What Fight, Flight, and Freeze Look Like in Dentistry

Dr. Tom and the freeze response

Dr. Tom has been a practicing dentist for over a decade. He’s meticulous, experienced, and calm under pressure. But one afternoon, in the middle of what should have been a routine crown preparation, he felt something unfamiliar.

His mind went completely blank.

The handpiece was in his hand. The patient was waiting. His assistant looked at him, expecting direction. But for several seconds, long, uncomfortable seconds,  Dr. Tom couldn’t remember what came next. His body felt heavy, his thoughts foggy. He wasn’t panicking. He wasn’t angry. He was just... stuck.

Later, in the privacy of his office, the question came quietly: What just happened to me?

The body’s automatic stress responses

What Dr. Tom experienced is known as the freeze response, one of the body’s natural reactions to perceived danger. It’s part of a system known as fight, flight, or freeze, automatic nervous system responses that help us survive when we feel under threat.

• Fight: preparing to confront or control a threat
• Flight: the urge to escape or avoid
• Freeze: a shutdown or temporary paralysis, where the brain and body hesitate or go still

These responses are not choices. They are protective reflexes controlled by the autonomic nervous system, the same system that manages your heartbeat and breathing. They happen quickly, often without conscious awareness.

Why the brain reacts this way

The key player in this system is the amygdala, the brain’s alarm center. Its job is to scan for potential threats and respond quickly. When it detects danger, it triggers a cascade of stress hormones, including cortisol and adrenaline, to prepare the body to survive.

In the past, this system helped humans react to physical threats, like a predator in the wild. But today, it can be activated by more modern forms of stress: time pressure, patient anxiety, medical complications, interpersonal conflict, or even emotional overwhelm.

Importantly, the amygdala doesn’t distinguish between real danger and perceived threat. In a high-pressure moment, such as a complex procedure going off-track, the body may respond as if it’s in danger, even if the actual risk is minimal. That’s when freeze can happen.

During a freeze response:

• Heart rate may rise or suddenly drop
• Breathing can become shallow
• Muscles may tighten or go still
• Thoughts feel foggy or disorganized
• Speech and decision-making become more difficult

This is what happened to Dr. Tom. His freeze response was not a failure, it was his nervous system doing its best to keep him safe.

When these responses show up in dentistry

In dentistry, the conditions that trigger a stress response can be subtle or cumulative. Common contributors include:

• Running behind schedule
• Complicated or unpredictable cases
• Anxious or distressed patients
• Tension within the dental team
• A sense of being observed or judged
• Personal fatigue, hunger, or burnout

Sometimes, the body’s response comes not from one dramatic event, but from the buildup of stress over hours or days. This is especially true in fast-paced clinical environments where breaks are short, recovery time is limited, and emotional labor is high.

How Dr. Tom recovered

After the incident, Dr. Tom chose not to ignore what happened. He spoke with a trusted colleague, who shared a similar story. He read about the nervous system and how freeze responses can affect professionals in high-stakes fields. Over time, he learned to:

• Recognize the early signs of stress in his body (tightness in his chest, shallow breathing, difficulty focusing)
• Pause and ground himself, even briefly, between patients — with a breath, a stretch, or a moment of silence
• Name what was happening, rather than blaming himself (“This is my body reacting to stress”)
• Talk openly with peers and team members about the pressures of the work

He also began building short, intentional pauses into his day to reset and regulate. These changes didn’t eliminate stress, but they gave him tools to meet it with more awareness and less fear.

What this means for you

If you’ve ever experienced something similar, freezing mid-procedure, blanking on your next step, or feeling mentally distant from your work, you are not alone.

These responses are not signs of weakness. They are deeply human reactions to pressure and uncertainty. In fact, many healthcare professionals experience them, even if they don’t talk about it.

Understanding the biology behind fight, flight, and freeze can help remove the shame that often surrounds these moments. More importantly, it can give you the space and self-awareness to respond with care rather than criticism.

You can’t control how your nervous system reacts in every moment, but you can learn to support it. And with time, practice, and compassion, those moments of disconnection can become turning points, not setbacks.