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Dental Anxiety Is Real. You're Not Being Dramatic. And We've Heard It All Before.
- John Barclay
- May 25
- 4 min read
By Dr John Barclay | DRJB Smile Clinic, Ruabon, North Wales
My mum used to cut my hair. I say "cut." It was more of an optimistic approximation. At some point — the details are hazy, possibly suppressed — she caught my ear with the scissors. I have blanked out the specifics. What I haven't blanked out is the feeling: slightly trapped, unable to move, someone behind me doing something I couldn't see or control, hoping it would be over soon.
I avoid the hairdresser to this day. Months go by. My hair becomes, in the words of my nurses, "a situation." Eventually I go. And every single time, I wonder why I put it off so long.
I'm a dentist. I understand, better than most, that avoidance makes things worse. I know the biology of it. I know the outcome data. And I still sit in the barber's chair counting down the seconds.
So when a patient tells me they've been putting off coming for three years — I'm not judging. I'm nodding.
How Common This Is
Dental anxiety affects somewhere between a third and a half of all adults in the UK to some degree. Severe dental phobia — the kind that means someone genuinely cannot attend regardless of how much pain they're in — affects around one in ten. These are not rare conditions. They are not weakness. They are a normal human response, often rooted in something that went badly at some point, often years ago, sometimes in childhood.
The thing about a bad early experience is that it doesn't stay in the past. It becomes the template. Every subsequent appointment is filtered through it — the anticipation shaped by the memory, the memory often worse than the reality ever was.
What We Actually Do Differently
We don't rush. That sounds simple. It turns out to be the single most important thing.
Anxious patients need time — time to ask questions, time to feel the environment, time to decide they're ready. We build it in. We will explain exactly what we are about to do before we do it, every time. Nothing happens without your agreement.
We use a stop signal — usually a raised hand — that means everything stops immediately. No "just one more second." Immediately. You are in control of this chair. That is not a slogan. It is how every appointment runs.
We also work with a dental operating microscope, which means we can be more precise with smaller instruments. Less intervention, done more carefully, causes less discomfort. For anxious patients — where every sensation is amplified by the anticipation of it — that matters more than it might seem.
The Things Patients Tell Us
That they feel stupid for being scared. That they know it's irrational. That a previous dentist told them to just relax.
None of that is helpful. Anxiety isn't a mindset problem you can talk yourself out of. It's a physiological response — real, physical, often involuntary. It needs managing with patience and structure, not dismissal.
We don't tell anxious patients to relax. We give them a reason to.
Getting Here in the First Place
If the hardest part is walking through the door, we can start before that. A phone call with no obligation. An email. A visit just to look around and meet the team before any treatment happens at all. Whatever makes the first step manageable is where we start.
There's no right way to begin. There's just beginning.
A Note on Avoidance
I understand avoidance. I've described my own version of it above, and mine has essentially no consequences beyond a bad haircut.
Dental avoidance has consequences. Problems that could be caught early become problems that require more to fix. Anxious patients often know this — they carry the weight of what's been building as an extra layer on top of the anxiety itself. The avoidance feeds the fear of what they might be told. The fear feeds the avoidance.
The only way out of that loop is a first step that goes well. We understand the pressure that puts on an appointment. We take it seriously.
Come and Have the Conversation
No drills on a first visit if you don't want them. No rush. No judgement. Just a conversation with a dentist who avoids his own hairdresser and fully understands why you've been avoiding us.
📞 01978 823490
References & Further Reading
1. Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Australian Dental Journal, 2013. → Comprehensive review of dental anxiety prevalence, aetiology and evidence-based management strategies.
2. Hmud R, Walsh LJ. Dental anxiety: causes, complications and management approaches. Journal of Minimum Intervention in Dentistry, 2009. → Covers the physiological basis of dental anxiety and the clinical communication strategies that reduce it.
3. Kirova DG et al. Dental anxiety — a review of associated factors and management. Journal of IMAB, 2019. → Supports the role of patient-centred communication, informed consent and stop signals in anxiety management.
4. Thomson WM et al. Changes in self-reported dental anxiety in New Zealand adults over 26 years. BMC Oral Health, 2018. → Longitudinal data on dental anxiety prevalence in adults; supports the claim that this affects a significant proportion of the population.
5. NHS England / Oral Health Foundation. Understanding dental phobia. Oral Health Foundation, 2022. → UK-specific prevalence data and patient-facing guidance supporting the one-in-ten severe phobia figure cited in this post.
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