How do I cope with dental anxiety?
Tell the dentist, and agree a stop signal before they start. NHS England calls it simple but effective. Then a score on a 5-question quiz shows which extra help to ask for.
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How do I cope with dental anxiety?
Tell the dental team what scares you, then agree a stop signal. NHS England’s guide for dentists says a stop signal is simple, yet so effective.
It works like a pause button on a film. You no longer have to sit through the scary part. You can stop it, breathe, and carry on when you’re ready.
The same guide suggests a rising hand. A resting hand means you’re fine. Lift it higher as you get more anxious, and the team can see it before you need a full stop.
Six things to ask for at your next appointment
- Tell the team what scares you most, such as the injection or the drill.
- Agree a stop signal, like raising your hand, before they start.
- Ask them to explain what they’re doing and why, during and after treatment.
- Ask whether the easiest treatment can come first, and the harder work later.
- If you’re very anxious, ask for a longer appointment.
- Practise slow breathing at home: in through your nose, out through your mouth, counting to 5 each way.
Sources: NHS England; NHS: breathing exercises
Hard to say it out loud? NHS England suggests you write a letter to the dentist. Put down what sets you off and what helps you cope.
Write yours this week and take it to your next visit.
How bad is my dental anxiety?
That quiz is the Modified Dental Anxiety Scale (MDAS). It’s the most used dental anxiety quiz in the UK. Score each question from 1 to 5, then add them up.
| If you were about to… | Score 1 to 5 |
|---|---|
| Go to the dentist for treatment tomorrow | 1 not anxious, 5 extremely anxious |
| Sit in the waiting room, waiting for treatment | 1 not anxious, 5 extremely anxious |
| Have a tooth drilled | 1 not anxious, 5 extremely anxious |
| Have your teeth scaled and polished | 1 not anxious, 5 extremely anxious |
| Have a numbing injection in your gum above an upper back tooth | 1 not anxious, 5 extremely anxious |
Source: Humphris 2013
- 10 points or belowNHS England: mild.
- Above 10 to just under 19 pointsNHS England: moderate.
- 19 points or aboveNHS England: severe or phobic.
Sources: NHS England; Humphris 2013
Under 19? The tips above, plus a longer visit if you need one, are what NHS England suggests for mild and moderate anxiety.
On 19 or more? That’s the level where a dentist may think about extra help, such as relaxation training or a calming medicine. Tell them your score.
Is fear of the dentist common?
Yes. In a survey of adults in England, Wales and Northern Ireland who had been to a dentist, 12.1% scored 19 or more. That’s about 1 in 8.
| Group | Scored 19 or more |
|---|---|
| Everyone who had been to a dentist | 12.1% |
| Women | 16.7% |
| Men | 6.9% |
At a London clinic for dental phobia, the injection and the drill were the most feared parts. If those are yours, say so first.
Feel faint at needles or blood? Ask about applied tension. NHS England says it helps people prone to fainting at blood or injections, by stopping the drop in blood pressure.
Wincing at cold drinks or grinding your teeth? See sensitive teeth and teeth grinding.
Can CBT help dental phobia?
Often, yes. CBT (cognitive behavioural therapy) is a talking therapy. It helps you learn new ways to handle the thoughts and habits behind a fear.
NHS England says it usually takes 6 to 10 sessions of about an hour. It sees sedation as a way to get treatment done, and CBT as the long-term fix for the fear itself.
At one King’s College London clinic, 130 people were referred for CBT. Afterwards 79% had dental treatment without sedation, after five sessions on average.
That was one clinic’s own records, not a trial. So it shows what can happen, not a promise.
How to get CBT for a fear of the dentist
- 1
Ask your dentist
Some dental teams are trained in CBT methods, or can refer you.
- 2
Or refer yourself
NHS talking therapies take phobias. You need to be registered with a GP and aged 18 or over (16 in some areas).
- 3
Weekly sessions
Usually 6 to 10, about an hour each.
- 4
Treatment in steps
Easier work first, with your stop signal agreed.
Sources: NHS England; NHS talking therapies
Dread starts days before? See anticipatory anxiety. The same step-by-step idea helps with driving anxiety.
What sedation can I have at the dentist?
Sedation is a medicine that makes you sleepy and relaxed. It’s different from a general anaesthetic, which puts you to sleep.
| Type | How it’s given | Good to know |
|---|---|---|
| Gas (inhalation) | Breathed through a small nosepiece | You recover quickly. |
| Into a vein (IV) | A thin tube in your arm or hand | Many people remember very little. |
| Nose spray | A small spray into your nose | Often used if you’re very afraid of injections. |
| Drink (oral) | A drink with the medicine in it | Not suitable for a lot of people. It can be slow to work. |
Source: Guy’s and St Thomas’
Not everyone needs sedation, and not every type suits everyone. The dentist decides with you at an assessment.
A general anaesthetic carries more risks. It’s for people who can’t have treatment with sedation, or who need a lot of work.
Never stop or change a prescribed medicine without your prescriber. Ask your dentist which types they offer.
When to speak to a GP
Book an appointment if:
- You think you have a phobia and the symptoms are affecting your life, such as putting off care you need.
- You’re not sure about referring yourself for talking therapy. A GP can help you find what’s available.
- Fear of the dentist comes with low mood or other mental health problems. NHS England advises specialist help, such as NHS talking therapies.
For tooth pain, see a dentist, not a GP. Go if toothache lasts more than 2 days or painkillers don’t help. Go too if you have a high temperature, pain when you bite, red gums, a bad taste, or a swollen cheek or jaw.
No dentist? Call 111.
Go to A&E if you have toothache and the area around your eye or your neck is swollen. Go too if swelling makes it hard to breathe, swallow or speak.
Don’t drive yourself. Call 999 if you need an ambulance.
Panic in the chair? See panic attack symptoms and natural remedies for anxiety.