Adult Anxiety Clinic, Department of Psychology, Temple University, Philadelphia, PA 19122, USA.
J Anxiety Disord. 2013 May;27(4):365-78. doi: 10.1016/j.janxdis.2013.04.002. Epub 2013 Apr 13.
Dental anxiety and specific phobia of dental procedures are prevalent conditions that can result in substantial distress and oral health impairment. This paper critically reviews 22 randomized treatment trials aimed at reducing dental anxiety and avoidance in adults, published in peer-reviewed journals between 1974 and 2012. The following treatment techniques are reviewed: various forms of cognitive-behavioral therapy (CBT), relaxation training, benzodiazepine premedication, music distraction, hypnotherapy, acupuncture, nitrous oxide sedation, and the use of lavender oil scent. CBT delivered in a variety of formats, including one-session treatment, has the most evidence for its efficacy. Cognitive techniques, relaxation, and techniques to increase patients' sense of control over dental care are also efficacious but perform best when combined with repeated, graduated exposure. Other interventions require further study in randomized trials before conclusions about their efficacy are warranted. Limitations of the extant outcome research and implications for future treatment and research are discussed.
牙科焦虑症和对牙科操作的特定恐惧症是普遍存在的情况，可能会导致严重的痛苦和口腔健康受损。本文批判性地回顾了 22 项旨在减少成人牙科焦虑症和回避的随机治疗试验，这些试验发表在 1974 年至 2012 年期间的同行评议期刊上。本文回顾了以下治疗技术：各种形式的认知行为疗法（CBT）、放松训练、苯二氮䓬类药物预处理、音乐分散注意力、催眠疗法、针灸、笑气镇静以及薰衣草油气味的使用。以各种形式提供的 CBT，包括单次治疗，其疗效最有证据支持。认知技术、放松和增加患者对牙科护理控制感的技术也同样有效，但当与重复、分级暴露相结合时效果最佳。其他干预措施需要在随机试验中进一步研究，才能证明其疗效。讨论了现有结果研究的局限性以及对未来治疗和研究的影响。
