Prediction of success and failure of behavior modification as treatment for dental anxiety

Abstract

Behavior modification techniques are effective in the treatment of extreme dental anxiety, but their success is by no means absolute. In the present article, the Corah Dental Anxiety Scale (DAS), the self-report symptom inventory SCL-90R and a questionnaire accessing subjects' daydreaming styles (the Short Imaginal Process Inventory) were used to develop possible predictive measures for success and failure of behavior modification as a treatment for dental fear. The patients' level of distractibility and mind wandering, initial dental anxiety and somatization significantly predicted the success of therapy. The odds ratio indicated that the risk of therapy failure increased about 11 times with an increase of one scale of the Poor Attention Control Scale, about three times with an increase of one level of the mean DAS score, and 0.17 times with an increase of one level of somatization. The predictive value of the chosen scales was 80%. Thus, the use of these scales as part of an initial admittance process for patients who suffer from dental anxiety can enhance our ability to better recognize patients who are prone to fail behavior therapy as treatment for their problem, and enable their referral for other possible modes of treatment.

A cross sectional study of gender differences in dental anxiety prevailing in the students of a Pakistani dental college

“…27,28 Techniques that can alter the behavior of the patients could prove useful in reducing severe anxiety but even they cannot guarantee total success. 29 Counseling sessions for these severely anxious students conducted by trained professionals could prove helpful in decreasing their anxiety level. In addition, the authors recommend 'Exposure therapy' for junior dental students which is a type of behavior therapy intended to reduce the anxiety by the exposure of feared object or procedure repeatedly.…”

Behavior‐Associated Self‐Report Items in Patient Charts As Predictors of Dental Appointment Avoidance

“…D entally anxious patients tend to present with long-term avoidance behavior and seek treatment only when severe pain is experienced. [1][2][3][4] This avoidance pattern often complicates the patient's required dental procedures, induces stress in the dentist, and interferes with the dentist's ability to provide comprehensive care. 5 More importantly, the patient's oral health is significantly compromised due to avoidance.…”

“…Reports have indicated that, in comparison to control groups, phobic patients present with more missing teeth, more tooth decay, fewer filled surfaces, more periradicular lesions, and more bone loss. 1,5 In addition, because dental providers lack sufficient knowledge in addressing anxiety-related psychological issues, dentist-patient rapport and the quality of care often suffer as a result. 6 Considering the ramifications of this problem, dental care providers need to acquire the ability to recognize and adequately manage patient anxiety.…”

“…14,15 In addition, researchers have reported that long-term avoidance behavior appears to play a significant role in fearful patients' treatment-seeking patterns. [1][2][3][4] In the current health questionnaire adopted by the UCLA Dental Center, there are seven items presented to patients under the behavioral category. Because there appear to be indirect relationships among depression, anxiety, avoidance pattern, and general dental fearfulness, it would be reasonable to hypothesize that, among the seven items, behaviors identified by the three specific health questionnaire items (items 117, 118, and 120 in Table 1) are likely to play a role in patients' canceling or missing dental appointments.…”

A comprehensive review of predictive and prognostic composite factors implicated in the heterogeneity of treatment response and outcome across disease areas

“…The study found that the predictive value of the chosen scales was 80% and that the risk of therapy failure increased about 11 times with an increase of one scale of the PACS (OR = 11.20; 95% CI = 1.70–73.10), about three times with an increase of one level of the mean DAS score (OR = 2.96; 95% CI = 1.15–7.63) and 0.17 times with an increase of one level of the SCL‐90R (OR = 0.17; 95% CI = 0.03–0.92). Ultimately, the study recommended that the scores be used as part of an initial admittance process for patients who suffer from dental anxiety to enhance the ability to recognise patients who are prone to fail behaviour therapy (25).…”