title: Efficacy of virtual reality exposure therapy for treatment of dental phobia: a randomized control trial.
abstract: BACKGROUND
  Virtual Reality Exposure Therapy (VRET) is found to be a promising and a viable alternative for in vivo exposure in the treatment of specific phobias. However, its usefulness for treating dental phobia is unexplored. The aims of the present study are to determine: (a) the efficacy of VRET versus informational pamphlet (IP) control group in terms of dental trait and state anxiety reductions at 1 week, 3 months and 6 months follow-up (b) the real-time physiological arousal [heart rate (HR)] of VRET group participants during and following therapy (c) the relation between subjective (presence) and objective (HR) measures during VRET.
  
  
  METHODS
  This study is a single blind, randomized controlled trial with two parallel arms in which participants will be allocated to VRET or IP with a ratio of 1:1. Thirty participants (18-50 years) meeting the Phobia Checklist criteria of dental phobia will undergo block randomization with allocation concealment. The primary outcome measures include participants' dental trait anxiety (Modified Dental Anxiety Scale and Dental Fear Survey) and state anxiety (Visual Analogue Scale) measured at baseline (T0), at intervention (T1), 1-week (T2), 3 months (T3) and 6 months (T4) follow-up. A behavior test will be conducted before and after the intervention. The secondary outcome measures are real-time evaluation of HR and VR (Virtual Reality) experience (presence, realism, nausea) during and following the VRET intervention respectively. The data will be analyzed using intention-to-treat and per-protocol analysis.
  
  
  CONCLUSIONS
  This study uses novel non-invasive VRET, which may provide a possible alternative treatment for dental anxiety and phobia.
  
  
  BACKGROUND
  ISRCTN25824611 , Date of registration: 26 October 2015.
authors.affiliation: Department of Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 LA, Amsterdam, The Netherlands. drrags80@gmail.com.|Faculty of Dentistry, SEGi University, No:9 Jalan Teknologi, Kotadamansara, PJU-5, Petalingjaya-47810, Selangor, Malaysia. drrags80@gmail.com.
authors.forename: Kumar
authors.initials: K
authors.lastname: Raghav
authors.affiliation: Department of Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 LA, Amsterdam, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Van Wijk
authors.affiliation: Faculty of Dentistry, SEGi University, No:9 Jalan Teknologi, Kotadamansara, PJU-5, Petalingjaya-47810, Selangor, Malaysia.
authors.forename: Fawzia
authors.initials: F
authors.lastname: Abdullah
authors.affiliation: Faculty of Dentistry, SEGi University, No:9 Jalan Teknologi, Kotadamansara, PJU-5, Petalingjaya-47810, Selangor, Malaysia.
authors.forename: Md Nurul
authors.initials: MN
authors.lastname: Islam
authors.affiliation: Virtual Simulations Inc, Quebec, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Bernatchez
authors.affiliation: Department of Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 LA, Amsterdam, The Netherlands.|School of Health Sciences of Salford University, Manchester, UK.
authors.forename: Ad
authors.initials: A
authors.lastname: De Jongh
mesh_terms: D016854:Dental Anxiety / Q000628:therapy*; D006801:Humans; D010698:Phobic Disorders / Q000628:therapy*; D012107:Research Design; D016037:Single-Blind Method; D016896:Treatment Outcome; D063367:Virtual Reality Exposure Therapy