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Behavioral Therapy May Benefit Patients With Dental Phobias

Individuals who fear the dentist may avoid the dental office for years, leading to poor oral health and lack of trust. And while avoidance is a typical response for those who experience dental phobia, hope exists in the form of cognitive behavioral therapy. A new study conducted at King's College in London reveals that a combination of behavioral modification and talk therapies may provide a viable long-term solution to dental anxiety and fear.

The study examined 130 patients who experienced dental anxiety, due mostly to fear of dental injections and/or drilling. Seventy six percent of patients received cognitive behavioral therapy over a total of five sessions. Of those treated, 79% went on to receive dental care without the need for sedation or injection. Tactics employed comprise exposure therapy, relaxation therapy, and discussion of self-control. Study results were published in the paper "Characteristics of Patients Attending for Cognitive Behavioral Therapy at One UK Specialist Unit for Dental Phobia and Outcomes of Treatment" in the November 2015 edition of the British Dental Journal. Future studies are planned to examine the long-term effects and required time investment of such treatment.

 

Dental Hygienists Expand Access to Care in Colorado

Malea Johnson, BS, RDH  

The recent launch of the Colorado Medical-Dental Integration Project (CO-MDI) is helping make affordable medical and dental care for the centennial state's most vulnerable residents more accessible than ever before. Thanks to funding from the Delta Dental of Colorado Foundation, the state now has 16 medical organizations that are employing registered dental hygienists on their medical care teams. Dimensions of Dental Hygiene recently spoke to a CO-MDI program grantee about this integration process, the program's current status, and how low-income/ vulnerable Colorado residents will benefit.

Malea Johnson, BS, RDH, a 2014 graduate of Pacific University in Hillsboro, Oregon, was hired in June 2015 by a federally qualified community health center to help integrate the medical and dental care in Routt and Moffat counties. Johnson tells Dimensions that she credits her undergraduate training—at a university with a strong interprofessional program—for preparing her for this unique career. "My collegiate studies focused on integration between physician assistants, physical therapists, and pharmacists, and required extensive knowledge sharing in a supportive environment," she explains.

Since being hired, she has been charged with researching and purchasing new dental operatory equipment and collaborating with the medical care team to determine the best approach for delivering interprofessional care. "The combining of medical and dental care in a single facility is a new concept and not without its challenges," Johnson admits. "This hasn't been done before. It's been a process of learning and discovering the best flow. The most cohesive experience for patients will be determined, most likely, through trial and error," she speculates. To help ease this process, she adds, the Delta Dental of Colorado Foundation has supported its grantees via open collaboration. All 16 recipients have access to files on a shared cloud and partake in monthly conference calls. The foundation also provides 2-day learning network events, and progress pertaining to the center is monitored weekly via phone.

Johnson's patients, many of whom will travel up to 45 minutes to receive medical and/or dental care, must be patients of record within the center's medical practice in order to receive oral health services. The integration of software platforms so that all medical and dental professionals may access patient health histories, forms, and charts helps simplify the interprofessional aspect of care. Pregnant women, patients with diabetes, and children younger than 12 will receive priority care at this time. The center plans to open to the community in January and will operate with the goal of the CO-MDI in mind—to increase access to oral health care, examine the impact on behaviors and oral health outcomes, and test the financial sustainability of various practice models. "I'm very excited about this project," Johnson says. "It's thrilling to eliminate potential barriers to care by serving patients in a single setting with collaboration and the support of the extended medical care team."

 

From Dimensions of Dental Hygiene. January 2016;14(01):14. 

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