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Decode Anxiety in the Dental chair: A Non-Verbal Guide for Dentists


When you were a child, you might remember a situation where you felt deeply anxious and didn’t want to be there at all. Still, your Mother insisted:

Your Mother: “It has to be done” or “It won’t hurt.”

You: “What?! It will hurt? Why me?!”

As we grow into adulthood, many childhood fears linger in our unconscious mind. Certain triggers can bring those feelings rushing back. Suddenly, the adult becomes a frightened child again, now overwhelmed by the fear of losing control, feeling judged about oral hygiene, or experiencing trypanophobia (fear of needles).


Recognizing the Signs of Dental Anxiety

Patients with dental anxiety often exhibit distinct non-verbal behaviors that reveal their discomfort before they even speak. Understanding and interpreting these behaviors can help dental professionals offer more sensitive and effective dental care.


There are 3 key categories of non-verbal communication that help "decode" a patient’s true feelings:




3 types of non - verbal communication

  • Facial Expressions

  • Body Language

  • Personal Space (Proxemics)


Facial Expressions

Common facial expressions indicating anxiety include:

  • Avoiding eye contact or constantly scanning the room

  • Biting lips

  • Swallowing frequently (a dry mouth is a common fear response)

  • Flaring nostrils

  • Widened eyes, especially when instruments are handled

  • Tightened jaw or clenched teeth

  • Forced or nervous smile, sometimes disappearing quickly.


Some anxious patients won’t open their eyes at all, during the consultation. They may sit down in the dental chair and immediately shut their eyes while nervously listing all their concerns (even non-dental ones), often without taking proper breaths. Others might breathe loudly and rapidly or swallow repeatedly during the examination, leading to dizziness and further stress.


Body Language

Anxious patients often show:

  • Stiff posture: Sitting rigidly or tightly in the dental chair

  • Tense shoulders: Often raised or hunched

  • Fidgeting: Tapping fingers, bouncing legs, playing with their hands or phone

  • Crossed arms or legs: A defensive, closed-off posture

  • Clenched fists or gripping the armrests tightly



These cues can often be observed even in the waiting room. As you walk the patient to the surgery for the first time, watch their movements. Are their steps slow or hesitant? Do they pause and scan the environment nervously? Are they rushing in silently, avoiding interaction? I once had a patient so nervous he didn’t even sit properly—he kneeled on the dental chair and rested his chin on the headrest.....


Personal Space (Proxemics)

Proxemics is the study of personal space and how people use it to feel safe and communicate. Depending on the situation, different distances feel appropriate. In a dental setting, where personal space is naturally invaded, it’s critical to respect boundaries, especially for anxious patients.

Start consultations with a respectful distance—about 1.5 meters—while speaking. Sit face-to-face, not hovering over them. Always ask permission before beginning any physical contact or examination. For example: “Would you mind lying back so I can take a look at your teeth, please?”


7 Basic Guidances for Dentists: How to Reduce Patient Nervousness

1. Recognize and Name It Gently

Validate the patient's feelings by saying: “I know the dentist can make a lot of people nervous, and that’s perfectly okay. We’ll go at your pace.”

Give them time to speak. If time runs short, offer at the beginning of the consultation a extra one instead of rushing.

2. Create a Calming Environment

  • Use soft lighting and gentle background music

  • Ask them what kind of music relaxes them

  • Keep sharp tools out of sight

  • Start by speaking in a normal chair before moving to the dental chair

3. Use Clear and Calming Communication

  • Speak slowly, using a calm tone (Chris Voss’s "late-night FM DJ voice")❤️

  • Use gentle phrasing: “This may feel a little cold” instead of “This might hurt”

  • Use the Tell-Show-Do method to prepare them for each step

4. Give the Patient Control

  • Offer a stop signal (e.g., raise a hand)

  • Remind them they can pause anytime

  • Always ask: “Is it okay if I start examining you now?”

5. Use Relaxation Techniques

  • Recommend deep breathing before the procedure

  • Provide stress balls or soft items to hold

  • Encourage them to use their own headphones and calming playlists

6. Minimise Wait Times

  • Bring anxious patients in on time to prevent prolonged stress

  • Use in-chair distractions like a ceiling-mounted screen with remote control

7. Follow-Up and Build Trust

  • After the appointment, say: “You did great today. I know it wasn’t easy.” or “The first step is always the hardest.”

  • Call or message them the next day to check how they’re feeling


Triggers to Watch For


Many dental anxiety cases are tied to specific triggers. Being aware of these helps in adapting your approach:

  • Sound of the drill

  • Smell of dental materials

  • Sight of needles or sharp tools

  • Feeling out of control

  • Previous traumatic experiences

  • Gag reflex sensitivity or claustrophobia


Why It Matter



Dental anxiety isn’t a personality flaw. It’s often rooted in real experiences or deep-seated fears. When dental professionals learn to read both spoken and unspoken signals, they build trust, reduce cancellations, and improve the quality of care.


Above all, it shows the patient: You see them. You hear them. And you’re here to help them heal—not just their teeth, but their confidence too.


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