Who’s Afraid of the Dentist? Calming Patients’ Dental Anxiety
Fear associated with getting dental care, or dental anxiety, is such a common touchpoint in pop culture that it can seem like a cliché. Like most cliches, however, it has roots in fact: estimates of the number of people who have some degree of dental anxiety range up to 80% of the population. Of course, this spectrum is very broad, encompassing those who are mildly uncomfortable on the one end and phobic on the other. But chances are that somewhere around half your patients will be affected. How can you help calm their nerves—and improve their care?
What causes Dental Anxiety?
Dental anxiety has several potential causes. Fear of pain is by far the greatest, and is perhaps somewhat unfair, since pain control is so much better now than historically in dentistry. Some patients may have experienced painful dental procedures in the past, and some may have been told horror stories about others’ experiences. Regardless, anxiety associated with anticipated pain can be the beginning of a vicious cycle in which patients avoid dental care until they need invasive treatment that is more likely to be, if not painful, at least as intimidating as what they were trying to escape in the first place.
Other factors associated with dental anxiety include fear surrounding anesthesia—the needles, the sensation, worries that it will be inadequate—loss of control, and invasion of personal space. All of these situations are, to some degree, inevitable because of the precision and intimacy needed to work in the oral cavity (and, ironically, the desire to prevent pain). However, there are several measures you can take to help put your patients at ease both before and during their time in the chair, and the good news is that some require little more than your own positive attitude.
Help Patients Leave Anxiety at The Door
As a new dentist, you may not have the luxury of setting the practice’s environmental tone. If you can, though, creating a calming atmosphere is a good way of welcoming all patients to the practice, not just the anxious ones. One simple way of doing this is to minimize visible clutter, which has been shown to increase subconscious stress not just for patients, but also for staff. “Clutter” might even include unnecessary furniture—think about how the COVID-19 pandemic has changed people’s perception of personal space, for example. At the same time, having some kind of visual distraction in the waiting room and operatories, such as artwork or video displays (even lightweight posters overhead), can keep patients from finding the space too clinical and oppressive. Lighting, music, and even aromatic choices (e.g., oil diffusers) can also make the office seem more welcoming and less clinical.
No matter how nice your waiting room is, don’t keep patients sitting there—or alone in the chair—too long. The longer people wait, the longer their imagination has to work on why they might not want to be there.
Identifying Anxious Patients
Some people may be up front about their anxiety, but others may be embarrassed to admit it. Good communication skills and empathy can help you identify patients who are trying to hide their fear and, thus, give you a chance to address it. If you have the time, short dental anxiety questionnaires exist to help assess degrees of anxiety. These could even be included in pre-visit paperwork. Sometimes, just taking a questionnaire and having their anxiety acknowledged helps patients relax.
In addition, because loss of control and personal space are factors for some patients, being clear about what is going to happen during a procedure and allowing them to give you feedback throughout can help them prepare mentally for the experience and give them some assurance of control. The “tell-show-do” approach of explanation can help with the former, and agreeing on a signal—a simple raised hand will do—to indicate comfort during the process is an example of the latter. Even patients who aren’t anxious in the chair can appreciate these steps!
High-Tech Solutions to Anxiety
Advances in technology can also play a role in soothing patients’ fears, especially those related to anesthesia and the sound or vibration of the handpiece. For example, computer-controlled anesthesia delivery systems reduce the pain experienced during injection and do not look like traditional syringes, while lasers can be used in caries removal.
More and more dental practices are finding that virtual reality (VR) can help reduce patients’ fear, pain, and anxiety during their appointments. VR immerses the patient in other worlds with scenes and sounds designed to help them feel relaxed and calm during a procedure.
If your practice finds that many patients are intimidated by injections and drills, such systems may be worth investigating.
Patient DIY Relaxation Techniques
Simple anxiety-reducing breathing and muscle exercises exist and can be carried out by patients either in the office or at home in preparation for the visit. Guides to these exercises can be found online. Some patients may benefit from herbal supplements, although it’s important for them to ask their primary care physician about potential medication interactions before taking them.
Less Anxiety, Better Care
Patients who have actual phobia about dental visits will likely need to seek treatment outside the dental office for their fear, such as medication or therapy. But for those who are simply more or less reluctant, simple measures like creating a pleasant, calm setting and acknowledging their concerns can help put them at ease and make them feel that they are being cared for, not just worked on. And whether they realize it or not, the more willing they are to come to you for regular visits, the better their care—and health—will be.