Stressors like work pressures, family illness, relationship conflicts, financial struggles, traffic congestion, and even dental appointments can trigger an acute stress response. Our primitive brain reacts to all triggers without discrimination as if our lives were in danger.

During an acute stress response, two parallel pathways are activated, the sympathetic adreno-medullary (SAM) arm of the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal axis (HPA axis). Both systems can be triggered in a bottom-up manner from the brainstem by critical homeostatic perturbations, like respiratory distress, pain or inflammation. They can also be triggered in a top-down fashion from the limbic system, particularly from the amygdala, by psychogenic stressors, either innate or experiential. The SAM responds almost immediately, whereas the HPA axis responds a little slower. Activation of the SAM releases epinephrine/adrenaline from the medulla of the adrenal glands. As epinephrine circulates through the body, respiratory and heart rate accelerates and blood pressure increases to maximize the delivery of oxygenated blood to vital organs. Additionally, it causes sight, hearing, and other senses to sharpen. However, this immediate ANS response is short lived and the HPA axis is required to trigger a series of hormonal signals to maintain this state of hyper-alertness. The hypothalamus releases corticotropin-releasing factor (CRF), which signals the anterior pituitary gland, to release adrenocorticotropic hormone (ACTH). This hormone travels to the adrenal glands, prompting them to release cortisol, the well-known stress hormone. The release of cortisol can increase the production of epinephrine, as well as, trigger the glucose release from protein stores to supply the body with energy.

All of these changes happen so quickly that people are not aware of them. In fact, the process is so efficient that it occurs in milliseconds – before the neocortex knows what is happening. For dentists, this hijack manifests as gagging, excessive salivary flow, aggressive tongue movement, flinching, clutching, burning through local anesthetic, irrational social behaviors, and confusion. A stressed patient is not able to cognitively process information and is likely to have little or no memory of any dialog during and after the procedure. The hardest thing to understand is that your patients, during an active stress response, are not in control of their actions – they are crippled by their survival instinct.

Why does the dental chair trigger such a primal response? The answer is simple. We are animals. An animal must protect its mouth to survive. For humans, our mouth is our source for food, communication, and intimacy. It is not natural for any animal to lie on its back and open its mouth for treatment with sharp instruments. This is why for many people, the mere thought of going to a dentist elicits a “fight-or-flight” response. Every workday you are faced with challenges most other professionals never encounter or even think about. Managing your patient’s stress response and psychological vulnerability can be exhausting. What if you could naturally interrupt the stress response, put yourself in a state of deep relaxation, allow your body to rejuvenate, and build your resilience to stressful situations? What if you could help your family and friends better manage their personal stress? What if your team could get relief from stress and perform better at work? What if you could convert your patients from resistant to relaxed in less than five minutes? This neuroscience technology is available today and is being used by the U.S. military, top research universities, oncologists, cardiologists, psychotherapists, professional athletes, top executives, and dentists.