Dental anxiety is very common, and it is nothing to be embarrassed about. The most useful things you can do are tell the dental team how you feel, agree on a signal to pause, start with a simple visit, and ask about comfort options such as numbing gel, local anaesthetic or happy gas. For more severe fear, there are further options, including referral for sedation and talking therapy that has good evidence behind it.
Why people feel anxious about the dentist
Fear of the dentist exists on a spectrum, from mild nerves before an appointment to strong fear that leads people to avoid care for years. Common reasons include:
- A painful or frightening experience in the past, often in childhood
- Fear of needles, drills or particular sounds and smells
- Feeling a loss of control while lying back with your mouth open
- A strong gag reflex or difficulty breathing through the nose
- Embarrassment about the state of your teeth or how long it has been since your last visit
- Worry about cost or about being told you need a lot of treatment
- General anxiety, or past trauma that makes close physical contact difficult
Understanding where your fear comes from can help you and your dentist work out which strategies are most likely to help.
The cycle of avoidance
Many anxious people put off going to the dentist until something hurts. By then, a small problem that could have been a quick filling may have become an infection that needs more involved treatment. That experience can reinforce the fear and make the next visit feel even harder.
Breaking the cycle usually starts with a low-pressure visit when nothing is urgently wrong. Regular check-ups tend to mean shorter, simpler appointments, which in turn help build confidence.
Practical tips before your appointment
Choose the timing
Many anxious patients prefer an early appointment so they don’t spend the day worrying. Avoid booking when you’re rushed, and allow time to arrive without stress. Our Macquarie Park practice has free on-site parking and is about three minutes’ walk from Macquarie University Metro station, which can take some of the hassle out of getting there.
Tell us when you book
Let the receptionist know you feel nervous. It helps the team plan extra time, and you won’t need to explain everything again once you’re in the chair.
Start with a conversation
You can ask for the first appointment to be a chat and an examination only, with no treatment that day. Knowing you won’t be surprised can make a big difference.
Bring support
A friend or family member can come with you to the appointment. Some people also find it helpful to bring headphones and listen to music or a podcast.
Look after yourself beforehand
Have a light meal unless you’ve been told otherwise, and consider avoiding too much caffeine, which can make anxiety feel worse.
Tips for during your appointment
- Agree on a stop signal. Raising your hand is the usual one. Knowing you can pause at any time gives back a sense of control.
- Ask for a “tell-show-do” approach. The dentist explains what’s next, shows you the instrument, then goes ahead. No surprises.
- Use slow breathing. Breathe in gently through your nose for about four counts and out slowly through your mouth or nose for about six. A longer out-breath helps calm the body’s stress response.
- Relax your muscles. Notice tension in your shoulders, hands and legs, and let it go a little with each breath out.
- Take breaks. Shorter appointments, or pauses during longer ones, are completely reasonable.
- Mention gagging. Small changes, such as sitting more upright or using a smaller instrument, can help with a strong gag reflex.
Comfort options your dentist may offer
Numbing gel and local anaesthetic
A topical numbing gel can be applied to the gum before an injection so the needle is felt much less. Local anaesthetic numbs the area being treated. It is very effective for most people, though occasionally a tooth that is very inflamed can be harder to numb and may need extra anaesthetic. Let your dentist know immediately if you can feel anything sharp.
Happy gas (nitrous oxide)
Happy gas is a mix of nitrous oxide and oxygen breathed through a small mask over your nose. It helps you feel relaxed and calm while staying awake and able to respond. Its effects wear off quickly once the mask is removed, and many people can return to normal activities soon afterwards, although your dentist will advise you on this. It is available at North Ryde Dentistry, with the fee available on request.
Happy gas isn’t suitable for everyone. It may not be recommended in early pregnancy, with some lung or nasal conditions, or with certain medical conditions and medications, and some people feel light-headed or nauseous. It also doesn’t work as well if you can’t breathe comfortably through your nose. Your dentist will check your medical history first.
Sedation and general anaesthetic
For people with severe anxiety or who need extensive treatment, intravenous sedation or treatment under general anaesthetic in a hospital may be considered. These involve appropriately qualified practitioners and facilities, and patients may be referred elsewhere for them. They carry additional risks and costs, and suitability depends on your medical history and the treatment needed.
Help beyond the dental chair
For strong, long-standing fear, sometimes called dental phobia, psychological approaches such as cognitive behavioural therapy (CBT) have good evidence of helping people feel more able to attend the dentist. A psychologist can work with you on gradual exposure and coping strategies. Your GP can talk to you about options and referral. Combining this with a gentle, step-by-step dental plan often works well.
What a gentle approach looks like
A good experience for an anxious patient is less about any single technique and more about how the whole visit feels: unhurried, explained, and with you in control. Our page on gentle dental care describes how the team approaches nervous patients, and you can find general information about our North Ryde dentist services, location and hours.
It is also fine to ask questions about cost and options before agreeing to anything. You should receive a written estimate after assessment, and you can take time to think about it. You won’t be pressured into treatment you’re not ready for.
Helping children with dental nerves
- Start check-ups early, ideally by age one or when the first tooth appears, so visits become familiar.
- Use calm, neutral language and avoid words like “hurt” or “needle” when talking about the dentist.
- Try not to pass on your own worries; children pick up on adult anxiety.
- Read books or play “dentist” at home to make the experience familiar.
When to see a dentist
If it has been a long time since your last visit, a routine check-up is the right place to start, ideally before anything hurts. See a dentist promptly if you have toothache, swelling, bleeding gums, a broken tooth or a bad taste that won’t go away, because these problems are usually simpler to treat early. If anxiety is stopping you from booking, it’s fine to call first just to ask questions.
Frequently asked questions
How common is dental anxiety?
Very common. Many adults feel some nervousness about the dentist, and a smaller number have fear strong enough to avoid care. Dental teams see anxious patients often and are used to adapting how they work.
Can I just have a check-up without any treatment?
Yes. You can ask for your first appointment to be a conversation and examination only. Any treatment can be planned and booked separately once you feel ready.
What does happy gas feel like?
Most people feel relaxed, light and calm, sometimes with a tingling sensation, while staying awake and able to talk. It wears off quickly once the mask is removed. Some people feel light-headed or nauseous, and it isn’t suitable for everyone.
Will I be judged if I haven’t been to the dentist for years?
No. Dentists regularly see people who have stayed away for a long time. The focus is on understanding where things are now and planning care at a pace that suits you.
What if local anaesthetic doesn’t work for me?
Tell your dentist straight away if you can feel sharp sensations. Extra anaesthetic or a different technique can often help, and treatment can be paused or rescheduled if needed.
If you’d like to talk through your concerns before booking, our team is happy to answer questions. Call North Ryde Dentistry on (02) 8090 1102 or book an appointment.
This article is general information only and is not a substitute for advice from your own dentist. Any treatment carries risks; your dentist will discuss whether it is suitable for you.
Related at North Ryde Dentistry: our North Ryde dental clinic