Outcome of Chair-Side Dental Fear Treatment: Long-Term Follow-Up in Public Health Setting

Abstract

Aim. Purpose of this practice and data-based study was to evaluate the outcome of dental fear treatment of patients referred to the Clinic for Fearful Dental Patients (CFDP) in the primary oral health care, City of Oulu, Finland, during period 2000–2005. Methods. A psychological approach including behavioral interventions and cognitive behavioral therapy (BT/CBT) was used for all participants combined with conscious sedation or dental general anesthesia (DGA), if needed. The outcome was considered successful if later dental visits were carried out without any notifications in the patient records of behavioral problems or sedation. Data collection was made in 2006; the average length of the observation period from the last visit in the CFPD to data collection was 2 y 3 m (SD 1 y 5 m). All information was available for 163 patients (mean age 8.9 y at referral). Study population was dominated by males (58.0%). Cause for referrals was mostly dental fear (81.0%) or lack of cooperation. Results. The success rate was 69.6% among females and 68.1% among males. Success seemed to be (p=0.053) higher for those treated in ≤12 years compared with the older ones. The participants, without need for dental general anesthesia (DGA) in the CFDP, had significantly a higher success rate (81.4%) compared with those who did (54.8%, p<0.001). Use of conscious oral sedation (p=0.300) or N2O (p=0.585) was not associated with the future success. Conclusions. A chair-side approach seems successful in a primary health care setting for treating dental fear, especially in early childhood. Use of sedation seems not to improve the success rate.

Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review

“…Of note, another open issue involves the investigation of sedation procedures separately from psychological and behavioral evaluations. A previous study showed a long-term reduction of dental fear in children thanks to behavioral and cognitive-behavioral interventions, while conscious sedation was less effective [31]. Furthermore, there was no strong evidence of anxiolytic effects of specific drugs such as opioids, which can lead to difficult social management if overprescribed.…”

10-year follow-up study on attendance pattern after dental treatment in primary oral health care clinic for fearful patients

“…The aim of this retrospective, data-based 10-year follow-up study was to assess the effect of dental fear treatment in the Clinic for Fearful Dental Patients (CFDP) in the City of Oulu, Finland, on dental attendance in primary health care as indicated by examinations, emergency visits and missed appointments. During the 10-year-follow-up, those who had been referred to dental fear treatment at an early age (< 10 years) or whose dental fear treatment was considered successful in 2006 [ 20 ] had more dental examinations than the rest. As for emergency visits and missed appointments, no association with the success of dental fear treatment was discovered.…”

“…The present study population was 152 patients who made up 93% of the population evaluated in 2006 for the success of dental fear treatment with a follow-up period of about 2 years. Most participants were children living at home at the time of the original dental fear treatment (2000–2006) and still lived in Oulu in 2016 (93%) [ 20 ]. Because the lack of nationwide welfare databases before year 2017 records of those patients`who have moved to another area or continued their dental care in private dental offices were missing.…”

“…After dental and fear treatment in CFDP, patients were treated by their own dentists in PDS or by private dentists according their or their guardians choice. This description of the study method partly includes text from our previous study [ 20 ]. By public dental health setting dentists coded patients` examinations, emergency visits and missed appointments and data were readily available from the local patient record database.…”

A Comprehensive Approach Limiting Extractions under General Anesthesia Could Improve Oral Health

“…Among them, patients with dental anxiety have special needs that require both a dental professional and a psychological therapist. The dental fear cycle was well-studied by David Locker, and behavioral and cognitive therapies (BCT) are indicated to treat dental anxiety [ 48 ]. During BCT, patients need to be exposed to dental care progressively, in a positive situation without pain exposition nor negative judgment.…”