Interventions to reduce adult state anxiety, dental trait anxiety, and dental phobia: A systematic review and meta-analyses of randomized controlled trials.

Autor: Steenen SA; Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands, Amsterdam University Medical Centers, Meibergdreef 5, Room D2-214, 1105 AZ, Amsterdam, the Netherlands; Department of Department of Oral Public Health, ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands. Electronic address: serge.steenen@gmail.com., Linke F; Department of Department of Oral Public Health, ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands., van Westrhenen R; Parnassia Psychiatric Institute, Overschiestraat 55, 1062 HN Amsterdam, the Netherlands; The Institute of Psychiatry, Psychology & Neuroscience, IoPPN, King's College London, United Kingdom; St. John's National Academy of Health Sciences, Bangalore, India., de Jongh A; Department of Department of Oral Public Health, ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands; The Institute of Health and Society, University of Worcester, Worcester, United Kingdom; The School of Psychology, Queen's University, Belfast, Northern Ireland, UK.
Jazyk: angličtina
Zdroj: Journal of anxiety disorders [J Anxiety Disord] 2024 Jul; Vol. 105, pp. 102891. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1016/j.janxdis.2024.102891
Abstrakt: This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: