Comparing the Effect of Acceptance and Commitment Therapy and Cognitive Behavioral Therapy on Dental Anxiety
Background: This study was aimed at the comparison of the effect of acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) on dental anxiety.
Methods: The present clinical trial was performed with a pretest-posttest design, a control group, and a 3-month follow-up period on patients with dental anxiety. The study participants were 48 patients who were selected through convenience sampling and randomly assigned to 2 experimental groups and one control group. The first experimental group received 10 weekly 90-minute sessions of ACT and the second group received 10 weekly 90-minute sessions of CBT. The control group received no intervention. The Dental Anxiety Inventory (DAI) was used to assess the dependent variable and Symptom Checklist-90-R (SCL-90-R) and a pulse oximeter were used as screening tools. Data were analyzed using repeated measures ANOVA in SPSS software.
Results: The results showed a significant difference between the experimental groups and the control group in terms of dental anxiety (P < 0.01). Furthermore, there was a significant difference in dental anxiety between the pretest, and follow-up and posttest (P < 0.01), but there was no significant difference between the posttest and follow-up (P > 0.05). Moreover, there was no significant difference between the ACT and CBT groups (P > 0.05), but there was a significant difference between the 2 treatment groups and the control group (P < 0.05).
Conclusion: ACT and CBT can be used to reduce dental anxiety, and thus, prevent treatment avoidance.
Azizi, F. (2014). Prevention of Thyroid Disease. Iran J Endocrinol Metab, 16(1), 33-46.
Baltaci, E., Baygin, O., Tuzuner, T., & Korkmaz, F. M. (2019). Evaluation of the knowledge, attitudes and behaviors of pre-school teachers on oral and dental health in the city center of Trabzon. Eur.Oral Res, 53(1), 12-20. doi:10.26650/eor.20199213 [doi];eor-53-1-462 [pii]. Retrieved from PM:31309187
Beaton, L., Freeman, R., & Humphris, G. (2014). Why are people afraid of the dentist? Observations and explanations. Med Princ.Pract, 23(4), 295-301. doi:000357223 [pii];10.1159/000357223 [doi]. Retrieved from PM:24356305
Bennett, J. D., Kramer, K. J., & Bosack, R. C. (2015). How safe is deep sedation or general anesthesia while providing dental care? J Am Dent Assoc, 146(9), 705-708. doi:S0002-8177(15)00459-6 [pii];10.1016/j.adaj.2015.04.005 [doi]. Retrieved from PM:26314981
Bhaskar, V., McGraw, K. A., & Divaris, K. (2014). The importance of preventive dental visits from a young age: systematic review and current perspectives. Clin Cosmet.Investig.Dent, 6, 21-27. doi:10.2147/CCIDE.S41499 [doi];ccide-6-021 [pii]. Retrieved from PM:24672258
Eilenberg, T., Fink, P., Jensen, J. S., Rief, W., & Frostholm, L. (2016). Acceptance and commitment group therapy (ACT-G) for health anxiety: A randomized controlled trial. Psychol.Med, 46(1), 103-115. doi:S0033291715001579 [pii];10.1017/S0033291715001579 [doi]. Retrieved from PM:26281857
Gavita, O. A., David, D., Bujoreanu, S., Tiba, A., & Ionutiu, D. R. (2012). The efficacy of a short cognitivebehavioral parent program in the treatment of externalizing behavior disorders in Romanian foster care children: Building parental emotion-regulation through unconditional self- and child-acceptance strategies. Child Youth Serv Re, 34(7), 1290-1297.
Gumport, N. B., Williams, J. J., & Harvey, A. G. (2015). Learning cognitive behavior therapy. J Behav Ther Exp.Psychiatry., 48, 164-169. doi:S0005-7916(15)00046-4 [pii];10.1016/j.jbtep.2015.03.015 [doi]. Retrieved from PM:25898288
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York, NY: Guilford Publications.
Hayes, S. C. (2016). Acceptance and Commitment Therapy: State of the evidence. Colloquium presented to the University of Toronto, Toronto, Ontario.
Heydari, M., Masafi, S., Jafari, M., Saadat, S. H., & Shahyad, S. (2018). Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff. Open.Access.Maced.J Med Sci, 6(2), 410-415. doi:10.3889/oamjms.2018.064 [doi];OAMJMS-6-410 [pii]. Retrieved from PM:29531615
Hmud, R., & Walsh, L. (2008). Dental anxiety: Causes, complications and management approaches. International Dentistry SA, 9(5), 6-16.
Kritsidima, M., Newton, T., & Asimakopoulou, K. (2010). The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial. Community Dent Oral Epidemiol, 38(1), 83-87. doi:COM511 [pii];10.1111/j.1600-0528.2009.00511.x [doi]. Retrieved from PM:19968674
Leitch, J., & Macpherson, A. (2007). Current state of sedation/analgesia care in dentistry. Curr.Opin.Anaesthesiol., 20(4), 384-387. doi:10.1097/ACO.0b013e32825ea2a4 [doi];00001503-200708000-00019 [pii]. Retrieved from PM:17620850
Manski, R. J., Hoffmann, D., & Rowthorn, V. (2015). Increasing access to dental and medical care by allowing greater flexibility in scope of practice. Am J Public Health, 105(9), 1755-1762. doi:10.2105/AJPH.2015.302654 [doi]. Retrieved from PM:26180970
Mohammed, R. B., Lalithamma, T., Varma, D. M., Sudhakar, K. N., Srinivas, B., Krishnamraju, P. V. et al. (2014). Prevalence of dental anxiety and its relation to age and gender in coastal Andhra (Visakhapatnam) population, India. J Nat.Sci Biol Med, 5(2), 409-414. doi:10.4103/0976-9668.136210 [doi];JNSBM-5-409 [pii]. Retrieved from PM:25097425
Murray, C. & Lopez, A. D. (1990). The global burden of diseases. WHO: Harvard School of Public Health and World Bank.
Prunas, A., Sarno, I., Preti, E., Madeddu, F., & Perugini, M. (2012). Psychometric properties of the Italian version of the SCL-90-R: A study on a large community sample. Eur.Psychiatry., 27(8), 591-597. doi:S0924-9338(10)00271-3 [pii];10.1016/j.eurpsy.2010.12.006 [doi]. Retrieved from PM:21334861
Roberts, J. F., Curzon, M. E., Koch, G., & Martens, L. C. (2010). Review: Behaviour management techniques in paediatric dentistry. Eur.Arch Paediatr.Dent, 11(4), 166-174. doi:10.05 [pii];10.1007/BF03262738 [doi]. Retrieved from PM:20840826
Saatchi, M., Abtahi, M., Mohammadi, G., Mirdamadi, M., & Binandeh, E. S. (2015). The prevalence of dental anxiety and fear in patients referred to Isfahan Dental School, Iran. Dent Res J (Isfahan), 12(3), 248-253. Retrieved from PM:26005465
Seligman, L. D., Hovey, J. D., Chacon, K., & Ollendick, T. H. (2017). Dental anxiety: An understudied problem in youth. Clin Psychol.Rev., 55, 25-40. doi:S0272-7358(16)30233-1 [pii];10.1016/j.cpr.2017.04.004 [doi]. Retrieved from PM:28478271
Shahnavaz, S., Hedman, E., Grindefjord, M., Reuterskiold, L., & Dahllof, G. (2016). Cognitive behavioral therapy for children with dental anxiety: A randomized controlled trial. JDR.Clin Trans Res, 1(3), 234-243. doi:10.1177/2380084416661473 [doi];10.1177_2380084416661473 [pii]. Retrieved from PM:29417092
Soares, F. C., Lima, R. A., de Barros, M. V. G., Dahllof, G., & Colares, V. (2017). Development of dental anxiety in schoolchildren: A 2-year prospective study. Community Dent Oral Epidemiol, 45(3), 281-288. doi:10.1111/cdoe.12290 [doi]. Retrieved from PM:28266046
Stouthard, M. E., Mellenbergh, G. J., & Hoogstraten, J. (1993). Assessment of dental anxiety: A facet approach. Anxiety Stress Coping, 6(2), 89-105.
Tarkhan, M. (2017). The effectiveness of Acceptance and Commitment Therapy (ACT) on emotion regulation and life meaning of depressed women. Journal of Psychological Studies, 13(3), 147-164.
Vermaire, J. H., van Houtem, C. M., Ross, J. N., & Schuller, A. A. (2016). The burden of disease of dental anxiety: generic and disease-specific quality of life in patients with and without extreme levels of dental anxiety. Eur.J Oral Sci, 124(5), 454-458. doi:10.1111/eos.12290 [doi]. Retrieved from PM:27506593
Wang, J., Jian, F., Chen, J., Ye, N. S., Huang, Y. H., Wang, S. et al. (2012). Cognitive behavioral therapy for orthodontic pain control: a randomized trial. J Dent Res, 91(6), 580-585. doi:0022034512444446 [pii];10.1177/0022034512444446 [doi]. Retrieved from PM:22492277
Wide, B. U., Carlsson, V., Westin, M., & Hakeberg, M. (2013). Psychological treatment of dental anxiety among adults: A systematic review. Eur.J Oral Sci, 121(3 Pt 2), 225-234. doi:10.1111/eos.12032 [doi]. Retrieved from PM:23659254
Wide, U., Hagman, J., Werner, H., & Hakeberg, M. (2018). Can a brief psychological intervention improve oral health behaviour? A randomised controlled trial. BMC Oral Health, 18(1), 163. doi:10.1186/s12903-018-0627-y [doi];10.1186/s12903-018-0627-y [pii]. Retrieved from PM:30285814
Yousefi, R. & Piri, F. (2017). Psychometric properties of dental anxiety inventory. J Mashad Dent Sch, 41(1), 69-78.
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