Clinical Management of Anxiety and Access to Health Care

Dental and health anxiety are common and potentially distressing problems, for both patients
and health care providers. Anxiety has been identified as a barrier to regular dental visits
and as an important target for enhancement of oral health-related quality of life. The goal
of this project is to develop a computer-administered dental anxiety management program that
can easily be implemented in dental health care settings. Our aim is for this management
program to: 1) integrate different treatments modalities such as cognitive-behavioral
therapy (CBT) and motivational interviewing (MI) into one computer-based protocol; 2)
facilitate patient adherence to this protocol; 3) lend itself to empirical validation; and
4) lend itself to dissemination to other research and treatment settings. A randomized
controlled trial (RCT) will be conducted (n=200). Based on the subjects responses to the
screening questionnaires, consenting dental patients at Temple University Kornberg School of
Dentistry will be assigned to one of 2 possible groups, (1) high dental anxiety and (2) low
dental anxiety. The intervention package will be delivered to a randomly selected half of
participants in group 1 (high anxiety group), whereas the remaining participants in this
group will be assigned to a delayed treatment control condition. The low dental anxiety
patients (group 2) will be used as a benchmark against which to compare post-treatment (or
post-control) outcomes for the high anxiety patients. We hope to develop an intervention
that can be easily implemented in a broader context without the need for highly specialized
personnel.