Computerized Tool to Manage Dental Anxiety: A Randomized Clinical Trial.
Author(s): Tellez M(1), Potter CM(2), Kinner DG(2), Jensen D(2), Waldron E(2), Heimberg
RG(2), Myers Virtue S(3), Zhao H(4), Ismail AI(3).
Affiliation(s): Author information:
(1)Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, PA,
USA marisol@temple.edu. (2)Adult Anxiety Clinic of Temple, Department of
Psychology, Temple University, Philadelphia, PA, USA. (3)Maurice H. Kornberg
School of Dentistry, Temple University, Philadelphia, PA, USA. (4)School of
Medicine, Temple University, Philadelphia, PA, USA.
Publication date & source: 2015, J Dent Res. ,
Anxiety regarding dental and physical health is a common and potentially
distressing problem, for both patients and health care providers. Anxiety has
been identified as a barrier to regular dental visits and as an important target
for enhancement of oral health-related quality of life. The study aimed to
develop and evaluate a computerized cognitive-behavioral therapy dental anxiety
intervention that could be easily implemented in dental health care settings. A
cognitive-behavioral protocol based on psychoeducation, exposure to feared dental
procedures, and cognitive restructuring was developed. A randomized controlled
trial was conducted (N = 151) to test its efficacy. Consenting adult dental
patients who met inclusion criteria (e.g., high dental anxiety) were randomized
to 1 of 2 groups: immediate treatment (n = 74) or a wait-list control (n = 77).
Analyses of covariance based on intention-to-treat analyses were used to compare
the 2 groups on dental anxiety, fear, avoidance, and overall severity of dental
phobia. Baseline scores on these outcomes were entered into the analyses as
covariates. Groups were equivalent at baseline but differed at 1-mo follow-up.
Both groups showed improvement in outcomes, but analyses of covariance
demonstrated significant differences in dental anxiety, fear, avoidance, and
overall severity of dental phobia in favor of immediate treatment at the
follow-up assessment. Of the patients who met diagnostic criteria for phobia at
baseline, fewer patients in the immediate treatment group continued to meet
criteria for dental phobia at follow-up as compared with the wait-list group. A
new computer-based tool seems to be efficacious in reducing dental anxiety and
fear/avoidance of dental procedures. Examination of its effectiveness when
administered in dental offices under less controlled conditions is warranted
(ClinicalTrials.gov NCT02081365).
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