The Outcome of Treatment of Dental Fear–a Retrospective Practise-Based Study

Objectives: Aim of this practice-based study was to evaluate the outcome of dental fear treatment of patients referred to the Public Dental Health Clinic for Fearful Dental Patients (CFDP) in the City of Oulu, Finland considering different background factors and treatment methods.

Methods: Study group comprised patient documents of those referred to CFDP during 2000–2006 (n=266). Public health dentists had given cause for referral (ICD-10; n=163). Patients were treated by three experienced clinical practitioners trained in treating dental fear. A psychological approach including relaxation, distraction and cognitive behavioral therapy (CBT) was used for all. N2O, enteral conscious sedation or dental general anesthesia (DGA) was used if considered necessary. Following information was collected from documents: age at referral, starting and ending dates of treatment, number of visits, gender, ICD-10, and sedation (yes/no). The outcome of dental fear treatment was considered successful if later dental visits were carried out without any difficulties or notices of fear in documents. Results were presented as frequencies and distributions and groups compared using cross-tabulation with chi square analysis.

Results: Study population was dominated by males. Main cause for referrals was dental fear (81%). About half (45%) needed enteral conscious sedation, 20% N2O, and 35% DGA. The success rate after treatment was 69.6% among females, and 68.1% among males. Success was significantly (p=0.053) better for those treated at ≤12 years compared with those >13 years. Outcome was significantly better for those who did not need treatment under DGA (81.4%) compared with those who did (54.8%) (p<0.001). Sedation using pharmaceutics (p=0.300) or N2O (p=0.585) was not associated with the success rate later on.

Conclusions: Psychological approach is successful for treating dental fear especially for those who can be treated early in life. Use of sedation does not increase success rate.