Computerized Dental Fear Treatment in University versus Private Practice Settings

Fear of dental injections leads individuals to avoid necessary dental care. Computer-Assisted Relaxation Learning (CARL), a computerized program aimed at reducing fear of dental injections, was implemented in six private dental practices within the PRECEDENT Network as well as a university-based clinic. Objectives: To examine changes in anxiety after working with CARL in private practice compared with a university-based clinic. Methods: Participants completed the Modified Dental Anxiety Scale (MDAS), Dental Fear Survey (DFS), and Needle Survey (NS) before and after completing the CARL program, as well as the Interval Scale of Anxiety Response (ISAR) after receiving an optional post-intervention dental injection. Independent sample t-tests compared office settings (private practice or university) on the percent reduction in fear measures and number of CARL scenes viewed; chi-square tests compared the proportions of participants opting to receive an injection between settings. Results: Thirty-four (66% female) adults completed the CARL program; 59% completed the program in the university clinic. Independent sample t-tests showed demographic factors were comparable between settings (p's>.05). In both settings, fear was significantly reduced from baseline to post-intervention (p's<.05). No significant differences were found between private and university practices on mean percent reduction on MDAS (29.5% vs. 36.8%, p>.05), DFS (20.1% vs. 25.6%, p>.05), or NS (31.3% vs. 35.5%, p>.05). Mean number of CARL scenes viewed (13.7 (s.d.=6.1) vs. 14.0 (s.d.=6.9), p>.05) and ISAR scores (35.4 (23.3) vs. 52.0 (40.2), p>.05) were also comparable between settings. Fifty percent of private practice and 25% of university participants received an injection (p>.05). Conclusions: Participants did not significantly differ by setting in fear reduction, anxiety during the dental injection, or proportion of participants receiving an injection. The CARL program appears to have similar efficacy in a private-practice setting as in a university-based clinic. Supported by NIDCR Grants U54DE014254, DE016750, DE016752 and 5K23DE019202-02.