Parental acceptance of advanced behaviour management techniques in normal treatment and in emergency situations used in paediatric dentistry

  • L. Al ZoubiEmail author
  • J. Schmoeckel
  • M. Mustafa Ali
  • M. Alkilzy
  • C. H. Splieth
Original Scientific Article



Behaviour management techniques (BMT) in children are essential to achieve a successful dental treatment, but parents are not equally accepting BMT.


To investigate the parental acceptance of advanced behaviour management techniques used in paediatric dentistry in normal and in emergency situations in Germany.


Parents bringing their children for dental care answered a questionnaire on the acceptance of four advanced BMT: passive restraint, active restraint, nitrous oxide sedation and general analgesia. The study was conducted in five university dental clinics in Germany. Parents rated overall acceptance of each technique using a five points Likert scale.


136 parents answered the questionnaire. The acceptance of all advanced BMT was significantly higher when the treatment was urgent (p < 0.001, paired sample t test). Nitrous oxide sedation was rated as the most acceptable technique in normal treatment (52.6%) and in emergency situation (68.2%), while passive restraint was the least acceptable technique in both normal (19.9%) and emergency situation (37.8%).


Parents in Germany are more willing to accept advanced BMT in emergency situations, with nitrous oxide being generally the most preferred technique.


Behaviour management technique Parental acceptance Nitrous oxide sedation 



We thank the parents who took part in this study and the dentists who helped to distribute the questionnaire in the different universities.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.


  1. AAPD. Guideline on behavior guidance for the pediatric dental patient. Pediatr Dent. 2016;38(6):185–98.Google Scholar
  2. Abushal MS, Adenubi JO. Attitudes of Saudi parents toward behavior management techniques in pediatric dentistry. J Dent Child. 2003;70(2):104–10.Google Scholar
  3. Alammouri M. The attitude of parents toward behavior management techniques in pediatric dentistry. J Clin Pediatric Dent. 2006;30(4):310–3.CrossRefGoogle Scholar
  4. Boka V, Arapostathis K, Vretos N, et al. Parental acceptance of behaviour-management techniques used in paediatric dentistry and its relation to parental dental anxiety and experience. Eur Arch Paediatr Dent. 2014;15(5):333–9. Scholar
  5. Elango I, Baweja D, Shivaprakash P. Parental acceptance of pediatric behavior management techniques: a comparative study. J Indian Soc Pedod Prev Dent. 2012;30(3):195.CrossRefGoogle Scholar
  6. Fields HW Jr, Machen JB, Murphy MG. Acceptability of various behavior management techniques relative to types of dental treatment. Pediatr Dent. 1984;6(4):199–203.PubMedGoogle Scholar
  7. Gazal G, Fareed WM, Zafar MS, et al. Pain and anxiety management for pediatric dental procedures using various combinations of sedative drugs: a review. Saudi Pharm J. 2016;24(4):379–85.CrossRefGoogle Scholar
  8. Kamolmatayakul S, Nukaw S. Parent attitudes toward various behaviour management techniques used in pediatric dentistry in Southern Thailand. Int J Health Promot Educ. 2002;40(3):75–7.CrossRefGoogle Scholar
  9. Lawrence SM, McTigue DJ, Wilson S, et al. Parental attitudes toward behavior management techniques used in pediatric dentistry. Pediatr Dent. 1991;13(3):151–5.PubMedGoogle Scholar
  10. Machado GDCM, Mundim AP, Prado MMD, et al. Does protective stabilization of children during dental treatment break ethical boundaries? A narrative literature review. Oral Health Dent Manag. 2015;14(4-August):188–93. Scholar
  11. Paryab M, Afshar H, Mohammadi R. Informing parents about the pharmacological and invasive behavior management techniques used in pediatric dentistry. J Dent Res Dent Clin Dent Prospect. 2014;8(2):95–100. Scholar
  12. Patel M, McTigue DJ, Thikkurissy S, et al. Parental attitudes toward advanced behavior guidance techniques used in pediatric dentistry. Pediatr Dent. 2016;38(1):30–6.PubMedGoogle Scholar
  13. Scott S, Garcia-Godoy F. Attitudes of Hispanic parents toward behavior management techniques. ASDC J Dent Child. 1998;65(2):128–31.PubMedGoogle Scholar
  14. Torriani D, Ferro R, Bonow M, et al. Dental caries is associated with dental fear in childhood: findings from a birth cohort study. Caries Res. 2014;48(4):263–70.CrossRefGoogle Scholar
  15. Webb MD, Moore PA. Sedation for pediatric dental patients. Dent Clin North Am. 2002;46(4):803–14. xi.CrossRefGoogle Scholar
  16. Wilson S. Pharmacological management of the pediatric dental patient. Pediatr Dent. 2004;26(2):131–6.PubMedGoogle Scholar
  17. Hallonsten A, Jensen B, Raadal M, et al. EAPD guidelines on sedation in paediatric dentistry. European academy of paediatric dentistry Im internet. 2013. Accessed 20 Dec 2017.
  18. Gao X, Hamzah S, Yiu CKY, et al. Dental fear and anxiety in children and adolescents: qualitative study using YouTube. J Med Internet Res. 2013;15(2):379–85.CrossRefGoogle Scholar
  19. World Medical Association Inc. Declaration of Helsinki. Ethical principles for medical research involving human subjects. J Indian Med Assoc. 2009;107(6):403–5.Google Scholar

Copyright information

© European Academy of Paediatric Dentistry 2019

Authors and Affiliations

  • L. Al Zoubi
    • 1
    Email author
  • J. Schmoeckel
    • 1
  • M. Mustafa Ali
    • 1
  • M. Alkilzy
    • 1
  • C. H. Splieth
    • 1
  1. 1.Department of Preventive and Pediatric DentistryUniversity of GreifswaldGreifswaldGermany

Personalised recommendations