How Dr. Henley Approaches Dental Anxiety
Treating anxious patients is nothing new to dentists. However, I have always been astonished by how much a patient’s anxiety affected me while treating them. Despite my best efforts, it is difficult to separate my anxiety from their’s when a patient is rude, short, squirming, or crying while under going treatment. I believe that part of our humanity is in our ability to be empathetic. Because of this I would imagine (and hope) that many clinicians feel their own anxiety as we treat scared and fearful patients. As dentists we need to have a strong understanding of what anxiety is, how a patient’s anxiety can affect us and the efficacy of our treatment, how it can affect our practice economically, and how it can impact our own stress level.
If the dentist makes you nervous, tell us when you call and again when you arrive. I'll explain what I'm going to do before I do it, we'll agree on a way for you to pause me at any point, and we'll plan treatment at a pace you can manage. You stay in control of the visit. I wrote about this for other dentists in 2016, and that article is reproduced below.
What can anxious patients expect at our office?
Your first visit is a conversation as much as an examination. New-patient visits are scheduled for two hours, normally an hour with me and an hour in hygiene, so there's time to talk about past experiences and what worries you before anything happens in your mouth.
During treatment I'll:
Tell you what each step involves and roughly how long it will take
Check in with you as we go
Stop when you signal, and start again only when you're ready
Explain the sensations you may feel, such as pressure or vibration, so they aren't a surprise
Anxiety causes real physical changes, like a racing heart or tense muscles. Those are normal reactions, and recognizing them for what they are often makes them easier to manage.
What can you ask for?
You can ask for any of these:
A stop signal. We'll agree on one before we start, such as raising your hand.
Breaks. Short pauses are fine during longer procedures.
A step-by-step explanation, or less detail if you'd rather not know.
Shorter appointments, with treatment spread over more visits where that's sensible.
Time to check that you're numb before any work begins.
Your own headphones and music if that helps you relax.
A conversation about medication to help you relax. Whether it's appropriate depends on your health, your medications and the treatment planned. We'll talk it through in advance, and it isn't the right choice for everyone.
It also helps to tell us what has gone badly before. A gag reflex, a hard time getting numb or a bad experience as a child are all useful to know.
Where can you start in Jacksonville?
Our office is at 3675 Hendricks Avenue, near San Marco. Read what to expect as a new patient, see how stress can affect your teeth and gums, or contact the office at 904-398-1549 and mention that you're nervous when you call. More of my writing is collected on Dr. Henley's published articles.
The original article (Today's FDA, 2016)
As published in Today's FDA, Vol. 28, No. 6, September/October 2016. Written for dentists.
Treating Anxious Patients
Treating anxious patients is nothing new to dentists. However, I have always been astonished by how much a patient's anxiety affected me while treating them. Despite my best efforts, it is difficult to separate my anxiety from theirs when a patient is rude, short, squirming, or crying while undergoing treatment. I believe that part of our humanity is in our ability to be empathetic. Because of this I would imagine (and hope) that many clinicians feel their own anxiety as we treat scared and fearful patients. As dentists we need to have a strong understanding of what anxiety is, how a patient's anxiety can affect us and the efficacy of our treatment, how it can affect our practice economically, and how it can impact our own stress level.
Anxiety is defined as a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. While anxiety is a normal and valuable emotion, with some dental patients, anxiety regarding dental procedures can become an excessive and persistent fear about routine procedures. As a result, many patients cope with this anxiety through avoidance behavior. Dental fear or phobia, that leads to avoidance of treatment, affects from 5-10 percent of the population. Avoidance behavior can increase cancelations of appointments, thus having a detrimental impact on production.
Nearly 60 percent of patients have moderate to severe anxiety about certain dental procedures, and perhaps more importantly, nearly all of the patients that proceeded with treatment had low anxiety. In order for patients to accept treatment they need to have little fear regarding the proposed treatment. This is essential to understanding case acceptance in practice. Assessing a patient's anxiety level can help dentists understand how to present treatment to patients in an appropriate manner. Likewise, managing a patient's anxiety can increase their trust and confidence in the practitioner. Trust and confidence in the dentist and his/her staff is critical. Patients that trust their dentist are more likely to be pleased with treatment regardless if there were any complications.
A study completed in 1981 investigated the effects of fear and anxiety on the productivity of dental practice. The findings showed that patients with significant fear required about 20 percent more chair time than low fear patients. The time required to prepare the teeth was basically the same for both groups, as measured by drilling time, but the fear group was shown to have more frequent interruptions during treatment. This additional time required to manage an anxious patient ultimately results in increased stress and anxiety for the dentist as our schedule gets behind and productivity drops.
Because we work in a field that involves so many anxious patients, it is imperative that we, as clinicians, spend time understanding how patient's anxiety can cause us to be anxious. Psychologists refer to this as mirroring. Mirroring is the behavior in which one person subconsciously imitates the gesture, speech pattern, or attitude of another. In most situations, mirroring is a beneficial reaction that can help people relate to one another in social situations. However, in the situation of a nervous or frustrated patient, mirroring can be disastrous. It can be difficult to overcome our "pre-programmed" need to mirror others.
It is paramount that dentists focus on their own stress level during treatment; failure to do so can contribute to the patient's anxiety. The inability to understand when a patient is suffering from severe anxiety before, during, or after treatment and failure to address the problem can allow the patient to incorrectly believe that chaos is about to unfold.
Two critical considerations must be addressed when treating patients with significant dental anxiety, these are:
Reminding patients that they are in control of the situation and/or symptoms.
Helping patients interpret their symptoms as nervousness, or a normal and explainable physiologic change that should be present.
Helping patients with significant dental anxiety develop cognitive-behavioral measures such as relaxation and cognitive-restructuring techniques can help reduce patient's anxiety to a manageable level. Reducing patient's anxiety level can reduce the anxiety level of the dentists and ultimately provide greater job satisfaction.
When we care about our patients and the quality of treatment we provide, dentistry can be both extremely rewarding and an extremely stressful profession. Steps should be taken to mitigate both the stress of the clinician and the stress of the patient as the emotional states of both parties can be interdependent. Taking the time to assess the anxiety level of patients and yourself can make a dental practice more productive, improve the satisfaction of patients, and improve your quality of life.
Sources
Henley CJ. Treating anxious patients. Today's FDA. 2016;28(6). Florida Dental Association. Reproduced here by the author.
About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.
Rally Round the Flagpole: A Book by Jacksonville Educator Donna Snively Hulsey
I believe that part of what makes our practice so amazing is our patients. I am always amazed by how much they accomplish. Most recently Donna Hulsey finished her first book, Rally Round the Flag Pole.
When Donna Snively Hulsey found out in July 1989 that she'd be the first principal of a state-of-the-art elementary school, she teamed up with the community and got to work.
It didn't matter that the school in Jacksonville, Florida, would not open until the fall of 1990: Before the first steel girder of Alimacani Elementary School was erected, the community began to spread a positive image of the school.
Within seven years of opening, the school was recognized as a National Blue Ribbon School and a National Safe and Drug-Free School, and accordingly was honored twice by the president of the United States at the White House.
Redbook magazine named Alimacani the top school in Florida for its "uncompromising commitment to excellence in school and community partnerships." Three Alimacani teachers were individually tapped as Duval Teacher of the Year, Florida Physical Education Teacher of the Year, and Florida Media Specialist of the Year.
Whether you're a parent, an educator wanting to fix problems at an existing school or establish a solid foundation at a new one, or a concerned citizen working on behalf of children, you'll find a blueprint for educational success in Rally Round the Flagpole.
Donna Snively Hulsey is an award-winning principal who has served America and its youth as a teacher, principal, and regional director in the Duval County Public Schools in Jacksonville, Florida. She has also taught undergraduate and graduate level courses. She has two children, five grandchildren, and lives in Jacksonville with her husband.
This post was first shared in September 2016 and updated in January 2026. We are glad to recognize Donna Snively Hulsey, a member of our Jacksonville community, for her book Rally Round the Flagpole, which describes how she and a community built a new elementary school around a shared vision.
What is the book about?
In July 1989, Donna was named the first principal of Alimacani Elementary in Jacksonville, more than a year before the school opened. Rather than wait for the building, she worked with families, teachers and neighbors to agree on what the school should be before construction was finished. The book tells the story of how the school took shape and what its early years were like.
It is written for parents, educators and community members who want to improve a school, whether they are starting a new one or renewing an existing one. Drawing on her experience, she lays out how clear leadership, a shared purpose and collaboration helped the school succeed.
About the author
Donna Snively Hulsey has served Duval County Public Schools as a teacher, principal and regional director, and has taught at the undergraduate and graduate levels. She lives in Jacksonville with her husband and has two children and five grandchildren.
Why we share stories like this
Our office is part of a neighborhood full of people doing good work. When someone in our community publishes a book like this, we are happy to help others find it. If you are interested in education, leadership or community building, we encourage you to read it.
To reach our office, please visit our contact page.
About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.
Sources
Amazon listing for Rally Round the Flagpole by Donna Snively Hulsey.