A team of German researchers have found that cognitive behavioral therapy offers the best outcome in the treatment of dental anxiety.

Also known as dental phobia, the condition is characterized by an excessive fear of dentists and dental treatment. Sufferers avoid routine dental visits and cleaning, with many seeking help only for severe emergencies. Those crises, however, often result in invasive and painful treatments that reinforce and further escalate the primary dental fears. Up to 10 percent of American adults struggle with dental anxiety, with more women and younger individuals reporting symptoms.

Treating Dental Phobia

Specialists sometimes diagnose dental anxiety utilizing the Corah's Dental Anxiety Scale or the Modified Dental Anxiety Scale. Through self-reported questionnaires completed in dental offices, both forms help identify fearful patients at the onset. Many dentists, though, prefer personal interactions with their patients to determine potential problems, relying on their own expertise to diagnose and treat such patients.

Within this context, German scientists compared the effectiveness and acceptability of the following four treatment methods for dental phobias: standardized hypnosis, hypnosis with individualized imagery, cognitive behavioral treatment (CBT) and general anesthesia. Their research initially entailed assigning 137 patients with dental phobia to one of four groups, each receiving one of the forms of treatments being compared in the study. Ultimately, 77 completed the trial, with an average of 21 people in each group.

Participants answered questionnaires at the beginning of the study, before and after their first dental visit, and before their second dental appointment a week later.

CBT Gave Patients the Courage to Go to the Dentist

The results showed that patients who received standardized hypnosis prematurely terminated their treatment at a significantly higher rate than patients in the CBT group. Dental anxiety was greatly reduced among both those receiving CBT and individualized hypnosis as compared to patients treated with general anesthesia alone. Furthermore, only the group of patients who underwent CBT showed significant improvements in the intent-to-treat analysis, an assessment that counts a patient dropping out of the study as a failure of the treatment they were receiving.

Ultimately, the results prompted the scientists to suggest that CBT may be the most effective treatment option for dental phobia. The study, lead by Professor Gudrun Sartory, PhD of the University of Wuppertal, Germany, was recently published in the journal Psychotherapy and Psychosomatics.

What is CBT?

CBT is a form of talk therapy that directs patients to identify and evaluate thoughts and feelings. This approach is based on the underlying principle dysfunctional patterns of interacting thoughts, emotions, and behaviors are the foundation of many psychiatric problems. Treatment tends to be short-term and procedural, with the therapist training and instructing the patient on how to identify patterns of dysfunctional “automatic" thoughts that cause distressing or unhelpful emotions like dental anxiety.

CBT is used to treat various mental health conditions including, but not limited to, generalized anxiety disorder, depression, post-traumatic stress disorder, and panic disorder. Depending on the severity and diagnosis, medication therapy is sometimes concurrently administered with CBT.

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Date of original publication:

Updated: March 08, 2017