Computerized dental injection fear treatment: a randomized clinical trial

Abstract

One in four adults reports a clinically significant fear of dental injections, leading many to avoid dental care. While systematic desensitization is the most common therapeutic method for treating specific phobias such as fear of dental injections, lack of access to trained therapists, as well as dentists' lack of training and time in providing such a therapy, means that most fearful individuals are not able to receive the therapy needed to be able to receive necessary dental treatment. Computer Assisted Relaxation Learning (CARL) is a self-paced computerized treatment based on systematic desensitization for dental injection fear. This multicenter, block-randomized, dentist-blind, parallel-group study conducted in 8 sites in the United States compared CARL with an informational pamphlet in reducing fear of dental injections. Participants completing CARL reported significantly greater reduction in self-reported general and injection-specific dental anxiety measures compared with control individuals (p < .001). Twice as many CARL participants (35.3%) as controls (17.6%) opted to receive a dental injection after the intervention, although this was not statistically significant. CARL, therefore, led to significant changes in self-reported fear in study participants, but no significant differences in the proportion of participants having a dental injection.

Trial registration: ClinicalTrials.gov NCT00609648.

Keywords: computer-assisted therapy; dental anesthesia; dental anxiety; pamphlets; phobic disorders; psychological desensitization.

Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1.

CONSORT flow diagram for screening and recruitment.

Figure 2.

Changes in Modified Dental Anxiety Scale (MDAS; Humphris et al., 1995), Dental Fear Survey (DFS; Kleinknecht et al., 1973), and Needle Survey (NS; Milgrom et al., 1997) scores by condition. T-bars represent standard error of the mean.