What is the Most Effective Intervention for the Management of Dental Anxiety among Adults? A Systematic Review of Interventions (original) (raw)
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Journal of Community & Public Health Nursing, 2016
This review aimed to find the most effective intervention for the management of dental anxiety among adults by way of a systematic review of Randomised controlled trials. Compared to European and US counterparts, the number of studies concerning the management of dental anxiety in the United Kingdom is limited. Several interventions have been reported with varying modes of action and duration. Two main groups of interventions: pharmacological and psychological/behavioural have been implemented. The pharmacological interventions employ the use of centrally acting sedatives whereas the psychological/behavioural interventions serve to change the behavioural and learning effects of dental anxiety. A third group operationally defined as "Complementary" for the purpose of this review consists of holistic therapies such as acupuncture, music distraction and aromatherapy for in the management of dental anxiety. Although reduction of dental anxiety before and after dental treatment has been recorded historically in the majority of trials, these have mainly investigated psychological/behavioural interventions. Exploring more recent trials, this study uncovers the benefits of complementary interventions for managing dental anxiety in adults and computer based variants of psychological/behavioural interventions. None compared the efficacy of one type or group against the other. Also, outcomes such as avoidance of dental treatment and economic implication of interventions were scarcely evaluated thus evidence on this remains inconclusive. The need for further investigation of these outcomes as well as those in Complementary Therapies is justified.
Effects of a combination of non-pharmaceutical psychological interventions on dental anxiety
Journal of Clinical and Translational Research, 2017
Background: Dental anxiety is a common problem associated with poorer oral health. Managing anxiety is key to improving oral health of patients with dental anxiety. The present pilot study therefore investigated dental anxiety prevalence among patients visiting a university dental clinic. We further examined the effect of combined psychological interventions on anxiety or concern towards dental treatment procedures before treatment, after treatment, and at follow-up. Methods: In this prospective pilot study, patients seeking restorative treatment were screened for dental anxiety and dental concern about treatment using the Dental Anxiety Scale-Revised (DAS-R) and Dental Concern Assessment (DCA) questionnaires. Participants with a DAS-R score of 9 or above were randomly assigned to an experimental or control group. The patients in the experimental group received two psychological interventions (psychoeducation and progressive muscular relaxation) prior to dental treatment. During treatment, patients received another psychological intervention (music distraction). No psychological interventions were given to control patients. DAS-R and DCA scores were used to assess dental anxiety and concern, respectively, before treatment, after treatment, and at follow-up. Nonparametric tests were used for intergroup and intragroup statistical analyses. Results: Out of 64 patients surveyed, 33 (51.6%) had experienced dental anxiety. Of those, 2 were excluded, and 31 patients with a mean ± SD age of 41.2 ± 15.9 y completed the study. No intergroup differences in dental anxiety were found in terms of pretreatment, posttreatment, and follow-up treatment. The mean rank value of the dental anxiety score was less in the experimental group (13.53) than the control group (18.31), albeit not significant. More specifically, differences (Kruskal-Wallis χ2 = 14.82, P = 0.001, effect size = 0.33) were found in the experimental group for pretreatment, posttreatment, and follow-up treatment levels of dental anxiety for extraction (P = 0.01), injection (P = 0.02), and sound/vibration of the drill (P = 0.00). No significant intragroup differences between pretreatment, posttreatment, and follow-up treatment were found in the control group. Conclusions: The combined brief psychological interventions reduced dental anxiety. Relevance for patients: The psychological interventions of the present study could be applied right before or during dental treatment to reduce the dental anxiety of patients. However, additional research involving larger groups is needed to replicate the results of this pilot study.
Non-pharmacological methods of fighting dental anxiety
Journal of Pre-Clinical and Clinical Research
Anxiety related to dental prophylactic and therapeutic procedures and experienced by children, adolescents and adults is an important obstacle in the everyday practice of dental professionals. The methods to reduce and/or eliminate dental anxiety and to influence patients' attitudes may be divided into the non-pharmacological and pharmacological. The presented study analyzes the specialist literature available through Pubmed and Google Scholar databases, examining the papers published during the 10 years prior to this study. The article, discusses non-pharmacological methods of fighting dental anxiety, including basic behavioural as well as alternative methods, such as using VR goggles, music and hypnosis. The authors also report evaluations of the effectiveness of these methods in clinical dental practice, while at the same time stressing that such an assessment is extremely difficult. Most research covers only those patients who report to dental surgeries, which results in excluding subjects who feel too great an anxiety to seek the help of a dentist. Various sources assessing the effectiveness of the various methods are cited. The popularization and more frequent use of the methods for reducing and/or elimination of dental anxiety chosen according to the patient's age, personality, temperament, and his/her anxiety level is beneficial both for the patient suffering from dental anxiety and for the dentist.
International Journal of Psychological Studies, 2016
Dental anxiety is a common problem and is considered an obstacle to providing quality dental care to patients. The present study was conducted to determine the prevalence of dental anxiety among patients under going restorative procedures in a university dental clinic, to determine the effect of a combination of psychological interventions (psychoeducation, relaxation therapy, and modeling technique) in reducing dental anxiety within and between experimental and control groups, and to identify differences in concern or anxiety towards dental procedures between pre-assessment, post-assessment, and follow-up assessment of experimental and control groups. Corah’s Dental Anxiety Scale, Revised (DAS-R) measured dental anxiety prevalence, and the Dental Concerns Assessment (DCA) identified factors causing dental anxiety. Patients experiencing dental anxiety were randomly assigned into an experimental or control group. Experimental group patients (n=15) received a 45-minute session of a co...
Journal of Dental Anesthesia and Pain Medicine, 2022
BackgroundThe first dental experience is vital in molding a child's attitude towards dentistry and dental outcomes. The cooperation of a child during dental treatment is essential to render successful and high-quality treatment. Dental anxiety is common in children undergoing dental treatment. The success of pediatric dental treatments and patient comfort depends on controlling the levels of patient anxiety in clinical settings. This study aimed to compare the effectiveness of the recorded maternal voice and virtual cognitive tool (Roogies application) in the management of pediatric dental patients.MethodsThe study was carried out with children aged of 4-7 years [n = 80, (40 male and 40 female)], without any past dental history, and were randomly allocated into two groups. After informed consent was obtained, the entire procedure was explained to the parents. Anxiety was assessed pre-, during, and post-treatment by measuring pulse rate, and recording Venham Picture Test (VPT) scores. Group A [n = 40; 20 boys and 20 girls)] was provided with a headphone that played a recorded maternal voice. Group B [n = 40; 20 boys and 20 girls)] was administered the virtual cognitive tool. After conditioning the children, oral prophylaxis was performed for both groups. A comparative evaluation was conducted for each treatment session.ResultsThe intra-group comparison of VPT scores and heart rate for patients assigned to the recorded maternal voice showed a statistically significant difference in dental anxiety (P-value ≤ 0.001).ConclusionThis study demonstrated that a reduction in dental anxiety with the help of recorded maternal voice forms an important component of non-pharmacological behavior management. Alternatively, the use of a virtual cognitive tool as an anxiety-reducing technique can also be advocated.
2010
Aim: To compare the degree of anxiety reduction in dentally anxious patients attending a Dental Access Centre where the dentist did or did not receive the patients' assessment of dental anxiety. Methods: Patients attending two Dental Access Centres in England, completed the Modified Dental Anxiety Scale (MDAS). Those that scored high completed a state anxiety questionnaire (STAI-S) and were randomized into three groups (n=182) to test the hypothesis that patients sharing assessment information about their dental anxiety to members of the dental team has beneficial effects on their state anxiety. Group 1 were controls (n=60), Group 2 gave their MDAS to the receptionist who passed it onto the dentist unknown to the patient (n=62) and Group 3 handed their MDAS to the dentist (n=60). After their appointment they repeated the STAI-S. Results and conclusion: Patients in Group 3 were less anxious (by more than STAI-S 3 scale units) on leaving the surgery than those from the other groups especially if they entered into a discussion with the dentist about their concerns (by more than 5 scale units). Brief assessment of dental anxiety shared by the patient with the dentist collaboratively has the potential to reduce anxiety on completion of the appointment.