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Most of what makes a dental appointment frightening is the feeling of having no control over it: lying down, mouth open, somebody working on a part of you that you cannot see, for a length of time nobody has told you.
Almost all of that is adjustable, and almost nobody knows it is. You can change how the appointment runs, and the changes are ordinary requests that dentists are asked for regularly — not favours, and not a confession.
Say it when you book
This is the single most useful thing on this page, and it is the one most people skip because it feels like making a fuss over the phone.
Telling the practice when the appointment is made is different from telling the dentist when you are already in the chair. In advance, it can change things:
- A longer appointment, so nothing is rushed and there is time to stop.
- A quieter time of day — often first thing, before a waiting room has filled up, or the last slot, when there is nobody after you.
- Starting with nothing being done. A first appointment can be a conversation and a look, with no treatment at all, so that the first time you meet the person is not also the first time they are drilling.
- A note on your record, so you do not have to explain it again every time.
On the day, in the chair, with the clock running and somebody waiting, none of that is available any more.
What to actually say
If the wording is the obstacle, this is enough:
"I find dental appointments difficult. Could you book me a bit longer, and make a note so I don’t have to explain each time?"
You do not need to give a reason, a history, or a diagnosis.
Agree a stop signal
Ask, before anything begins: if I raise my hand, will you stop?
The answer will be yes, and the asking matters more than the signal. The sensation most people describe as the worst part is not pain. It is being unable to speak and not knowing whether anything they did would be noticed. A signal that has been agreed out loud removes that, and you may never use it.
It is worth also agreeing what "stop" means — pause and let you sit up and rest, rather than abandon the appointment.
Ask to be told before, not during
There is a real difference between a running commentary and a warning.
"I’m going to put some cold water on now" before it happens is reassuring. The same sentence while it is happening is not, because the thing has already started. If you would rather know what is coming, say tell me before each bit, not while you’re doing it.
Some people want the opposite — no narration at all, headphones in, just get it done. That is equally valid and equally arrangeable. Say which you are.
Pain, and saying so
Two things worth knowing.
Being numb is checkable, and it should be checked. You should be asked, or tested, before anything starts. If you are not sure you are numb, say so before rather than finding out during.
Needing more anaesthetic is ordinary. Some teeth are harder to numb than others — a hot, acutely infected tooth genuinely resists local anaesthetic, and so do some lower back teeth in some people. It is not a sign of anything about you.
If you feel something sharp, raise your hand. Getting through it is the worst available option: it hurts now, and it makes you more frightened next time, which makes the next appointment harder to numb and harder to attend.
Bring someone, or bring something
- Someone with you in the waiting room, or in the surgery if you would rather. Ask when you book.
- Headphones. Most practices do not mind at all, and for a lot of people the noise is the whole problem — much of which is the suction rather than the drill.
- Something to do with your hands. It sounds trivial. It is not.
If it has been years
The fear of being told off is its own, separate thing, and for many people it is the bigger of the two.
If not knowing the sequence is part of it, the whole of a routine examination is set out step by step in what to expect at a dental check-up.
Worth saying plainly: a mouth that has been left for a decade is a common thing to see, not a shocking one. What a dentist is working out is what to do first, not how you got here. And you do not have to agree to everything, or anything, at a first appointment — "I’d like to think about it" is a complete answer.
If the amount that needs doing is the worry, ask for it in order of urgency. A long list is much less frightening once it is three things that matter now and five that can wait.
Sedation, and what it is not
For some people and some treatment, sedation is an option — usually inhalation sedation, or an injected sedative that leaves you awake but detached and remembering little.
Four honest points:
- It is not general anaesthetic. You are conscious and able to respond.
- It is not available everywhere, and availability, suitability and cost all vary. Whether it is appropriate depends on you, your medical history and what is being done.
- Anything beyond inhalation sedation needs somebody with you. For an injected sedative a responsible adult has to bring you and take you home, and you cannot drive, cycle, drink or make decisions that matter for the rest of the day. Without an escort the appointment cannot go ahead at all, so arrange it when you book rather than on the morning.
- Ask. It is a reasonable question and it will not be taken badly. Your dentist can tell you whether it applies in your case, or refer you to somebody who provides it.
What this page cannot tell you is whether it is right for you. That needs somebody who can examine you and read your medical history.
