"I can't face the chair"

For some things the fear is less about the news than about the experience. There's the dentist's chair and the sound of the drill. There's the speculum, the needle, or the scanner that feels like a tunnel. If this is your reason, you probably know it, and you may be a little ashamed of it. There's no need to be. Fear of dental treatment in particular is among the commonest fears there is.

It's also been studied well, and the findings help explain why it gets worse if you leave it. Jason Armfield, Judy Stewart and John Spencer surveyed a random sample of 6,112 Australians about their dental fear, their dental health and how they used dentists. They were testing the idea of a vicious cycle, and every link in it held up. People with more dental fear visited less often and waited longer between visits. They had worse oral health by their own account, and more need for treatment. When they did go, it was more likely to be because something hurt than for a check-up. About 29 per cent of the people who were very afraid of the dentist had delayed visiting, had poor oral health and only went when there was a problem. Among people with no fear, about 12 per cent had all three.

The cycle is easy to trace. Fear leads you to stay away, and staying away lets small problems grow into larger ones. Larger problems mean that when you're finally forced to go, because of pain, the visit involves more drilling, more injections and more discomfort than a check-up would have done. That experience confirms the fear, so you stay away longer next time. Someone who goes every year mostly has check-ups and the odd small filling, and their experience of the dentist is mild. If you go once in five years, in agony, you have root canals and extractions. Your fear is an accurate report of your own experience, and the avoidance is what made the experience so bad.

I can't promise that a check-up after four years will find nothing. But the cycle runs in both directions. One ordinary appointment, even if it leads to a filling or two, begins to replace the bad memories with a duller one. After that, check-ups at whatever interval the dentist suggests keep the work small. On that point, the NHS says the gap between check-ups can be anywhere from three months to two years, depending on the state of your teeth and gums. You may have assumed you're supposed to go every six months and have been failing for years. The standard you've been failing may not apply to you.

As for the appointment itself, the NHS advice is short and sensible. Tell your dental team that you're anxious, and they'll be able to help you feel more comfortable. That sentence does more than you'd think. A dentist who knows you're frightened will generally explain what's coming, go more slowly, and agree a signal you can give to stop. Much of the fear is about being helpless in the chair, and a stop signal takes that away. Nervous patients are a large share of any dentist's list, so you won't be the first that week.

The same approach works for other procedures. If you dread the smear test, say so to the nurse. They're used to it, and there are things that help. You can ask for a smaller instrument, a different position, a longer appointment so there's no rush, or a friend in the room. If it's needles, tell the person taking the blood. They'd much rather know than have you faint. You're allowed to ask for what would make it bearable. Nobody will think it precious of you, since an appointment that's bearable is one you'll come back for.

If the fear is severe, so that you can't even make the call without panic, it may be a phobia. Phobias respond well to treatment. A GP or the NHS talking therapies service can help, and some areas have dental services for very anxious patients. Getting help with the fear counts as getting the thing looked at.