Dental anxiety affects many patients and can hinder them from taking the next step to achieve their oral health care goals.

Dental anxiety and dental phobia are extremely common. Many people have at least some anxiety about visiting the dentist.  But for a patient with a dental phobia, a dental visit can be terrifying. Up to 15 percent of Americans report they avoid seeing the dentist due to severe dental anxiety or dental phobia.  Some people will put off dental care for years or sometimes even decades! This can lead to advanced gum infections (periodontal disease), pain, or even broken or decayed teeth.  The price of dental phobia can include a higher risk of gum disease and can lead to tooth loss. Other people have to live with a loss of self-esteem or reduced quality of life due to embarrassment over how their smile looks, inability to eat well, or discomfort.

There are many different degrees of dental anxiety or phobia. In the case of a dental phobia, there can be a complete avoidance of the dentist – sometimes for years! Some will go to their appointment, but they may not sleep the night before or feel sick before or during their dental appointment.

When people are feeling tense, they may have a lower threshold for pain and may need extra anesthetic or other pain treatments. They may also suffer from headaches or muscle tension in their back, neck, arms or legs while in the dental chair.

Symptoms of dental phobia or anxiety

  • Tense muscles or trouble sleeping the night before a dental appointment
  • Increasing nervousness or feeling ill while in the waiting room.
  • Feeling like crying or getting overly emotional when you think of going to the dentist.
  • You panic, gag excessively, or have trouble breathing during a dental appointment.

What are the causes?

Those suffering from dental anxiety or phobia report the main triggers as:  pain, a feeling of helplessness and loss of control, embarrassment, or negative past experiences as the cause for their fear of the dental office.

The major triggers of dental anxiety or phobia, and how they may be handled:

Pain – Some people have had a previous dental experience that may have been uncomfortable, had trouble getting numb or have very sensitive teeth or gums.  Some of these experiences may have happened before many of the advances in “pain-free” dentistry.  These days, we have many pain control techniques, analgesics and anesthetics available.

  • Before and during the appointment: different comfort choices can be offered including headphones, music, blanket, a relaxed environment, distraction, mental imaging, sleep mask, breathing techniques, a bite block, or other comfort measures. Dental professionals have different local anesthetic and topical rinses, liquids, sprays or subgingivally applied gels that can be used.  Tooth desensitizing agents are also available.  Your dental professional will be very knowledgeable about what is available and can select the appropriate method based on the type of procedure, length of procedure as well as your individual needs and preferences.
  • For surgical or more intensive procedures, IV conscious sedation or oral sedation is often an option. Sedation dentistry can provide a calming experience for patients who have experienced high levels of anxiety related to dental treatment.  Some dentists are highly trained and certified in IV conscious sedation or oral sedation.


Intravenous (IV) Sedation helps even our most anxious patients remain relaxed and comfortable during procedures. Many patients feel as though they, “went to sleep” during the sedation. The goal of IV conscious sedation is not to provide general anesthesia but instead to allow patients to remain conscious and relaxed with minimal risk during the procedure.


A prescription medication can be given that can relieve anxiety patients feel before and during their dental procedure. It allows patients to respond verbally and physically to directions all while in a very “restful” state. Patients using oral sedation will need to be driven to and from the procedure.

  • After the appointment: Warm saltwater rinses, over the counter or prescription pain medications are available to assist in a person’s recovery after the procedure. Having post-appointment care information in writing as well as given verbally is also helpful.

Helplessness or loss of control — in the dental chair, a patient has to stay still, they can’t see what’s going on or predict any potential discomfort.  It’s common for people to feel helpless and out of control, which may trigger anxiety.  A patient’s state of mind is very important especially when one has dental anxiety or phobia.  For some patients, a clear explanation of what procedures will be done, what to expect, and how to indicate if they need the operator to stop or give them a rest can help immensely.

Embarrassment — People may feel ashamed or embarrassed to have a stranger looking in their mouth.  Some people lack self-confidence or are ashamed of how their teeth look, and may be afraid they’ll be judged or ridiculed. Dental care also involves an invasion of a person’s personal space as dental treatments require physical closeness. During a treatment, the hygienist’s or dentist’s face may be just a few inches away. This can make people anxious and uncomfortable.

Negative past experiences — many that have had pain or discomfort during a previous dental procedures, often in childhood, but it could be any other time, are likely to be more anxious.

To cope with dental fear, it is best to tell your dentist about your feelings, concerns and fears so they can help you overcome these feelings by adjusting your comfort and care in the dental office.

Through the specialty of periodontics & implant dentistry, we at Britten Periodontics strive to deliver comfortable care and ethical treatment in a welcoming environment.  Our goal is to deliver exceptional dental care with compassion, using the latest research based techniques. With education and encouragement, our goal create a strong relationship with our patients and a comfortable experience.

Our team members understand that the treatment provided is not always pleasant or comfortable but they possess the personality to make the patient feel at ease in spite of this.   As a team, we partner with other caring healthcare providers to deliver patient treatment with honor and dignity. A healthy, satisfied patient is our ultimate reward!  For our surgical procedures, Dr. Britten is highly trained and certified in both IV conscious sedation and oral sedation. He is one of the few Periodontists in the Tampa Bay area who offers IV sedation.

Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten received his Bachelor of Science & Doctorate of Dental Surgery from University of Florida, a Master’s Degree and Certificate in Periodontology and Implant Dentistry; and completed extensive training at the Institute of Advanced Laser Dentistry. He is one of the only board-certified periodontists in Pinellas County. He is a member of the American Academy of Periodontology, American Dental Association, Florida Association of Periodontists, Upper Pinellas County Dental Association, Hillsborough County Dental Association, Hillsborough County Dental Research Association and Florida West Coast Dental Association.

To learn more about Dr. Britten and his dental services visit his website at or call (727) 586-2681.

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