Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental or Injection Phobia : 1-year Follow-Up Assessment

Background: Dental phobia (DP) and injection phobia (IP) are common in pediatric populations, resulting in inability to receive dental care. Internet-based cognitive behavioral therapy (ICBT) has demonstrated efficacy, but its long-term effects are unexplored. Objective: This study aimed to evaluate the long-term effects of ICBT on DP and IP in children and adolescents. Methods: In total, 49 participants (mean age 11.1 years, SD 2.1) with DP, IP, or both underwent a 12-week, parent-guided, exposure-based ICBT, supplemented by visits at local dental clinics and weekly psychologist correspondence. Assessments occurred at baseline, posttreatment, and 1-year follow-up. Primary outcomes included diagnostic status (clinical interview) and ability to receive dental procedures. Secondary outcomes included measures of dental anxiety, injection anxiety, negative cognitions, and self-efficacy. The study was conducted in Sweden. Results: Of the 49 participants, 42 (86%) completed the 1-year follow-up. At 1-year follow-up, 19 (53%) of 36 (86%) participants who initially met the criteria for DP no longer did (P<.001), and 17 (46%) of 37 (88%) participants who initially met the criteria for IP did not fulfill the IP diagnosis (P < 0.001) Repeated-measures ANOVA showed significant improvements, with large effect sizes for self-reported ability to undergo dental procedures (d = 1.1, P < 0.001) dental fear (d = 1, P < 0.001) negative cognitions (d = 0.9, P < 0.001) injection fear (d = 0.7, P < 0.001) and self-efficacy (d = 1.1, P < 0.001) Predictor analysis showed greater improvements in older participants and males. Conclusions: This study discussed the clinical implications of and approaches to ICBT implementation. ICBT for children and adolescents with DP and IP maintains its effects over a 1-year follow-up period, facilitating improved self-reported willingness to undergo dental treatment. Given its accessibility and sustained efficacy, ICBT should be considered for managing severe dental fear in ...