Oral health and its influence on cognitive behavioral therapy in patients fulfilling the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for intra-oral injection phobia.
OBJECTIVE
To describe self-perceived and clinically assessed oral health and oral treatment needs among intra-oral injection-phobic patients (Diagnostic and Statistical Manual of Mental Disorders-IV) and to explore whether these factors have an impact on the outcome of cognitive behavioral therapy (CBT).


METHODS
Fifty-five patients (43 women, mean age 32.5 years, range 18-62 years) were treated with short-duration CBT. Dental anxiety (Dental Anxiety Scale and Dental Fear Survey) and self-perceived oral health were assessed by means of questionnaires. Three dentists assessed oral health by means of clinical examination and radiographs. Treatment outcome was measured by ability to receive an intra-oral injection by a general dentist within a 1-year follow-up (FU) period or ability to complete a behavioral avoidance test (BAT) at FU, and changes in dental anxiety and positive and negative thoughts from pretreatment to FU.


RESULTS
Forty percent of patients ranged their oral health as "good" or "very good". Mean decayed teeth (DT) was 2.2 (range 0-15). The total number of teeth in need of treatment, periodontal treatment, endodontic treatment and extractions ranged from 0 to 15, 0 to 19, 0 to 4 and 0 to 5, respectively. Self-rated oral health correlated significantly with clinical oral health. The outcome of CBT in terms of being able to receive a dental injection during FU was not influenced by oral health status. However, correlation analyses indicated that patients with the poorest oral health had the greatest increase in positive thoughts and the greatest decrease in negative thoughts from pretreatment to FU.


CONCLUSIONS
The oral health of intra-oral injection-phobic patients varies substantially, but is comparable to that of the normal population. Coping with a dental injection after CBT is not influenced by oral health and treatment needs.
Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Aarstadveien 17, Bergen, Norway. maren.agdal@iko.uib.no
Maren Lillehaug
ML
Agdal
Magne
M
Raadal
Erik
E
Skaret
Gerd
G
Kvale
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy; D004245:DMF Index; D016854:Dental Anxiety / Q000523:psychology / Q000628:therapy*; D003729:Dental Care / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007267:Injections / Q000295:instrumentation*; D007576:Jaw, Edentulous, Partially / Q000145:classification; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa; D009339:Needles; D020380:Needs Assessment; D009909:Oral Health; D010512:Periodontal Index; D012390:Root Canal Therapy; D012649:Self Concept; D014081:Tooth Extraction; D016896:Treatment Outcome; D055815:Young Adult