Tellez Marisol, Dunne Eugene M, Konneker Elizabeth, Zhao Huaqing, Ismail Amid I
Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA.
School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
Community Dent Oral Epidemiol. 2025 Jun 13. doi: 10.1111/cdoe.13049.
The study aimed to test the efficacy of an online cognitive-behavioural therapy dental anxiety intervention (o-CBT) that could be easily implemented in dental healthcare settings.
An online cognitive-behavioural protocol based on psychoeducation, exposure to feared dental procedures and cognitive restructuring was developed. A randomised controlled trial was conducted (N = 499) to test its efficacy. Consenting adult dental patients (18-75 years old) who met inclusion criteria (e.g., high dental anxiety) were randomised to one of three arms, (a) intervention assisted by psychology staff (PI) (n = 162), (b) intervention assisted by dental staff (DI) (n = 167), or (c) a control condition (C) (n = 170). Primary outcome measures were the Modified Dental Anxiety Scale (MDAS) and the Anxiety and Related Disorders Interview Schedule DSM-V (ADIS) rating of fear. Generalised linear models for repeated measures based on intention to treat analyses were used to compare the three groups on dental anxiety, fear, avoidance and overall severity of dental phobia.
Dental anxiety was significantly lower in both PI and DI groups when compared to the control condition. Interestingly, reductions in dental anxiety favoured the DI group at 6 (p = 0.008) and 12 months only (p = 0.009). Overall, equivalency was observed between the two intervention groups (PI and DI), as there were no significant differences in dental anxiety when the dental arm was compared to the psychology arm across all time points (p > 0.05).
The online cognitive-behavioural intervention was efficacious in reducing dental anxiety when compared to a control condition in an urban sample of patients receiving treatment in a dental school setting. Examination of its effectiveness when administered in dental offices under less controlled conditions is warranted.
NCT03680755.
本研究旨在测试一种可在牙科保健环境中轻松实施的在线认知行为疗法牙科焦虑干预措施（o-CBT）的疗效。
制定了一种基于心理教育、接触令人恐惧的牙科程序和认知重构的在线认知行为方案。进行了一项随机对照试验（N = 499）以测试其疗效。符合纳入标准（如牙科焦虑程度高）的成年牙科患者（18 - 75岁）被随机分为三组之一：（a）由心理工作人员协助的干预组（PI）（n = 162），（b）由牙科工作人员协助的干预组（DI）（n = 167），或（c）对照组（C）（n = 170）。主要结局指标为改良牙科焦虑量表（MDAS）以及焦虑及相关障碍访谈量表DSM-V（ADIS）的恐惧评分。基于意向性分析的重复测量广义线性模型用于比较三组在牙科焦虑、恐惧、回避及牙科恐惧症总体严重程度方面的差异。
与对照组相比，PI组和DI组的牙科焦虑均显著降低。有趣的是，仅在6个月时（p = 0.008）和12个月时（p = 0.009），DI组的牙科焦虑降低更为明显。总体而言，两个干预组（PI和DI）之间观察到等效性，因为在所有时间点将牙科组与心理组相比时，牙科焦虑无显著差异（p > 0.05）。
在牙科学校环境中接受治疗的城市患者样本中，与对照组相比，在线认知行为干预在降低牙科焦虑方面是有效的。有必要在控制条件较差的牙科诊所中对其有效性进行检验。
NCT03680755。
