ABSTRACT Background Dental anxiety in children is a major health concern. Process drama adopts distancing techniques that allow children to examine the possible causes of dental anxiety safely and with authority. Using this method to inform paediatric dentistry is novel and could be adopted in other fields where children experience health-related anxiety. Methods A 90-minute process drama workshop was conducted in three primary schools in Batley,West Yorkshire. Sixty-three children participated in the study. Sessions were audio-recorded, transcribed and thematic analysis conducted. Results Four key concepts emerged: 1) Fear of the unknown; 2) Unpleasant sensory experience; 3) Society’s perception and portrayal of the dentist and 4) Learnt negative associations with the dentist. Conclusion Process drama offers a novel approach to develop an understanding of dental anxiety in children. It elicits critical insights from a child’s perspective and offers a participatory model for engaging children in health research on sensitive issues.