Effectiveness of a Computerized Dental Fear Treatment

Dental phobia is readily treated using psychological therapies such as systematic desensitization.  Nevertheless, there are financial and time constraints associated with using staff to deliver this type of therapy in the dental office.  Objectives: This study assessed the effectiveness of a self-paced computerized psychological intervention, CARL (Computer Assisted Relaxation Learning; modeled on systematic desensitization), for treatment of dental injection fear within six Northwest PRECEDENT dental practice-based research network offices and one university-based clinic. Methods: Patients with dental injection fear were recruited using advertisements placed in local media. Interested patients phoned a central toll-free number for information about the study and assignment to the nearest participating dental practice, where they were consented, screened for eligibility, completed baseline fear assessments, and were randomized to treatment arm within each practice.  Treatment arms consisted of either 1) working with the CARL program until self-assessed anxiety was reduced when viewing videos about dental injections or 2) reading an informational pamphlet about dental injections and discussing this material with a staff member for 15 minutes. Patients completed the Modified Dental Anxiety Scale (MDAS), Dental Fear Survey (DFS), and Needle Survey (NS) before and after completing their respective intervention. Results:   Eighty-four patients were randomized to study condition (41 CARL, 43 pamphlet).  A total of 68 patients completed pre- and post-treatment fear assessments, 34 in each treatment arm. There were no baseline differences between groups in fear scores.  Patients using CARL had significantly reduced fear compared with those given a pamphlet on all fear scales: MDAS (12 vs. 18), DFS (54 vs. 71), and NS (38 vs. 47), p’s < 0.001. Conclusions: The CARL program was effective at reducing dental injection fear compared with an informational pamphlet, and may be a cost-effective means of reducing fear in dental practice.  Supported by NIDCR Grants U54DE014254, DE016750, DE016752 and 5K23DE019202-02.