For many, the thought of visiting a dentist conjures fear that borders on phobia. It is not a niche anxiety: studies suggest that around one in four British adults experience dental fear, while approximately one in ten suffer from extreme dental phobia. The result is often avoidance, with check-ups skipped for years until the consequences become urgent and painful.
At Pure Smiles in Fulham, Dr Ayzaaz Akram and Dr Shiraz Akram have built a reputation not only for clinical excellence but for transforming how anxious patients experience dentistry. Their philosophy is simple: anxiety must be addressed before a single tooth is touched.
When asked about anxious patients, Ayzaaz recalls the case of a man who had avoided the dentist for two decades. “He sat in the chair completely silent, rigid with terror. We didn’t rush. We began with breathing exercises, with small steps. By the end of his journey, he was giving us instructions about how he wanted his smile to look.”
Shiraz agrees. “Empathy is the most underused clinical skill in dentistry,” he says. “Before we touch a single tooth, we earn trust.”
The brothers describe their approach as slow dentistry. Appointments are deliberately paced. Breaks are encouraged. Patients are spoken to in calm, measured tones. They employ breathwork, distraction techniques, even elements of hypnotherapy to help individuals regain control. It is an approach designed to flip the traditional dynamic, where the patient feels powerless in the chair.
The demand for such approaches is significant. Research by the Adult Dental Health Survey suggests that dental anxiety remains one of the most common barriers to care in the UK. The British Dental Association has described it as a “public health challenge” that not only affects oral health but wider wellbeing. A 2023 study by King’s College London found that patients with severe dental anxiety often experience poorer quality of life, higher rates of depression and greater social withdrawal.
Private practices are increasingly expected to address this need. “It isn’t optional anymore,” says Ayzaaz. “Patients want to know not just what you will do, but how you will make them feel safe.”
Many clinics still treat anxiety as a technical problem, managed primarily through sedation. The Akrams take a different view. Shiraz explains: “Sedation can be useful, but it doesn’t build trust. Our aim is for patients to feel they can come back, that they can engage with their care without being put to sleep each time.”
This philosophy is more demanding. It requires dentists to develop skills often considered outside their training: active listening, psychological insight, and patience. Yet it is this investment of time that has produced some of their most memorable transformations. Patients once immobilised by fear now attend regular check-ups, smiling confidently as they walk through the door.
Technology, too, plays a role in reducing fear. Digital scanning replaces uncomfortable impressions, 3D visualisations help patients understand what will happen before it does, and intraoral cameras demystify what is otherwise hidden.
But Ayzaaz stresses that technology is only effective when paired with sensitivity. “You can have the best scanner in the world, but if the patient doesn’t feel safe, it won’t matter. It’s about using technology to build confidence, not overwhelm.”
Market research backs this integration of comfort-focused technology. A 2024 report on digital dentistry in the UK noted that patient experience – reduced discomfort, faster appointments, clearer communication – is now considered a primary driver of adoption, alongside clinical outcomes.
Perhaps the most distinctive part of the Pure Smiles ethos is their willingness to hand control back to the patient. “We let patients set the pace,” says Shiraz. “If they want us to stop, we stop. That sense of control is what changes everything.”
Ayzaaz reflects on one patient who had previously fainted in dental environments. “We slowed everything down, introduced breathwork, gave them complete control. By the end, not only did they complete treatment, they told us they actually looked forward to coming back.”
These stories highlight a philosophy that goes beyond anxiety management. It is about reshaping the entire patient-dentist relationship – from one of hierarchy to one of partnership.
As NHS dentistry continues to face capacity issues and patients increasingly turn to private care, expectations are changing. Individuals no longer see dentistry as a purely functional service. They want reassurance, empathy and transparency. Market data shows this shift clearly: demand for private dentistry has risen steadily, with anxious patients forming a significant share of those seeking alternatives to traditional models.
Pure Smiles believes the profession must respond. “This is the future of dentistry,” says Shiraz. “It’s not just about technical skill. It’s about emotional intelligence.”
For those who live with dental anxiety, the thought of walking into a clinic may always be daunting. But what the Akrams demonstrate is that with the right approach, fear can give way to confidence, avoidance can give way to engagement, and dentistry can be something patients actively welcome into their lives.
As Ayzaaz reflects: “We don’t just fix teeth. We help people reclaim control. That’s what really changes their lives.”
To discover how Pure Smiles supports anxious patients through calm, empathetic dentistry, visit www.puresmiles.co.uk or call 020 7736 6276 to book your consultation.
