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Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia

BACKGROUND: People with dental phobia often present with more active dental caries and fewer teeth. Minimally Intervention oral Healthcare offers a possible solution to address the high care needs of this group. The aim was to determine this patient group’s eligibility and willingness to participate...

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Autores principales: Heidari, Ellie, Banerjee, Avijit, Newton, Jonathon Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391962/
https://www.ncbi.nlm.nih.gov/pubmed/37525153
http://dx.doi.org/10.1186/s12903-023-03095-8
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author Heidari, Ellie
Banerjee, Avijit
Newton, Jonathon Tim
author_facet Heidari, Ellie
Banerjee, Avijit
Newton, Jonathon Tim
author_sort Heidari, Ellie
collection PubMed
description BACKGROUND: People with dental phobia often present with more active dental caries and fewer teeth. Minimally Intervention oral Healthcare offers a possible solution to address the high care needs of this group. The aim was to determine this patient group’s eligibility and willingness to participate and the effect of MIOC, compared to treatment as usual (TAU), on their oral health outcomes for planning a future randomised controlled trial (RCT). Minimum intervention oral healthcare (MIOC) comprises of four interlinked domains. In the first domain, we identified and diagnosed the disease status and participants’ anxiety status (≥ 19 MDAS). In the second domain, an individualised prevention-based personalised care plan was designed. During this process, patients with dental phobia were exposed to the dental environment in a stepped manner (‘graded exposure’) and had their urgent care provided with conscious sedation. In the 3(rd) domain, we took a minimally invasive operative approach to restore teeth while preserving tooth substance and limiting the use of fear-provoking stimuli (e.g., rotary instruments) when possible. At the review and the recall appointment(s) (4(th) domain), the patients’ oral health care behaviours, disease risk/susceptibility and fear levels were re-assessed. METHODS: This two-arm randomised feasibility trial (N = 44) allocated participants to the experimental arm (MIOC) or the control arm (treatment as usual [TAU]). The primary outcomes were the eligibility and willingness to participate and feasibility to conduct a trial of MIOC for people with dental phobia. The secondary outcomes were oral health status, oral health related quality of life and care completion. A written and verbal consent for participation and dental care provision were obtained. RESULTS: Forty-four people diagnosed with dental phobia were allocated randomly to the two study arms. At the six-month recall after completed care, the outcome of each study arm was assessed. It was feasible to conduct a clinical trial (eligibility rate [56%], completion rate [81%], declined to participate [12%]). The intervention group showed improvements in all health care outcomes, and oral health related quality of life. CONCLUSION: A clinical trial of MIOC vs TAU in people with dental phobia is feasible. Preliminary findings suggest that patients in the MIOC arm are more likely to successfully complete their course of treatment. The study was ‘retrospectively registered’ on 02/05/2018 (ISRCT15294714) with the International Standard Randomised Controlled Trial (ISRCT).
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spelling pubmed-103919622023-08-02 Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia Heidari, Ellie Banerjee, Avijit Newton, Jonathon Tim BMC Oral Health Research BACKGROUND: People with dental phobia often present with more active dental caries and fewer teeth. Minimally Intervention oral Healthcare offers a possible solution to address the high care needs of this group. The aim was to determine this patient group’s eligibility and willingness to participate and the effect of MIOC, compared to treatment as usual (TAU), on their oral health outcomes for planning a future randomised controlled trial (RCT). Minimum intervention oral healthcare (MIOC) comprises of four interlinked domains. In the first domain, we identified and diagnosed the disease status and participants’ anxiety status (≥ 19 MDAS). In the second domain, an individualised prevention-based personalised care plan was designed. During this process, patients with dental phobia were exposed to the dental environment in a stepped manner (‘graded exposure’) and had their urgent care provided with conscious sedation. In the 3(rd) domain, we took a minimally invasive operative approach to restore teeth while preserving tooth substance and limiting the use of fear-provoking stimuli (e.g., rotary instruments) when possible. At the review and the recall appointment(s) (4(th) domain), the patients’ oral health care behaviours, disease risk/susceptibility and fear levels were re-assessed. METHODS: This two-arm randomised feasibility trial (N = 44) allocated participants to the experimental arm (MIOC) or the control arm (treatment as usual [TAU]). The primary outcomes were the eligibility and willingness to participate and feasibility to conduct a trial of MIOC for people with dental phobia. The secondary outcomes were oral health status, oral health related quality of life and care completion. A written and verbal consent for participation and dental care provision were obtained. RESULTS: Forty-four people diagnosed with dental phobia were allocated randomly to the two study arms. At the six-month recall after completed care, the outcome of each study arm was assessed. It was feasible to conduct a clinical trial (eligibility rate [56%], completion rate [81%], declined to participate [12%]). The intervention group showed improvements in all health care outcomes, and oral health related quality of life. CONCLUSION: A clinical trial of MIOC vs TAU in people with dental phobia is feasible. Preliminary findings suggest that patients in the MIOC arm are more likely to successfully complete their course of treatment. The study was ‘retrospectively registered’ on 02/05/2018 (ISRCT15294714) with the International Standard Randomised Controlled Trial (ISRCT). BioMed Central 2023-07-31 /pmc/articles/PMC10391962/ /pubmed/37525153 http://dx.doi.org/10.1186/s12903-023-03095-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Heidari, Ellie
Banerjee, Avijit
Newton, Jonathon Tim
Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia
title Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia
title_full Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia
title_fullStr Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia
title_full_unstemmed Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia
title_short Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia
title_sort feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391962/
https://www.ncbi.nlm.nih.gov/pubmed/37525153
http://dx.doi.org/10.1186/s12903-023-03095-8
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