Online Cognitive-Behavioural Intervention to Manage Dental Anxiety: A 12-Month Randomised Clinical Trial

IF 2.1 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2025-06-13 DOI:10.1111/cdoe.13049

Marisol Tellez, Eugene M. Dunne, Elizabeth Konneker, Huaqing Zhao, Amid I. Ismail

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引用次数: 0

Abstract

Objective

The study aimed to test the efficacy of an online cognitive-behavioural therapy dental anxiety intervention (o-CBT) that could be easily implemented in dental healthcare settings.

Methods

An online cognitive-behavioural protocol based on psychoeducation, exposure to feared dental procedures and cognitive restructuring was developed. A randomised controlled trial was conducted (N = 499) to test its efficacy. Consenting adult dental patients (18–75 years old) who met inclusion criteria (e.g., high dental anxiety) were randomised to one of three arms, (a) intervention assisted by psychology staff (PI) (n = 162), (b) intervention assisted by dental staff (DI) (n = 167), or (c) a control condition (C) (n = 170). Primary outcome measures were the Modified Dental Anxiety Scale (MDAS) and the Anxiety and Related Disorders Interview Schedule DSM-V (ADIS) rating of fear. Generalised linear models for repeated measures based on intention to treat analyses were used to compare the three groups on dental anxiety, fear, avoidance and overall severity of dental phobia.

Results

Dental anxiety was significantly lower in both PI and DI groups when compared to the control condition. Interestingly, reductions in dental anxiety favoured the DI group at 6 (p = 0.008) and 12 months only (p = 0.009). Overall, equivalency was observed between the two intervention groups (PI and DI), as there were no significant differences in dental anxiety when the dental arm was compared to the psychology arm across all time points (p > 0.05).

Conclusion

The online cognitive-behavioural intervention was efficacious in reducing dental anxiety when compared to a control condition in an urban sample of patients receiving treatment in a dental school setting. Examination of its effectiveness when administered in dental offices under less controlled conditions is warranted.

Trial Registration: NCT03680755

Abstract Image

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在线认知行为干预管理牙科焦虑：一项为期12个月的随机临床试验。

目的：本研究旨在测试在线认知行为治疗牙科焦虑干预（o-CBT）的效果，该方法可以在牙科保健机构中轻松实施。方法：基于心理教育，暴露于恐惧的牙科手术和认知重构的在线认知行为协议被开发。采用随机对照试验（N = 499）检验其疗效。符合纳入标准（例如，高度牙科焦虑）的同意成年牙科患者（18-75岁）被随机分为三组之一，(a)心理工作人员辅助干预（n = 162）， (b)牙科工作人员辅助干预（n = 167），或(c)对照条件（n = 170）。主要结果测量是改良牙科焦虑量表（MDAS）和焦虑及相关障碍访谈表DSM-V （ADIS）恐惧评分。使用基于治疗意向分析的重复测量的广义线性模型来比较三组牙科焦虑、恐惧、回避和牙科恐惧症的总体严重程度。结果：与对照组相比，PI组和DI组牙焦虑明显降低。有趣的是，牙科焦虑的减少仅在6个月（p = 0.008）和12个月（p = 0.009）时有利于DI组。总体而言，两个干预组（PI和DI）之间的等效性是观察到的，因为牙科组与心理组在所有时间点上的牙科焦虑没有显著差异（p > 0.05）。结论：与在牙科学校接受治疗的城市患者的对照条件相比，在线认知行为干预在减少牙科焦虑方面是有效的。检查其有效性时，在牙科诊所在控制较少的条件是必要的。试验注册：NCT03680755。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.