Seven RCTs were included in the review (318 participants, range 20 to 99). Two RCTs were of moderate quality and five were of low quality.
Compared with controls, behavioural interventions were associated with a significant reduction in dental anxiety as measured using the Dental Anxiety Scale (WMD -2.67, 95% CI -3.87 to -1.48; five RCTs; Ι²=65%). Subgroup analyses did not significantly alter the results. One of the two studies that measured dental anxiety using the Dental Fear Survey scale reported a significant reduction in dental anxiety.
At long-term (one to two years) follow-up, behavioural interventions were associated with a significant reduction in dental anxiety as measured using the Dental Anxiety Scale (WMD -2.25, 95% CI -3.58 to -0.91; two RCTs; Ι²=48%). One study evaluated anxiety at five years and found no difference between behavioural interventions and controls.
One RCT reported a significant positive effect of behavioral therapy on the acceptance of conventional dental treatment compared with general anaesthesia (80% versus 53%; p=0.009).
No data were reported on quality of life, oral health-related quality of life and complications.