Cognitive Behavioral Therapy Investigated for Easing Dental Anxiety in Children

Dentistry Today


Researchers at the University of Sheffield School of Clinical Dentistry and Sheffield Teaching Hospitals will investigate whether cognitive behavioral therapy (CBT) could reduce the high number of children who are afraid of the dentist.

Approximately one in three children are scared of going to the dentist, the researchers said, leading to dental avoidance and poor oral health, more toothache, dental infection, and tooth decay.

Now, the researchers including dentists have received more than £1.6 million from the National Institute for Health Research (NIHR) to investigate a new way of reducing dental anxiety based on CBT.

The study, which will involve 600 children from 30 dental practices and clinics across England and Wales will examine whether specially developed, child-friendly resources for children, parents, and dental professionals will help children complete their dental treatment at their family practice rather than being sent to the hospital for specialist services for sedation or general anesthetics.

“Dental anxiety is very common in children and can lead to poor oral health, more tooth decay, and extractions,” said principal investigator and professor Zoe Marshman of the School of Clinical Dentistry and honorary consultant in dental public health at the Sheffield Teaching Hospitals Foundation Trust.

“Dental anxiety is very common in children and can lead to poor oral health, more tooth decay, and extractions,” said Marshman.

“Traditionally, children with dental anxiety have been referred by high street dentists to specialist services for sedation or general anesthetic. This approach does nothing to stop this fear, and they may go on to spend a lifetime avoiding the dentist. A simple and cost-effective way of helping dentally anxious children is desperately needed,” Marshman said.

“This has the potential to help children who may otherwise spend a lifetime avoiding the dentist and ignoring potentially serious oral problems,” Marshman said, adding that it may also result in cost savings for the National Health Service.

The researchers will investigate a new approach based on the principles of CBT involving dental professionals, children, and parents working together using specially designed resources to help understand why these children are anxious, give them information and choices about the procedures they may need, provide activities the children will find useful to help them cope, and make talking to the dentist easier.

There is strong evidence to support the use of CBT, a talking therapy, for other forms of anxiety and mental health conditions, the researchers said. But there is currently very limited research into CBT delivered specifically by dental professionals, rather than by psychologists, for children with dental anxiety, the researchers said.

The self-help CBT resources were developed online and hard copy for children aged 9 to 16 and aim to help children provide dental information, suggest strategies for reducing anxiety, encourage reflection, and support better communication.

“If our study finds CBT resources delivered by dental professionals are effective, then children can be helped directly in high street dental practices without the need to travel for dental treatment in hospitals,” said Marshman.

The four-year “CALM Trial: The Clinical and Cost-Effectiveness of a Guided Self-Help Cognitive Behavioural Therapy Intervention to Reduce Dental Anxiety in Children” will be overseen by Sheffield Teaching Hospitals NHS Foundation Trust.

The study is looking to recruit 60 dentists to take part, beginning in September 2021. Those interested in participating can contact

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