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Managing Dental Anxiety

Our thoughts can set off a cascade of neurotransmitters that lead to physical symptoms.

Some of our patients experience anxiety when presenting for a dental appointment. For a few of them, it is the memory of a bad childhood dental experience. For others it is fear of the unknown or a loss of control. Whatever the reason, the mental anxiety they experience results in physical symptoms that are very real.

Thoughts are very powerful, and by visualizing untoward events, we can actually initiate a cascade of neurotransmitter activity within our bodies. When worrying about a potential threat, our breathing becomes more rapid, our heart rate quickens, and our adrenal glands dump adrenaline and cortisol into our system. All of a sudden, we are in fight-or-flight mode.  

The body is responding to a perceived threat by increasing its oxygen intake in order to direct energy to the muscles and extremities. In a real-life situation, this allows us to either face the threat head-on or quickly remove ourselves from the situation. The problem is, our body doesn’t know that the threat was conjured up by our imagination. It is simply providing an adequate response to the perceived threat.

Take Control

The Navy SEALs, law enforcement officers, and others who are frequently in high-stress situations use a scientifically-proven method to mitigate the fight/flight response. It is a simple technique that will re-set the runaway nervous system, and can be done anytime, anywhere. The method is called box breathing, and is also known as four-square breathing. By consciously taking control of our breathing, we signal to our body that the threat has passed and our situation has returned to normal.


  • Take a long, slow deep breath into the belly over four counts.
  • When you reach the apex of the breath, hold for four counts.
  • Release the breath over four counts.
  • When you reach the bottom of the breath, hold for four counts.

Repeat this procedure 5-6 times or until you feel more relaxed.

See it, Speak it

It is also helpful to feed your mind with positive imagery. Visualizing your “happy place”, such as a beach or mountaintop, or playing with your children and pets can release endorphins that make you feel happy. You may also think back to a time when you conquered a personal obstacle. The purpose is to replace the mental image that is causing you anxiety with one that shows you in a more pleasing spot.

Additionally, using a positive vocabulary changes your mental state. Instead of saying “I can’t do this”, declare to yourself that “I’ve got this!” Instead of repeating “I can’t wait for this to be over”, state that “When this is over I will be healthier. I am taking control of my well-being.” This, again, is a method in which you control your thoughts rather than letting them control you. Just as your body responded to your thoughts of a perceived threat, it will now respond to the stimuli you provide for it, leading to a calmer state.

Music Soothes

Finally, listening to your favorite music instantly takes you to another level. Our musical touchstones take us to specific times in our lives and set up particular mood states. Feel free to bring your headphones with you and access your favorite music on Spotify or iTunes while in our office.

Dr. G in one of his happy places discussing dental anxiety.
Michael D. Gillespie, DDS

Michael D. Gillespie, DDS