Cognitive behavioral therapy helps patients overcome dentist anxiety

Visiting the dentist is an unpopular activity among most, but some suffer more than others. Thankfully, researchers have been developing a treatment that has proven to be relatively successful in helping these anxious patients face their fears.

A study released Thursday by King’s College London explored the ability of cognitive behavioral therapy to help people with anxiety disorders such as dental phobia overcome their obstacles. This form of therapy teaches patients to think more logically through any distorted thought processes they may be experiencing.

“When we are anxious or sad, we have certain cognitions that serve to reinforce that anxious mentality,” said Jami Furr, associate clinical director at the Center for Children and Families at Florida International University. “What ends up happening is that we tend to avoid the situations that we feel afraid of because in the short term, that makes us feel better.”

After analyzing the characteristics of 130 subjects with severe dental phobia, the researchers found that 79 percent were able to undergo dental treatment without sedation after an average of five CBT sessions.

This form of therapy helps patients confront their fears in a constructive manner, Furr said, as depicted by the subjects confronting their phobia of undergoing dental treatment without sedation.

“[This form of therapy] is really about helping reduce the anxiety by helping them think differently about the situation and then helping expose them to those anxious situations gradually and systematically until their anxiety comes down,” Furr said.

Michelle Bourgeois, a clinical fellow at Boston University’s Center for Anxiety and Related Disorders, said CBT also works to break the cycle of anxiety-induced behaviors and choices that many patients make.

“It’s a type of treatment that looks at the cognitions that are underlying emotional responses that people usually don’t want,” Bourgeois said. “You look at the thoughts or cognitions, the emotional reactions that people have and also the behaviors that they end up doing that kind of keep the cycle of anxiety going.”

In addition to the possibility of being biologically predisposed to anxiety, a problem many patients face is having to alter their reactions to the thoughts and actions of those around them, Furr said. Young patients are often under the care of overprotective parents or have family members with similar disorders, both of which are potential obstacles.

“It’s likely that the environment around them is promoting anxious behavior and avoidance behavior,” Furr said. “Most families don’t understand that if they keep their child from the thing that they fear, then that anxiety may grow or be maintained over time.”

Bourgeois also expanded on the long-term dangers of older patients avoiding stimuli related to their phobias.

“While they’re intended to reduce the anxiety, [these behaviors] keep the fear going in the long run,” she said. “It doesn’t reduce the fear over time. It just reduces it in that moment.”

These actions of avoidance are exactly what CBT aims to change. David Langer, a co-director of research at CARD, described physical sensations such as a quick heartbeat and sweaty palms as being common symptoms of anxiety. After being encouraged to confront their phobias through CBT, patients are increasingly able to overcome these symptoms, or at least disassociate the sensations from the phobia.

“By practicing more and not escaping the situation, the body eventually calms down anyway,” Langer said. “It’s called habituation. It becomes easier to do what was once a lot harder.”

CBT is also helpful for those undergoing severe stress, which Langer said might especially resonate with newly independent college students.

“College is a time of a lot of stress but also a lot of growth,” Langer said. “ … As people approach things that could cause that anxiety, using some of the principles of cognitive behavioral therapy could be helpful.”

According to Furr, CBT has proven successful for about 60 to 70 percent of the anxious population. Not only does this form of therapy help patients with the specific phobia addressed by the CBT sessions, but it also provides them with the tools to face any future maladaptive cognitions as well.

“It’s really about … being able to manage not only in that distinct moment, but also throughout their lifetime,” Furr said. “Patients can use these skills for other things that might cause them to feel anxious or nervous.”

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