Cognitive-behavioral therapy might be useful for treating dental phobia
It could be an alternative to sedation for some patients
Cognitive-behavioral therapy has a pretty solid reputation within the psychological research community. The basic idea behind CBT is to teach patients that many people have certain patterns of thought that skew the world, sometimes making it appear darker or more anxiety-producing than it really is, and that we’re not prisoners to these patterns: We can reframe how we see the world.
So, to take an oversimplified example, a clinician might teach a patient with anxiety that when they see their parents are calling and automatically assume someone has died, they’re engaging in catastrophizing, or assuming the worst of a given situation. The clinician might ask the patient to reframe the situation: Isn’t it pretty common for parents to call even when there isn’t bad news?
This approach seems to work across a variety of different domains; patients dealing with anxiety and eating disorders and anger-management issues, among other problems, have benefited from CBT.
Now a new study takes CBT, which has also shown effectiveness for treating a variety of phobias, into the dentist’s office. Writing in the British Dental Journal, a team led by Ellie Kani of King’s College London looked at 130 British patients who were referred to up to ten one-hour sessions of CBT for dental phobia. The researchers wanted to both get a sense of who this population was and what percentage went on to have dental treatment with or without sedation.
Not surprisingly, dental fears were common in this group — the researchers write that “Approximately 77% of the patients scored at levels suggestive of dental phobia on the Modified Dental Anxiety Scale (MDAS),” which, yes, is a thing. About 37 percent had problems with anxiety, and 12 percent with depression.
As for the treatment’s effectiveness, a full 79 percent of the patients eventually had dental procedures done without sedation, after an average of five sessions. It’s unclear exactly what this means, because this wasn’t a full-blown experiment with a control or comparison group, but the largest group of referrals for this study did consist of folks who’d had previous dental work done under sedation.
It can only be a good thing, in other words, for people who are fearful of the dentist to go from requesting sedation (assuming the decision wasn’t partially made for them by a dentist) to going without.
That said, for CBT to catch on in this area, it would definitely be helpful to have more rigorous evidence that controls for things like the seriousness of the dental procedure in question, and that compares CBT to other approaches designed to help get people to stop squirming in terror in their dentists’ chairs.