Patient Care

5 Common Behaviors of Anxious Patients

By Karen Willman, RDH on March, 9 2021
Karen Willman, RDH

Karen graduated from The Ohio State University with a B.S. in Dental Hygiene in 1992 and has worked as a clinical dental hygienist in the Columbus, OH area ever since. She strives to connect with patients and help them achieve their health goals. In her spare time, Karen enjoys cooking, traveling and spending time with her family and friends.

We’ve all been there, trapped in the operatory with someone who wants nothing more than to not be in the chair.

For us, it’s frustrating, tiring and demoralizing all at once. It can feel like a standoff at times. “I’m here to help you” we assure them, often to no avail.

The psychology behind why some patients feel like dental treatment is torture while others do not can stem from many different sources, and often from nowhere specific at all. I was finishing my last year of dental hygiene school when I discovered my own mother was one of “them.”

How had she kept it from me all of those years? Why was my mother dental-phobic? The answers were “because I never wanted you to be afraid like I am” (good parenting, thanks, Mom!) and “I’ve never been hurt or had a bad experience, I just don’t like it.” Mmmmkaaaay…

Do all patients who are anxious exhibit the same behaviors in the chair? I wish! Here is a list of just a few ways patients consciously and subconsciously make their anxiety known:

The Chatty Patient
This patient comes into the office and talks a mile a minute. They chat up the front office staff when they arrive, often never sitting down in the reception area. When we go to greet them, they are all smiles and positivity and keep that mask on during the whole appointment. The chatty patient is often masking their internal fear, monopolizing their appointment time and decreasing the time we are actually working in their mouths.

The Silent Patient
The silent patient is the one who comes in and appears to eternally be in a bad mood. They will often barely speak when spoken to and give one-word answers to our questions. By internalizing their fear, they approach an appointment with a “get it done and over with as quickly as possible” mentality.

The Defensive Player
How many times have you asked a patient to move their head toward you? How many times have you completed an appointment and felt like you just had a wrestling match with your patient’s lower lip, tongue, cheek and salivary glands? Say hello to the defensive player.

While many times these actions are not intentional or conscious on their part, this is a dental patient who is simply not comfortable in the chair. Oftentimes the patient playing defense will not admit to you or themselves that they are anxious, but their body tells us a different story.

The “Expert”
“Don’t floss under my bridge.”

“My front teeth have veneers; you have to be careful.”

“It’s normal for my gums to bleed, they always have.”

Meet the expert. This patient tells you how to do your job, lets you know that they already know everything you recommend, and is often very closed off to conversation. Dental anxiety comes in many forms and this one may be the most frustrating.

I would never tell my physician what tests to order or what medications to prescribe (I am not an MD) but that doesn’t stop the expert from letting you know just what they need and how it should be done. By feeling “in charge” they are able to cope with the loss of control they feel while in the chair.

The Lay-It-All-Out-There Patient
By far, this is the anxious patient I want in my chair. The “lay it all out there” patient knows they’re afraid, tells you they’re afraid, can give reasons why they are afraid and acknowledges maybe they shouldn’t be – but this is their reality.

I love it when patients tell me about their fears because it gives us the ability to address them and develop strategies for making them as comfortable as we can during their treatment. This is the patient who is most likely to overcome their dental anxiety if treated with understanding and given options to make them comfortable.

Why does this matter?
By being able to quickly identify an anxious patient, we are better able to treat them with sensitivity and understanding while performing their dental care. Will we be able to “convert” someone with dental anxiety? Maybe, maybe not. But if we’re aware that not all anxious patients present in the same way, we can do our best to alleviate fears and deliver quality dental care at the same time.


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