6 Ways Anxious Patients Show Their Dentistry Fears

Dental Anxiety Shapes Patient Communication

I walk out to meet Julie, introduce myself and ask how are you? She let’s me know and continues on at a rapid pace, hardly taking a breath. After deflecting into a discussion about her teeth I then find her letting me know about every filling and every tooth. Julie is lovely yet Julie is anxious.

Everyday the majority of our patients are anxious. Sometimes they manage it without without letting their secret slip and other times they broadcast it wide and far. Yet most of the time the subtleties of their struggle can be easily missed.

6 Ways Patient Tell You They’re Anxious

  • Sometimes it’s obvious. Patients tell us directly, recount a bad experience or have obvious signs of anxiety such as tremour or sweating.
  • Overly talkative – Julie from before just won’t stop talking.
  • Excessively quite – in situations where it is hard to build rapport its likely they’ve put up some formidable walls due to their anxiety
  • Awkward moments – if you find your patient acts strange or says things out of place they’re stumbling on their anxiety
  • Answering the wrong question – Ever asked “how are you?” and they say “Thanks”. They’re usually preoccupied by their anxiety
  • Abrasive or rude – These patients are the ones that get under our skin. Often we’re frustrated by them or worse still, worried about the case because of their actions. Often the key is in your perception and understanding. Their emotions are running high and their defenses are up.

These all sound fairly obvious don’t they? Next time you’re in the office spend a day really analysing your patients behaviours. You’ll find the signs are particularly common.

Change your perspective and change their experience

“I hate dentists”. Sometimes they just tell you straight up. It’s a strange thing to say if you think about it. Not often do we walk into the mechanics workshop and tell them we hate them or let the plumber know how we feel even though it costs about as much. You’ll hear dentists whine about this “if I hear another patient say they hate dentists I’ll…” Is that really the best way to manage this? That perspective can only create anger and resent and is a sign of being worn down.

I try to manage it differently. I had three patients say something similar. “this isn’t my favourite place’ My usual response is “I’d be worried if it was!” which is my attempt to disarm them, use some humour and acknowledge their distress. Because let’s face it, they are anxious and not infrequently we’re about to give them bad news which most of the time would ideally require costly complex treatment. We give them the classic one two punch. One in the face and one in the wallet. And for most people the wallet hurts just as much.


The constant performance of being a dentist – part time psychologist? – can be tiring. However I think re-framing in your mind and changing your goals can be the ultimate win win for our patients.

Patients come in anxious. Especially new patients, those in pain or those who have had previous bad experiences. Their behaviour and communication often gives clues to this. That awkward guy is actually just emotionally preoccupied due to dental anxiety. She isn’t evil, she’s just scared.

Make helping your patient’s anxiety your goal

Go into your appointments with the goal of understanding their anxiety and making it your priority to help. You might not solve the issue and let’s face it, we’re still doing dentistry. However you can make it better. Acknowledging and checking in on your patient ensures they know you care.

Let them know they have control. Explain what you plan to do and how they can indicate a problem, a question or a break. Control makes most people feel more comfortable.

When communication isn’t enough

For some patients the anxiety can be overwhelming. Often these patients stay away until pain forces them to make an appointment. At this stage it is common to see multiple problems. For some of these patients anxiolytics may be necessary. At times i use relative analgesia (Nitrous oxide sedation) and in other situations a benzodiazepine is more appropriate (such as lorazepam). Yet the most potent anxiolytic in my opinion is good communication, rapport building and trust between your patient and yourself.

Challenge yourself to identify and be the support your anxious patient needs. 



David is a recent graduate dentist working in private practice in regional NSW, Australia. Read more at www.dentalheadstart.com/meet-david/

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