The effectiveness of Cognitive Behavioural Therapy in the reduction of dental anxiety in children

Abstract

Data sources Cochrane Library, Embase, PubMed, Scopus, Web of Science, LILACS/BBO, PsycINFO, ClinicalTrials, ISRCTN registry, UK National Institute for Health and Care Excellence, International Clinical Trials Registry Platform, ProQuest and OpenGrey. Study selection Two independent and calibrated reviewers selected randomised controlled trials investigating cognitive behavioural therapy use in dentally anxious children. Data extraction and synthesis Risk of bias was assessed by two independent reviewers according to the Cochrane Collaboration tool. Clinical and methodological heterogeneity were assessed to determine whether a meta-analysis could be performed but the data were not similar enough and therefore a narrative synthesis is provided. Results Six studies were included, all written in English between 1980 and 2017. Two were completed in the United States, one in Jamaica, one in Iran, one in Sweden and one in Norway and included 269 patients in total ranging from 41 months to 18 years. Two studies had high risk of bias. In five studies, CBT patients showed significantly reduced levels of anxiety. In three studies improvement was observed in cooperation/behaviour. In two studies, avoidance behaviours improved. Conclusions CBT has been shown in published literature to have a positive effect on children’s anxiety and co-operation; however the quality of evidence for this is low. There is no current consensus on which outcome measure/s should be used, which prevents meta-analysis of results. Further randomised controlled studies are required, ideally using the same outcome measures, to develop evidence based guidance on the use of CBT in dentally anxious children.