Behavioral treatments for adult dental avoidance. A stepped-care approach.

The growing research literature dealing with the psychologic treatment of dental fear and avoidance suggests several interventions as effective, but provides little guidance in choosing among them. Under these circumstances, experienced psychologic practitioners may choose among these interventions on the basis of their own clinical impressions as to which treatment might be best suited to each patient they see. An alternative approach is the stepped-care approach in which the least expensive/most practical intervention is implemented, with more costly or complex procedures implemented only if the less expensive intervention proves unsuccessful. Each of the behavioral treatments for dental fear that has received researchers' attention is briefly described, and they are ordered in terms of their costs in professional time. Finally, an account of the special precautions needed to implement a stepped-care strategy for the reduction of dental fear is outlined.