many who seem completely calm in the waiting room. It ranges from mild unease before a dental examination to a fear strong enough to keep someone away for years, even when they are in pain.

Being anxious doesn't make you difficult, and it isn't something you have to hide. It is useful information. Once we know how you feel, we can change how we work: slowing down, explaining more, building in breaks or, when it's needed, using sedation.

At Comely Bank Dental in Edinburgh, many of the people we see are nervous, and some haven't been to a dentist for a long time. The practical steps in this guide are the ones that tend to make the biggest difference.

Why Does the Dentist Make People Anxious?

There is rarely a single reason. The most common ones are:

• A bad experience in the past, often in childhood: a painful filling, a rushed appointment or a dentist who didn't listen
• Fear of pain or of injections, including worry that the numbing won't work
• Feeling out of control, lying back with someone working in your mouth, unable to speak
• The sounds, smells and sensations of a dental surgery, especially the drill and suction
• A strong gag reflex or difficulty breathing through your nose
• Embarrassment about the state of your teeth, particularly after a long gap
• Not knowing what's happening, or worrying about what the dentist will find
• Wider anxiety, past trauma or sensory sensitivity, which can make clinical settings harder

Knowing which of these applies to you is helpful, because each has a different answer. Fear of the unknown responds well to explanation; feeling out of control responds well to a stop signal; a strong gag reflex has its own techniques. You don't need to work this out alone. Tell us what you can, and we'll take it from there.

What We Change in the Chair

Most of what helps is simple, and none of it needs special equipment.

• A stop signal. Before we start, we agree a signal, usually raising your left hand. When you use it, we stop. It sounds small, but knowing you can pause at any moment changes how the whole appointment feels.
• Breaks whenever you need them, to sit up, rinse, breathe or talk.
• Explaining each step before we do it: what you'll feel, what you'll hear and roughly how long it lasts. If you'd prefer to know less, tell us that too.
• Sitting up to talk first. We talk with you upright and face to face before the chair goes back.
• Headphones. You're welcome to bring your own and listen to music, a podcast or an audiobook. Many people find it blocks out the noises they dread.
• Numbing gel first. The gum is numbed with gel before any injection, and the anaesthetic is given slowly. We check that you're fully numb before starting work.
• Going at your pace. If you would rather do a little now and finish another day, we can plan that.

Tell us if there are other things that would help.

Start Small: Short First Visits

If it has been a long time, or the idea of a full appointment feels like too much, you don't have to start there. A first visit can be little more than a conversation.

A first step might be:

• meeting the dentist in the surgery, sitting upright
• talking through what worries you and what has happened before
• a look in your mouth with a small mirror, only if you're ready
• leaving with a plan for next time and nothing else

From there, each visit can go a little further: an examination, then X-rays, then something straightforward such as a clean with our hygienist, before anything more involved. Each appointment that goes the way you were told it would makes the next one easier.

It is usually better to start this way before something hurts. When you're in pain, treatment is more urgent and there is less room to go slowly. Our guide to your first visit after years away explains what the examination involves.

Things You Can Do Before Your Appointment

A little preparation can take the edge off the day itself.

• Book a time that suits you. Many nervous patients prefer the first appointment of the morning, so there's less time for worry to build. We're open Monday to Friday, 9am to 5.30pm, with later appointments by arrangement.
• Eat a light meal beforehand, unless you've been told otherwise for sedation. Being hungry can make you feel shakier.
• Go easy on caffeine, which can make a racing heart worse.
• Bring someone with you if it helps. Tell us when you book.
• Write down your questions, so you don't have to remember them in the moment.
• Plan something pleasant for afterwards.

On the day, a simple breathing pattern helps many people: breathe in gently through your nose for a count of four, then out slowly through your mouth for a count of six or more. Making the out-breath longer than the in-breath helps calm the body's stress response. Practise at home a few times first so it feels familiar.

When Anxiety Is More Than Nerves

For some people, the fear is strong enough that the steps above aren't enough on their own. Signs of this include avoiding the dentist for years despite problems, losing sleep for days beforehand, or feeling panic at the thought of booking.

If that sounds like you, there are two routes, and they can work together:

Talking therapy. Cognitive behavioural therapy (CBT) is well recognised as an effective treatment for dental phobia. It helps you understand the fear and gradually reduce it, with benefits that can last. Your GP can advise on what is available in Edinburgh.

Sedation for treatment. Sedation makes dental treatment possible while you work on the fear, or when there's treatment that can't wait. It's explained in the next section.

You don't have to choose one or the other. Some people have urgent treatment under sedation and then build confidence for routine visits without it.

Could Sedation Help You?

We provide IV sedation at the practice. It is a form of conscious sedation: a sedative medicine is given through a fine tube in the back of your hand or arm, and you become deeply relaxed. You stay conscious and able to respond, but many people remember little of the treatment afterwards. Local anaesthetic is still used to numb the tooth.

Who it can suit: people with significant anxiety or a strong gag reflex, and people having longer procedures such as wisdom tooth removal or implant surgery. Dr Davinder Kalsi has a special interest in sedation.

What it involves:

• an assessment beforehand, including your medical history and medicines
• an adult who can take you home and stay with you afterwards
• no driving, alcohol, operating machinery or important decisions for at least 24 hours afterwards

IV sedation isn't suitable for everyone, including during pregnancy and with some medical conditions. We'll tell you honestly if it isn't right for you. General anaesthetic for dental treatment is only given in hospital in the UK and needs a referral.

Read more on our sedation page and in our guide to IV sedation.

How to Tell Us You're Nervous When You Book

You don't need to explain why you're anxious, or how much. A single sentence is enough.

You can tell us:

• by phone on 0131 332 3971, when you book
• by email at info@comelybankdental.co.uk, if writing it down feels easier
• when you book online at our booking page, and again when you arrive

Useful things to mention, if you're comfortable:

• how long it has been since your last visit
• anything that has gone badly before
• the parts you find hardest: injections, the drill, gagging, lying back
• whether you're in pain at the moment
• what you think would help

We'll make sure the person seeing you knows before you arrive, so you don't have to repeat yourself in the chair. Our nervous patients page has more on how we look after anxious patients at our practice in Comely Bank, a few minutes' walk from Stockbridge.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.