Dental anxiety is common, and for some people it is the reason a problem that could have been small has become large. Avoiding treatment rarely resolves anything, but telling someone that has never helped them walk through the door. What helps is knowing what options exist.
Dr. Jin-Ho Cho at Shine Dental Newington — BDS (University of Sydney, 1987), more than 35 years in practice — sees patients who have avoided dental care for years. This article sets out the approaches used to manage anxiety, so you can have an informed conversation rather than a vague one.
Start with what causes it
Anxiety is not one thing, and the useful response depends on the source.
Some people fear discomfort. Some fear loss of control, or not knowing what is happening. Some have a strong gag reflex and dread the sensation. Some had a bad experience years ago, often as a child, in an era when practice was different. Some are embarrassed about the state of their teeth and fear being judged.
That last one matters and is worth saying plainly: a dentist who has practised for decades has seen every state of neglect there is, and the job is to help rather than to comment. Embarrassment keeps more people away than pain does.
Identifying which of these applies to you changes what will actually help. Being told "it won't hurt" is useless if what you fear is not being in control.
Approaches that do not involve sedation
These are often underrated and are the foundation for everything else.
Explanation before action. Knowing what is about to happen, in what order, and how long it will take, reduces the anticipation that drives much of the anxiety.
An agreed stop signal. A raised hand that reliably stops the procedure restores a sense of control. It works because it is honoured.
Shorter appointments to begin with. A first visit that involves only looking and talking, with no treatment, is a legitimate way to start.
Local anaesthetic used well. Modern techniques include topical gel before the injection and slow delivery, both of which make a noticeable difference.
Breaks during longer procedures, arranged in advance rather than requested mid-treatment.
Our article on practical tips for nervous patients goes into these in more detail.
What sedation options exist in Australian dental practice?
Sedation covers a range, and the terms are often used loosely.
Oral sedation involves a prescribed medication taken before the appointment to reduce anxiety. You remain conscious. You cannot drive afterwards and need someone to accompany you.
Inhalation sedation, commonly called relative analgesia or nitrous oxide, is breathed through a nosepiece. It produces a relaxed state, works quickly and wears off quickly, and you remain awake and responsive throughout.
Intravenous sedation is administered by a suitably qualified practitioner, produces a deeper state of relaxation and usually little memory of the procedure. It requires specific monitoring, an escort home and a recovery period.
General anaesthetic means full unconsciousness, is delivered in a hospital or day surgery setting by an anaesthetist, and is reserved for particular circumstances.
Which of these is available depends on the practice and the practitioner's qualifications. Not every option is offered everywhere, and that is a reasonable question to ask when you enquire.
What determines whether sedation is appropriate?
It is a clinical decision, not simply a preference, and it depends on:
- Your medical history, including heart and respiratory conditions, sleep apnoea, and pregnancy.
- All medications you take, including over-the-counter products and supplements, some of which interact.
- The procedure planned and how long it will take.
- Whether you have someone to accompany you and appropriate arrangements afterwards.
- Your weight and airway, which affect suitability for deeper sedation.
Every form of sedation carries some risk. Deeper sedation carries more, which is why monitoring requirements increase with depth. Any recommendation should come with a clear explanation of what is involved and what the alternatives are.
What should I say when I book?
Say you are anxious. It is not an unusual thing to hear, and it changes how the appointment is arranged — the time allowed, the pace, and how much is attempted at the first visit.
It is also worth mentioning specifics: a strong gag reflex, difficulty with numbness in the past, a particular sound or sensation that troubles you. These are practical details that can be worked around when known in advance.
What about a first visit if it has been years?
A long gap is common and is not a reason to keep waiting. A first appointment can reasonably be limited to an examination and a conversation about what would be involved, with nothing done on the day. Knowing the situation, even when it is not good news, is usually less distressing than not knowing.
Our guide on what happens at a dental check-up sets out what an examination involves.
Being realistic
Sedation reduces anxiety during treatment. It does not remove the need for treatment, and it is not a substitute for a plan you understand and agree with. For many people, clear communication and an unhurried appointment achieve more than medication does.
Individual suitability varies, and any sedation requires an assessment of your medical history. Nothing in this article replaces that assessment.
Arranging an appointment
Consultations run in English or Korean. HICAPS on-the-spot claiming is available, and the practice is a CBHS and NIB preferred provider.
Call (02) 9748 4822, mobile 0430 442 018, or send an enquiry. If it helps, say in the message that you are nervous — it will be taken into account when the appointment is arranged.