Cognitive Behavioral Therapy for Dental Phobia and Anxiety

It is estimated that up to 15% of the population in Western countries avoid dental care due to fear. Yet irrational fear of dental treatment is a clinical phobia like any other, and as such it can be effectively treated using Cognitive Behavioral Therapy (CBT). Describing how to implement brief CBT in clinical or dental settings, this book shows how even a single session of treatment may enable patients with longstanding avoidance to return to regular dental care. Chapters cover epidemiology, diagnosis and differential diagnosis, symptoms, clinical characteristics and consequences, and aetiology of dental phobia, as well as intra–oral injection phobia. The book also addresses dental treatment of fearful children, and the use of conscious sedation and other pharmacological methods to supplement psychological treatment in fearful patients.

List of Contributors vii Preface ix Acknowledgements xi Part I Background, Assessment and Aetiology 1 1 Symptoms, Clinical Characteristics and Consequences 3 Magnus Hakeberg and Jesper Lundgren 2 Background Description and Epidemiology 21 Magne Raadal and Erik Skaret 3 Assessment of Dental Phobia and Anxiety 33 Kristin Haukebø and Margrethe Vika 4 Aetiology of Dental Phobia 45 Tiril Willumsen, Kristin Haukebø and Magne Raadal 5 Intra–Oral Injection Phobia 63 Margrethe Vika and Maren Lillehaug Agdal 6 Dental Anxiety in Children and Adolescents 79 Gunilla Klingberg Part II Treatments 89 7 Cognitive Behaviour Therapy: Principles, Procedures and Evidence Base 91 Lars–Göran Öst and David M. Clark 8 Multimodal Cognitive Behavioural Treatment 109 Jesper Lundgren and Ulla Wide Boman 9 One–Session Treatment of Dental Phobia 119 Lars–Göran Öst 10 The Combined Treatment 135 Erik Skaret 11 Dental Treatment under Sedation 153 Magne Raadal 12 Effects of Cognitive Behavioural Treatments: A Systematic Review and Meta–Analysis 163 Lars–Göran Öst and Gerd Kvale Part III Cultural Aspects, Prevention and Future Research 183 13 Different Treatment Approaches in Different Cultures and Health–Care Systems 185 Peter Milgrom, Lisa J. Heaton and J. Timothy Newton 14 Prevention of Dental Phobia 201 Erik Skaret and Magne Raadal 15 Future Research and Applications 221 Lars–Göran Öst and Erik Skaret Index 231

Lars–Göran Öst is Professor and Chair of Clinical Psychology at Stockholm University, Sweden, and Professor of Clinical Psychology at the University of Bergen, Norway. Considered the pioneer of one–day phobia treatment, he is a regular keynote speaker at major CBT conferences and has lectured at universities worldwide. He is a former editor of the Scandinavian Journal of Behaviour Therapy and Behavioural Psychotherapy , and serves on the editorial boards of Behaviour Research and Therapy , Cognitive Behaviour Therapy , Journal of Anxiety Disorders , Behavioural and Cognitive Psychotherapy , Applied and Preventative Psychology , Journal of Experimental Psychopathology , Behaviour Therapy , and Clinical Psychology: Science and Practice . Erik Skaret is Professor Emeritus in Behavioral Sciences in Dentistry, Institute of Clinical Dentistry, Department of Pediatric Dentistry and Behavioral Sciences, University of Oslo. He has many years of experience with research and psychological treatment of dental phobia and intra–oral injection phobia based on CBT. Other research areas are prevention of dental anxiety and avoidance of dental care in children and adolescents.  He has published widely in peer–reviewed journals.