More than one out of four Americans (26 percent) has had a bad brush with a denist, the American Dental Association reports. One-quarter of us avoid checkups.

According to another survey, 40 percent of us don't go at all.

A main reason: Pain panic.

Dental phobia has caused many adults to postpone much-needed treatment. But dentists have ways to soothe jittery patients and help them conquer their anxieties. Options range from oral sedation to warm blankets to simply using less clinical-sounding language.

You don't have to grin and bear dental fears

"Is it safe?"

This quote from "Marathon Man" (1976) is ranked among the top movie quotes of all time. The cryptic line is repeatedly asked by a Nazi dentist as he drills -- sans anesthesia -- into the teeth of Dustin Hoffman's unfortunate character.

Pure fiction. But many adults, even those too young to remember the film, still ask the question, hoping an answer will come that will alleviate their fear of going to the dentist.

"Is it safe?"

Dentophobia, or odontophobia, is the fear of dentists and dental procedures.

"People have a preconceived notion of what their experience is going to be at the dentist," said Dr. Garfield Batchelor, a dentist with offices in Hobart and South Chicago. "You have to be aware that everybody is apprehensive."

Dr. James Arnold of Smiles by Arnold and Associates in Chesterton and Valparaiso says the general rule is that adults who have had bad dental experiences in the past are the most fearful of future procedures.

"Specific fears often stem from a particular experience from the patient's past," Arnold said. "For some, the sound of the drill causes tremendous anxiety. For others, the thought of a dental injection causes an increase in blood pressure.

"Ultimately, though, most people who have dental anxiety are afraid of feeling discomfort during a procedure."

For some patients, it's not just the sound of a drill that provokes fear. It's the word "drill" itself. Most dentists know the importance of using language that is non-threatening. Often a patient's fear is alleviated when less "clinical sounding" words are used. Examples include "numb" or "freeze" as opposed to "needle" or "giving a shot" and saying "handpiece" instead of "drill."

"When I speak of procedures I don't use a lot of words like ‘inject' or ‘shot,' Batchelor said. "I say things like ‘I'm going to put that tooth asleep'."

Batchelor gets a lot of patients who have what he calls "post- traumatic stress disorder" in which they've had a bad dental experience or difficult procedure performed "a generation ago."

"When the techniques weren't the same as what we have now," Batchelor said.

These patients not only have the bad memory, but time has blurred the specifics of the actual event.

"That's when you start hearing things like `That dentist, he had to put his foot on my chest to get that tooth out,' " Batchelor said. "So what happens is a lot of those people postpone treatment."

Those who eventually seek treatment and are still fearful may find it beneficial to undergo oral conscious sedation. Arnold first spends time with patients, chatting about their past experiences to determine their level of anxiety. He gives them options, and is happy to provide sedation if that's what they want.

"Everyone is different, however, so we never make assumptions about whether or not they need to be sedated for dental treatment," Arnold said. "Patients who undergo procedures under oral conscious sedation generally don't remember their appointment, and they feel great the same day. Many of them never need sedation again because the fear is minimized or even removed completely."

Arnold's office also uses several techniques to help patients overcome their anxiety including massage pads on chairs, headphones for music, aromatherapy, and birdfeeders within view of treatment rooms.

"Just about anything else a patient might want to put their mind at ease," Arnold said.

What might surprise many people is the fact that most dentists agree that children are not terrified of appointments. Arnold says children are only fearful if their parents or some other adult in their life transfers their own fear to them -- accidentally or intentionally.

As a child, Jesus Rangel, 17, was never nervous visiting the dentist. It was when he became a teenager that a checkup triggered anxiety.

"I was nervous," said Rangel, of Blue Island. "It was because of the rumors I heard of the needles. But then I realized it was just a little sting."