Overcoming a fear of dental injections

28% of adults were reported to have an extreme fear of dental injections in the most recent publication of the Adult Dental Health Survey. For many people this fear is reason enough to stop them accessing dental services completely, pushing them further away from the single most effective means of fear eradication: systematic desensitisation, a type of counter conditioning used to assess fear, establish a coping technique and eliminate the anxiety. Without acceptance, attempted relaxation and gradual exposure (specifically to dental injections in this case), fear is unlikely to be overcome.

The completed trial assessed 68 adults agreeing to take part in the survey. While 257 were originally contacted, the final 68 were those in agreement, available, attended and had high enough fear levels to be considered for the trial.

Before commencement of fear treatment, each person was required to rate their own levels of anxiety according to a variety of commonly used dental fear assessment self-surveys. These were the Modified Interval Scale of Anxiety Response, the Dental Fear Survey, the Needle Survey and the Modified Dental Anxiety Scale, the self-assessment used to gain insight into the levels of anxiety currently present in the UK used by the Adult Dental Health Survey in the most recent publication of 2009.

While half of the group then became exposed to CARL (Computerised Assisted Relaxation Learning) the other half became controls and were given a pamphlet about dental injections. This group was also allowed to ask any questions they had to a member of staff after reading the pamphlet. After either CARL or studying the pamphlet, the participants were then requested to complete the initial self-assessment surveys again so that their change in feeling regarding dental injections could be recorded.

For many of the participants, the study was probably more than a way to further research (along with a financial incentive to compensate for time), but an opportunity to help them with a life-long fear. Once the study was finished, each person who took part in the trial was offered the opportunity to come back on another day and have a completely voluntary and unnecessary dental injection.

Even those of us without a fear of needles don’t relish dental injections, but the fact that 12 out of 34 participants taking part in the CARL program agreed to have the optional injection speaks volumes about the success of the treatment. For those 12 at least, a dentally healthy future seems bright.

6 of the 34 with the pamphlet opted to have the optional injection, half the number of the CARL group, though this result does not prove to be significant when statistically analysed. What has been shown to be statistically significant, however, are all the results of the before and after self-assessment surveys, which conclusively confirmed that the post-intervention anxiety scores of those having completed the CARL program were considerably lower than those who merely read the pamphlet (whose mean fear level hardly fell). Whilst still impressive that any dental phobic would agree to have an unnecessary injection, the pamphlet seems to come short in offering the needed comfort and desensitisation required in overcoming fear. It is also important to add that there was no financial incentive to have the injection, unlike the completion of the self-assessment surveys, and agreement to take part was a purely unmotivated decision.

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