Seeing the person before the teeth: A realist evaluation of a dental anxiety service in Norway

Patients with a trauma history, whether sexual abuse or torture, or dental phobia, tend to avoid dental services due to severe dental anxiety. Subsequently, they experience poor oral health, lower quality of life, and poorer general health. In Norway, a specific service (torture, abuse, and dental a...

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Bibliographic Details
Published in:European journal of oral sciences 2022-06, Vol.130 (3), p.e12860-n/a
Main Authors: Bryne, Emilie, Hean, Sarah Catherine Patricia Duff, Evensen, Kjersti Berge, Bull, Vibeke Hervik
Format: Article
Language:English
Subjects:
abuse
Anxiety
Cognitive ability
cognitive behavioural therapy
dental phobia
Original
person‐centred care
Quality of life
Sexual abuse
Sexual assault
Teeth
Torture
Trauma
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Summary:Patients with a trauma history, whether sexual abuse or torture, or dental phobia, tend to avoid dental services due to severe dental anxiety. Subsequently, they experience poor oral health, lower quality of life, and poorer general health. In Norway, a specific service (torture, abuse, and dental anxiety [TADA]) targets these patients’ dental anxiety through cognitive behavioural therapy (CBT) prior to dental restoration. By exploring patients’ experiences with TADA services using a realist evaluation approach, this paper aims to increase our understanding of how this type of service addresses patients’ dental anxiety in terms of its mechanisms and contextual factors. Interviews with TADA patients (n = 15) were analysed through a template analysis driven by context‐mechanism‐outcome heuristics. The analysis revealed that patients value a dental practitioner who provides a calm and holistic approach, positive judgements and predictability elements that lean towards a person‐centred care approach. Provided this, patients felt understood and cared for, their shame was reduced, self‐esteem emerged, and control was gained, which led to alleviation of dental anxiety. Therefore, our findings suggest that combining CBT with a person‐centred care approach helps alleviate patients’ dental anxiety. This provides insights into how dental services could be executed for these patients.
ISSN:0909-8836
1600-0722
DOI:10.1111/eos.12860