ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title A Self-Administered Computerized Treatment Based on Systematic Desensitization Can Reduce Fear of Dental Injections in Fearful Patients
Clinical Question In patients with a fear of dental injections and treatment, does a self-administered computerized treatment program better reduce dental injection and treatment fear compared to information provided in a pamphlet form?
Clinical Bottom Line Although both approaches showed evidence of reduction in self-reported levels of both dental injection fear and overall dental anxiety, there is a far more significant reduction after patients go through the Computer Assisted Relaxation Learning (CARL) treatment compared to reviewing the pamphlet for patients with a baseline level of anxiety classified as “high dental anxiety.”
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23690352Heaton/201368 adults with a Modified Dental Anxiety Scale (MDAS) over 19 (high dental anxiety).Randomized Controlled Trial
Key resultsCARL shows a highly significant (p < .001) reduction in MDAS scores from 18.5 to 12.5 (on a scale from 5 to 25), showing a decrease in general dental anxiety. The CARL was more effective in this reduction, with a difference of 5.5 points on the MDAS scale, as compared to the pamphlet conditioning. Similar findings apply for dental injection fear measurements.
Evidence Search ("Dental Anxiety"[Mesh] AND "therapy"[Subheading]) AND "Software"[Mesh]
Comments on
The Evidence
Validity: The groups in this study design started with similar levels of dental injection fear and general dental anxiety; the study completion rate was greater than 80%, with adequate compliance and follow-up. The double-blind study was adequately randomized with no evidence of competing interests, and recall bias is unlikely.
Applicability This study is applicable to all patients with a self-reported fear of injections or dental anxiety and therefore should be noted by all dental professionals. The CARL therapy does not require a specialist or prior training to administer to patients, broadening its level of access. This treatment is of low cost to the dentist, and its benefits to patient management outweigh the cost and time put into offering this therapy to an anxious patient.
Specialty/Discipline (Public Health) (Endodontics) (General Dentistry) (Oral Surgery) (Pediatric Dentistry) (Periodontics) (Restorative Dentistry)
Keywords Dental injection, fear, anxiety, computer software, local anesthetic
ID# 3087
Date of submission: 04/14/2016spacer
E-mail tranjt@livemail.uthscsa.edu
Author Juliette Tran
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author John Hatch, PhD
Faculty mentor/Co-author e-mail Hatch@uthscsa.edu
Basic Science Rationale
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