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A different approach to dental anxiety

April 7, 2023
Learn about a long-term study that uses a form of cognitive behavioral therapy to help anxious patients deal with their fear of going to the dentist.
Elizabeth S. Leaver, Digital content manager

Anxious patients are part of almost every dental professional’s every workday. Now, researchers are looking into whether a behavioral intervention that exposes patients to their fears before their treatments might be the thing to ease their dental anxiety and get them to keep their appointments.

A study at Temple University’s Kornberg School of Dentistry in Philadelphia, detailed in Health Affairs, combines the knowledge and experience of dentists and psychologists to examine whether exposing patients to their dental fears through a series of videos—an approach called exposure therapy—can help them manage their anxiety.

Reasons for dental anxiety range, with fear of the dental experience, a previous bad experience, family history, and a gag reflex among the most cited. Severity also varies from mild nerves to extreme dental fear—dentophobia or odontophobia—which can can cause people to avoid going to the dentist even when they're in pain.

But over time, avoiding appointments makes things worse as it can set off a “cascading effect” that can result in patients who’ve avoided the dentist needing “emergency care and more invasive treatment.”

“What [those patients] experience is more issues when they’re actually at the dentist. So as a result, that cycle continues because it’s being reinforced,” says Eugene Dunne from the Kornberg School of Dentistry.

The study, which plans to enroll some 450 patients, assesses patients’ anxiety before their treatment, immediately after their appointment, and for several more months, as well as checks how well patients keep up with appointments.

Study participants pick their three most anxiety-producing procedures from a list of six— cleanings, x-rays, cavity fillings, root canals, injections, and tooth extractions—and watch a series of videos about those three procedures, starting with their least-feared.

The computer-based intervention incorporates several cognitive behavioral techniques with the idea of working with patients to develop a “hierarchy of fear,” while at each level of exposure encouraging them to develop strategies to cope—an approach of “Facing that fear, letting that anxiety peak, using those skills to face that anxiety,” says Dunne.

Learn more in A promising tool for overcoming dental anxiety