Many people are hesitant to visit the dentist for a variety of reasons, such as concerns about the pain that may be involved. For many patients, needles (as well as needle size) in particular may invoke a great deal of anxiety. However, in a study from the May/June 2007 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal, researchers found that there was no difference in pain perception regarding the size of the needle used to inject anesthesia, which helps to make patients comfortable during dental procedures.

One of the study's authors, Michael J. Wahl, DDS, says that there was no difference in the pain that patients perceived when using larger-diameter (wider) needles. "Many assume that small diameter needles (and therefore smaller puncture wounds)mean less injection pain—but that's not what we found. For perceived injection pain, size doesn't matter."

•  Avoid caffeine before a dental appointment.
•  Eat high-protein foods, which produce a calming effect, unlike sugary foods.
•  During the procedure, focus on breathing regularly and slowly. When you are nervous you tend to hold your breath, which    decreases oxygen levels and further increases feelings of panic.
•  Talk to the dentist about specific fears and concerns. He or she can go a long way to dispel any negative or frightening images.

However, Gene Antenucci, DDS, FAGD, and an AGD spokesperson, feels that patients become fearful when they see the needle. "Often times, when a patient sees a needle coming, the pain perception is heightened," he says. However, dentists can do a number of things to make a patient feel comfortable. "To ease their fears, it often helps to focus on relaxing by breathing regularly and slowly. Patients can also use hand signals to indicate when they are uncomfortable."

No matter the gauge of the needle, the most important factor in overcoming dental anxiety is a good dentist/patient relationship. "Dental anxiety is a real condition," Dr. Antenucci says. "I encourage my patients to speak to me about their concerns. If I am aware of their fears, I will work with them."