A programme for the treatment of severe dental fear. Report of three cases

This paper describes the use of a sequence of recollection and discussion, training in muscle tone control, dental imagery, audio simulation and graded re-exposure to dental procedures to eliminate a severe fear of dental treatment in three adult female patients. All three patients had abstained from regular dental visits throughout their lives and all were in need of urgent dental treatment when the therapy began. One of the patients also identified in herself other maladaptive behaviour and reported a history of mood disorder as well. The recollections of these patients reveal that the aetiology of dental fear is more complex than dental questionnaires would indicate and, in particular, they supply further evidence of the capacity for adverse medical events to initiate this fear. Although the programme specified in this paper yielded good results, it nonetheless has a number of shortcomings. It is time consuming, dental damage is likely to be well advanced when it commences and it attracts very few patients. Thus those afflicted with severe dental fear are effectively destined for only emergency dental visits and eventually are likely to be edentulous. For this reason every possible precaution against the initiation of dental fear should be taken.