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Study of Anxiety Free Experiences at the Dentist (SAFE-D)

5. november 2026 opdateret af: Laura Seligman, University of Texas Rio Grande Valley

One Session Treatment for Dental Phobia in an Underserved Population

The goal of this clinical trial is to compare two treatments for dental phobia in children and adolescents: One-Session Treatment for Dental Phobia (OSTD) and psychoeducation plus relaxation training (RELAX).

The main questions this study aims to answer are:

  • Is one intervention more effective in reducing the severity of dental phobia 6 months after treatment?
  • Are improvements in dental fear and anxiety maintained 12 months after treatment?
  • How do changes in fear-related learning and beliefs contribute to treatment outcomes?
  • How acceptable and practical are these treatments for youth, their parents, and the professionals delivering the treatments?

Researchers will enroll approximately 160 youth with dental phobia and randomly assign them to one of two treatment groups. Participants will receive either OSTD or RELAX.

Participants will:

  • Complete an initial assessment of their dental fear and anxiety.
  • Participate in their assigned treatment.
  • Complete assessments 1 week, 6 months, and 12 months after treatment to evaluate changes in dental fear, anxiety, and related beliefs and behaviors.

Researchers will compare the two groups to determine which treatment is more effective in reducing dental phobia, whether improvements last over time, and how changes in fear-related learning may contribute to treatment outcomes.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The study will examine inhibitory learning as a potential mechanism underlying improvements in dental phobia following One-Session Treatment for Dental Phobia (OSTD) compared with psychoeducation and relaxation training (RELAX). Inhibitory learning involves developing new associations that reduce the influence of previously learned fear responses. The study will investigate whether changes in implicit associations with dental-related stimuli and beliefs about potential harm help explain treatment-related improvements in dental phobia.

Exploratory analyses will examine potential predictors and moderators of treatment outcomes at 6 and 12 months post-treatment. Variables of interest include coping efficacy, habituation, fear activation, acculturation, outcome expectancy, fear of pain, cognitive vulnerability, comorbidity, and distress tolerance. Multiple regression models will evaluate associations between these variables and treatment outcomes, including dental phobia severity, dental anxiety symptoms, individualized treatment goal attainment, and dental cleaning appointment attendance. Selected analyses will be restricted to participants receiving OSTD when the predictor is specific to that intervention. Additional analyses will examine whether baseline characteristics moderate differences in treatment outcomes between OSTD and RELAX.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

160

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: SAFE-D Research Team Member
  • Telefonnummer: 956-665-3500
  • E-mail: safe-d@utrgv.edu

Studiesteder

    • Texas
      • Brownsville, Texas, Forenede Stater, 78520
        • Ikke rekrutterer endnu
        • University of Texas Rio Grande Valley
        • Kontakt:
      • Edinburg, Texas, Forenede Stater, 78539
        • Rekruttering
        • University of Texas Rio Grande Valley
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

7 år til 16 år (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

To be eligible to participate in this study, an individual must meet all the following criteria:

  • Subject and one parent/LAR must be willing and able to give informed assent/consent for participation in the study.
  • Subject and one parent/LAR must be willing and able to comply with all study procedures for the duration of the study, including randomization to treatment condition and interventionist.
  • Subject must be between 7 and 16 years of age.
  • Subject must meet DSM 5 criteria for a specific phobia, blood- injection -injury type with dental stimuli as the focus of the phobia.
  • Subject and parent/LAR must be able to read, write, and converse in English or Spanish.

Exclusion Criteria:

An individual who meets any of the following criteria at baseline will be excluded from participating in this study:

If the parent-reports:

  • Subject or first degree relative participated in the pilot study (UG3DE031247).
  • Subject has active suicidal ideation, psychotic disorder, intellectual disability (as indicated by school placement), or severe autism spectrum disorder.
  • Subject's dental fears are limited to fear of injections or sight of blood.
  • Subject resides in the same household as another individual already participating in current study.
  • Subject is a first degree relative of another individual already participating in current study.
  • Subject has received a trial of exposure therapy or relaxation treatment for dental phobia in the past year.
  • Subject is currently taking anxiolytic medication, and the dose or medication is likely to change between Baseline Assessment and Six-Month Post Treatment Assessment.
  • Any other significant disease or disorder that would place the subject at risk because of participation in the study or preclude the subject's full compliance with or completion of the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: OSTD

OSTD is a cognitive behavioral treatment with the main component of the treatment being massed exposure exercises guided by an inhibitory learning framework.

OSTD is a single-session behavioral intervention designed to reduce dental phobia in children and adolescents. The intervention uses individualized, graduated exposure to feared dental situations and procedures. Exposure activities are guided by a participant-specific fear hierarchy and cognitive-behavioral assessment developed before treatment. During the treatment session, participants engage in exposure exercises intended to help them confront feared dental situations and develop new learning about anticipated negative outcomes.

Aktiv komparator: RELAX

RELAX is a psychoeducational intervention paired with progressive muscle relaxation.

RELAX is a single-session behavioral comparison intervention consisting of psychoeducation and relaxation training for children and adolescents with dental phobia. The intervention includes information about dental-related fear and anxiety and instruction in relaxation strategies, including progressive muscle relaxation. Participants receive guided relaxation training intended to support the management of anxiety associated with dental situations.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Dental Phobia Severity From Baseline to 6 Months Post-Treatment
Tidsramme: 6 months post-treatment

Dental phobia severity will be assessed using the dental phobia module of the Anxiety Disorders Interview Schedule for Children. Information obtained from parent and child interviews will be used to establish a consensus Clinician Severity Rating (CSR). The primary outcome is the consensus CSR at 6 months post-treatment. Score range is 0 to 8, lower scores indicate less severe dental phobia. Treatment group differences will be evaluated using regression analysis adjusting for baseline CSR and prespecified covariates.

6 months post-treatment
Change in Dental Phobia Severity From Baseline to 12 Months Post-Treatment
Tidsramme: 12 months post-treatment

Dental phobia severity will be assessed using the dental phobia module of the Anxiety Disorders Interview Schedule for Children. Parent and child interview information will be used to establish a consensus Clinician Severity Rating (CSR). Score range is 0 to 8, lower scores indicate less severe dental phobia. The 12-month consensus CSR will be compared between treatment groups, adjusting for baseline CSR and prespecified covariates.

12 months post-treatment
Change in Dental Anxiety Symptoms From Baseline to 12 Months Post-Treatment
Tidsramme: 1 week, 6 months, and 12 months post-treatment

Dental anxiety symptoms will be assessed using the Modified Child Dental Anxiety Scale (MCDAS) and a modified parent version (MDAS-P) administered to children and parents. Scores will be used to evaluate dental anxiety at 1 week, 6 months, and 12 months post-treatment. Treatment group differences will be evaluated at each follow-up assessment using regression models adjusting for baseline dental anxiety and prespecified covariates. Higher scores indicate greater dental anxiety.

1 week, 6 months, and 12 months post-treatment
Attainment of Personalized Treatment Goal at 6 Months and 12 Months Post Treatment
Tidsramme: 6 months and 12 months post-treatment

Treatment goal attainment will be evaluated using a personalized treatment goal identified by the participant's family. Goal attainment will be classified into three ordered categories: no attainment, partial attainment, and full attainment. Treatment group differences will be evaluated using ordinal regression models.

6 months and 12 months post-treatment
Attendance at Recommended Dental Cleaning Appointment
Tidsramme: 6 months and 12 months post-treatment

Compliance with dental health treatment recommendations will be assessed by determining whether the participant attended a recommended dental cleaning appointment. Attendance will be recorded as a binary outcome (attended or did not attend). Treatment group differences will be evaluated at the 6-month and 12-month follow-up assessments.

6 months and 12 months post-treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Implicit Associations With Dental Stimuli Assessed by the Affect Misattribution Procedure (AMP)
Tidsramme: Baseline (within 14 days before treatment), Treatment (Day 0), 1 week post-treatment, and 6 months post-treatment

Implicit associations with dental-related stimuli will be assessed using the Affect Misattribution Procedure (AMP). AMP performance will be examined as an indicator of inhibitory learning and evaluated as a potential mediator of treatment outcomes. The measure will be assessed before treatment and at subsequent assessment points to examine treatment-related changes in automatic affective responses to dental stimuli.

Baseline (within 14 days before treatment), Treatment (Day 0), 1 week post-treatment, and 6 months post-treatment
Change in Outcome Expectancy Violation from Baseline to 6 Months Post-Treatment
Tidsramme: Baseline (within 14 days before treatment), Treatment (Day 0), 1 week post-treatment, and 6 months post-treatment

Beliefs about potential harm associated with dental treatment will be assessed using the Harm Beliefs component of the Harm Beliefs and Coping Efficacy Interview. Changes in harm beliefs will be evaluated as an indicator of outcome expectancy violation and examined as a potential mediator of treatment outcomes. Perceived Likelihood (Probability): Rating how certain the participant is that a worst-case scenario will happen (from 0 Not Going to Happen to 8 Definitely Going to Happen). Perceived Severity (Impact): Rating the magnitude of the anticipated danger (from 0 Not Bad at All to 8 Very, Very Bad).

Baseline (within 14 days before treatment), Treatment (Day 0), 1 week post-treatment, and 6 months post-treatment

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Parent-Reported Treatment Satisfaction
Tidsramme: 1 week, 6 months, and 12 months post-treatment

Parent satisfaction with the assigned treatment will be assessed using the parent version of the Treatment Satisfaction Survey. Scores will be compared between OSTD and RELAX at each follow-up assessment to evaluate parent-reported treatment satisfaction. Scores range from 12-60 with higher scores indicating more satisfaction.

1 week, 6 months, and 12 months post-treatment
Child-Reported Treatment Satisfaction
Tidsramme: 1 week, 6 months, and 12 months post-treatment

Child satisfaction with the assigned treatment will be assessed using the child version of the Treatment Satisfaction Survey. Scores will be compared between OSTD and RELAX at each follow-up assessment to evaluate child-reported treatment satisfaction. Scores range from 12-60 with higher scores indicating more satisfaction.

1 week, 6 months, and 12 months post-treatment
Interventionist-Reported Treatment Satisfaction
Tidsramme: Within 6 months of completion of treatment delivery for all study participants

Interventionists will complete the Acceptability of Intervention Measure (AIM) to evaluate their perceptions of treatment acceptability. Scores will be compared between OST-D and RELAX to assess differences in perceived acceptability. Interventionists will complete the Feasibility of Intervention Measure (FIM) to evaluate their perceptions of the feasibility of delivering the treatment. Scores will be compared between OST-D and RELAX to assess differences in perceived treatment feasibility. Interventionists will complete the Intervention Appropriateness Measure (IAM) to evaluate their perceptions of the appropriateness of the treatment for youth with dental phobia. Scores will be compared between OST-D and RELAX. Scores range from 4-20 with higher scores indicating greater acceptability, feasibility and appropriateness for each respective measure.

Within 6 months of completion of treatment delivery for all study participants
Treatment Fidelity and Interventionist Competence
Tidsramme: Treatment (Day 0)

Treatment fidelity and interventionist competence will be assessed using the study-specific Fidelity and Competence Coding Form. Selected treatment sessions will be evaluated to assess adherence to the assigned intervention protocol and competence in treatment delivery. 25% of sessions in each condition will be coded for fidelity and competence.

Treatment (Day 0)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Laura D Deligman, Ph.D., University of Texas Rio Grande Valley
  • Ledende efterforsker: Joseph H Hovey, Ph.D., University of Texas Rio Grande Valley

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. november 2026

Primær færdiggørelse (Anslået)

1. marts 2030

Studieafslutning (Anslået)

1. marts 2030

Datoer for studieregistrering

Først indsendt

20. oktober 2026

Først indsendt, der opfyldte QC-kriterier

5. november 2026

Først opslået (Faktiske)

12. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 22-113-E
  • 4UH3DE031247-03 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

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