Children and parents' experiences of cognitive behavioral therapy for dental anxiety – a qualitative study

Abstract

Background There is a high prevalence of dental anxiety in children and adolescents. Cognitive behavioral therapy is emerging as a treatment option. Aim The purpose of this study is to explore how children with dental anxiety and their parents experience cognitive behavioral therapy (CBT) in dentistry. Design We interviewed 12 children and one of their parents and conducted a thematic analysis of the transcribed interviews. Results Perspective shift emerged as overarching theme in our thematic analysis. This theme consisted of three main themes, which were mastery, safety, and reduced fear. Six subthemes were also identified according to our analyses. Mastery includes two subthemes, gradual exposure and autonomy and control. Subthemes and sources for safety feeling were therapeutic alliance and changed appraisal. The theme reduced fear also consisted of two subthemes; reduced anticipatory anxiety and coping. Conclusions The results show that parents and children had positive experiences of CBT and its outcome and were able to benefit from this psychological treatment when dealing with dental anxiety.

Objective assessment of the influence of the parental presence on the fear and behavior of anxious children during their first restorative dental visit

“…[ 1 2 ] Knowledge of the child's behavior and the factors influencing that behavior are, therefore, an invaluable tool to the dentist. [ 3 4 ] Parents play an important role in the dental behavior of a child patient, and it is for this reason that the role of the parent in dental fear remains a topic of interest to pediatric dentists. [ 3 4 5 6 ] As early as the 1990s, citing the increased parental participation in dental treatment, it was recognized that the traditional approach of keeping the parent out of the operatory may not be feasible or effective in all cases.…”

“…[ 3 4 ] Parents play an important role in the dental behavior of a child patient, and it is for this reason that the role of the parent in dental fear remains a topic of interest to pediatric dentists. [ 3 4 5 6 ] As early as the 1990s, citing the increased parental participation in dental treatment, it was recognized that the traditional approach of keeping the parent out of the operatory may not be feasible or effective in all cases. [ 7 ] Parental desire to be a part of the process, combined with fears of litigation have also played a role in an increased number of dentists opting to keep the parents inside the operatory.…”

Non-pharmacological methods of fighting dental anxiety

“…Cognitive-Behavioural Therapy -CBT. The effectiveness of this therapy method has already been confirmed in psychiatry, especially when dealing with anxiety disorders and phobias [19,20,21]. Cognitive-behavioural therapy has proved to be an effective way of reducing dental anxiety, especially in adult patients with moderate anxiety levels [21,22].…”

“…This kind of therapy is based on the same principles as the regular CBT. Yet, instead of face-to-face sessions, all the therapeutic work is done online [20]. In another study, Shahavaz et al have observed that children undergoing the regular CBT easier cope with fear and dental procedures.…”

Children's experiences following a CBT intervention to reduce dental anxiety: one year on

“…A qualitative paper, published by a multidisciplinary Swedish group, explored the experiences of dentally anxious 7-19 year olds following 4-15 sessions of CBT with a clinical psychologist. 12 The main theme to emerge was a 'perspective shift' which helped participants change their (negative) attitude towards dentistry and also enhance their personal capacity to cope with any dental procedures. The same team subsequently reported outcomes from a randomised controlled trial involving 30 dentally anxious young patients.…”