The Calm Approach to Extractions — and Why Nervous Patients Get Sent to Me

Say the word “extraction” and you’ll see a lot of people flinch. For many patients it’s the procedure that puts shivers up their spine, the one they’ve been dreading and putting off. So it might seem odd that it’s some of my favourite work — and that at BDS, I’m the one the other dentists tend to send their most anxious patients to. In this piece I want to explain why, because the reasons say a lot about how I think good dentistry should feel.

This is the fourth piece in my BDS Dental series.

Where my extraction skills come from

First, a word on the technical side, because confidence in the dentist is itself reassuring. After I graduated, I spent a year in hospital doing maxillofacial surgery, and that’s where I really developed my extraction skills. That grounding means that when I take a tooth out, I’m doing it from a place of genuine surgical experience, not occasional practice. Patients can often sense that steadiness, and it helps.

But honestly, the bigger reason nervous patients end up with me isn’t only technique. It’s temperament.

Why the anxious patients come to me

Of the dentists at BDS, I’m probably the calmest — and that’s exactly why my colleagues refer the patients who are very on edge to me. Outside of work I’m a go-go-go sort of person, but the moment I’m in the surgery, I slow right down. I’m relaxed, and I think patients feel that. Calm is contagious in both directions, and I try to make sure it travels the right way.

A lot of how I keep someone at ease is simply chairside manner. I’ll find something to distract a nervous patient with — usually just a genuine conversation. I keep notes so that next time I can pick up a topic we talked about before, or find some common interest. It sounds small, but feeling known rather than processed makes an enormous difference to someone who’s frightened. I’m quite warm and, I’m told, quite motherly — I see a lot of families and children here — and I think that puts people at ease.

The luxury of time

Here’s the thing that, more than anything, lets me do extractions gently: time. I book a full hour for my extractions. Not because every extraction takes an hour, but because I want to know I have that time and never feel rushed.

That hour buys two things. First, it means I can make absolutely sure you’re fully numb before I even start — no beginning until I’m certain you can’t feel what you shouldn’t. Rushing the anaesthetic is where a lot of unpleasant experiences come from, and I simply don’t do it. Second, it lets me go slowly and gently throughout, at a pace that suits you rather than the clock. That ability to take my time is one of the real luxuries of working in a private practice, and I use it deliberately for exactly these patients.

Consent that calms rather than scares

You might think that explaining everything that could go wrong would make a nervous patient more frightened. I’ve found the opposite, as long as it’s done right.

My consent process for extractions is very thorough. From the start, I talk you through what’s involved and what the risks are — but I do it in a calm, measured way. Yes, some of the risks can sound daunting when you hear them listed out. But hearing them explained gently, by someone who is clearly unhurried and unworried, is reassuring rather than alarming. It tells you that I know exactly what I’m doing, that there are no surprises coming, and that you’re in careful hands. Being properly informed, it turns out, is one of the things that calms people down the most.

What I want you to feel

When a patient leaves my chair, the two things I most want them to feel are well-informed and that they’ve had value for money. Those might sound like modest goals, but together they describe an experience where you understood everything that happened to you, nothing was rushed or hidden, and you were genuinely cared for. I work very closely with my nurse, and I think patients can see that teamwork — we get lovely comments on it.

Modern dentistry really can make extractions calm and essentially pain-free, especially when the dentist refuses to hurry. If you’ve been dreading having a tooth out, or you’ve been quietly putting it off, I’d gently encourage you not to let the fear grow. It’s almost never as bad as the version you’ve built up in your head — and a calm, unhurried appointment is exactly the kind of thing we can offer.

In the final piece of this series, I want to step back and talk about the philosophy underneath all of this — knowing when to treat and when to simply watch, and what I think the biggest misconception about modern dentistry really is.

Dr Reem Al-Kufaishi is a general dentist at BDS Dental, known for her calm chairside manner with anxious patients. To book with her, contact the practice here.