A Stepped Care Approach to Treating Dental Fear

New York University1,000 enrolled

Overview

The purpose of this study is to compare an intervention for dental fear to the usual approach (i.e., whatever participants' dentist typically does to help participants manage their fear). The dental fear intervention has 2 separate steps. Step 1 (the less intensive or 'light touch' intervention step) involves using a mobile application (app). Step 2 consists of a one-hour telehealth session with a mental health provider tailored to individualized dental fear. This is a randomized study. The time spent participating in the study will depend on which study condition(s) participants are randomly assigned to. Because this study compares the dental fear intervention to the standard approach, 25% of participants will not get the intervention during the study period. These participants (called controls) will be offered the opportunity to provide feedback about their experiences with dentists. Participants will be offered the intervention free of charge at the conclusion of the study. For each step of the intervention (Dental FearLess app or one-on-one session) relative to treatment as usual, the investigators hypothesize that participants will show greater declines in self-reported dental fear and improved oral health-related quality of life at post-treatment and follow-up period. De-identified attendance records will be collected from dental practices.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

1,000

Conditions

Dental Fear

Interventions

A stepped-care approach to the treatment of dental fear; Dental FearlessBEHAVIORAL

Step 1. Dental FearLess is a self-administered CBT-based mobile app that takes approximately 1 hour to complete. Step 2. A one-hour, one-on-one telehealth session with a mental health provider tailored to the participant's individualized dental fear for those who still report moderate to severe dental fear following completion of the Dental Fearless app.

Eligibility

Sex: ALLMin age: 13 YearsMax age: 99 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Provide signed and dated informed consent form * Access to a smartphone or tablet * Willing to comply with all study procedures and be available for the duration of the study * 13 years or older, and if under 18 years, a parent or legal guardian can consent to their participation in the study * Proficient in English * Score 4 or above on the Gatchel single-item dental fear rating scale * Willingness to allow access to dental attendance records * Located in the USA Exclusion Criteria: Given the scope and nature of the study, there is no exclusion criteria.

Outcomes

Primary Outcomes

Change in dental fear in intervention group

Assess the efficacy of a CBT-based stepped-care (i.e., progressive treatment dosing) approach in the reduction of moderate to severe dental fear (measured via subjective report on IDAF).

Time frame: Up to 15-21-month period following enrollment and baseline measures.