Treatment of intra-oral injection phobia: a randomized delayed intervention controlled trial among Norwegian 10- to 16-year-olds

Abstract

Objective: To evaluate the effect of five sessions of cognitive behavioural therapy (CBT) for 10- to 16-year-olds with intra-oral injection phobia.

Material and methods: This was a randomized delayed intervention controlled trial in 67 patients, fulfilling the DSM-5 criteria for specific phobia. All patients received the same CBT performed by dentists specially trained in CBT. The patients were randomly assigned to either an immediate treatment group (ITG) (34 patients) or a waitlist-control group (WCG) (33 patients). The WCG was put on a waitlist for 5 weeks. After treatment, all patients were combined for post-treatment analyses. Assessments including the psychometric self-report scales Intra-oral injection fear scale (IOIF-s), Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), Injection Phobia Scale for children (IS-c) and Mutilation Questionnaire for children (MQ-c) and a behavioural avoidance test (BAT) followed by a questionnaire on cognitions during the BAT, occurred pre-, post-treatment/waitlist and at a 1-year follow-up.

Results: CBT had a significant effect compared to no treatment (WCG). After treatment, the scores on the psychometric self-report scales were significantly reduced and higher levels in the BAT were achieved. The results were maintained at 1-year follow-up. Of the 67 patients, 70.1% received intra-oral injections during CBT treatment, whereas 69.4% of those completing the CBT, in need for further dental treatment, managed to receive the necessary intra-oral injections at their regular dentist.

Conclusions: The 10- to 16-year-olds diagnosed with intra-oral injection phobia benefitted positively on CBT performed by specially trained dentists.

Keywords:

• Cognitive behavioural therapy
• intra-oral injection phobia
• dental fear
• randomized delayed intervention controlled trial

Acknowledgements

The authors acknowledge the contributions of the dentists Jana Ingebrigtsen and Rim Bertz for their involvement in delivering the treatment, and psychologist Jofrid Bjørkvik who took part in the diagnostic interviews. We also want to express our gratitude to the children and adolescents that were involved in the study.

Disclosure statement

The authors report no conflicts of interest.

Notes on contributors

Karin G. Berge, dentist and Ph.D. candidate at the Oral Health Centre of Expertise in Western Norway, Hordaland, Norway and Department of Clinical Dentistry, University of Bergen, Bergen, Norway.

Margrethe Vika, psychologist at the Oral Health Centre of Expertise in Western Norway, Hordaland, Norway and associate professor at the Department of Clinical Dentistry, University of Bergen, Bergen, Norway.

Maren Lillehaug Agdal, pedodontist at the Oral Health Centre of Expertise in Western Norway, Hordaland, Norway and associate professor at the Department of Clinical Dentistry, University of Bergen, Bergen, Norway.

Marit Slåttelid Skeie, pedodontist and associate professor at the Department of Clinical Dentistry, University of Bergen, Bergen, Norway.