Comparison of the effect of acceptance and commitment therapy and cognitive behavioral therapy on pain tolerance and intensity perception in patients with dental anxiety: A randomized trial

Abstract

Background: Dental anxiety has negative effects on dentists’ pain management. Patients have
different levels of pain tolerance. Therefore, providing psychological interventions can reduce
treatment avoidance and promote oral health. This study compared the effect of acceptance and
commitment therapy (ACT) and cognitive behavioral therapy (CBT) on pain coping strategies and
pain perception intensity in patients with dental anxiety.
Materials and Methods: This clinical trial with a pretest–posttest control group design and a
3‑month follow‑up period was performed on 45 patients with dental anxiety. They were randomly
selected by convenience sampling method and assigned to two experimental groups and one
control group. The first experimental group underwent 10 sessions of ACT, the second experimental
group underwent 10 sessions of CBT, and the control group underwent oral care training. Data
were collected by the Rosenstiel and Keefe’s Coping Strategies Questionnaire and McGill Pain
Questionnaire and analyzed by SPSS (version 24) software. The considered significance level is 0.05.
Results: The results showed no significant difference between ACT and CBT in pain coping strategies
and pain perception intensity (P < 0.05) but indicated a significant difference between the treatment
groups and the control group. Moreover, the results showed a significant difference between posttest
and follow‑up and pretest in pain coping strategies and pain perception intensity (P < 0.01) but
indicated no significant difference between posttest and follow‑up (P < 0.05).
Conclusion: ACT and CBT can play an important role in the sustainable improvement of pain
coping strategies and pain perception intensity in patients with dental anxiety.
Key Words: Acceptance and commitment therapy, cognitive behavioral therapy, dental anxiety, pain