Computerized dental injection fear treatment: a randomized clinical trial

J Dent Res. 2013 Jul;92(7 Suppl):37S-42S. doi: 10.1177/0022034513484330. Epub 2013 May 20.


One in four adults reports a clinically significant fear of dental injections, leading many to avoid dental care. While systematic desensitization is the most common therapeutic method for treating specific phobias such as fear of dental injections, lack of access to trained therapists, as well as dentists' lack of training and time in providing such a therapy, means that most fearful individuals are not able to receive the therapy needed to be able to receive necessary dental treatment. Computer Assisted Relaxation Learning (CARL) is a self-paced computerized treatment based on systematic desensitization for dental injection fear. This multicenter, block-randomized, dentist-blind, parallel-group study conducted in 8 sites in the United States compared CARL with an informational pamphlet in reducing fear of dental injections. Participants completing CARL reported significantly greater reduction in self-reported general and injection-specific dental anxiety measures compared with control individuals (p < .001). Twice as many CARL participants (35.3%) as controls (17.6%) opted to receive a dental injection after the intervention, although this was not statistically significant. CARL, therefore, led to significant changes in self-reported fear in study participants, but no significant differences in the proportion of participants having a dental injection.

Trial registration: NCT00609648.

Keywords: computer-assisted therapy; dental anesthesia; dental anxiety; pamphlets; phobic disorders; psychological desensitization.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Computer-Assisted Instruction / methods*
  • Dental Anxiety / prevention & control*
  • Dental Care / psychology
  • Desensitization, Psychologic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections / psychology*
  • Male
  • Middle Aged
  • Needles / adverse effects
  • Pamphlets
  • Patient Education as Topic*
  • Relaxation Therapy
  • Single-Blind Method
  • Young Adult

Associated data