Last Reviewed 22 May 2025
Authored by Dr Agata Kijowska, Founder & Principal Dentist, Calm Dental
The Psychology Behind Dental Anxiety:
8 Personality Traits That Shape
Fear and 8 Evidence-Based Ways to Stay Calm
Table of Contents
Introduction
Dental anxiety isn’t simply a fear of needles or drills. It’s a nervous system response – rooted in how we perceive safety, control, and trust (Porges, 2011). At Calm Dental, we meet patients who feel embarrassed about their fears, but the reality is that dental anxiety is a biologically valid reaction shaped by both personality and experience.
Understanding how the brain and body interpret the dental setting – as either safe or threatening – can help patients and clinicians work together more effectively. When the nervous system shifts into “fight-or-flight” mode, even routine procedures can feel unbearable. But the good news is that the nervous system is also responsive to calm, clarity, and predictability (Porges, 2003).
Let’s explore 8 psychological traits that influence whether someone feels anxious or safe at the dentist, and 8 strategies rooted in neurobiology and behavioural science that can reduce stress and increase comfort during appointments.
8 Personality Traits
That Increase Dental Anxiety (and Why)
1. Heightened Pain Sensitivity
Some people’s nervous systems are wired to experience physical sensations more intensely. Even the anticipation of discomfort activates brain regions like the anterior cingulate cortex and amygdala, which are involved in pain perception and emotional threat detection.
2. Strong Need for Control
Being in a reclined position, unable to speak clearly, while someone works inside your mouth, can feel deeply unsettling for individuals who value autonomy and control. This activates the sympathetic nervous system, triggering stress responses like rapid heartbeat, muscle tension, and hyper-alertness.
3. Catastrophic Thinking
People who tend to overthink or imagine worst-case scenarios activate their brain’s default mode network, which intensifies emotional distress (Kross et al., 2009). Their thoughts aren’t always rational – but the body responds as if the imagined threat is real.
4. Experience with Healthcare Professionals
Patients who’ve experienced rushed, dismissive, or painful healthcare encounters in the past may enter the dental setting with their HPA axis already on high alert (Heim and Nemeroff, 2001). Their nervous system interprets the clinical environment as potentially unsafe, regardless of the present-day reality.
5. Social or Sensory Sensitivity
Close contact, clinical smells, bright lights, and sharp sounds can overwhelm patients with high sensory processing sensitivity. Their brain doesn’t filter out background stimuli easily, making it hard to feel grounded or relaxed during treatment.
6. Fear of Judgement
Many patients delay care because they’re afraid of being criticised for the condition of their teeth. This triggers limbic system activity, particularly in the amygdala, where fear and shame responses originate. The emotional discomfort often outweighs physical concerns.
7. History of Medical or Dental Trauma
The body remembers trauma. Past painful or distressing dental experiences can leave imprints that re-emerge during future appointments. These reactions bypass conscious thought – they are reflexive, driven by the brainstem and limbic structures (Van der Kolk, 2014).
8. Highly Empathic or Sensitive Individuals
Empathic patients often absorb emotional energy from their surroundings. Neurologically, this is linked to greater activity in the anterior insula and mirror neuron system – brain regions involved in emotional resonance (Singer et al., 2004). In a dental context, this means they might mirror subtle stress signals from the environment, even if no one says a word. They may also find clinical stimuli (sounds, smells, facial expressions) more emotionally charged. These patients are not “difficult” – they are simply more tuned in, and therefore more easily overstimulated.
8 Traits
That Support Calm in the Dental Chair
1. Secure Attachment and Trusting Disposition
Patients who feel safe in relationships often extend that trust to healthcare providers. This lowers overall nervous system reactivity and supports ventral vagal engagement – the physiological state associated with calm and connection (Porges, 2011).
2. Use of Healthy Coping Tools
Those who practise mindfulness, breathing techniques, or reframing thoughts tend to have greater prefrontal cortex regulation – meaning they can downregulate fear responses when discomfort arises (Zeidan et al., 2011).
3. Routine-Oriented Personality
Patients who see dentistry as regular maintenance, not crisis response, are less likely to experience acute stress. Consistency trains the nervous system to treat dental visits as normal, not threatening.
4. Positive Early Experiences
A gentle childhood dentist can shape a lifetime of dental comfort. These early memories are stored in the hippocampus and can act as a buffer against future stress.
5. Low Sensory Reactivity
Some people’s brains naturally filter out background noise, bright lights, and physical sensations more easily. This reduces stimulus-driven arousal and makes treatment feel more neutral.
6. Clear and Assertive Communicators
Patients who can say “this worries me” or “can we take a break?” are engaging their executive function systems and reinforcing self-agency – a core factor in reducing fear.
7. Strong Sense of Agency
People who feel they are choosing treatment, not submitting to it, tend to stay more regulated. Autonomy boosts feelings of control and reduces amygdala reactivity.
8. Rational-Cognitive Orientation
Patients who trust the science of dentistry – and their provider’s expertise – tend to have lower emotional reactivity because their left prefrontal cortex helps balance limbic responses with logic and perspective.
8 Techniques
We Use to Support the Nervous System
1. Tell-Show-Do for Predictability
We explain everything before we start, show you the instruments gently, and only begin when you’re ready. This step-by-step method reduces uncertainty, helping your brain interpret the situation as safe rather than threatening.
2. Calming Environment and Gentle Communication
From the relaxed pace of our appointments to our choice of soothing music and language, we create a setting that supports nervous system regulation. A warm, calm tone of voice and a non-judgmental approach help patients feel emotionally grounded.
3. Longer Appointments When Needed
If you feel anxious, we offer longer slots so you never feel rushed. This extra time allows space for questions, pauses, and reassurance – giving your nervous system time to settle rather than react.
4. Consultation Before Treatment
If you are unsure about going ahead, we welcome you to book a consultation with no treatment involved. Just a conversation – a chance to ask questions, be heard, and feel safe before anything clinical happens. This is especially helpful for patients with past trauma or long-standing anxiety.
5. Hand Signal for Immediate Stop
You are in control throughout the appointment. We agree on a simple hand signal that lets you pause treatment at any time. This restores a sense of
agency – a key factor in calming the sympathetic nervous system.
6. Guided Breathing and Grounding Techniques
Our team can gently guide you through slow, paced breathing if you feel nervous. Even a few focused exhalations can help activate the vagus nerve, reduce heart rate, and shift your body from a fight-or-flight state into calm focus (Brown and Gerbarg, 2005).
7. Seeing the Same Dentist Every Time
Familiarity builds trust. When you see the same clinician at each visit, your nervous system doesn’t have to “start over” each time. That continuity creates
emotional safety and reduces anticipatory anxiety.
8. Gentle, Empathetic Style of Care
We treat every patient with kindness, patience, and respect – especially those who’ve delayed care due to fear. You’ll never be judged or rushed. Instead, we focus on creating a human connection that supports calmness and
cooperation.
Summary
Calm Dentistry Is Neuro-Informed Dentistry
At Calm Dental, we understand that dental anxiety isn’t irrational – it’s a nervous system response to uncertainty, vulnerability, or past experiences. That’s why everything we do is designed to signal safety: from how we speak and how we pace treatment, to the continuity of care and the calm, professional atmosphere we maintain.
This matters especially for patients who are sensitive, empathic, or easily
overwhelmed. We know these individuals don’t need “toughening up” – they need
consistency, kindness, and a space where their body can stop bracing for stress.
And that’s what we offer. Because we are calm by nature – not just in name – our patients feel it too. The tone we set, the way we listen, the time we take: it all adds up to an experience where even the most anxious patient can begin to feel safe again.
