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Can child dental anxiety be managed with CBT?

The British Society of Paediatric Dentistry (BSPD) recommends a resource called 'Your teeth, you are in control' to help anxious children cope with their dental appointment or treatment.

Dental anxiety is a reality for many children, who may require special measures to help them cope with having a dental appointment as well as treatment. Children with dental anxiety are frequently referred to specialist services in hospital or clinics for a general anaesthetic which has additional challenges and risks.

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'Your teeth, you are in control' was developed by the University of Sheffield School of Clinical Dentistry and is underpinned by cognitive behavioural therapy (CBT).

Now, working with other dental schools, Sheffield is undertaking a £1.6 million trial funded by the National Institute for Health Research (NIHR) to investigate the approach. The study will involve 600 children aged 9-16 and will examine whether CBT helps them manage their dental treatment at their family dental practice.

Principal Investigator, Professor Zoe Marshman from the University of Sheffield's School of Clinical Dentistry and Honorary Consultant in Dental Public Health at Sheffield Teaching Hospitals Foundation Trust, said: 'Traditionally, children with dental anxiety have been referred by high street dentists to specialist services for sedation or general anaesthetic. This approach does nothing to stop their fear, and they may go on to spend a lifetime avoiding the dentist'.

The study will involve children from 30 dental practices and clinics across England and Wales. Working together, dental professionals, children and their parents will set out to understand what specifically is making the child anxious; they will be given information and choices about the procedures they may need, activities to help them cope, and support with talking to the dentist.

Professor Marshman said: 'There is strong evidence to support the use of CBT, a talking therapy, for anxiety and mental health conditions; however, there is currently very limited research into CBT delivered specifically by dental professionals for children with dental anxiety.

'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.'

The four-year trial alsoinvolves Sheffield Hallam, Cardiff, King's College London, Leeds, Newcastle and York. It is called CALM: 'the clinical and cost-effectiveness of a guided self-help cognitive behavioural therapy intervention to reduce dental anxiety'andis overseen by Sheffield Teaching Hospitals NHS Foundation Trust. The collaborative team of researchers are looking to recruit 60 dentists to take part in the study which will start in September 2021.

Dental professionals or practices interested in taking part in the study can contact z.marshman@sheffield.ac.uk for more information.

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Can child dental anxiety be managed with CBT?. Br Dent J 230, 389 (2021). https://doi.org/10.1038/s41415-021-2925-z

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