It’s helpful for many people who are fearful and anxious to know that they are not alone. It’s also important to realize that help is available. Actually, evidence has shown that even people who have extreme fear about dental procedures can conquer their fears and learn to have dental treatment in a manner that feels calm and safe. If you have been fearful for a long time, you may have difficulty believing this, but even people with long standing fear can be helped. Before I describe how it’s possible to get over dental fear, let’s first review some things about what makes people fearful. How do people become fearful of dental visits? No one is born being fearful of dental visits. So everyone who is fearful has learned somewhere that dental treatment is something to fear. Some people learn this because they’ve had previous bad dental experiences and some feel a sense of loss of control in the dental environment. And still, others may be fearful due to stories they have heard, movies they have seen or other indirect experiences. The message conveyed to a child from an anxious parent might be that going to see a dentist is something to be fearful of. Such messages may cause individuals to avoid treatment and not have any opportunity to learn that things can be different. Phobias can also be reinforced inadvertently. Think about it this way; try to remember a time when you were really fearful of something. Do you remember how your body felt? Was your heart beating quickly, palms sweaty, stomach in a knot? Those and other symptoms of being fearful are all unpleasant feelings. So, if someone who is already fearful forces themselves to go have dental treatment and re-experiences those same bad feelings during the appointment, then what they will remember afterward is those same unpleasant feelings. It doesn’t matter how friendly the dentist is or how pain free and pleasant the treatment is. What you remember is the feeling of being fearful, thus reinforcing the idea that there is something to be fearful of. In fact, dental fear begins at the subconscious level. People have what is called an automatic fear response. It has been described as “I feel like something just takes over and I begin to sweat and my stomach tightens up. I don’t really have any control over it.” Since this automatic fear response is subconscious, you can’t make it go away using logic or reason. Telling yourself that “there is nothing to be fearful of” won’t help. In fact, it might make things worse because it could sound like you are saying there is something wrong with you. So, how do we change this pattern of fear and reinforcement? Let’s find out. How can I feel safe and calm during a dental visit? Several methods have been used to assist people with phobias including dental visit phobia. The most effective are cognitive behavioral therapy (CBT), hypnotherapy, the use of antianxiety medications and on occasion sedation. To actually overcome the phobia, CBT and hypnotherapy are the best long-term methods. With these therapies you can actually train your brain to overcome the subconscious ingrained stimulus that is causing the phobia thus improving your mental health. Sedation allows the patient to have treatment but a fearful patient may never come to the office and it does not address the ingrained phobia. Antianxiety medications are useful on special occasions, but they can become a crutch and they do have addictive possibilities. Trained therapists in CBT and hypnotherapy who treat phobias are able to assist most phobic patients in just a few sessions. As I said earlier, it’s possible, even for those people who are the most fearful, to reduce their fear and to learn to have dental treatment in a way that feels calm and safe. Imagine being able to go to the dental office calm and peaceful know you will be in good hands and stay relaxed throughout the whole visit. Dental health professionals know that your mouth is a very personal place and trust is a big part of allowing us to partner in your care. Ask your dentist or physician about a referral to a CBT or hypnotherapy specialist. Your dental and mental health will benefit greatly. Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, he is on the faculty of Spear Education, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association. Dr. Gallegos practices dentistry in Middleburg, VA. www.MiddleburgSmiles.com.