Abstract
Aim
The aim of this study was to examine the acceptance by Greek parents of nine behaviour-management techniques and its association with several possible confounding factors.
Study design
Following ethical approval, 106 parents whose 3- to 12-year-old children had been receiving treatment in a university postgraduate paediatric dental clinic, and 123 parents of children from a private paediatric dental practice agreed to participate.
Methods
After being shown a video with nine behaviour-management techniques, parents rated the acceptance of each technique on a 0–10 scale. They were then asked to complete a questionnaire about demographics, their previous dental experience and dental anxiety (modified Corah dental anxiety scale).
Results
The best accepted technique was tell–show–do (9.76 ± 0.69), followed by parental presence/absence (PPA) technique (7.83 ± 3.06) and nitrous oxide inhalation sedation (7.09 ± 3.02). The least accepted techniques were passive restraint (4.21 ± 3.84) and general anaesthesia (4.21 ± 4.02). No correlations were found between acceptance of any individual management technique and parental age, gender, income, education, dental experience and dental anxiety or the child’s age, gender and dental experience. Parents whose children had been treated at the University clinic had lower income and educational levels, and rated passive restraint, oral sedation and general anaesthesia higher than those from the private practice. When the parents were specifically asked to choose between general anaesthesia over any of the active or passive restraint, hand-over-mouth and voice control techniques, 10 % preferred general anaesthesia, and these parents reported statistically significant more negative dental experience but not higher dental anxiety.
Statistics
Statistical significance of differences was explored using the Tukey–Kramer method.
Conclusion
There was no correlation between parental dental experience and dental anxiety and the acceptance of any specific behaviour-management technique. However, parents with negative dental experience would prefer general anaesthesia over any of active or passive restraint, hand-over-mouth and voice control techniques. PPA is a highly acceptable technique for Greek parents.
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References
Abushal MS, Adenubi JO. Attitudes of Saudi parents toward behaviour management techniques in paediatric dentistry. J Dent Child (Chic). 2003;70(2):104–10.
Adair SM, Rockman RA, Schafer TE, Waller JL. Survey of behaviour management teaching in paediatric dentistry advanced education programs. Pediatr Dent. 2004;26(2):151–8.
Alammouri M. The attitude of parents toward behaviour management techniques in paediatric dentistry. J Clin Pediatr Dent. 2006;30(4):310–3.
Arch LM, Humphris GM, Lee GT. Children choosing between general anesthesia or inhalation sedation for dental extractions: the effect on dental anxiety. Int J Paediatr Dent. 2001;11(1):41–8.
Balmer R, O’Sullivan EA, Pollard MA, Curzon ME. Anxiety related to dental general anaesthesia: changes in anxiety in children and their parents. Eur J Paediatr Dent. 2004;5(1):9–14.
Coolidge T, Arapostathis KN, Emmanouil D, Dabarakis N, Patrikiou A, Economides N, Kotsanos N. Psychometric properties of Greek versions of the Modified Corah Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS). BMC Oral Health. 2008;30(8):29–35.
Davis MJ. Conscious sedation in paediatric dentistry: a survey of members of the American Board of Paediatric Dentistry College of Diplomates. Pediatr Dent. 1988;10:328–9.
Eaton JJ, McTigue DJ, Fields HW Jr, Beck M. Attitudes of contemporary parents toward behaviour management techniques used in paediatric dentistry. Pediatr Dent. 2005;27(2):107–13.
Guideline on Behaviour Guidance for the Paediatric Dental Patient, Clinical Guidelines, American Academy of Paediatric Dentistry. http://www.aapd.org. Revised 2011; Accessed at 10/11/2013.
Hayer AJ. A proof of the conjecture that the Tukey–Kramer multiple comparisons procedure is conservative. Anal Stat. 1984;12(1):61–75.
Houpt M. Project USAP: the use of sedative agents in paediatric dentistry: 1991 update. Pediatr Dent. 1993;15:36–40.
Kotsanos N, Arhakis A, Coolidge T. Parental presence versus absence in the dental operatory: a technique to manage the uncooperative child dental patient. Eur J Paediatr Dent. 2005;6(3):144–8.
Kotsanos N, Coolidge T, Velonis D, Arapostathis KN. A form of ‘parental presence/absence’ (PPA) technique for the child patient with dental behaviour management problems. Eur Arch Paediatr Dent. 2009;10(2):90–2.
Krikken JB, Vanwijk AJ, Tencate JM, Veerkamp JS. Child dental anxiety, parental rearing style and dental history reported by parents. Eur J Paediatr Dent. 2013;14(4):258–62.
Kuhn BR, Allen KD. Expanding child behavior management technology in pediatric dentistry: a behavioral science perspective. Pediatr Dent. 1994;16(1):13–7.
Lawrence SM, McTigue DJ, Wilson S et al. Parental attitudes toward behaviour management techniques used in paediatric dentistry. Pediatr Dent. 1991;13(3):151–5.
Luis de León J, Guinot Jimeno F, Bellet Dalmau LJ. Acceptance by Spanish parents of behaviour-management techniques used in paediatric dentistry. Eur Arch Paediatr Dent. 2010;11(4):175–8.
Muhammad S, Shyama M, Al-Mutawa SA. Parental attitude toward behavioural management techniques in dental practice with school children in Kuwait. Med Princ Pract. 2011;20:350–5.
Murphy MG, Fields HW Jr, Machen JB. Parental acceptance of paediatric dentistry behaviour management techniques. Pediatr Dent. 1984;6(4):193–8.
Peretz B, Zadik D. Parents’ attitudes toward behaviour management techniques during dental treatment. Pediatr Dent. 1999;21(3):201–4.
Oueis HS, Ralstrom E, Miriyala V, Molinari GE, Casamassimo P. Alternatives for hand over mouth exercise after its elimination from the clinical guidelines of the American academy of paediatric dentistry. Pediatr Dent. 2010;32(3):223–8.
Roberts JF, Curzon ME, Koch G, Martens LC. Review: behaviour management techniques in paediatric dentistry. Eur Arch Paediatr Dent. 2010;11(4):166–74.
Seale NS. Behaviour management conference panel III report-legal issues associated with managing children’s behaviour in the dental office. Pediatr Dent. 2004;26(2):175–9.
Sheller B. Challenges of managing child behaviour in the 21st century dental setting. Pediatr Dent. 2004;26:111–3.
Themessl-Huber M, Freeman R, Humphris G, Macgillivray S, Terzi N. Empirical evidence of the relationship between parental and child dental fear: a structured review and meta-analysis. Int J Paediatr Dent. 2010;20(2):83–101.
Wigen TI, Skaret E, Wang NJ. Dental avoidance behaviour in parent and child as risk indicators for caries in 5-year-old children. Int J Paediatr Dent. 2009;19(6):431–7.
Acknowledgments
We are grateful to Dr. Eaton for his information on the video and the questionnaire used in their study in the USA. We express our thanks to Professor Guinot Jimeno for providing us the video and the questionnaire used in their study in Spain.
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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 15, 333–339 (2014). https://doi.org/10.1007/s40368-014-0119-y
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DOI: https://doi.org/10.1007/s40368-014-0119-y