Molde Competence Clinic for Public Dental Health Service, Møre and Romsdal County Authority, Molde, Norway.
Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
BMC Psychiatry. 2024 Sep 10;24(1):606. doi: 10.1186/s12888-024-06055-w.
While cognitive-behavioural therapy (CBT) is a well-established treatment for odontophobia, research is sparse regarding its effect on patients with dental anxiety related to psychological trauma experiences. This study aimed to evaluate changes in symptoms and acceptability of interdisciplinary Torture, Abuse, and Dental Anxiety (TADA) team treatment for patients with odontophobia or dental anxiety. We also wanted to describe the sample's oral health status. The TADA teams offer targeted anxiety treatment and adapted dental treatment using a CBT approach.
The study used a naturalistic, case series design and included 20 consecutively referred outpatients at a public TADA dental clinic. Pre- and post-treatment assessments included questionnaires related to the degree of dental anxiety, post-traumatic stress, generalized anxiety, and depression. Patients underwent a panoramic X-ray before treatment. Before dental restoration, patients underwent an oral health examination to determine the mucosal and plaque score (MPS) and the total number of decayed, missing, and filled teeth (DMFT). Patients were referred to dentist teams for further dental treatment and rehabilitation (phase 2) after completing CBT in the TADA team (Phase 1). Results from the dental treatment in phase 2 is not included in this study.
All patients completed the CBT treatment. There were significant improvements in symptoms of dental anxiety, post-traumatic stress, and depression and moderate changes in symptoms of generalized anxiety. Dental statuses were heterogeneous in terms of the severity and accumulated dental treatment needs. The TADA population represented the lower socioeconomic range; 15% of patients had higher education levels, and half received social security benefits. All patients were referred to and started adapted dental treatment (phase 2).
TADA treatment approach appears acceptable and potentially beneficial for patients with odontophobia and dental anxiety related to psychological trauma experiences. The findings suggest that further research, including larger controlled studies, is warranted to validate these preliminary outcomes.
The study was approved by the regional ethical committee in Norway (REK-Midt: 488462) and by the Data Protection Board at Møre and Romsdal County Authority.
认知行为疗法（CBT）是一种成熟的治疗恐牙症的方法，但关于其对因心理创伤经历而导致的牙科焦虑症患者的疗效的研究却很少。本研究旨在评估跨学科酷刑、虐待和牙科焦虑症（TADA）团队治疗对恐牙症或牙科焦虑症患者的症状和可接受性的变化。我们还想描述样本的口腔健康状况。TADA 团队提供有针对性的焦虑症治疗和采用 CBT 方法进行的适应性牙科治疗。
本研究采用自然主义、病例系列设计，纳入了一家公立 TADA 牙科诊所的 20 名连续转诊的门诊患者。治疗前后评估包括与牙科焦虑症、创伤后应激、广泛性焦虑症和抑郁症程度相关的问卷。患者在治疗前接受全景 X 光检查。在进行牙科修复之前，患者接受口腔健康检查以确定黏膜和菌斑评分（MPS）和龋齿、缺失和补牙的总数（DMFT）。患者在完成 TADA 团队中的 CBT 治疗后（第 1 阶段），被转诊给牙医团队进行进一步的牙科治疗和康复（第 2 阶段）。第 2 阶段的牙科治疗结果不在本研究范围内。
所有患者均完成了 CBT 治疗。牙科焦虑症、创伤后应激和抑郁症的症状显著改善，广泛性焦虑症的症状也有所改善。在严重程度和累积牙科治疗需求方面，牙科状况存在异质性。TADA 人群代表了较低的社会经济阶层；15%的患者受过高等教育，一半人领取社会安全福利。所有患者都被转介并开始接受适应性牙科治疗（第 2 阶段）。
TADA 治疗方法似乎对因心理创伤经历而导致的恐牙症和牙科焦虑症患者是可接受的，并且可能有益。研究结果表明，需要进一步的研究，包括更大的对照研究，以验证这些初步结果。
本研究得到了挪威地区伦理委员会（REK-Midt：488462）和莫尔达伦郡行政委员会数据保护局的批准。
