An evaluation of a behavioural treatment programme directed at reducing pain anticipation versus one directed at using distraction as a coping strategy in patients with disproportionate dental anxiety

Abstract

Many studies investigating dental anxiety have concluded that dentally anxious individuals anticipate more pain than they actually experience during dental treatment. In view of this, a four week treatment programme based on relaxation and exposure in imagination was varied to include training in reconstruing pain anticipation realistically (experimental group) or distraction and thought stopping techniques to deal with anxiety responses (control group). A comparison was made of the relative efficacy of the two approaches. -- Twelve disproportionately dentally anxious individuals who answered a newspaper advertisement were selected on the basis of their scores on a dental anxiety scale. The clients were divided equally into two groups matched for age, level of dental anxiety and length of time since last dental visit. The programmes were carried out on a weekly basis by a clinical psychology graduate student and a clinical psychologist. Outcome was evaluated on the basis of dental anxiety scale scores, a measure of general anxiety, expectations of pain, and expectations of being able to keep a dental appointment, as well as actually visiting a dentist. Both programmes brought significant decreases in dental anxiety and pain expectations, with all subjects making an appointment and attending this initial visit. The inclusion of pain anticipation information, however, did not enhance treatment to the degree expected. On a measure of general anxiety, members of the experimental group rated themselves as less behaviourally avoidant at programme completion. This was thought to augur better for future dental visits.