Anxious-PatientAs we all know the thought of visiting a dental office can cause anxiety for many of our patients. This anxiety can range from mild nervousness to extreme anxiety or phobia. The good news is that no matter what level of anxiety, if our patients make the commitment to seek treatment we can provide a positive experience for them.

When thinking about patients with anxiety I like to divide them into three groups: mild, moderate or severe anxiety. In this article I'll discuss the mild and moderate groups.


I refer to patients with mild anxiety as level one, and they make up the largest group. In my opinion nearly everyone walking through my door has at least some degree of anxiety. The good news is these patients are easy to manage. Typically these patients respond to a calm, comfortable and reassuring environment along with a clear understanding of what we will be doing prior to doing it. When it comes to treatment it's critical for our patients to have the knowledge that we are going to do whatever is needed to make certain they're comfortable. On the other hand, when it comes to managing the stress involved with exams one thing I like to do is meet my patients in a room other than a treatment room because it's less intimidating.

I refer to patients with moderate anxiety as level two. For this group I incorporate all the things I do for level one but I also add medication to help these patients relax. The three medications I use most often are nitrous oxide, diazepam and triazolam. Personally I find nitrous oxide to be most effective for those in the milder end of this spectrum and diazepam or triazolam for those at the more severe end. It's important to note that what I'm referring to here when using oral medications such as diazepam or triazolam are single or multiple doses that when combined do not exceed the recommended maximum single dose for that patient.

Additionally with diazepam or triazolam, it's necessary for the patient to have someone bring them to their appointment, take them home and take care of them following treatment. Last but not least, when using any medications it's critical that you adhere to the rules and regulations of the area in which you practice.

John R. Carson, DDS, PC, Spear Visiting Faculty and Contributing Author [ ]

If you found this article helpful, there are even more available to you in the new Spear Monthly Digest. In the recent issue you'll find an article by Dr. Kevin Kwiecien on how to deal with the stress and anxiety of the dental profession. If you're not yet a member of Spear, sign up now for a free Basic membership.


Commenter's Profile Image Jeffrey Siegel
June 3rd, 2014
Have you, or has anyone else you know tried NuCalm? And if so, how well is it working?