Protocol for a feasibility study of a self-help cognitive behavioural therapy resource for the reduction of dental anxiety in young people (original) (raw)
Related papers
Development and Testing of a Cognitive Behavioral Therapy Resource for Children's Dental Anxiety
JDR Clinical and Translational, 2017
Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for dental anxiety; however, access to therapy is limited. The current study aimed to develop a self-help CBT resource for reducing dental anxiety in children, and to assess the feasibility of conducting a trial to evaluate the treatment efficacy and cost-effectiveness of such an intervention. A mixed methods design was employed. Within phase 1, a qualitative " person-based " approach informed the development of the self-help CBT resource. This also employed guidelines for the development and evaluation of complex interventions. Within phase 2, children, aged between 9 and 16 y, who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital, were invited to use the CBT resource. Children completed questionnaires, which assessed their dental anxiety and health-related quality of life (HRQoL) prior to and following their use of the resource. Recruitment and completion rates were recorded. Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/carers and dental professionals. For this analysis, the authors adhered to the Mixed Methods Appraisal Tool criteria. There were 24 families and 25 dental professionals participating in the development and qualitative evaluation of the CBT resource for children with dental anxiety. A total of 56 children agreed to trial the CBT resource (66% response rate) and 48 of these children completed the study (86% completion rate). There was a significant reduction in dental anxiety (mean score difference = 7.7, t = 7.9, df = 45, P < 0.001, Cohen's d ES = 1.2) and an increase in HRQoL following the use of the CBT resource (mean score difference =-0.03, t = 2.14, df = 46, P < 0.05, Cohen's d ES = 0.3). The self-help approach had high levels of acceptability to stakeholders. These findings provide preliminary evidence for the effectiveness and acceptability of the resource in reducing dental anxiety in children and support the further evaluation of this approach in a randomized control trial. Knowledge Transfer Statement: This study details the development of a guided self-help Cognitive Behavioral Therapy resource for the management of dental anxiety in children and provides preliminary evidence for the feasibility and acceptability of this approach with children aged between 9 and 16 y. The results of this study will inform the design of a definitive trial to examine the treatment-and cost-effectiveness of the resource for reducing dental anxiety in children.
Trials
Background Globally, around 13% of children experience dental anxiety (DA). This group of patients frequently miss dental appointments, have greater reliance on treatment under general anaesthesia (GA) and have poorer oral health-related quality of life (OHRQoL) than their non-dentally anxious peers. Recently, a low-intensity cognitive behavioural therapy (CBT)-based, self-help approach has been recommended for management of childhood anxiety disorders. A feasibility study conducted in secondary care found this guided self-help CBT resource reduced DA and a randomised controlled trial was recommended. The present study aims to establish the clinical and cost-effectiveness of a guided self-help CBT intervention to reduce DA in children attending primary dental care sites compared to usual care. Methods This 4-year randomised controlled trial will involve 600 children (aged 9–16 years) and their parent/carers in 30 UK primary dental care sites. At least two dental professionals will p...
Dentistry Journal
Dental anxiety is very common; however, there is a lack of studies focusing on reducing children’s dental anxiety. One such initiative, the guided self-help cognitive behavioural therapy (CBT) resources ‘Your teeth, you are in control’, reduces dental anxiety in children attending paediatric dentistry clinics. This service evaluation aims to investigate whether such CBT resources reduce children’s dental anxiety when implemented in general dental practice. A convenience sample of children was given the resources by their dental practitioner. There was no control group. Children completed the Children’s Experiences of Dental Anxiety Measure (CEDAM) prior to using the resources and on completion of a course of dental treatment. Overall, 84 children were involved, with a mean age of 10.9 years; 48 were female and 59 were living in the most deprived area of England. At baseline the mean CEDAM score was 20.3, and on receiving the resource and completing treatment the mean CEDAM score was...
Behavioral and cognitive-behavioral approaches to the reduction of dental anxiety
Behavior Therapy, 1992
The effects of cognitive-behavior therapy (CBT) and a semi-automated behavioral intervention (BT) for the treatment of dental anxiety were compared to a waiting-list (WL) control and to a positive dental experience condition (PDE), which used dentists particularly gentle with anxious patients. Multimodal assessment of cognition, behavior, physiological response, and dental anxiety was employed. Both BT and CBT subjects showed significant improvement compared to PDE and WL groups on their level of dental anxiety and negative thoughts during a dental procedure. On measures of self-efficacy, negative anticipatory thoughts, and pain experienced, the WL group improved significantly less than did the other three conditions. At a l-year follow-up, subjects treated with B'r and CBT reported less dental anxiety and had been to the dentist more often than WL controls. All three approaches thus show promise, with semi-automated behavior therapy and contact with a sensitive dentist being especially cost-effective methods of treatment. This research is based upon a doctoral dissertation conducted by the first author under the direction of the second author. We would like to thank Thu Getka, Steve Scott, Robin Hill, and Suzan Winderz for their assistance in conducting the study. We are grateful to Doug Bernstein for providing treatment videotapes. Thanks also go to the other members of the doctoral committee, Diane Arnkoff and
International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children, 2015
There is a high prevalence of dental anxiety in children and adolescents. Cognitive behavioral therapy is emerging as a treatment option. The purpose of this study is to explore how children with dental anxiety and their parents experience cognitive behavioral therapy (CBT) in dentistry. We interviewed 12 children and one of their parents and conducted a thematic analysis of the transcribed interviews. Perspective shift emerged as overarching theme in our thematic analysis. This theme consisted of three main themes, which were mastery, safety, and reduced fear. Six subthemes were also identified according to our analyses. Mastery includes two subthemes, gradual exposure and autonomy and control. Subthemes and sources for safety feeling were therapeutic alliance and changed appraisal. The theme reduced fear also consisted of two subthemes; reduced anticipatory anxiety and coping. The results show that parents and children had positive experiences of CBT and its outcome and were able ...
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...
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.