Treatment modalities in a dental fear clinic and the relation with general psychopathology and oral health variables.
OBJECTIVE
To assess differences among highly anxious dental patients assigned to different treatment modes (i.e. behavioural management (BM), nitrous oxide sedation (NOS), intravenous sedation (IVS). Patients were compared with regard to psychological and dental variables before treatment (e.g. number of decayed teeth), and dental variables after treatment (e.g. number of fillings made).


METHODS
Dentists experienced in the treatment of highly anxious patients allocated patients to a treatment mode based upon their clinical judgement.


METHODS
Centre for Special Dental Care, Amsterdam, The Netherlands.


METHODS
211 patients from this dental fear clinic.


METHODS
General psychopathology, as measured by the Symptom Checklist 90 (SCL-90), and dental anxiety (DAS, S-DAI, 10-point scale) were measured prior to treatment. From the panoramic radiograph the following pre-treatment dental variables were assessed: number of teeth, number of decayed teeth, number of retained roots, and number of root-filled teeth. After treatment, number of fillings, extractions, endodontically treated elements, number of visits, and treatment duration, were determined from the patients' records.


RESULTS
Of the 144 patients who received dental treatment at the clinic, 46.5% was treated using a BM approach, 27.8% with NOS, 22.9% with IVS, and 2.8% under GA. No differences among the treatment groups were found with regard to SCL-90 and dental anxiety. The results showed that patients in the IVS group had statistically significant more decayed teeth than patients in the BM group. Furthermore, more fillings were made in the IVS group than in the BM group.


CONCLUSIONS
Since it appeared possible to treat a large proportion of patients by BM alone, training dentists in the application of psychological methods for the treatment of anxious patients should be stimulated. In addition, future research should seek for variables that, besides oral health, are better able to discriminate between groups of highly anxious patients than measures of dental anxiety and psychopathology.
Aartman
I H
IH
Department of Social Dentistry and Dental Health Education, Academic Centre for Dentistry, Amsterdam, The Netherlands.
de Jongh
A
A
Makkes
P C
PC
Hoogstraten
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000379:methods*; D000771:Anesthesia, Intravenous; D001521:Behavior Therapy; D016292:Procedural Sedation; D004245:DMF Index; D016854:Dental Anxiety / Q000150:complications* / Q000628:therapy*; D003731:Dental Caries / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis; D008609:Mental Status Schedule; D008875:Middle Aged; D009609:Nitrous Oxide; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
D009609:Nitrous Oxide