A Practice-Based Comparison of Brief Cognitive Behavioural Treatment, Two Kinds of Hypnosis and General Anaesthesia in Dental Phobia

Abstract

Background: A practice-based study was carried out to assess the comparative effectiveness and acceptability of standardised hypnosis, hypnosis with individualised imagery, cognitive behavioural treatment (CBT) and general anaesthesia (GA) in the treatment of dental phobia. Methods: A 4-group design was used with 4 repeated measurement occasions. Of an initial total of 137 dental phobics, 77 completed the study with sample sizes of between 14 and 29 patients in the 4 groups. Participants completed questionnaires of dental anxiety at the beginning of the trial, before and after the first dental appointment and again before the second dental appointment a week later. Results: Standardised hypnosis evidenced a significantly higher rate of premature termination of treatment than CBT. The completer analysis showed a significant reduction of dental anxiety after CBT and individualised hypnosis compared to the GA condition. The intent-to-treat analysis showed significant improvement only after CBT. Conclusions: The results suggest that CBT is the treatment of choice in dental phobia when taking both effectiveness and acceptability into account.

Large Group Exposure Treatment: A Feasibility Study of Exposure Combined with Diaphragmatic Breathing in Highly Dental Fearful Individuals

“…Presented in an individual setting, the program yielded very high effects on subjective and behavioral fear responses in a pilot-study (Wannemüller et al, 2015). A three-session individual version of the treatment evidenced significant predominant effects compared to two forms of dental-hypnosis (Wannemüller et al, 2011). …”

“…Point prevalence of DP ranges from 2.1% (Frederikson et al, 1996) to 3.7% (Oosterink et al, 2009). In individuals suffering from DP, serious dental health indices have been reported with about eight teeth currently requiring dental treatment (Thom et al, 2000; Wannemüller et al, 2011). The risk of somatic comorbidities, such as cardiac disease (Cronin, 2009) resulting from poor dental health, as well as psychiatric comorbidities such as other anxieties, mood disorders or substance abuse (Roy-Byrne et al, 1994) is greatly enhanced in individuals suffering from DP.…”

A controlled trial on the effect of hypnosis on dental anxiety in tooth removal patients

“…Our findings are not applicable to those patients with severe levels of dental anxiety including those who totally avoid dental care. The current evidence suggests that cognitive-behavioral approaches are the most efficient interventions for this specific group [12,[16][17][18]. But these interventions are not part of routine dental care and should be implemented or at least supervised by psychotherapists.…”

“…Severely burdened patients with dental phobia require more complex psychotherapeutic interventions like cognitive-behavioral techniques. There are few studies investigating positive effects of cognitivebehavioral interventions for dental phobia showing improved utilization rates of dental care and reduced dental anxiety after treatment [14,[16][17][18]. In these patients cognitive-behavioral interventions are supposed to be more effective than hypnosis or other psychological interventions [12,[16][17][18].…”

A randomized controlled trial of the effect of a brief cognitive‐behavioral intervention on dental fear

“…Finally, Wannemueller et al . found two sessions of cognitive‐behavioral therapy to be superior to both hypnosis and general anesthesia.…”