Dental anxiety causes 20 percent of Americans to return to the dentist only if absolutely necessary, according to the Dental Fears Research Clinic at the University of Washington. As a result, fearful patients have a higher risk of gum disease, tooth decay, early tooth loss and discolored or damaged teeth. Skipping regular dental check-ups can, in fact, cause serious health problems. To sooth nerves and reduce anxiety before your next dental visit, consider the following tips:

Talk to your dentist

Communicate honestly and openly with your dentist and share your concerns. Most dentists offer options to help calm your nerves by creating a comfortable environment. You and your dentist can also agree on a signal that tells your dentist “stop” while they are working on your teeth. You will feel more in control during the procedure and a little less anxious.

Try relaxation techniques

Taking a deep breath, holding it and gradually letting it out can slow down your heartbeat and relax your muscles. Progressive muscle relaxation, which involves tensing and relaxing different muscle groups, is another way to relax your mind and body

Stay distracted

While you are in the dentist’s chair, try to focus on something positive. Listen to soothing music or audio books simply by disconnecting with headphones. You can also plan a fun event for after your appointment to give yourself something to look forward to and keep your mind occupied.

Consider medication options

In cases of extreme anxiety, ask your dentist which sedatives are available and appropriate. Many dentists recommend a local anesthetic, nitrous oxide (“laughing gas”), oral sedatives or anti-anxiety medicine. If your dentist doesn’t offer these medications, ask what other options are available to help relieve stress.

Overcoming your fears of the dentist and getting regular check-ups can help avoid serious dental procedures in the future.