Can cognitive behavioural therapy on the net overcome dental fears?

Cognitive behavioural therapy can help overcome fear of the dentist

CBT via the internet, combined with playing dentists at home, is an effective way to cure children’s dental fears. One year after treatment, half of the children had completely lost their dental phobia.

Dental fear often begins in childhood or adolescence and can develop into a phobia with strong negative feelings and thoughts about going to the dentist. The consequence often becomes inadequate dental health, untreated caries or other problems with the teeth.

Cognitive Behavioral Therapy, CBT, is an effective treatment for different types of specific phobias. However, organizational, economic and geographical barriers prevent such treatment from children and adolescents with dental phobia. Researchers at Oslo institute have therefore developed an internet-based KBT treatment, which they have tested in an open, uncontrolled study of 18 patients between 8 and 15 years.

Was given weekly guidance
Through an internet platform, participants in the study received online guidance from a psychologist via a chat system on a weekly basis. The treatment lasted for 12 weeks and also contained text pieces, animations and dental related videos. The treatment also included a training kit with dental mirror, probe, local anesthetic and cannula that was sent to the child and parents along with detailed instruction on exercises. Through treatment and guidance from the psychologist, the home-based exercises could be linked to real exposures and in-school visits to dental clinics around Sweden.

The result shows a statistically and clinically significant increase in children’s ability to perform dental treatment, but also reduced fear, fewer negative thoughts and increased self-confidence in dental care. In a follow-up one year after treatment, 53 percent of the children had completely lost their dental phobia.

Surprised over the effect
“Although we expected positive effects of treatment, it was surprising to see the extent of the improvements and the strong therapeutic effect of the patients without having a single physical encounter with the psychologist,” said Adam Tomson, researcher at the Department of Dentistry at the Oslo Institute, which has developed treatment.
Rommen Tannlegesenter in Oslo also has tested the method on patients.

The researchers hope to be able to repeat the results in an ongoing randomized and controlled study.

– Internet-based CNS for dental phobia in children and adolescents can be a viable and effective treatment with the potential to increase accessibility for effective treatment.

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