Almost half of American adults have at least moderate fears about going to the dentist, and 5 to 10 percent have told researchers that they avoid dental care as a result.

The obvious consequences are increased cavities, bad breath and periodontal disease, but secondary consequences are broader: Decayed or missing teeth have a negative effect on self-esteem and employability. And since periodontal disease is associated with such conditions as cardiovascular disease, diabetes and stroke, fear of dental care can even be life-threatening.

In the March issue of Monitor on Psychology, the magazine of the American Psychological Association, Rebecca A. Clay lays out this grim scenario in the context of describing psychologists who are trying to help people tackle that fear. Techniques include cognitive behavioral therapy, relaxation therapy, medication, acupuncture, hypnosis, musical distraction and gradual exposure to certain elements of a procedure, such as injections.

But as Richard Heimberg, a psychology professor at Temple University, points out in Clay’s article, few dental practices have psychologists on staff. So his clinic for adults with anxiety has developed a video-based “dental anxiety intervention.”

To prepare a frightened person for a certain procedure — such as getting a filling or undergoing a root canal — the dentist shows the patient three videos. The first shows a dentist performing the procedure, while animated graphics show what’s going on inside the mouth. The next shows the procedure as a close-up of the video patient’s face while the dentist talks like a therapist, “helping the patient translate what Heimberg calls ‘Oh, my God!’ thoughts into more positive thoughts.” In the last one, a voice-over by the video patient talks through the procedure, helping the actual patient develop “coping thoughts.”

In trial of 151 patients with high dental anxiety or phobias, Heimberg’s team found that the intervention significantly reduced fears. And the effects were lasting: A month later, some of the patients were so comfortable with dental care that they no longer qualified as phobic.