Assessment of parental acceptance towards different non-pharmacological behaviour management techniques in pediatric dental care—a cross-sectional study

It is imperative to manage children with empathy and concern for their well-being in order to carry out any dental procedure smoothly. Owing to the inherent fear of dental operatory, behaviour management of children is an important aspect of pediatric dental care. Many techniques are available to help manage the behaviour of children. It is, however important to educate parents about these techniques and to get their cooperation for these techniques to be used on their children.This study aimed to familiarize the parents with non-pharmacological behavior management techniques and to determine the parental acceptance of such techniques in children seeking dental treatment in specialty care dental units. A total of 303 parents were evaluated through online questionnaires in this research. They were shown videos of randomly selected non-pharmacologic behaviour management techniques including tell-show-do, positive reinforcement, modelling and voice control. Parents were asked to watch the videos and give their response on seven-items inquiring about their acceptance levels regarding the respective techniques. The responses were recorded on a Likert scales ranging from strongly disagree to strongly agree. According to parental acceptance score (PAS), positive reinforcement was the most accepted technique whereas voice control was the least acceptable technique. Majority of the parents were more receptive towards those techniques that involved a healthy and friendly communication between a dentist and the pediatric patient such as, positive reinforcement, tell show do and modelling. Most significantly the people having low socio-economic status (SES) in Pakistan were more acceptable of voice control than people with high SES.

Behaviour management; Dental care; Pediatric; Parental acceptance

[1] American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. Pediatric Dentistry. 2017; 39: 246–259.

[2] Stein Duker LI, Grager M, Giffin W, Hikita N, Polido JC. The relationship between dental fear and anxiety, general anxiety/fear, sensory over-responsivity, and oral health behaviors and outcomes: a conceptual model. International Journal of Environmental Research and Public Health. 2022; 19: 2380.

[3] Desai SP, Shah PP, Jajoo SS, Smita PS. Assessment of parental attitude toward different behavior management techniques used in pediatric dentistry. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2019; 37: 350–359.

[4] Janus M, Reid-Westoby C, Lee C, Brownell M, Maguire JL. Association between severe unaddressed dental needs and developmental health at school entry in Canada: a cross-sectional study. BMC Pediatrics. 2019; 19: 481.

[5] Murphy MG, Fields HW Jr, Machen JB. Parental acceptance of pediatric dentistry behavior management techniques. Pediatric Dentistry. 1984; 6: 193–198.

[6] Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007; 7: 1.

[7] Lawrence SM, McTigue DJ, Wilson S, Odom JG, Waggoner WF, Fields HW Jr. Parental attitudes toward behavior management techniques used in pediatric dentistry. Pediatric Dentistry. 1991; 13: 151–155.

[8] Havelka C, McTigue D, Wilson S, Odom J. The influence of social status and prior explanation on parental attitudes toward behavior management techniques. Pediatric Dentistry. 1992; 14: 376–381.

[9] Al Zoubi L, Schmoeckel J, Mustafa Ali M, Splieth CH. Parental acceptance of advanced behaviour management techniques in pediatric dentistry in families with different cultural background. European Archives of Paediatric Dentistry. 2021; 22: 707–713.

[10] Boka V, Arapostathis K, Vretos N, Kotsanos N. Parental acceptance of behaviour-management techniques used in pediatric dentistry and its relation to parental dental anxiety and experience. European Archives of Paediatric Dentistry. 2014; 15: 333–339.

[11] Walker LE. Changing behaviour using video self modelling: its training applications and perceptions in New Zealand settings [master’s thesis]. University of Canterbury. 2009.

[12] Shukla H, Kulkarni S, Wasnik MB, Rojekar N, Bhattad D, Kolekar P. Acceptance of parents for behavior management technique with reference to previous dental expertise and dental anxiety. International Journal of Clinical Pediatric Dentistry. 2021; 14: S193–S198.

[13] Peretz B, Kharouba J, Blumer S. Pattern of parental acceptance of management techniques used in pediatric dentistry. Journal of Clinical Pediatric Dentistry. 2013; 38: 27–30.

[14] Seangpadsa K, Smutkeeree A, Leelataweewud P. Parental acceptance of behavior management techniques for preschool children in dental practice: revisited. Journal of the Indian Society of Pedodontics and Preventive Dentistry. 2020; 38: 274–279.

[15] Acharya S. Parental acceptance of various behaviour management techniques used in pediatric dentistry: a pilot study in Odisha, India. Pesquisa Brasileira em Odontopediatria e Clinica Integrada. 2017; 17: 1–6. (In Portuguese)