Background
phobias, phobia, anxiety, PTSD, depression
Dental anxiety has a high prevalence, and this combined with a high impact on oral health, constitutes a serious public health challenge [Cognitive behavioural therapy (CBT) is recognized as the treatment of choice for specific phobias, including the most severe form of dental anxiety, dental phobia [The daily management of patients with dental anxiety in general dental practices often includes the use of sedatives [Awareness of the importance of adequate communication and functional dentist-patient relationships for treatment outcome in dentistry is growing [Although studies on dentist-administered dental anxiety treatments are promising, little is known about how the presence of comorbid psychological symptoms may influence treatment effect, or how dental anxiety treatment may influence pre-existing problems. Knowledge on how these symptom levels fluctuate during and after dental anxiety treatment by a dentist in general dental practice is also lacking. In addition, we know very little about how the dentist-patient relationship influence outcome of dental anxiety treatments. Accordingly, the present study tested the following hypothesis: 1. High score on comorbid symptoms (anxiety, depression, and PTSD) will not negatively affect the dental anxiety treatment effect measured by the reduction in dental anxiety. 2. No increase in symptoms of general anxiety, depression, or PTSD will be observed following systematic dental anxiety treatment administered by a dentist in a general dental practice. 3. The patient rated dentist-patient relationship will be of importance to the outcome of treatment by D-CBT and Four Habits/midazolam.