Previous traumatic experience (dental or non-dental)
“Something about this setting really triggers me.”
What does it feel like?
For some people, dental anxiety is not just about discomfort or worry, it is connected to past experiences that felt overwhelming, frightening, or out of control. These experiences may have occurred in a dental setting, such as a painful procedure, feeling ignored, or being unable to stop treatment. In other cases, they may come from unrelated life events, including medical procedures or personal trauma.
When this type of fear is present, the response can feel intense and immediate. Patients may experience a surge of anxiety as soon as they enter the clinic, lie back in the chair, or hear certain sounds. Some describe feeling panicked, frozen, or disconnected from what is happening. Others may feel an urge to leave suddenly, even if they had intended to go through with the appointment.
Importantly, these reactions are not a sign of weakness or overreaction. They are the body’s natural protective response. The brain is trying to keep the person safe by reacting quickly to situations that feel similar to past experiences, even when the current situation is actually safe.
Why might it develop?
Trauma affects how the brain processes safety and threat. Experiences that felt overwhelming, particularly those involving pain, loss of control, or fear, can be stored in a way that makes them easily triggered later.
In a dental setting, there are many potential triggers: lying back in a chair, having limited ability to speak, unfamiliar sensations in the mouth, or sounds such as the drill. These sensory cues can activate the body’s stress response automatically.
Even if the original experience was not dental, similar elements (such as physical proximity, vulnerability, or lack of control) can trigger the same response. This is why some patients feel anxious in the dental chair without being able to fully explain why.
Dentists do not need to know the details of past trauma to practice trauma-informed care. It is more about creating an environment where the patient feels safe, respected, and in control.
How it affects dental avoidance
Patients with trauma-related dental anxiety may avoid care entirely or find it extremely difficult to attend appointments. Even when they do attend, they may feel overwhelmed quickly, sometimes needing to stop partway through.
Appointments may feel exhausting, both physically and emotionally. Some patients may cancel at the last minute or struggle to rebook after an incomplete visit.
This can lead to long gaps in care, which may increase the complexity of dental problems over time, further adding to anxiety.
What can help?
The most important approach is trauma-informed care. Dentists do not need to know the details of past trauma to practice trauma-informed care. It is more about creating an environment where the patient feels safe, respected, and in control.
Patients can help by sharing as much or as little as they feel comfortable about their experience. Even saying, “I’ve had difficult experiences in the past and may need things to go slowly,” can guide the dentist’s approach.
Dentists can support this by explaining each step, asking permission before proceeding, and allowing the patient to control pacing. Stop signals are particularly important, as they give immediate control back to the patient.
Starting with very small steps — such as a consultation or short visit — can help build confidence gradually. In some cases, working with a psychologist alongside dental care can be beneficial.
Recovery is not about forcing yourself through treatment. It is about rebuilding a sense of safety, one step at a time.
Dr Sharonne Zaks is an Australian dentist, educator and researcher recognised for pioneering the integration fo trauuma-informed principles into dentistry, with a particular focus on supporting trauma survivors. Her resources for survivors can be found at https://zaksdental.com.au/videos-for-survivors/.
Where to next?
