Dear Amy: Recently I have had a lot of dental issues to deal with. This is due to poor health care in my youth, as well as skipping some of my regular checkups during the pandemic.

I have a lot of fear going to the dentist, so the entire time I’m there, I am in somewhat of an anxious state. This can make some of the experiences (drilling, for instance) seem worse – because I am so tense.

I have a couple of questions. After my most recent visit, on the way out as I was paying my bill, the receptionist mentioned several additional “services” and treatments that the practice offered.

It seemed as if she was trying to pressure me to sign up for these extra things, even though my dentist had not suggested them.

Is this right?

I’m also wondering how to get back on track in order not to be so freaked out during my visits. I still have some work that needs to be done, and I’m already worrying about it.

Can you give me some advice?

— Worried

Dear Worried: Dental anxiety is common, and to some extent, perfectly rational. The important health care that dentists offer is invasive, noisy, and oftentimes uncomfortable or painful.

It is important to let your hygienist and dentist know that you are nervous.

They might offer you increased pain control and also agree on a signal during treatment if you would like them to stop and give you a breather (raising your arm, for instance).

Listening to music via earphones during treatment can help.

Some dentists will write a prescription for one dose of anti-anxiety medication to take before a bigger procedure, while others will offer sedation for some treatments.

Dentists know that anxiety or fear can keep patients from receiving important care and treatment, and this can negatively affect your overall health.

In terms of the receptionist “upselling” you on the way out — this is definitely something to mention to the dentist, because it is adding to your distress. If this dental practice doesn’t serve your needs well, you should research recommendations and consider switching.

You can email Amy Dickinson at [email protected] or send a letter to Ask Amy, P.O. Box 194, Freeville, NY 13068.