Afraid of the dentist? You’re not alone. In fact, an estimated 25 million Americans refuse to go to the dentist out of fear, according to the Academy of General Dentistry. But certain strategies, including sedation, relaxation techniques and cognitive behavior therapy, can help treat dentophobia and get you back in the chair before your teeth and gums start to show signs of neglect.

Why we’re afraid

In light of modern anesthesia, why are we so terrified of the person in the white coat who says, “open wide”?

The biggest cause of dental anxiety is the memory of an unpleasant dental experience, such as being strapped to a board as a child while getting fillings, according to an article in Community Dental Health.

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Some dentists say it may be anticipation of pain (rather than the pain itself) that keeps people away, combined with the loss of control and invasive nature of dental work.

"As a dentist, to treat you I have to get into your personal space," says Matthew Messina, DDS, a spokesperson for the American Dental Association. “I have to be closer to you than almost any other physician gets — at least while a patient is awake.”

Fear can lead to putting off dental visits — sometimes with serious consequences. Colin Yoshida, DDS, a Fremont, California dentist who practices holistic dentistry, recalls treating one patient whose teeth had deteriorated badly because he put off seeing a dentist for so long. “His imagination had run wild and he was fearing the worst,” he says. “This led to anxiety and more procrastination.” (When the patient finally came in, Yoshida used sedation and filled all his cavities over the course of two days. “The patient doesn’t remember shots or anything,” he says.)

Once you have a good or even a neutral experience with a dentist, Yoshida says, you may just turn the corner. “The funny thing is that after a few good experiences, a lot of these same people learn to have dental work again without the need for the sedation,” he says.

Related: 5 Times Never To Ignore Teeth Pain

Overcoming the phobia

So how can you get rid of your dental phobia and get yourself to the dentist? Here are some suggestions from Yoshida and other dentists who treat dental phobia.

Consider sedation. “For the severely phobic patient, generally the best solution is some sort of sedation,” says Yoshida. For a moderately phobic patient, nitrous oxide or "laughing gas" might be appropriate, he notes. And for the mild cases, he says, talking with the patient, using calming music and essential oils such as lavender could be enough.

Some dentists who treat patients with dental phobia, including Michael Krochak, DMD, of New York, prefer to avoid sedation due to the risk of side effects or a drug reaction. Instead, he focuses on developing a trusting relationship with his patients.

Try cognitive-behavioral therapy (CBT). A study published in November 2015 in the British medical journal BMJ found CBT could help many people with dental phobia accept dental treatment without sedation. CBT is a form of short-term psychological counseling that helps people reframe negative or inaccurate thinking.

Find a dentist who specializes in dental anxiety. You can find many dentists online who treat patients with dental phobia — people who are so nervous they hug the wall, refuse to sit down or even come in the office. These dentists treat people who may be more fearful than you, so you may feel more relaxed there.

Look for one who listens well. “The most important thing is to find a dentist who truly listens to your fears and communicates with you honestly,” Krochak says. “That dentist will work with you at a pace that you can handle.” As a patient experiences dental work that isn’t traumatic like his or her past experiences, he says, “you can become “desensitized” to those fears.

Learn about “no drill” dentistry. Consider laser dentistry, in which dentists use lasers to clean dental decay and (at least in the case of small to medium-sized cavities) don’t need to use drills or numbing shots. A recent study from the University of Sydney suggests drilling may be unnecessary if dentists catch the earliest signs of tooth decay and treat it with highly concentrated fluoride, good oral hygiene, dietary changes and regular monitoring. (Other dentists warn it can be difficult to get patients to comply with the changes they would need to make.)

Prepare yourself mentally. Once you’re in the chair, here are some other tips that may help you get through the treatment, courtesy of a study from dental researchers at the University of Gothenburg in Sweden.

  • Distract yourself. Count to yourself or play mental games that force you to think about something else.
  • Create some mental distance by telling yourself the pain feels like something else or pretend it’s happening to someone else.
  • Challenge yourself. Tell yourself to be strong, and it will be over soon.
  • Be optimistic. Tell yourself that everything will be OK after the dental treatment.
  • Pray. If you are religious, the Swedish scholars suggest with all seriousness that you “pray that the dental treatment will end soon.”

According to the British Dental Journal, dental researchers at the University of Gothenburg have also suggested that if you and your dentist can engage in some humor, you may feel a lot less stress during treatment.

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Luke James is a freelance writer and musician who writes about music, soccer, kids, pets and life with his family in northern California.