Dental Anxiety: Dentist-administered CBT-treatment (D-CBT): A Pilot Study

Objectives: Dental anxiety is a risk factor for oral health problems. Thusly, evidence based treatment methods developed for use in primary care can reduce dental anxiety and risk of poor oral health. The aim for the first step in establishing a scientifically tested treatment method to be delivered in primary care by dentists, was to develop and pilot-test a 3-5 session manualized psychological intervention based on cognitive behavioral therapy (D-CBT).
Methods: The manual for D-CBT was developed in four steps: (i) Based on literature reviews and clinical experience the 3 main researchers developed a first manual draft describing the intervention in detail. (ii) The manual was evaluated by 2 professors of psychology and by an expert group consisting of 3 clinical psychologists and 3 dentists with a high level of clinical experience. Based on the corresponding feedback, the final D-CBT-manual was developed. (iii) A pilot-study including 10 patients suffering from dental anxiety received 5 x 60 minutes manualized D-CBT consultations. Dental anxiety was measured before and after the treatment using Modified Dental Anxiety Scale (MDAS), a 5-point questionnaire with a total score ranging from 5-25.
Results: The final D-CBT manual included 4 main components: A. Building a good relationship with the patient B. Psychoeducation in anxiety symptoms C: Exploration of individual symptoms of anxiety D: Exposure to the frightening stimuli. MDAS score at baseline ranged 15-25, mean 21 (sd. 3.5) after treatment the mean MDAS-score was reduced to 14 sd. 2.8. (range 10-20). The mean reduction was 7 (sd 3.6), range 5-7. All patients reported benefit from the treatment.
Conclusions: The D-CBT-manual used by a dentist in a regular dental general practice setting show promising results in the treatment of dental anxiety and will be tested in a population with sample size calculation based on the pilot study.