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Lillehammer February 2009 PhD
candidate Maren Lillehaug Agdal
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• Oral health and its influence on cognitive
  behavioural therapy in patients fulfilling the
  DSM-IV criteria for intra-oral injection phobia

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Rational

• Dental phobia and intra oral injection phobia may
  be comorbid conditions though they often are
  not.
• We have found that oral health is compromised in
  patients diagnosed with dental phobia
• No exposure to dental treatment procedures was
  done during the phobia treatment.

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Materials and methodsAnxiety treatment

• Patients were randomly assigned to two treatment
  conditions (cognitive behavior therapy - CBT)
• 1 session - lasting 3 hours (Öst 1988)
• 5 sessions - lasting 1 hour each

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Materials and methodsMeasures

• Dental anxiety DAS, DFS.
• Coping with intra oral injection Behavioral
  approach test (BAT).
• Coping with dental treatment All patients were
  scheduled for a dental appointment at a general
  dentist after treatment at Center for
  Odontophobia.

• Measured
• pretreatment
• post treatment (one week after)
• 1-year follow up

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Materials and methodeSample
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Materials and methodsMeasures Oral health
registrations

• Clinical examination (one examiner)
• OPG 2 BW (3 examiners)
• Agreement by consensus
• Self perceived oral health

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ResultsOral health

• The self-perceived oral health correlated
  positively with the patients objectively
  evaluated oral health.
• There were large variations in oral health and
  oral treatment needs among the patients, but
  overall their oral health was considered as good.

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DMFT-index
Skudutyte-Rysstad et al. 2007
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Teeth in need of treatment
of the patients
Number of teeth in need of treatment
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Oral health and CBT outcome

• One patient dropped out during treatment
  sessions.
• 7 patients had either not been to the dentist
  within 1-y FU or refused to have an injection
  during the BAT at FU because of anxiety.
• These patients (N8, 14.5 ) had statistically
  significant more teeth with caries (Man Whitney
  test p0.027) than the patients who had been to
  the dentist and who did not report anxiety as
  reason for not performing the BAT at FU.

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Dentists should be aware that extensive dental
decay may affect the patients motivation for
overcoming their intra-oral injection phobia and
their anxiety may be more complex.
Patients overcome their intra-oral injection
phobia regardless of teeth in need of dental
treatment.
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Thanks to my supervisors

• Professor Magne Raadal
• Professor Erik Skaret
• Professor Gerd Kvale