Dentist phobia: why the fear of the dentist takes hold, and how to get back in the chair

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Dentist phobia is an intense fear of dental visits or treatment that is out of step with the real risk. Mind names going to the dentist among the most common medical phobias, and NHS England's clinical standards for dental anxiety management cite the Adult Dental Health Survey: roughly one adult in three reports moderate dental anxiety and around one in eight reports it at a level that could be considered phobic. If you have a tooth that has hurt for months and a phone you cannot bring yourself to pick up, you are in a large and quiet crowd.

This guide covers why the fear takes hold, why putting off the appointment makes it grow, and what helps, from the phone call to the chair. It belongs to the same family of fears as emetophobia, the guide that opens our phobias series, and the pattern is the same: the things you do to feel safe are the things that keep the fear going. Everything here is drawn from NHS guidance, NHS England's clinical standards, the Oral Health Foundation and Mind. It is not a diagnostic tool, and it will not tell you whether what you have is a phobia. If the fear is affecting your life or your teeth, your GP or your dentist is the right first conversation.

What dentist phobia actually is

Dentist phobia is a specific phobia, which means a fear far bigger than the danger in front of you. Mind describes a phobia as an extreme fear of an object, place or situation, a fear that does not match the risk of the thing you are afraid of. The NHS describes phobias as an anxiety condition usually caused by a particular object or situation, and says some phobias affect daily life more than others. Mind lists medical phobias, including going to the dentist and procedures that involve needles, among the most common specific phobias.

Being nervous before a check-up is a different thing. The Oral Health Foundation says nervousness about the dentist is very common, and that some people feel slightly anxious while others have a strong fear or phobia. What separates the two is what the fear makes you do. When thinking about an appointment is enough to set your heart going, when you cancel more than you attend, or when a tooth has hurt for a long time and you still have not rung anyone, the fear has started making your decisions for you. You do not need to decide which side of the line you are on before you act on it.

Why am I so scared of the dentist?

Most people who are scared of the dentist learned the fear somewhere, often early, and it has never been corrected. The NHS says it is not always clear why a phobia starts, but that many can be linked to a frightening event or a stressful situation, that phobias usually develop as a child, teenager or young adult, and that you can learn one from family or friends who have it. Mind adds that you can develop a phobia of something without ever having a bad experience of it yourself.

The dentist gives the fear a lot to work with. The Oral Health Foundation lists the sound of the drill, the smells of the surgery, needles, the discomfort of lying back in the chair, a closed-in feeling during treatment, a bad experience in the past, unpleasant childhood memories, other people's stories, a long gap since your last visit, and worry about what treatment you might need. Several of those usually stack. Someone who hates needles, dislikes lying flat with their mouth open, and once had a rough filling as a child has three reasons layered on top of each other, and the fear reads all three as one.

The body joins in. The NHS lists the symptoms of a phobia as severe anxiety and worry, feeling dizzy or lightheaded, a noticeable or unusual heartbeat, tightness in the chest, feeling sick, trembling or shaking, and an intense fear that you may faint, lose control or die. Mind adds sweating, fast breathing, numbness or tingling, feeling frozen, and in some cases a full panic attack. If you have ever sat in a dental waiting room with your heart hammering and your hands wet, that is the list in action, and a fear response is all it is.

Why skipping the dentist makes the fear bigger

Avoiding the dentist feels like the sensible move, and it is the thing that keeps the fear alive. Mind calls the things we do to feel safe around a phobia trigger safety behaviours: avoiding it completely, only facing it with someone else there, or putting a lot of effort into getting round it. Mind is plain that they often do not help us deal with the symptoms, and that they can make the phobia worse. Mind also says phobias are unlikely to go away on their own, particularly if you have had them for a long time.

Every appointment you cancel teaches your brain that you were fine because you did not go, so nothing ever corrects the fear. With the dentist the cost is higher than with most phobias, because avoiding the trigger means avoiding the care behind it. NHS inform, the health information service for Scotland, says plainly that avoiding dental care can lead to serious damage to your oral health, and the Oral Health Foundation says that if fear stops you getting dental care, it can affect your health and wellbeing. The longer you stay away, the more there is to be afraid of. Our guide to fear of needles covers the same loop around blood tests and injections, and the two fears often travel together.

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I'm terrified of the dentist, what can I do?

Being terrified of the dentist is something you can work on, in small steps, without pretending you are not afraid. The Oral Health Foundation says dentists are trained to help nervous patients, and NHS inform says dental staff are trained to handle nervous patients and that dentists are more aware of anxious patients. Nobody in the building expects you to walk in calm. The steps below come from the Oral Health Foundation, NHS inform and Mind, and you can take as few or as many as you need.

Before you book

Telling the practice you are anxious is the most useful thing you can do before you sit in a chair. The Oral Health Foundation suggests saying so when you book, so the team can put you with a dentist who is experienced with nervous patients, and suggests visiting the practice beforehand, talking to the receptionist and looking around, so that it feels familiar on the day. If you are not registered anywhere, the NHS says you can contact any NHS dentist and ask for an appointment, that you may be asked to join a waiting list first, and that your local integrated care board can help if you cannot find one taking patients.

You can bring someone. The Oral Health Foundation says you can bring a friend or family member, and that they can stay with you during the appointment if you wish. NHS inform adds that you can ask the dental nurse to talk to you or sit with you. The first visit may also be smaller than you fear. The Oral Health Foundation says it may just be a check-up, where the dentist looks at your teeth and gums, perhaps takes x-rays, and explains what treatment is needed and what it costs, and then you decide what happens next.

In the chair

A plan for the chair gives you some say in what happens once you are in it. NHS inform suggests talking to your dentist about how you feel and planning the visit together so it is as relaxed as it can be, and agreeing a signal to use if you feel overwhelmed or want them to stop. NHS inform also suggests bringing headphones and listening to music to block out the noises that set you off, and trying breathing and relaxation techniques to calm your nerves and give your attention something else to do.

Pain is the part most people are actually afraid of, and the sources are direct about it. NHS inform says treatment can be painless, that numbing gels can be used on the gum before an injection, and that the injections themselves are designed to cause little or no pain. The Oral Health Foundation says the same: if you are afraid of needles, tell your dentist, and they can apply numbing gel to your gum first so you feel little or nothing from the injection. The Oral Health Foundation also says that for many people the fear does get better, because regular visits make the environment familiar, you build trust with your dental team, and visits often become easier over time.

If you panic in the chair

Panic in the chair is frightening and it will pass. The NHS says most panic attacks last between 5 and 20 minutes, that they are not dangerous, and that an attack will not cause you any physical harm. The NHS advice during one is to stay where you are if possible, breathe slowly and deeply, remind yourself that the attack will pass, and remember that it is not life threatening. Use your stop signal, and let the dentist know what is happening. Our guide to what a panic attack feels like goes through the sensations, and how to stop a panic attack covers the steps in more detail.

Slow breathing is worth practising before the day so it is there when you need it. The NHS breathing exercise for stress, anxiety and panic is to breathe in gently through your nose and out through your mouth, counting steadily from one to five on the way in and again on the way out if that helps, and to keep going for at least five minutes. The NHS also suggests breathing exercises as self-help for a phobia, alongside talking to someone you trust, joining a self-help group, and being careful about looking things up online before you are ready to see the images.

Building up to it one step at a time

Working up to the dentist in stages is how most people shrink a phobia. Mind uses the dentist as its own example, and describes graded exposure as building up tolerance to your trigger bit by bit: make a list of the things that set the fear off and how they make you feel, then a list of small tasks that slowly build into bigger ones. For a phobia of the dentist, Mind's example ladder is to read about the dentist, look at pictures of a dentist's chair, sit in the waiting room, talk to the dentist, and finally sit in the dentist's chair. You repeat a task until it no longer makes you anxious, then move to the next one.

Two things from Mind are worth keeping as you climb. While you do each task, remind yourself that you are safe, because that is what challenges the belief underneath the fear. And be kind to yourself as you go, with a reward at each step. Mind also suggests asking whether there is any evidence against the frightening thought, whether you are picturing the most likely outcome or the worst one, and what you would tell a friend who thought the same. Guy's and St Thomas' dental psychology service gives anxious patients self-help tasks along the same lines, such as practising relaxation skills or learning about dental equipment. Some NHS trusts publish graded exposure workbooks you can download, and your GP can point you to one. The same ladder works for driving anxiety and most other specific phobias.

Where Wobble fits

Wobble is the step before a course of therapy, or the check-in alongside one. You describe what is going on in text or voice and a qualified UK therapist records you a personal video, usually within hours, working to the Wobble response framework: what they understood, practical guidance, and one clear next step. Wobble's Clinical Lead is James Penney, NCPS Accredited Psychotherapeutic Counsellor. People use it once in the week before an appointment they have been dreading, or regularly while they work up the ladder above, the way therapy has a rhythm without the appointment. It is not a replacement for a course of therapy if that is what you need, and it is not a crisis service.

What if I'm embarrassed about the state of my teeth?

Embarrassment about your teeth is one of the most common reasons people stay away from the dentist. The Oral Health Foundation says dentists are trained to help nervous patients, and NHS inform says staff are trained to handle nervous patients and that your dentist will plan the visit with you. Dental teams are used to seeing teeth that have been left for years. Nobody can promise you what another person privately thinks, but the people in that room are there to fix teeth.

The first visit helps here too, because it may just be a check-up with nothing decided on the day. If it helps, say the embarrassing part out loud when you book: that it has been a long time, that you are ashamed of how things look, that you are scared. The Oral Health Foundation says telling the team you are anxious is what lets them match you with the right dentist, and saying it once to the receptionist is usually easier than carrying it into the chair.

When to see your GP

See your GP if the fear of the dentist is affecting your life or your health care. The NHS advice is to see a GP if you think you have a phobia and the symptoms are affecting your life. Mind suggests support might help if avoiding the trigger makes day-to-day life hard, if you need a lot of preparation or someone with you to face it, if it causes panic attacks, if you use alcohol or drugs to cope, or if it stops you getting support for other health problems, and Mind names a phobia that stops you seeing a doctor or having a test or treatment as an example. You do not need to be sure it is a phobia before you go. A GP can assess you and explain your options, which Mind says are usually the same as for other anxiety problems: guided self-help, talking therapies and, in some cases, medication. A GP is the right person to discuss medication with, and Mind notes it should not be the only thing offered because it does not treat the cause.

Mind says the therapies most often offered for phobias are cognitive behavioural therapy and exposure therapy, which do the work of the ladder above with a professional alongside you. In England you can refer yourself to NHS Talking Therapies at nhs.uk/talk without seeing your GP, phobias are on its list of problems you can self-refer for, and waits vary widely. Elsewhere in the UK your GP can tell you what talking support is available locally. A BACP, UKCP, BABCP, BPS or NCS-registered therapist can help privately.

Your dentist can help too. NHS England's clinical standards say behavioural techniques and sedation should be seen as complementary, and that the simplest and safest technique likely to work is usually the best first choice, so the conversation starts with what you can manage. NHS inform says that if your fear is severe you can consider a sedation clinic, where sedation lets the dentist carry out necessary work without too much stress, and it describes two kinds: inhalation sedation, breathed in through a nose piece and similar to gas and air, and intravenous sedation, given by an injection in the hand or arm, where you stay awake but calm and may not remember the procedure. The Oral Health Foundation says your dentist can refer you to a clinic that offers sedation, and that your dentist and doctor can help you decide which option is best for you. NHS England's standards also note that sedation services take referrals rather than people walking in, so ask your dentist or GP for the referral. If you ever feel you cannot keep yourself safe, that is urgent: call 999 or go to A&E, or call NHS 111 and select the mental health option.

Who you can talk to today

Free routes first, then your GP, then Wobble.

• NHS Talking Therapies (England): refer yourself at nhs.uk/talk without seeing your GP. Phobias are on the list. Free. Waits vary widely.
• NHS 111, mental health option: call 111 and select the mental health option, or use 111 online, for urgent help that is not an emergency. Free.
• Samaritans: call 116 123, free from any phone, 24 hours a day, 365 days a year.
• Shout: text 85258, free, confidential, 24/7.
• Mind Infoline: 0300 123 3393, 9am to 6pm Monday to Friday, for information about support and services near you. Mind's Support line is 0300 102 1234, same hours, if you want someone to listen.
• Your GP: if the fear is affecting your life or your health care, or you want to talk through talking therapies.
• Any NHS dentist: you can contact one and ask for an appointment, tell them you are anxious when you do, and your local integrated care board can help if you cannot find one taking patients. If you are in pain now, the NHS says 111 online can help with dental problems, including finding an emergency dentist where one is available locally.

Wobble is on-demand mental health support: you choose a topic, then answer six short questions about it, add more in writing or by voice note if you want, and a qualified UK therapist records you a personal video with practical guidance, usually within hours. Use it once, or make it a regular check-in. Your first Wobble is £9.99, usually £14.99. It is not a crisis service.

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Quick summary

Dentist phobia is a common specific phobia, and it can be worked on. The fear is usually learned, often early, and the dentist gives it plenty to attach to: the drill, the smells, the needles, lying back, a bad memory. Avoiding appointments keeps the fear alive and costs you your teeth, because the longer you stay away the more there is to dread. What helps is telling the practice you are anxious when you book, bringing someone, agreeing a stop signal, headphones and slow breathing in the chair, numbing gel before an injection, and a ladder of small steps towards the chair, with CBT, exposure therapy or a sedation clinic through your GP or dentist if the fear is severe. You do not have to sort this alone.

Sources and further reading

• NHS: Phobias
• NHS England: Clinical standards for dental anxiety management
• NHS inform: Coping with a fear of the dentist
• NHS: How to find an NHS dentist
• NHS: Panic disorder
• NHS: Breathing exercises for stress
• NHS: NHS Talking Therapies
• NHS: Where to get urgent help for mental health
• NHS: When to use 111
• Guy's and St Thomas' NHS Foundation Trust: Dental anxiety support
• Oral Health Foundation (dentalhealth.org): Fear of the dentist
• Oral Health Foundation (dentalhealth.org): Relaxation and sedation
• Mind: Understanding phobias
• Mind: Coping with phobias
• Mind: Helplines
• Samaritans: Contact a Samaritan
• Shout: text 85258

This article is for information only and does not replace advice from a qualified medical professional. If fear of the dentist or anxiety is affecting your daily life or your health care, please speak to your GP, your dentist or NHS 111. If you are in crisis, please call 999 or go to A&E.