If you have been putting off a dental appointment for a long time, the thing standing in the way is usually not the teeth. It is the appointment.
And the advice you normally get is useless. Relax. It is not that bad. You will be fine. None of that is information, and none of it changes anything, because being told not to be afraid has never once made anybody less afraid.
So here is what we can actually tell you, starting with the part most practices leave out.
What we do and do not offer
A lot of offices answer dental fear with sedation, so it is worth being precise about where we stand before you call.
- No nitrous oxide. We do not use laughing gas at all.
- Nobody gets put to sleep. No general anesthesia and no intravenous sedation here.
- Occasionally, an oral medication. For some patients we will prescribe triazolam or Xanax to take the edge off. That happens after a proper exam and a real conversation, not as an opening offer, and it is the exception rather than how we normally work.
Something you swallow before an appointment is a reasonable tool and we use it when it is genuinely the right call. It depends on your health history and your other medications, and it comes with practical conditions such as how you are getting home afterward, so it belongs in a discussion rather than in an arrangement made over the phone with somebody you have not met.
If nitrous or full sedation is specifically what you are looking for, you should find a practice that provides it rather than discover the gap after you have already worked up the nerve to book. That is a reasonable thing to want, and there are good offices in Las Vegas that do it.
Why we would rather you were awake
This is the part that usually gets left out of the conversation, and it is a clinical reason rather than a philosophical one.
We prefer our patients awake, because awake patients can tell us things. Whether that feels high. Whether the cold is hitting one spot. Whether the shape of a new tooth is right, whether it catches, whether you can say a word properly. Whether something hurts now, rather than after you have gone home.
That feedback is not a courtesy we collect at the end. It is part of how the work gets done accurately, and a sedated patient cannot give it. You cannot fit a bite to somebody who is not in a position to tell you how it meets, and you cannot adjust for a sensitivity nobody has mentioned yet.
It is the same reasoning we apply to much bigger cases. On a full-arch rebuild we deliberately fit the provisional teeth at a separate appointment the following day, once the anesthetic has worn off and you are alert, precisely so you can tell us how it feels and what you think of it. Fitting something you will wear for months to a patient who is still coming out of sedation is not how you get it right.
So the ordering above is not squeamishness about medication. It is that the appointment goes better when you are in it with us.
And there is a second reason, which matters over years rather than within one visit. A pill gets you through one appointment. It does nothing about the next one. If every visit requires being medicated first, the fear is still sitting there a year later, waiting. What we lead with instead is slower and less dramatic: we get to know you, we explain everything before it happens, and we work to make the experience as comfortable as we can. Trust is the thing that compounds.
The visit that exists for exactly this
Most people do not know this is available anywhere, and it is the single most useful thing on this page.
You can come in just to meet us. About fifteen minutes. Look at the office, meet the team, ask whatever you want to ask, and decide whether this is where you want your dental care to happen.
Nothing gets diagnosed. Nothing gets started. Nobody looks in your mouth unless you want them to. You leave knowing whether you want to come back, and that is the entire purpose of the visit.
For someone who has been avoiding this for years, that is an appointment with almost nothing in it to be afraid of. It is also the one that makes the real visit possible. Call 702-734-0776 and ask for a visit to come and meet us.
Fear is almost never general
People say they are afraid of the dentist. When you ask what specifically, the answer is usually precise, and it is usually one or two things rather than all of it.
That matters, because a specific fear can be addressed and a general one cannot. These are the ones we hear:
- Not being able to stop. Lying back with someone working in your mouth and no way to say wait. This is the most common one, and the easiest to solve.
- Not knowing what is happening. Sounds, instruments, and a conversation happening above your head that you are not part of.
- Pain, or the memory of it. Often from a specific appointment years ago that went badly.
- The needle. Frequently the whole fear, by itself, in someone who is otherwise fine.
- Gagging. Rarely taken seriously, and genuinely distressing. There is a section on it below.
- Being judged. For how long it has been, for what your teeth look like now, for what you have or have not been doing.
- What it is going to cost, and being talked into something you cannot afford.
- What they are going to find. Which is its own fear, and a rational one.
Tell us which ones are yours. Not as a courtesy – it changes how the appointment is run.
What you can ask for
This is the part nobody tells patients, so most people never ask. All of these are normal requests and none of them are an imposition.
- A signal that stops everything. Raise your hand and we stop. Not at a convenient moment. Immediately. Knowing you can stop is often enough that you never need to, and it only works because you are awake to use it.
- A running commentary, or none at all. Some people want to know exactly what is happening next. Others want to hear nothing and be left alone with their own thoughts. Both are fine, and we would rather be told which you are.
- No treatment at the first visit. You can come in, get examined, have it explained, and go home to think. Nothing has to be decided in the chair.
- To see it first. We photograph and scan everything, so you can look at your own teeth on a screen before anybody touches them. Being shown is different from being told.
- A morning appointment. Dread grows across a day. Most anxious patients do better at the start of one than at four in the afternoon.
- Shorter visits, more of them. Splitting work up is almost always possible. It costs some convenience and it is frequently worth it.
- To bring somebody with you. Entirely allowed, and more common than you would think.
- Your own headphones. The sound is a large part of it for a lot of people, and it is the easiest thing on this list to fix.
- To be told the cost before anything starts, and to say no to any part of it.
- To ask about medication, once we have examined you and talked it through. See the section above for what that does and does not mean here.
Notice what almost every one of those has in common. They return control to you. Most of what makes a dental appointment frightening is some version of not being in charge of it, which is why control is the thing worth asking for rather than reassurance.
If it has been years
Then you are the person this page was written for, and there are two things worth saying.
The first is that the gap itself is not the problem we are going to focus on. People stop going for ordinary reasons: a bad experience, a stretch with no money, a move, a year where everything else was louder. Then the longer it has been, the harder it gets to walk back in, partly because of what you imagine will be said about the gap. That is a real loop and it has been measured.
A birth cohort followed in southern Brazil found dental fear at age 31 in 22.1% of adults, and fear was more likely in people who had dental pain and more decay at fifteen, who had a worse decay trajectory over those sixteen years, who rated their own oral health poorly, and who had not visited a dentist in the last year. Fear leads to avoidance, avoidance leads to more disease, more disease makes the next visit more frightening.
Silveira ER, Cademartori MG, Schuch HS, et al. The vicious cycle of dental fear at age 31 in a birth cohort in Southern Brazil. Community Dent Oral Epidemiol. 2021;49(4):354-361. One cohort of 535 adults, observational, so it establishes the pattern rather than the direction of cause in any individual. We find it convincing because it matches what walks through the door.
The second thing is the more useful one. The thing you are imagining is usually worse than the thing you have. Not always, and we are not going to promise you otherwise. But a long gap very often produces a shorter list than the person expected, because the most common finding in a mouth nobody has looked at for a decade is still a set of teeth that are basically holding.
And where there is real work to do, you find out what it is and in what order, rather than carrying an unspecified dread around. A comprehensive exam produces a map, not a sales pitch, and most of what is on it is usually in the column marked stable.
You will not get a lecture
We want to be plain about this, because it is the fear people are least likely to admit to and the one that keeps them away longest.
Nobody here is going to tell you off. Not about how long it has been, not about what your teeth look like, not about flossing. We ask questions because the answers change the clinical picture, not to establish whether you have been good.
That applies to the things people are most embarrassed about. If you smoke, we ask because it changes how we read your gums and how often we want to see you, and that is the whole reason. If you have been vomiting, from illness or pregnancy or an eating disorder, that changes what we are looking at and what will protect it. If you have not been to a dentist since the nineties, that is a fact about your history, not a verdict on your character.
A patient who is being judged stops telling you things, and a dentist working without the real history is working with less information. Keeping the room safe to talk in is not kindness. It is how the diagnosis gets to be accurate.
If you gag
This gets dismissed constantly, and it is a legitimate reason to avoid a dental chair.
The traditional worst offender is the impression tray: a mouthful of material, held still, while it sets. We use a digital scanner for most of what used to need one. A small wand, no tray, no material, and you can stop and start as often as you need to. It is the single biggest improvement in comfort for anyone with a strong gag reflex, and it happens to be the same scan we take at every exam anyway.
We do still keep conventional impressions for the cases where a scan struggles, and there are a few where analog is genuinely easier. But for most people, most of the time, the thing you are dreading is not part of the appointment anymore. More on what we actually use.
Beyond that: sitting more upright, breathing through your nose rather than your mouth, working in shorter stretches, and being told before anything goes near the back of your mouth all help. If you cannot breathe through your nose, that is worth looking at in its own right, because it affects considerably more than this.
Money is part of this, and pretending otherwise is dishonest
For a lot of people, what gets described as dental anxiety is substantially a fear of being sold something. Of walking in with one problem and walking out with a five-figure plan and a finance application.
Three things about how this works here:
- You hear the cost before anything starts, and you can decline any part of it.
- Deciding to wait is a real decision, and we chart it as one. Sometimes the timing is wrong, and a patient who understands what is happening and chooses to wait has made a choice rather than a mistake.
- Large cases can be phased over years. Several of the transformations in our gallery were done exactly that way, stabilizing what was urgent first and rebuilding as budget allowed.
We are also not in any insurance network, which is worth knowing before you book rather than after. If your plan has out-of-network benefits, you still use them here and we file the claim for you. The full explanation is here, including how to find out in one phone call which kind of plan you have.
You are not unusual
A systematic review pooling nineteen studies and 9,267 adults worldwide put the prevalence of high dental anxiety at 18%. Roughly one in five, and that is the severe end rather than ordinary nervousness.
Lesna M, Gorna K, Kwiatek J. High dental anxiety among adults worldwide: a systematic review and meta-analysis using the MDAS. Br J Clin Psychol. 2026. The pooled estimate carries a 95% confidence interval of 10% to 30% and substantial heterogeneity between studies, so treat 18% as the middle of a wide range rather than a precise figure. The useful point survives either end of it.
Whatever the exact number, several people in any waiting room are managing the same thing you are, and most of them have not said so either.
Where to start
Smallest first step, in order of how little it asks of you:
- Call and ask questions without booking anything. 702-734-0776. You are allowed to do this, and you will not be pressured onto the schedule.
- Come in for the fifteen minute visit and meet us. Nothing gets diagnosed and nothing gets started.
- Book a real exam when you are ready, and tell us at the start which of the fears above are yours.
If you are in pain right now, that changes the order and you should call today. What to do in the first few minutes is here.
Our hours:
And if you would rather read about what a first appointment actually involves before speaking to anybody, that is written out in full.