Evaluation of the effectiveness of Virtual Reality Exposure Therapy (VRET) in the management of anxiety about dental treatment

Dental phobia afflicts 2-4 percent of the general population in the US and European countries. It has proven to be a significant barrier that prevents individuals from seeking regular dental care and adversely affects their quality of life. From an international perspective, many management strategies for carrying out dental treatment with people suffering dental phobia are still pharmacological (e.g. sedation, general anaesthesia) and do not treat the underlying fear structure. Gold standard face-to-face cognitive behavioural therapy may not be easily accessible. Therefore, an effective, non-invasive, and accessible treatment of dental phobia is highly desired. We developed a dental Virtual Reality Exposure Therapy (VRET) environment and tested its effectiveness in patients with dental phobia by carrying out a series of studies ranging from case studies, a multiple baseline study and a fully powered, parallel armed randomised controlled trial with a long term follow up. The application of VRET was found to be associated with a significant reduction in patients’ state anxiety, dental trait anxiety and avoidance behaviour, and appeared significantly more beneficial to patients compared to the informational pamphlet controls. At 6-month follow-up, the majority of the patients who had received VRET did not fulfil the diagnostic criteria of dental phobia anymore, and were able to schedule a dental appointment within 6 months following treatment. Hence, the results of the studies that are part of this thesis support the applicability, safety and effectiveness of VRET as a treatment for individuals suffering from high levels of dental anxiety and a tendency to avoid dental care.