Communication Skills to Reduce Dental Anxiety

Confident explanations from dentists
and honest discussions about fears are needed

Dental phobia refers to the fear that commonly arises from a dread of dental treatment.

Professor Nadia Chechova Abramova of the Department of Dental Public Health at Sofia Medical University in Bulgaria wrote in a paper published in the Journal of Psychiatry: “Despite advances in modern medicine and clinical practice, many people still associate dental care with discomfort and pain,” noting that “dental phobia, anxiety, and psychological barriers lead patients to avoid treatment, which in turn reduces their quality of life in terms of oral health.”

According to a study published in the Journal of the American Dental Association, more than 72% of U.S. adults have experienced dental anxiety, and 27% reported severe anxiety.

The Seoul National University Hospital website also introduces a technique called “sedation.” This method uses medication to induce a state of reduced consciousness, with the goal of managing fear and anxiety related to dental treatment. The website explains that this improves patient cooperation and enables high-quality dental care. Laughing gas therapy, which is used for children, is also available at dental clinics. My own child has also received treatment at a dental clinic that uses laughing gas for procedures.

The U.S. magazine *Dental Economics* published an article by dental consultant Sharine Weiss in its July/August issue this year. The article discusses what dentists and other healthcare professionals say when patients are hesitant.

A common phrase that comes to mind is “Please contact us when you’re ready.” This means the patient should go home, make up their mind, and then call the dental clinic to schedule an appointment. However, Weiss pointed out that this approach cuts off communication between the medical staff and the patient.

At first glance, the phrase “Please call us” seems polite. It doesn’t come across as overly pushy about treatment; rather, it appears to present the need for treatment based on the dentist’s expertise while leaving the decision up to the patient.

Weiss pointed out that when patients hear this, they do not think, “That was a helpful and encouraging conversation.” Instead, he noted, patients tend to think things like, “I’ve escaped,” or “I’ll worry about that later.”

Dental care is very expensive in the United States. A crown procedure that costs between 300,000 and 500,000 won in Korea costs between 2 million and 3 million won in the U.S. Because of this, many American dentists tend to assume that patients hesitate to seek treatment due to cost concerns. However, the problem arises when patients hesitate to seek treatment for reasons other than cost—and this goes uncommunicated to the dentist. In one case identified by

Weiss, a patient reported that a previous experience at another dental office—where a nerve was accidentally touched during anesthesia for a crown procedure, causing severe pain—had triggered dental phobia. However, the patient did not mention this experience to their current dentist. From the perspective of a dentist who was confident in their anesthesia and treatment skills, this is a situation that leaves them “stumped.”

Furthermore, even if there are financial concerns, patients can explore options such as installment plans, credit card payments, or treatment limited to the minimum scope determined by the dentist, in consultation with the dentist and clinic staff. However, if patients simply avoid treatment altogether, the resulting pain and decline in quality of life will ultimately fall back on them.

Weiss advises dentists to review their list of unfinished treatments and focus on the patients’ motivations and concerns hidden within it. Rather than simply saying, “Yes, think about it,” he suggests showing curiosity about the patients. Similarly, instead of cutting off communication by telling a hesitant patient to “take your time,” he recommends leaving the door open for future discussion—for example, by asking, “Would it be okay if I called to check in next month?”

Weiss recommended using open-ended questions to identify patients’ concerns and motivations. For example, if a patient says, “I’ll discuss this with my spouse,” you could follow up with, “What questions do you think your spouse might ask, and what concerns you the most?” In response to the question, “How long do I have to wait?” you could say something like, “I’m curious why you’re waiting. Is there a reason you’re hesitating?”

Christina Pastan, a clinical assistant professor at Tufts University, points out that it is important for patients to share their fears about dental treatment with their dentist. According to the Tufts University blog, Pastan adds that through this communication process, dentists can effectively alleviate patients’ pain.

In addition, patients with a fear of injections can be asked to close their eyes before anesthesia is administered, and there are various dental techniques available to alleviate pain. Professor Pastan also pointed out that when a dentist explains the treatment plan with confidence, it can help patients feel at ease and build trust.

Of course, given the system in place at leading dental hospitals in Korea—where directors and consultation managers provide customized treatment schedules and financial assistance based on one-on-one communication and consultations with patients—such concerns in the United States may seem somewhat distant. However, it is worth reflecting on whether, in our own clinical practice, we might be jumping to conclusions by attributing patients’ hesitation solely to cost or a busy schedule.

Writer. Lee Hyun-taek
<A former newspaper reporter who worked for 18 years at JoongAng Ilbo>and <as well as Chosun Ilbo>. He is currently working as a freelance columnist and planning his second career. In addition to his work in journalism, he has experience working in the PR and marketing team at JTBC and at Edelman Global Advisory in the United States.