Cognitive behaviour therapy may help people who fear dentist
Cognitive behavioural therapy, or CBT, could help many people with a dental phobia overcome their fear of visiting the dentist, a new study finds.
It will also enable them to receive dental treatment without the need to be sedated, according to researchers at the King’s College London. Anxiety about visiting a dentist is common and becomes a phobia when it has a marked impact on someone’s well-being. People with dental phobias typically avoid going to the dentist and end up experiencing more dental pain, poorer oral health and a detrimental effect on their quality of life, the team claims.
CBT, a short-term therapy that typically lasts for six to 10 sessions, has been shown to help with a range of psychological problems, most notably for depression and anxiety-related disorders.
In the study published in the British Dental Journal, the researchers looked at the characteristics of 130 patients attending a psychologist-led CBT service. Patients were surveyed for their levels of dental anxiety, general anxiety, depression, suicidal thoughts, alcohol use and oral health-related quality of life.
The team found that three-quarters of those assessed scored 19 or higher on the Modified Dental Anxiety Scale or MDAS, indicating dental phobia. The remainder all scored high on one or more items of the MDAS, suggesting a specific fear of some aspect of dentistry.
According to the researchers, fear of dental injections and the dental drill were the most common high scoring items on the MDAS. Nearly all patients reported a knock-on effect from problems with their teeth, mouth or gums on their daily living and quality of life.
People with dental phobia are most commonly given sedation to allow them to become relaxed enough for a short period of time to have their dental treatment performed, says Professor Tim Newton from the Dental Institute at King’s College London and lead author of the study. However, this does not help them overcome their fear in the long term, he adds.
“The primary goal of our CBT service is to enable patients to receive dental treatment without the need for sedation, by working with each individual patient to set goals according to their priorities. Our study shows that after on average five CBT sessions, most people can go on to be treated by the dentist without the need to be sedated,” Newton explains.
He cautions, however, that there is a need for people with dental phobia to be carefully assessed by trained CBT practitioners working with dental health professionals. This is because some of the patients referred to them were found to be experiencing additional psychological difficulties, and needed further referral and management.
“Our service should be viewed as complementing sedation services rather than as an alternative, the two together providing a comprehensive care pathway for the ultimate benefit of patients,” Newton clarifies.
According to the 2009 Adult Dental Health Survey, around 12 percent of dental adults suffer from extreme dental anxiety. There are many patients that also let their past experiences prevent them from visiting a dentist.
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