Forty participants fulfilling the DSM-IV criteria for dental phobia were randomly assigned to a waitlist group, one-session or five-session exposure treatment. Assessment occurred pre-, post-waitlist/treatment, and after 1 year. Mean avoidance of dental care before treatment was 11.4 years. A total of 77% sought dental care in the follow-up year. Both treatments were equally effective at reducing avoidance behavior and changing cognitions during the feared situation. Post-treatment, the five-session group scored lower on the dental anxiety scales, but at follow-up, both groups reported the same level of dental anxiety. Conclusion: Both treatment conditions enable a return to ordinary dental treatment.
Dental phobia (DP) refers to extreme fear of dental treatment and stimuli associated with this procedure. It is classified as a specific phobia of the situational type (DSM-IV; APA, 1994; ICD-10; WHO, 1992, 1993) with a prevalence of 3–5% of the general adult population (Kent, 1997). It leads to avoidance of dental treatment (Berggren & Meynert, 1984) with severe consequences for dental health, and is associated with interference in occupational and social functioning (Berggren, 1993).
It is documented that CBT-interventions are effective for DP (Kvale, Berggren, & Milgrom, 2004), but the recommended treatment, consisting of 8–11 sessions is resource-demanding (Kvale et al., 2004). In a series of randomized, clinical studies, Öst has documented that specific phobias like blood (Hellström, Fellenius, & Öst, 1996), injection (Öst, Hellström, & Kåver, 1992), spider (Hellström & Öst, 1995; Öst, Salkovskis, & Hellström, 1991), flying (Öst, Brandberg, & Alm, 1997), and claustrophobia (Öst, Alm, Brandberg, & Breitholtz, 2001) can be treated efficiently in one continuous session of 3 hours or less. The treatment effect is maintained at follow-up.
Previously published papers on rapid treatment of DP (e.g. De Jongh et al., 1995; Moses & Hollandsworth, 1985) lack adequate diagnostic-, randomization-, and control procedures, which restrict the possibility of firm conclusions regarding the treatment effect. When comparing the effect of one-session treatment of DP with that of benzodiazepines, Thom, Sartory, and Jöhren (2000) showed that patients in the one-session treatment condition improved significantly more than the benzodiazepine group. The improvement increased by 2-month follow-up.
So far, no studies have been published on one-session treatment of DP as delineated by Öst (1989) and Öst (1997). Despite the short duration, it includes all elements of treatment that have been identified in previous research. In contrast to other phobias, dental phobics report painful dental experiences as a main etiological factor (Lundgren, Berggren, & Carlsson, 2004). Thus, to actually perform dental treatment during one session of therapy on a diagnosed sample can be assumed particularly challenging. The aim of the present study was to assess the effect of the one-session treatment as delineated by Öst (1989) and Öst (1997) on DP whilst comparing it to a five-session treatment.
