Dental Phobia: Dental Anxiety Management Strategies For Mental & Oral Health

A trip to the dentist may seem routine for some—but for others, it’s an emotionally challenging hurdle. For people with dental anxiety, the thought of sitting down in the dental chair can cause a range of symptoms, from elevated heart rate to an overwhelming sense of dread. Beyond the general discomfort of dental work, individuals with dental fear often face significant mental health effects from receiving dental treatment or even thinking about it.

While oral health has long been linked to aspects of physical well-being, it can share a connection to mental health as well. For example, avoiding dental procedures due to fear may cause or intensify certain oral health challenges over time, potentially leading to a damaging cycle. Here, we’ll explore possible causes of dental anxiety or dental phobia and share strategies for addressing it so you can reclaim your dental and mental health.

What is dental phobia? 

Unlike general nervousness or discomfort surrounding dentist procedures, dental anxiety or dental phobia is more severe, potentially leading individuals to avoid the dentist altogether. This intense fear can sometimes qualify as a diagnosable condition and may manifest in physical symptoms long before an actual appointment, such as: 

• Nausea
• Shortness of breath
• Dizziness
• Elevated heart rate 
• Panic attacks

In many cases, it’s not not just the procedures or dental treatments themselves that provoke distress, but the entire dental setting. Those with severe dental anxiety may experience symptoms at the mere thought of going to the dentist. These individuals often face more than just the fear of pain, but a fear of judgment, losing control, or being “trapped” in the dental chair. 

Dental phobia can qualify as a diagnosable anxiety disorder known as a specific phobia, which the National Institute of Mental Health defines as “an intense, irrational fear of something that poses little or no actual danger.” Like other specific phobias, dental anxiety is a genuine psychological condition that typically requires a professional diagnosis and professional help to heal from. 

What causes dental anxiety?

The roots of dental anxiety are often tied to past trauma or negative experiences—such as a painful procedure or a dentist who lacked compassion. Traumatic events involving the head or neck or experiences of abuse may also intensify the feeling of vulnerability during dental appointments. 

Conditions such as post-traumatic stress disorder (PTSD), depression, obsessive-compulsive disorder, and generalized anxiety disorder can also contribute to or intensify dental phobia. Genetics and other factors are thought to play a role in the development of this type of condition as well.

Other contributors to the development of this type of phobia may include:

• A sense of invasion. The mouth is an intimate space. For some, any intrusion may feel like a violation.
• Loss of control. Lying back with your mouth open and tools inside can create a sense of helplessness.
• Negative associations. The smell of antiseptic, the sound of the drill, or even a white coat could cause distress for someone with a history of frightening medical experiences.

The link between oral health and mental health

For individuals avoiding dental treatment due to fear, the potential consequences can go beyond cavities or gum disease. The longer someone with dental anxiety avoids treatment, the worse their oral health may become. This often leads to more anxiety and more complex procedures when they do seek help. This cycle of avoidance and escalation can deepen existing anxiety disorders, and in some cases, cause other conditions like depression as well.

Additionally, avoiding dental treatment may lead to more serious dental conditions, such as chronic pain, infections, tooth loss, and even heart disease or diabetes. Moreover, the visible effects of ongoing dental issues can impact self-esteem, social interactions, and the ability to eat or speak comfortably.

The potential benefits of receiving dental treatment

Addressing dental issues may help relieve pain and prevent complications. Specifically, regular cleanings and checkups may allow for:

• Early detection of any problems, potentially reducing the chances of needing complex procedures
• The maintenance of oral health and improved overall health
• Reduced risk of future emergency dental situations that require urgent, invasive treatment

Beyond physical and oral health, managing dental anxiety can also bring a sense of empowerment. Patients with anxiety often report a sense of pride after confronting their fears, with ripple effects potentially reaching far beyond the dentist’s office. 

Finding the right dentist

The environment, attitude and experience of your dental team can make a significant difference in reducing dental anxiety. 

Additionally, a calm, clean, and welcoming dental practice can help set the tone. Some dental offices even offer weighted blankets, noise-canceling headphones, or comforting scents to help ease tension.

Also know that it’s okay to interview dentists before committing to an appointment. This time can allow you to ask questions and gauge how open they are to tailoring care to your comfort level. Finding the right dentist can be the difference between enduring and actually feeling okay during dental procedures.

Tips for dental anxiety management

Keep in mind that, for those whose fears qualify as a diagnosable phobia, professional mental health treatment is usually required. In addition, the following strategies may be worth exploring.

Discuss dental anxiety management strategies with your dentist 

Open communication can be a powerful tool in a dental setting. When patients express their concerns, a dental team may be able to make adjustments to the process, from the pace of the procedure to the tools used. Some patients need extra breaks, while others may need a detailed explanation of every step. 

Even small gestures like agreeing on a hand signal to pause treatment can help reduce feelings of panic. Being seen and heard, without judgment, can be powerful.

Find specialized dental treatment for dental phobia

Not every dentist is equipped to treat those with severe dental anxiety. When seeking one that is, you might look for:

• Practices that offer conscious sedation or general anesthesia
• Dental offices that advertise trauma-informed care
• Providers who work closely with therapists for comprehensive treatment

These types of clinicians typically understand that dental phobia isn't stubbornness, but a genuine barrier that requires compassion and teamwork to address. 

Maintain a consistent oral health routine

Taking care to engage in preventative measures may also be helpful to someone living with dental anxiety. When people brush and floss regularly, eat nutrient-dense foods, and avoid tobacco, their dental visits may be shorter and less invasive. While many factors affect a person’s baseline oral hygiene, taking care of your teeth and gums as best you can at home can be a positive practice.

Building a daily oral health routine may also help:

• Strengthen your sense of control
• Reduce your risk of needing emergency treatments
• Reinforce positive associations with oral care

Practice relaxation techniques

For patients who feel overwhelmed before or during dental appointments, mindfulness techniques may offer some relief, such as:

• Deep breathing exercises
• Listening to a guided visualization via headphones (imagining a peaceful place or scenario)
• Progressive muscle relaxation to reduce physical tension

Schedule appointments mindfully 

Booking dental appointments during a less stressful part of the day, such as early morning or after a restful weekend, may reduce anticipatory stress. It can also help to avoid double-booking emotionally draining events around the same time, allowing for space before and after the appointment to decompress. Arriving early with time to relax or consult with a dental assistant can also make the experience feel less rushed and tense.

How therapy can help

Therapy can be particularly beneficial for those with severe anxiety and/or trauma history. Cognitive behavioral therapy (CBT) is considered to be one of the most effective approaches for such conditions practiced today. It helps individuals learn to identify distorted beliefs and replace them with more realistic thought patterns. A CBT provider may also offer coping strategies tailored to individual fears as well as treatment to address any underlying conditions like PTSD or anxiety disorders.

The option of online therapy

Online therapy platforms can make it easier for those with a dental phobia to seek help without additional stressors like commuting. Online platforms also offer more flexible scheduling than many in-person offices as well as the ability to attend sessions virtually from a comfortable home environment. 

There’s limited but promising research to suggest the effectiveness of online therapy for treating symptoms of a specific phobia. Consider this in conjunction with a wealth of other research suggesting that online therapy is typically as effective as in-person therapy in general.