The August 2019 issue of the Journal of California Dental Association asks a big question: how can dental anxiety be reduced?
Peter Milgrom DDS, is the author of Treating Dental Fear Patients: A Patient Management Handbook, as well as an emeritus professor in the department of oral health sciences at the University of Washington, School of Dentistry. As guest editor of this issue he opened sharing his experience across 325 research papers. When he began researching dental fear in Seattle in the 1980’s the data showed that roughly 200 out of 1,000 people experienced fear levels from “somewhat afraid” to “terrified”. Thirty years later, the research data is nearly identical.
To this unchanging patient anxiety, Dr. Milgrom states:
The point is that over a more than 30-year period dental fear levels have remained high irrespective of how they were measured. The rate is more or less the same. This is a persistent clinical and public health problem and important because fearful people are more likely than those less fearful to have poor oral health and reduced oral health quality of life.
To improve the daily lives of those suffering from dental fear and anxiety, the CDA shares the latest research into new solutions, including Virtual Reality Exposure Therapy.
Virtual Reality Exposure Therapy (VRET) For Treatment of Dental Patients
In their article “Is Virtual Reality Exposure Therapy the Future Treatment for Anxious Dental Patients?” Kumar Raghav Gujjar, BDS, MDS, and Ad de Jongh, PhD completed two successful research examples of Virtual Reality Exposure Therapy. While research on Virtual Reality for Anxiety and Pain Relief has been ongoing for decades, their work represents one of the first recent mainstream discussions of modern VR in addressing dental anxiety, while exploring why 30 years of acknowledgement of patient anxiety has led to little return.
According to their work, they share the following reasons why existing dental anxiety treatments have had little impact:
- Dental therapy can be costly for many patients.
- Access to therapy may not be feasible for all patients.
- In vivo exposure therapy, repeated exposure to sources of anxiety, leads to patients avoiding treatment and sub-par outcomes.
- General dentists may not have the time or training to properly administer Cognitive Behavior Therapy (CBT) offerings.
- Using pharmacological offerings does not treat fear, resulting in avoidance of dental treatments.
As they explored utilizing Virtual Reality they learned:
We have conducted pioneering research examining the potential of VRET in the treatment of dental phobia. Results of our studies (a multiple baseline feasibility study and RCT) show that VRET is associated with a significant reduction in both state and dental trait anxiety scores and an improvement in dental treatment acceptance compared to the study control condition.
[…]
Our earlier case study and feasibility study tested the effects of a single VRET session on adult patients with dental phobia. In the present report, VRET resulted in noteworthy reductions in state anxiety, dental trait anxiety and behavioral avoidance. The self-reported measures were validated by patients’ behavioral changes when they scheduled their dental appointments and underwent dental treatment. In addition, both patients had no dental phobia at the six-month follow-up.
Pioneering VRET For Dental Anxiety In Your Dental Practice
Kumar Raghav Gujjar, BDS, MDS, and Ad de Jongh, PhD share that, “sufficient preliminary evidence exists for general dentists to explore VRET in their dental practice”. In our examination of the research we found the same: VRET was shown to work better than all other known options. So, if you’re a pioneering dentist looking to help those in pain now, not decades into the future, where do you begin?
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