Dental anxiety in children is more common than most parents realise. Around 1 in 4 Australian children experiences some degree of dental anxiety, and around 1 in 10 experiences anxiety severe enough to interfere with getting the care they need. At Dentist Pymble, we see anxious children of all ages at our practice, and the right approach depends on the child, the cause, and the severity. This page covers why kids are scared of the dentist, how to prepare them, the techniques our team uses, and when sedation is the right answer.

Why are kids scared of the dentist?

The reasons vary by age and by child, but the most common are:

• Fear of the unknown — young children have not yet learned what to expect at the dentist, and the strange noises, smells, and equipment can be overwhelming.
• Previous bad experience — a painful or scary visit in the past is the single biggest predictor of ongoing dental anxiety.
• Parental anxiety — children are very good at picking up how their parents feel about the dentist, and visible anxiety (even unspoken) tends to transfer.
• Stories from others — well-meaning siblings, friends, or even parents who say “it won’t hurt” can plant the idea of pain in the first place.
• Sensory issues — children with autism, ADHD, or sensory processing differences can find the dental environment particularly challenging.

The cause matters because the approach depends on it. A child who has never been to the dentist needs gentle introduction. A child with a previous bad experience needs trust-building. A child with parental anxiety needs the parent supported too. A child with sensory issues needs a tailored approach.

How to prepare an anxious child

The preparation starts days or weeks before the visit, not the morning of. The most useful steps:

• Talk about the visit in advance — but keep it brief and positive. “We’re going to see the dentist, who is going to count your teeth and show you how to keep them clean.” Avoid detail that might trigger anxiety.
• Use books and shows — there are excellent children’s books and shows about visiting the dentist. Reading the same one multiple times in the days leading up to the visit can be very effective.
• Role play at home — let your child practice opening their mouth wide while you “count” their teeth with a toothbrush. Take turns being the dentist and the patient.
• Avoid threats — “if you don’t brush your teeth, the dentist will pull them out” is a guaranteed way to create a phobia. So is “if you’re not good, the dentist will give you a needle.”
• Stay calm yourself — if you are anxious about the dentist, work on your own anxiety before the visit. Children pick up on the things we try to hide.
• Schedule well — book at a time when your child is rested and not hungry. Avoid appointments that conflict with naps, meals, or other stressful parts of the day.

Tell-Show-Do and other techniques our team uses

The most widely used behaviour management technique in paediatric dentistry is Tell-Show-Do. The dentist tells the child what is going to happen (in child-friendly language), shows them the instruments, and then does the procedure. The predictability reduces anxiety because the child knows what is coming.

Other techniques our team uses:

• Voice control — a calm, friendly tone of voice (or sometimes a firmer one for older children who need clear boundaries) is surprisingly effective at managing behaviour.
• Positive reinforcement — praise for brave behaviour, small rewards at the end of the visit, and a focus on what went well rather than what was hard.
• Distraction — counting games, stories, music, or videos during the procedure can take the child’s attention away from what is happening.
• Protective stabilisation — for very young children who cannot hold still safely, gentle holding by the parent or a trained team member can keep the child safe during a quick procedure. Used sparingly and only when necessary.
• Modelling — for children with older siblings, having the sibling go first and demonstrate that the visit is no big deal is a powerful technique.

The right combination depends on the child, the procedure, and what works. Our team is experienced with all of these and will tailor the approach to your child’s specific needs.

When is sedation considered?

Sedation is considered when the conservative techniques above are not enough to allow safe, comfortable treatment. The options for children are:

• Happy gas (nitrous oxide) — a mild inhaled sedative that takes the edge off anxiety. Safe, well-established, and wears off quickly. The child remains awake and responsive but is much more relaxed. Suitable for most mildly to moderately anxious children.
• Oral sedation — a stronger sedative given by mouth before the appointment. The child is awake but drowsy, and the appointment can be done comfortably. Suitable for moderately anxious children.
• General anaesthesia — the child is fully asleep in a hospital day-stay setting, with the treatment done by a specialist paediatric dentist. Reserved for the most severe cases where the treatment needs are extensive and the anxiety cannot be managed any other way.

Our sedation and sleep dentistry service at the Pymble practice offers happy gas and oral sedation for suitable cases. For general anaesthesia, we refer to a specialist paediatric dentist who does the work in a day-stay hospital setting. The right answer depends on the child’s needs, the treatment required, and the parent’s preferences.

Choosing a kids’ dentist experienced with anxious children

The right kids’ dentist for an anxious child has a few key characteristics:

• Patient and unhurried — willing to take the time to build trust, even if it means the first visit is “just” a chat and a ride in the chair.
• Trained in behaviour management — including Tell-Show-Do, voice control, and positive reinforcement.
• Sedation options on-site — so the child can be managed in the same practice if needed, rather than being referred elsewhere.
• Good with parents — keeps the parent informed, welcomes questions, and acknowledges that the parent’s anxiety matters too.
• Not pushy — willing to stop and reschedule if the child is genuinely distressed, rather than pushing through and creating a long-term problem.

If you live in Pymble, Gordon, Turramurra, Wahroonga or anywhere else in the Ku-ring-gai area and you have a child who is anxious about the dentist, call our practice. We see neighbouring Gordon patients and other nearby families, and we will take the time to build trust before we do anything else.

Frequently asked questions

Is it normal for a child to be scared of the dentist? Yes, completely. Dental anxiety is one of the most common childhood anxieties, and most children experience some degree of it. The good news is that with the right approach, most children grow out of it and end up comfortable with dental care.

Will my child need sedation? Most anxious children do well with the conservative techniques alone, without any sedation. Sedation is considered when those techniques are not enough, and the right level of sedation depends on the child’s needs and the treatment required.

Is happy gas safe for children? Yes, happy gas (nitrous oxide) is one of the safest sedatives used in dentistry, with a long track record in paediatric care. It is well-tolerated, easily adjustable, and wears off quickly after the appointment.

Can I stay with my child during the visit? Yes, for younger children, having the parent present is reassuring. For older children or when sedation is used, the dentist may ask the parent to wait outside so the child can focus on the dental team. You will always be nearby, and we will come and get you if needed.

What if my child’s anxiety is too severe for any of this? For the small minority of children with severe dental anxiety that does not respond to any of the above, general anaesthesia in a day-stay hospital setting is the answer. The child is fully asleep, the treatment is done by a specialist, and there is no memory of the visit. We can refer you to a trusted specialist paediatric dentist for this.