Fear of the Dentist: How to Overcome Dental Phobia

Fear of the dentist is one of the common fears people meet over the course of their lives. For some it is only mild unease before an appointment, for others a genuine burden that keeps them putting off even the most basic check-up for years. If you recognise yourself in this, you are not alone and, more importantly, there are proven ways to make a visit to the dentist calmer and more comfortable.

At Ortoimplant DENTAL SPA in Zagreb we have spent years working with patients who first called us only after a long period of avoidance. Experience has taught us one thing: fear is not beaten by pressure but by understanding, an unhurried pace and clear communication. Below we explain where the fear comes from, how it shows itself and what options, including analgosedation, are available.

Unease, fear or phobia: they are not the same thing

Although in everyday speech we call all of it “fear of the dentist”, clinically we distinguish several levels of intensity:

• Dental anxiety: tension, nervousness or unease linked to the anticipation of a dental examination or procedure, which does not necessarily stop the patient from coming.
• Dental fear: a stronger reaction to specific triggers, for example the sound of the instruments or the injection.
• Dental phobia: intense anxiety or even a panic attack at the mere thought of an appointment, so the visit is avoided, sometimes for years.

Mild unease is very widespread and affects a large share of adults in one form or another. Clinically significant fear, which seriously interferes with going to the dentist, is rarer but far from negligible. A systematic review and meta-analysis of data on adults estimates that around 15 per cent of adults experience dental fear and anxiety, while the more pronounced, severe form affects a little over 3 per cent of people.1 The figures vary depending on how fear is measured, but the message is the same: this is a common and entirely understandable phenomenon, not a personal weakness.

How fear shows itself

The body reacts to fear before we even sit in the chair. Patients most often describe:

• a racing heart and a pounding sensation in the chest,
• sweating and trembling,
• muscle tension and a clenched jaw,
• nausea and, in more severe cases, hyperventilation.

In some people the unease begins days in advance, disrupts sleep and stays with them all the way to the waiting room. This is a real physiological response of the body to fear and unease, and we take it seriously in the surgery.

Where the fear comes from

For many patients the roots reach back to childhood. Research into the age of onset of dental anxiety showed that roughly half of anxious people trace their fear precisely to an early negative experience in the surgery.2 A painful procedure, an insufficient explanation or a sense of losing control in childhood leave a mark that can carry into adult life.

Fear, however, is not always born in the surgery. It can also arise indirectly, through stories from parents or peers and impressions picked up from those around us, and sometimes it appears only in adulthood after a single bad experience. In practice, Dr Zdenko Trampuš notices that the trigger is often neither the needle nor the drill, but the sounds and smells of the surgery and the feeling of helplessness while the patient lies in the chair.

It was precisely this understanding of how those factors shape the experience of dental treatment, drawn from many years of clinical practice and from studying the professional and scientific literature, that was one of the premises on which Dr Trampuš developed the Ortoimplant DENTAL SPA concept. The idea was to change not only the way a dental procedure is carried out, but also the way the patient experiences it, from the space and the communication through to control of fear, comfort during the procedure and recovery afterwards. When we understand where the fear comes from, it is easier to disarm it.

How we work with anxious patients

Our approach rests on a few principles that sound simple but make a large difference:

• No rushing. We keep the first conversation calm and give the patient enough time to tell their story, their fears and their previous experiences.
• We explain everything in advance. When the patient knows what comes next and how long it will take, the sense of control returns, and fear and unease ease more readily.
• An agreed signal for a break. The patient can ask for a pause at any moment by raising a hand.
• Surroundings that do not resemble a conventional surgery. The Ortoimplant DENTAL SPA concept is designed so that both the space and the patient’s whole experience reduce some of the stimuli that can trigger fear and tension.
• Technology that increases precision and predictability. Digital planning and 3D CBCT diagnostics let us plan the implant procedure in detail before the operation itself.

For patients with pronounced fear, dental anxiety or dental phobia, analgosedation is also available. We use potentiated intravenous analgosedation as a matter of protocol for more extensive implant and oral surgery procedures as well, regardless of whether the patient has a fear of the dentist.

Analgosedation: a calm procedure for those whose fear stands in the way

Analgosedation is a controlled state of reduced consciousness whose depth is adapted to the patient and the procedure. With lighter analgosedation the patient stays awake, breathes independently and can communicate, while with deeper analgosedation they can effectively sleep through the procedure and afterwards remember little or nothing of it. At Ortoimplant DENTAL SPA potentiated intravenous analgosedation is administered by a specialist in anaesthesiology who continuously monitors the patient’s vital functions throughout the procedure. Together with local anaesthetic and appropriate pain control, it allows even a long and demanding procedure to pass without pain and fear, with maximum comfort for the patient.

This is not a marketing promise but an approach grounded in the literature. A systematic review and meta-analysis of conscious sedation during implant placement concludes that sedation reduces patient anxiety and increases the satisfaction of both patient and surgeon.3 Analgosedation is not needed for every dental procedure, but for patients with pronounced fear, dental anxiety or dental phobia it can be exactly what makes it possible for the necessary treatment to finally go ahead. At Ortoimplant DENTAL SPA we also use potentiated intravenous analgosedation as a matter of protocol for more extensive implant and oral surgery procedures.

Analgosedation is an important part of complete treatment solutions such as fixed teeth in 24 hours and All-on-4 or other All-on-X treatments All-on-4, in which an extensive implant procedure can be carried out in a single calm and precisely planned appointment. You can read more about analgosedation on a separate page.

The first step is the easiest

For many anxious patients the hardest part is picking up the phone. This is why the first examination with us is free and without obligation: you come in, we talk and we assess the situation, with no pressure to do anything straight away. The purpose of that meeting is not to sell a procedure but to find, together, a pace that suits you.

If treatment is needed, DENTAL SPA treatments can accompany the patient before, during and after the procedure, with the aim of maximum comfort, support for the body and a more comfortable recovery.

Frequently asked questions