Most of my patients experience anxiety, often debilitating and interfering with their ability to do the things they want and need to do in life. The National Institute of Mental Health estimates that 31% of adults in the United States will experience an anxiety disorder sometime in their lifetime and that 19% of the population had an anxiety disorder in the past year [1]. The Covid19 pandemic has only worsened this statistic with estimates that the prevalence of anxiety has more than tripled in the United States [2].  

My mental health practice in Northern New Mexico attracts clients seeking help to prepare for dreaded events: flying in an airplane, taking an exam, undergoing a medical procedure or giving a speech.   I’ve been surprised at the number of clients mentioning to me that the “dreaded event” is the dental chair.  In fact, 33% of the population report they experience moderate to severe dental anxiety [3].  Suffering for many of these people often begins before they even get to the dental office.  Difficulty sleeping, irritability, a racing heart-beat, feeling on edge, and being scared sometimes for days and weeks before an appointment is usual.  Many people only see the dentist for emergency care when the pain of not going is greater than the pain of going.  

I’ve been working with Dentists to give them more ways to support anxious patients using Active Anxiolytics. Accurate assessment is the first step and anxiety often has a “hidden face”.   Anxiety isn’t just a feeling, it’s a physiological response. We’ve all felt and seen the unmistakable signs of the mobilized fear response: sweaty palms, rapid heart rate, fidgeting movement, muscle tension, the eyebrows expressing concern, the “deer in the headlights” look. It’s hard to mask these overt signs of anxiety. But intense anxiety has another appearance, it can look quiet and still.  People may look extremely calm when their anxiety is intense.  This occurs when the body goes into the Freeze response.  The dominant characteristics of this state are immobilization and “shutting down” of systems such as little facial movement, halted digestion, slowed heart rate.  

I share much more about all this in my article “Dorsal Vagal Freeze: It’s Role in Dental Anxiety” and give you an effective technique to induce calm.  I’d love to hear how it works for you, not just for dental anxiety, but for all of those moments when fear shows up and you have to muster on.


[1] Anxiety and Depression Association of America. Managing Stress and Anxiety. February 2021.

[2] OECD. Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of- society response. May 2021.

[3] Silveira ER, et al. Estimated prevalence of dental fear in adults: A systematic review and meta-analysis. Journal of Dentistry. May 2021. doi: 10.1016/j.jdent.2021.103632


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