Intra-Oral Injection Phobia - A Randomized Controlled Trial Among 10-16-Year-Olds

Objectives: To explore the effect of 5 sessions of cognitive behavioural therapy (CBT) among 10- to 16-year-olds diagnosed with intra-oral injection phobia (I-OIP).
Methods: This was a randomized delayed intervention controlled trial in 67 patients, fulfilling the DSM-5 criteria for specific phobia. A diagnostic interview was performed by clinical psychologists, and the CBT was conducted by specially trained dentists. The patients were randomly assigned to either an immediate treatment group (ITG) (n=34), or a waitlist-control group (WCG) (n=33). For the ITG the treatment started the following week, endeavoring one session a week for 5 weeks. After 5 weeks on the waitlist, the patients in the WCG were assigned for the same CBT as the patients in the ITG, and the two groups were combined for further analyses. Assessments at pre-, post- treatment/waitlist and at a 1-yr follow-up included the psychometric self-report scales Intra-oral injection fear scale (IOIF-s), Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), Injection Phobia Scale for children (IS-c) and Mutilation Questionnaire for children (MQ-c). A mixed between-within subjects ANOVA for repeated measures was performed to compare the ITG and the WCG. Paired sample t-tests were used to analyse time changes (pre- and post- treatment, and at 1-year follow-up) in the combined sample of patients.
Results: CBT had a significant effect compared to no treatment (WCG). The scores on the psychometric self-report scales were significantly reduced after treatment, and the results were maintained at 1-yr follow-up. Of the 67 patients enrolled in the study, 70.1% managed to receive intra-oral injections by the specially trained dentists during CBT treatment.
Conclusions: CBT for children and adolescents diagnosed with I-OIP was found to be effective. CBT should be advocated as a recommended treatment for 10- to 16-year-old patients suffering from I-OIP.