Finding a Dentist When You Dread Going

Dental anxiety is common enough that most practices see it every day, and severe enough in some people that they go years without care. If that is you, the problem is not willpower. It is finding a practice set up to work with it.

There is a lot that can be arranged, and most of it costs nothing. Here is what to look for and what to ask for.

Say it when you book, not when you arrive

Telling the front desk you are anxious changes what happens next. They can book a longer slot so nobody is rushing, put you at a quieter time of day, and flag it to the dentist before you walk in.

The response you get to that phone call is itself the test. A practice that says of course, we will book you a longer first appointment just to talk, is a practice that has done this before. One that sounds impatient has told you to keep looking.

Ask for a talk first appointment

Many practices will see you with nothing happening: no instruments, no chair reclined, just a conversation about what you are afraid of and what they would suggest. It sounds small, and for a lot of people it is the thing that breaks a decade long standoff.

It also lets you agree the practical arrangements in advance: a stop signal, an explanation before each step, and permission to take breaks.

• Agree a hand signal that means stop, and check they will honour it
• Ask them to explain what is coming before each step, or to say nothing at all if you prefer
• Book the first appointment of the day so you are not sitting in the waiting room building it up
• Bring headphones and your own music or a podcast, which most practices are happy with
• Take somebody with you if that helps

What sedation actually involves

Nitrous oxide, sometimes called laughing gas, is inhaled through a small mask and takes effect in minutes. You stay awake and able to respond, it wears off quickly, and most people can drive home afterwards. It is the mildest option and the most commonly available.

Oral sedation is a tablet taken before the appointment. You are drowsy and relaxed, often remember little of it, and you will need somebody to drive you both ways. IV sedation goes further again and is usually offered by practices with specific training or by an oral surgeon, often for longer or more involved treatment.

General anesthesia, where you are fully unconscious, is reserved for particular cases and is normally done in a hospital or a specially equipped facility. Ask what the practice offers, who administers it, and what monitoring is in place.

Numbing, and why it sometimes fails

A common fear is that the numbing will not work. Sometimes it genuinely does not, particularly in a tooth that is already badly inflamed, where the tissue chemistry works against the anesthetic. This is a known problem, not you imagining it.

Tell the dentist if you have had numbing fail before. There are additional techniques and different anesthetics available, and knowing in advance means they can plan for it rather than discovering it midway.

Going back after years away

People who have avoided the dentist for a long time often fear the lecture more than the drill. A good practice will not deliver one. They see the same story constantly and are interested in what happens next, not in what you did or did not do for the last decade.

Expect the first visit to be an exam and a plan, usually not treatment. And expect to be told that most of it is fixable, because it usually is.

When you feel ready, our directory lists every dental practice in the United States by town or ZIP code. Pick two or three near you, phone them all, and go with whoever sounded least bothered by the question.

Frequently asked

This is general information to help you ask better questions, not a diagnosis. Anything happening in your own mouth needs a dentist who can look at it.