The Fear Paradox: Why Dentists Need to
- Filo Insstitute
- Nov 17, 2025
- 7 min read
Dentists frequently struggle with fear and anxiety, which affects both their personal and professional decisions. Anxiety is typically more prolonged, ambiguous, and future-focused than fear, which is an instantaneous, instinctive reaction to obvious threats. These feelings can influence everything in dentistry, including patient communication and treatment decisions. Dentists can better control these emotions by being aware of the distinctions between fear and anxiety as well as how these emotions are deeply wired in the human brain. This article examines the nature of anxiety and fear, how they appear in dental practice, and how awareness can promote professional confidence, personal development, and better patient care.
Carl Jung once said, "What you resist not only persists but will grow in size." Ignoring, denying, or burying fear deep within ourselves doesn't make it go away; instead, it intensifies and shapes our decisions and relationships with other people.
Understanding Fear and Anxiety in Dentistry
Fear: basic emotional response to an immediate, known, and definite threat. It is typically short-lived and prompts a “fight or flight” response to danger. Fear is often associated with specific cues or situations and activates defensive behaviors.
Here are some examples (later discuss them in more detail):
Fear of Failure: A dentist hesitates to take on complex procedures, worried about making mistakes that could harm the patient or damage their reputation.
Fear of Rejection: A dentist avoids suggesting advanced treatments to patients fearing the proposal might be refused, potentially affecting their confidence and income.
Fear of Not Being Good Enough: New dentists struggle with imposter syndrome, doubting their skills despite positive feedback, leading to stress and burnout
Anxiety: future-oriented mood state characterised by apprehension and worry about potential or vague threats. It could be prolonged, more diffuse, and cannot link to specific stimuli than fear.
If the anxiety becomes a persistent and constant condition it could lead to anxiety disorders such as generlised anxiety disorder, panic disorder, social anxiety disorder, and various phobia-related disorders, which sometimes lead patients to take medication or provide treatment under certain sedation.
Understanding Fear Through the Brain: A Dentist’s Perspective
Fear isn’t just a feeling—it’s deeply wired in our brains, shaped by millions of years of evolution. Knowing how this works can help dentists understand their fears and those of their patients, leading to better-coping strategies and care.
1. The Reptile Brain (Brainstem): This is the oldest part of our brain, shared with reptiles. It controls basic survival instincts like fight, flight, or freeze. It reacts instantly to danger but can’t think or reason.
2. The Mammalian Brain (Limbic System & Amygdala): This includes the amygdala, the emotional center that stores memories of threats and triggers stress hormones like cortisol and adrenaline. Originally developed to help ancient humans survive physical threats like predators, today it still reacts strongly to perceived dangers—even if those dangers are psychological.
3. The Neocortex (Thinking Brain): This is the newest and most evolved brain part. It allows us to think, reflect, evaluate risks, and make conscious decisions—like deciding to stay calm instead of reacting aggressively.
How Fear Shows Up in Dental Life
Imagine you are driving to work and “someone cuts you off”. Your reptile brain wants to shout or react immediately. But your neocortex has about half a second to step in, calm the reptile brain, and help you make a better choice like taking a deep breath instead of yelling (and hitting the brake). The same happens in dentistry when we are under pressure. That brief moment of awareness can prevent making mistakes or promising something without carefully considering the implications or feasibility.
The Neurobiology of Fear in Dentists
Dentists face many fears which usually learn early in their lives, often unconsciously, through childhood experiences with parents, teachers, or social expectations. For example, if a dentist’s father was afraid of taking risks, that fear might be quietly inherited in the subconscious, limiting his children’s willingness to innovate or take professional risks.
Dental Examples of Brain-Based Fear
Dentist feels sudden anxiety when a patient shows signs of rejection or dissatisfaction, triggering an amygdala-driven stress response.
During an emergency, a dentist’s reptile brain triggers fight-or-flight when something does not according to the planned path, but training and awareness allow the neocortex to take back control of the situation.
Fear of public speaking, during dental conferences or exams, activates stress hormones and starts shaking
Most fears live “underwater,” hidden in the subconscious. But you can bring them to the surface through awareness and inner work. Recognising that you are not your parents or teachers, you can choose your path and responses.
Dropping the Mask: How Facing Fear Transforms Dentists and Builds Authentic Connections
Many of us wear social masks to appear confident or superior, hiding the vulnerability beneath. Patients, for example, may hesitate to share their true struggles out of fear of judgment (such as their financial problems, and their fear of losing control). For example, freshly graduated dentists try to hide their insecurity and lack of experience in front of the patient by over-apologising, constantly seeking reassurance, and being overly critical of themselves. But the moment one person dares to be real, to drop the mask, something powerful happens. It invites the other to do the same. Then, instead of two people hiding, you become two human beings connecting through honesty and authenticity. For example, if you start working as a dentist for the first time, explain your treatment proposal in which you are confident to the patient such as the procedure, pros and cons of the treatment (try to use less clinical expression and more everyday language) and give yourself enough time for the treatment in advance. If you are not sure about the treatment let the patient know like “because of the complexity” of the treatment you might involve your mentor or you refer to a more advanced dentist and you will assist during their treatment.
Fear is often the doorway to our greatest growth. It shows up when we stand at the edge of the next level of life. It could be the relationships, careers, or personal healing. It’s like realising you’re at the bottom of a mountain you must climb it. At first, the mountain looks impossible. But each step up builds strength, awareness, and confidence. Then you see: fear was not the enemy, it was your guide. The real danger isn’t the fear - it’s letting the fear own you.
Many of us build our entire lives around avoiding the “monster” of fear. Let’s call it a mental construct we treat as real, a kind of hallucination our minds create to protect us from imagined threats. But when we stop running and start turning toward fear, something transformative happens. The “monster” shrinks. By confronting fear whether it's a hard conversation with the practice manager or with the patient, a complex treatment plan that you need to explain the next day, or simply being honest with yourself we begin to reclaim our power. Each time we face it, we spiral upward into a higher, freer version of ourselves.
So how do we get to know our fears? Through awareness. With better awareness comes better choices. And better choices lead to better results (Robin Sharma). When we stop seeing fear as a stop sign and start treating it as a teacher, we open the door to deep transformation and authentic growth.
Personal story
Let me give you a personal story. I remember early in my career as a dental student back in Hungary, there was my first procedure in a dental practice in a non-university setting (summer work experience in dental practices during the summer) that filled me with anxiety: surgical extractions.
It wasn’t the technical part, I had the training and I had my mentor as well. It was the fear of what if something goes wrong. What if I make a mistake, like causing an oroantral communication (OAC) or maxillary tuberosity fracture, or breaking the tooth on the apical third? That fear sat heavily on me, quietly shaping my choices. I’d refer certain cases out, even when I was perfectly capable. I justified it as a caution, but the truth was—I was afraid.
One day, one of my mentor’s neighbors came to the clinic needing a surgical extraction and my mentor suggested doing it. The patient trusted me at first sight, looked me in the eye, and said, “I want you to do it.” I paused. Every part of me wanted to find a reason to refer her back to my mentor. But something shifted. I thought: If I keep running from this, I’ll never grow. I took a deep breath, and acknowledged the fear—but didn’t let it lead.
The procedure went smoothly. Not perfectly, but well under the guidance of my mentor. And when it was done, I felt relief and pride (taking pictures of my victory). I had walked through the fear, and it didn’t own me anymore.
That experience taught me something bigger: fear doesn’t mean stop. It often just means, “Here’s your next level.” I realised fear had been my teacher all along - not something to run from, but something to walk with.
Summary
Although fear is an unavoidable aspect of the dental field, it need not be a barrier. We can start to identify and bravely confront our fears by understanding their nature, whether these fears are in the emotional amygdala, the rational neocortex, or the survival instincts of the reptilian brain. Growth, connection, and professional confidence can be attained by embracing vulnerability, removing social masks, and seeing fear as a guide rather than an enemy. Our experience with fear can change us as dentists, giving us the courage to take on new tasks, develop genuine connections with patients, and keep moving forward to achieve greater personal and professional success. Keep in mind that fear frequently signals that it's time to move forward rather than stop.
Next article: After recognising those fears, the next crucial stage is to understand how they show up in everyday practice as we work through the Facing the Fear: Why Dentists Struggle and How to Identify 10 Types of Fear
References:
Diagnostic and Statistical Manual of Mental Disorders (5th ed.) - American Psychiatric Association, 2013
Sapolsky, R. M. (2004). Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping.
Jung, C.G. (1959). Aion: Researches into the Phenomenology of the Self.
Goleman, D. (1995). Emotional Intelligence: Why It Can Matter More Than IQ.
Marcinowicz, L., et al. (2013). Stress and anxiety in dentists: A review. International Journal of Occupational Medicine and Environmental Health.
