Many people report that their dental fear began after a traumatic, difficult, and/or painful dental experience. Dental fear may also develop as people hear about others' traumatic experiences or negative views of dentistry.

Treatments for dental fear often include a combination of behavioral and pharmacological techniques. Specialized dental fear clinics, use both psychologists and dentists to help people learn to manage and decrease their fear of dental treatment. The goal of these clinics is to provide individuals with the fear management skills necessary for them to receive regular dental care with a minimum of fear or anxiety. Although specialized clinics exist to help individuals manage and overcome their fear of dentistry, many dental providers outside of such clinics use similar behavioral and cognitive strategies to help patients reduce their fear.

Treatment
Behavioral treatments include teaching individuals relaxation techniques, such as diaphragmatic breathing and progressive muscle relaxation, as well as cognitive, or thought-based techniques, such as cognitive restructuring and guided imagery. Both relaxation and cognitive strategies have been shown to significantly reduce dental fear. One example of a behavioral technique is systematic desensitization, a method used in psychology to overcome phobias and other anxiety disorders. For example, for a patient who is fearful of dental injections, the therapist first teaches relaxation skills to the patient, then gradually introduces the feared object (in this case, the needle and/or syringe) to the patient, encouraging the patient to manage his/her fear using the relaxation skills previously taught.

Pharmacological techniques to manage dental fear range from mild sedation to general anesthesia, and are often used by dentists in conjunction with behavioral techniques. One common anxiety-reducing medication used in dentistry is nitrous oxide (also known as “laughing gas”), which is inhaled through a mask worn on the nose and causes feelings of relaxation and dissociation. Dentists may prescribe an oral sedative, such as a benzodiazepine like alprazolam (Xanax), diazepam (Valium), or triazolam (Halcion). While these sedatives may help people feel calmer and sometimes drowsy during dental treatment, patients are still conscious and able to communicate with the dental staff. Intravenous sedation uses benzodiazepines administered directly intravenously into a patient’s arm or hand. IV sedation is often referred to as “conscious sedation” as opposed to general anesthesia (GA), In IV sedation, patients breathe on their own while their breathing and heart rate are monitored. In GA, patients are more deeply sedated.

Careful use of such an approach will not only facilitate better tolerance for an individual appointment or procedure, but will enhance patients’ willingness and ability to participate enthusiastically in a lifetime of dental maintenance and care.