Discussion
phobic, OHR, phobia, caries
SECONDARY, RECRUITMENT, CARIES, DECAYED TEETH
This feasibility study highlighted that a trial seeking to determine the effects of providing MIOC to patients with dental phobia is possible within a secondary care setting that is a major national provider of conscious sedation and CBT services. The recruitment process to identify eligible patients and acceptability of MIOC pathway by patients was successful as shown in the relatively low declining participating rates in the eligible participants (only 12% at the screening appointment and 17% at the care planning session). These factors indicate a possibility to conduct a future prospective MIOC randomised control trial (RCT) for people with dental phobia. The dentist fully adhered to the intervention (MIOC) protocol. The results from valid and reliable measures (MDAS, HADS, OHIP, caries diagnosis) also aided the comparison to other studies’ data.The participants’ background (such as age, gender and educational levels) was similar to a published general population with phobia [This study’s high number of decayed teeth [Previous studies [Although the rate of the intervention (MIOC) groups’ follow up could be improved (a dropout rate of 4 people), the participants who completed the MIOC approach reported high satisfaction rates and expressed improved OHR QoL. The drop out rates in particular in TAU can partly been explained by participants’ phobic status (only people with MDAS scores of 19 and above were invited to take part). The lower drop out rate for the intervention arm may reflect the greater person-centred nature of the MIOC approach, especially if this was combined with CBT.Although some anxious individuals report regular dental attendance [As a feasibility study, the population is a convenience sample with a fixed recall period that cannot give powerful statistical results [The lack of time was the reason for not collecting participants’ character and the reasons for refusals (rate of 48, [22%]), however, the refusal rate is comparable to a similar centre [The use of minimally invasive operative approaches (the third clinical domain of MIOC) to improve prognosis of treated teeth was welcomed by participants in this study unlike in the Schwendicke et al. (2016) [This study bias was limited by using simple randomization with concealed allocation numbers and randomly reviewing researcher’s adherence to intervention. The introduced self-reported OHR behavioural changes can be a consequence of study participation, however, currently there are no evidence of a single effect [A single examiner can be beneficial to provide a consistent care but there is a need to report intra-examiner reliability. The relatively short follow-up time might have overestimated the reported clinical effectiveness [