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News / August 31, 2011

On their best behaviour

by Guy Hiscott

People with severe dental phobia may be able to overcome their anxieties with a single session of cognitive behavioural therapy (CBT), research published in the latest issue of the British Dental Journal (BDJ) suggests.
The authors of the study, based on an initial pilot of 60 patients who relied on having intravenous sedation before they could undergo dental treatment, concluded that the benefits were of such significance that they advise dental providers to implement this approach now rather than wait to pursue further research. They point out that patients benefit from not being exposed to the health risks associated with repeated intravenous sedation.
The initial cohort of 60 patients had all attended a specialist dental clinic for people with severe dental phobia. Half the group were offered CBT, with 21 patients accepting the treatment. Twenty of these went on to have dental treatment without having to be sedated. An audit of these patients a decade later found that of the 19 patients located who had had CBT, none had returned to sedation in the intervening 10-year period. 
The benefits of having CBT for severe dental phobia appear to endure over time, the authors of A joint approach to treating dental phobia: A re-evaluation of a collaboration between community dental services and specialist psychotherapy services ten years on, conclude.
The latest 10-yearly survey on adult dental health published earlier this year by the NHS Information Centre suggests that as many as 12 per cent of people may experience extreme dental anxiety.
Professor Damien Walmsley, the BDA’s scientific adviser, said: ‘Dental phobia is a serious problem because it deters some people from ever going to the dentist, except when they are in severe pain. At this stage, they may require more invasive treatment than might be the case if they went to the dentist regularly. Sadly, this cycle of anxiety, non-attendance and pain is often repeated in the children of those with dental phobia, perpetuating the problem and feeding another generation of oral health problems.

‘CBT is one of a range of techniques than can be used to make the experience comfortable for patients who feel especially anxious about having dental treatment, and the results of this study look promising for those who experience severe dental phobia.

‘All dentists are highly-skilled, caring health professionals who are trained to put patients at ease. Many also undertake additional training in techniques, such as hypnosis, and acupuncture, and of course, CBT.’