Reduced dental anxiety among children with internet-based CBT

January 24, 2018, Karolinska Institutet
Dental anxiety often begins in childhood or adolescence. Credit: iStock 

Researchers at Karolinska Institutet have developed an accessible therapy for children and adolescents suffering from dental phobia. The study, published in the Journal of Medical Internet Research, shows that guided internet-based CBT is highly effective in reducing anxiety and increasing the ability to deal with dental treatment. One year later, half of the children were completely free of their phobia.

Dental anxiety often begins in childhood or adolescence, and can develop into a phobia with avoidance, strong negative feelings and thoughts aimed at dental care. Avoidance of often leads to poor oral health, untreated caries or other dental problems.

Cognitive behavioural (CBT) is an effective treatment for most forms of specific phobia. However, with regard to children and adolescents with dental phobia, there are organisational, financial and geographic obstacles to providing such therapy. Researchers in this study have therefore developed an internet-based CBT treatment that they have tested in an open, uncontrolled study of 18 patients between the ages of 8 and 15.

Treatment continued for 12 weeks

During the study, participants used an internet platform to obtain weekly online guidance from a psychologist via a chat system. Treatment continued for 12 weeks and included texts, animations and dental-related video clips. The treatment also included an exercise package with a dental mirror, probe, local anaesthetic and cannula delivered to the home of the child/parent(s) with detailed instructions for the exercises. Through therapy and guidance from the psychologist, the home-based exercises were linked to real exposure and training visits to dental clinics around Sweden.

The results show a statistically and clinically-significant increase in the children's ability to manage . The internet-based CBT also increased children's and parents' self-efficacy, led to fewer negative thoughts and reduced anxiety aimed at dental . At a one-year follow up, 53 per cent of the children were completely free of their dental phobia.

Surprisingly strong effects

"Even though we expected positive effects from the therapy, it was still surprising to see the scope of improvement and the strong effects of the therapy among the patients, given that they did not have a single physical meeting with the psychologist," explains Shervin Shahnavaz at Karolinska Institutet's Department of Dental Medicine who is the researcher behind the development of the therapy.

The researchers now hope to be able to repeat the results in an ongoing randomised controlled trial.

"Internet-based CBT for in children and adolescents may be an efficient form of therapy with the potential to increase access to ," says Dr. Shahnavaz.

Explore further: Phobia of dentists leads to more decay and tooth loss, new study finds

More information: Shervin Shahnavaz et al. Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental Anxiety: Open Trial, Journal of Medical Internet Research (2018). DOI: 10.2196/jmir.7803

Related Stories

Phobia of dentists leads to more decay and tooth loss, new study finds

April 20, 2017
People who have a severe fear of the dentist are more likely to have tooth decay or missing teeth, according to a new study from King's College London.

Dental anxiety has consequences beyond tooth decay

May 3, 2017
(HealthDay)—Does the mere thought of a dentist's drill make you cringe in fear? Be forewarned: Dental phobia can damage more than your teeth, a new British report indicates.

Cognitive behavior therapy can help overcome fear of the dentist

November 26, 2015
Cognitive behavioural therapy could help many people with a dental phobia overcome their fear of visiting the dentist and enable them to receive dental treatment without the need to be sedated, according to a new study by ...

What outcomes are associated with early preventive dental care among Medicaid-enrolled children in Alabama

February 27, 2017
Preventive dental care provided by a dentist for children before the age of 2 enrolled in Medicaid in Alabama was associated with more frequent subsequent treatment for tooth decay, more visits and more spending on dental ...

New CBT resource shows promise in reducing children's dental anxiety

November 1, 2016
The International and American Associations for Dental Research (IADR/AADR) have published an article titled "Development and Testing of a Cognitive Behavioral Therapy Resource for Children's Dental Anxiety" in the OnlineFirst ...

Research explores lasting effects of early preventive dental care in Medicaid-enrolled children

March 13, 2017
Research out of the University of Alabama at Birmingham School of Public Health suggests preventive dental care provided by a dentist for children before the age of 2 enrolled in Medicaid in Alabama may lead to more care ...

Recommended for you

Researchers identify immune culprits linked to inflammation and bone loss in gum disease

October 17, 2018
An unhealthy population of microbes in the mouth triggers specialized immune cells that inflame and destroy tissues, leading to the type of bone loss associated with a severe form of gum disease, according to a new study ...

Periodontal disease bacteria may kick-start Alzheimer's

October 4, 2018
Long-term exposure to periodontal disease bacteria causes inflammation and degeneration of brain neurons in mice that is similar to the effects of Alzheimer's disease in humans, according to a new study from researchers at ...

Dental research shows that smoking weakens immune systems

September 26, 2018
As if lung cancer, emphysema and heart disease weren't enough, there's more bad news for cigarette smokers.

Regrowing dental tissue with stem cells from baby teeth

September 11, 2018
Sometimes kids trip and fall, and their teeth take the hit. Nearly half of children suffer some injury to a tooth during childhood. When that trauma affects an immature permanent tooth, it can hinder blood supply and root ...

The starch risk to teeth

August 7, 2018
An examination of research on oral health, commissioned by the World Health Organisation, has indicated that for oral health we should stick to whole grain carbohydrates and avoid processed ones, especially if sweet.

Experts question benefits of fluoride-free toothpaste

August 7, 2018
Dental health experts worry that more people are using toothpaste that skips the most important ingredient—fluoride—and leaves them at a greater risk of cavities.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.