Effects of a combination of non-pharmaceutical psychological interventions on dental anxiety

BACKGROUND: Dental anxiety is a common problem associated with poorer oral health. Managing anxiety is key to improving oral health of patients with dental anxiety. The present pilot study therefore investigated dental anxiety prevalence among patients visiting a university dental clinic. We further examined the effect of combined psychological interventions on anxiety or concern towards dental treatment procedures before treatment, after treatment, and at follow-up. METHODS: In this prospective pilot study, patients seeking restorative treatment were screened for dental anxiety and dental concern about treatment using the Dental Anxiety Scale-Revised (DAS-R) and Dental Concern Assessment (DCA) questionnaires. Participants with a DAS-R score of 9 or above were randomly assigned to an experimental or control group. The patients in the experimental group received two psycho-logical interventions (psychoeducation and progressive muscular relaxation) prior to dental treatment. Dur-ing treatment, patients received another psychological intervention (music distraction). No psychological interventions were given to control patients. DAS-R and DCA scores were used to assess dental anxiety and concern, respectively, before treatment, after treatment, and at follow-up. Nonparametric tests were used for intergroup and intragroup statistical analyses. RESULTS: Out of 64 patients surveyed, 33 (51.6%) had experienced dental anxiety. Of those, 2 were exclud-ed, and 31 patients with a mean ± SD age of 41.2 ± 15.9 y completed the study. No intergroup differences in dental anxiety were found in terms of pretreatment, posttreatment, and follow-up treatment. The mean rank value of the dental anxiety score was less in the experimental group (13.53) than the control group (18.31), albeit not significant. More specifically, differences (Kruskal-Wallis %2 = 14.82, P = 0.001, effect size = 0.33) were found in the experimental group for pretreatment, posttreatment, and follow-up treatment levels of dental anxiety for extraction (P = 0.01), injection (P = 0.02), and sound/vibration of the drill (P = 0.00). No significant intragroup differences between pretreatment, posttreatment, and follow-up treatment were found in the control group. CONCLUSIONS: The combined brief psychological interventions reduced dental anxiety. RELEVANCE FOR PATIENTS: The psychological interventions of the present study could be applied right before or during dental treatment to reduce the dental anxiety of patients. However, additional research involving larger groups is needed to replicate the results of this pilot study.