Taking the Bite out of Dental Anxiety

Does a routine visit to the dentist give you the shakes? Are the words "open wide" the last thing you want to hear? Does the smell of fluoride make you queasy?

You’re not alone.

Dentists prepare to treat a patient

Anxiety over dental visits in adulthood is often based on childhood experiences in the dentist’s chair.

About 75 percent of adults fear going to the dentist, says Masahiro Heima, D.D.S., Ph.D., of Case Western Reserve University’s School of Dental Medicine—and most of those fears are rooted in childhood dental experiences.

"If we can help change the outlook of children early on," says Heima, "patients and their dentists will be better off."

That’s why, along with researchers at the University of Washington, Heima has developed techniques for helping young patients cope with anxiety. He mixes those techniques with his own chair-side manner.

Heima starts with the parents, who may have negative thoughts of their own about going to the dentist—thoughts that they may be consciously or unconsciously imparting to their children. Heima asks the parents about their own worries or concerns and then turns to the children to learn about their fears.

The next step is to return some control to young patients by familiarizing them with the instruments and the environment. Heima goes so far as to give children fake shots until they’re more comfortable. When it comes time for the real shot, he says, patients often expect the "pinch" to be worse than it really is, so he’s careful not to add to their fear unnecessarily. When work begins, Heima allows patients to raise a hand to stop the process and then resumes when they are ready.

Of course, not all visits to the dentist are successful, and even the best chair-side manner can’t overcome all fears. When a child has already had a bad experience, Heima works to change their memory of the previous visit.

"I may say, ‘Hey, I remember you. You cried for just a second, but you opened your mouth and let me fix your cavity. Do you remember? You can do it again.’"

Praise is important for young children, Heima adds.

"I always make children succeed in my practice," he says. "Creating a success story is the most effective technique for overcoming dental fear."