Effect of awards after dental care in children’s motivation

Effect of Choice of Flavor of Fluoride Varnish on Behavior in Dental Visits in Schoolchildren

OBJECTIVE

To investigate the effect of choosing the taste of a fluoride varnish on the behavior and acceptance of the children during the dental visit.

MATERIAL AND METHODS

This single-blinded, randomized controlled trial (NCT05285228) involved 70 healthy children aged 5-10 years who presented for a dental recall visit including the indication of an application of fluoride varnish to the specialized pediatric university dental service. The control group received the fluoride varnish (Profluorid varnish, VOCO Germany) with an allocated taste, whereas the test group had to choose the taste of the fluoride varnish just before the dental check-up.

RESULTS

The vast majority of the children (n = 53, 75.7%) felt happy/very happy (Facial image scale) regarding the taste of the fluoride varnish, with no significant difference between both groups (p = 0.188). Dental behavior (Frankl behavior rating scale) was assessed generally as positive/definitely positive (n = 58, 82.2%). Interestingly, children with a history of previous negative dental behavior in the test group showed a tendency of more positive behavior than in the control group (66.6% vs. 33.4%, p = 0.244).

CONCLUSION

Sense of control performed via choosing the flavor of the fluoride varnish increases the chance for positive behavior during the dental visit, especially in children with a history of negative dental behavior. Concurrently, it improves the child's taste acceptance, which is important for dental caries prevention.

TRIAL REGISTRATION

The study protocol was registered on Cli ClinicalTrials.gov (NCT05285228).

Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis

BACKGROUND

Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12.

METHOD

A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses.

RESULT

A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell-show-do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell-show-do and other NPBIs in reducing DFA among children.

CONCLUSIONS

The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA.

Influence of different personal protective equipment on children's anxiety in dental office: a randomized controlled trial

Background

A change in how a dentist looks may affect the child’s anxiety in the dental office. This study compared the effect of conventional facial PPE versus extra PPE as reusable respirators; on the preoperative child’s anxiety in the dental office.

Methods

Fifty two children were randomly allocated into 4 groups, (1) goggles + surgical mask, and (2) face shield + surgical mask versus (3) half-face respirator and (4) full-face respirator. Each child was communicated with and clinically examined by a dentist wearing the assigned PPE, and then his anxiety was assessed using CFSS-DS. Shapiro–Wilk’s test was used to analyse normality. Kruskal–Wallis test followed by Dunn’s post hoc test with Bonferroni correction test, were used to analyse non-parametric anxiety score data. Correlations between different factors and anxiety scores were analysed using Spearman’s rank-order correlation coefficient.

Results

There were no statistically significant differences in the number of anxious children in each group, boys had significantly higher scores than girls (p < 0.001) For the “Goggles and surgical mask” group and “overall”. There was no significant correlation between age and anxiety scores. Children who didn’t have a previous dental visit had statistically significant higher scores than children with previous experience for “Goggles and surgical mask”, “Face shield and surgical mask “groups and “overall”.

Conclusions

Half-face and full-face respirators have not affected the child’s preoperative anxiety in the dental office when compared to the conventionally used PPE. Overall, there is an association between gender and previous dental visits, and dental anxiety, however; there is no correlation between child’s age and dental anxiety. Dentists dealing with children should feel free to use reusable respirators, without the risk of affecting children’s anxiety in the dental office.

Trial Registration This study was registered on www.clinicaltrials.gov, ID: NCT05371561 on 12/05/2022.

Basic behavioral management techniques in paediatric dentistry: A systematic review and meta-analysis

OBJECTIVE

To systematically retrieve and assess studies regarding the effectiveness of basic behavioral management techniques (BMTs) in paediatric patients.

DATA SOURCES

Electronic and hand searches were conducted to locate Randomized Controlled Trials (RCTs) reporting on objective and subjective evaluation of anxiety and behavior of children up to 12 years of age. Data extraction and risk of bias evaluation, using the Cochrane risk of bias tool (RoB 2.0 Tool), were performed independently and in duplicate for all included studies. Mean differences and standard deviations were used to summarize the data from each study and meta-analyses were conducted with studies of limited heterogeneity.

STUDY SELECTION

A total of 708 papers were identified and screened, 122 retrieved for full text appraisal and 62 finally included. Results suggested that all basic BMTs have acceptable effectiveness on paediatric patients' anxiety, fear and behavior during dental treatment. Meta-analysis showed a statistically significant difference in favor of distraction for subjective anxiety using facial scale (Mean diff.: 2.78; 95% CI: -3.08, -0.53; p=0.005) and Modified Child Dental Anxiety Scale (Mean diff.: 12.76; 95% CI: -6.09, -4.47; p=0.001) and a non-significant difference for heart rate (Mean diff.: 1.70; 95% CI: -6.54, 0.46; p=0.09). Music significantly reduced heart rate when compared to a control comparator, underlining the superiority of the BMT (Mean diff.: 2.71; 95% CI: -3.70, -0.59; p=0.007).

CONCLUSIONS

Limited evidence about efficacy of one technique over another raises important issues on the topic for future research regarding the management of the child patient in the dental setting of the 21^st century.

CLINICAL SIGNIFICANCE

Behavioral management comprises a challenge for clinicians, who need to be familiar with a range of techniques to meet patients' needs at individual level and be flexible in their implementation. Appropriate technique should incorporate patients' personality and parents' active involvement, within the contents of the changes in modern societies.

Motivations, attitudes for choosing dental profession and preferred dental specialties amongst Turkish dental students

AIM

The aim of the study was to investigate the influential factors for choosing dentistry, their thoughts about the profession, their expectations for the future and their thoughts about the specialisation of dental students from all grades in the School of Dentistry, Marmara University.

MATERIALS AND METHODS

Socio-demographic information, influential factors the choice of profession, thoughts and expectations about dentistry, and thoughts about the specialisation were evaluated in the questionnaire that included different question types in four separate sections. Chi-square test was used to assess the relationship between categorical variables, and multiple linear regression was performed to examine the combined effects of variables that influence the always dream of becoming a dentist.

RESULTS

462 of the 471 participants from all grades who agreed to participate in the study completed the questionnaire with a response rate of 98.1%. It was seen that the students' clinical experience made differences in almost half of their motivational sources for choosing dentistry and their views on future opinions and expectations (p < .05). In addition to clinical experience, gender also made a statistically significant differences in almost all answers in the students' opinions about specialisation (p < .05).

CONCLUSION

From the results of the study, the majority of Turkish dental students were self-motivated compared to familial and environmental factors for choosing dentistry as a career. The career motivations of them seemed to be associated with the socioeconomic aspects of dentistry, whereas the perceptions regarding the future of dentistry seemed to be associated with the need for postgraduate education.

Is dental anxiety associated with the behavior of sedated children?

The aim of this cross-sectional study was to investigate factors associated with dental anxiety in children treated under moderate sedation. Prior to treatment, each child's dental anxiety was evaluated using the modified Venham Picture Test (VPT). Interviews were also conducted with parents/guardians to gather information on the child's dental anxiety (Corah's Dental Anxiety Scale [DAS]), age and sex, shyness or anxiety in the presence of strangers, and dental history, as well as socioeconomic factors. All the children were sedated, and had at least one tooth restored using the atraumatic restorative treatment technique. Child behavior was assessed using the Frankl scale. Data analysis involved descriptive statistics and bivariate tests. The median VPT score was 2.0 (range: 0 to 8). Children who were shy in the presence of strangers (yes: median 2.0 [0-8]; no: 0.5 [0-4]; p = 0.018), and those with negative behavior during dental care (negative: 3.0 [0-8]; positive: 1.0 [0-8]; p = 0.014) had greater anxiety. The child's dental anxiety was associated with the mother's education level (≤ 8 years: 4 [2-7]; > 8 years: 1 [0-8]; p = 0.016). The dental anxiety of children treated under sedation is associated with negative behavior, shyness, and the mother's education level.

"Mom Let's Go to the Dentist!" Preliminary Feasibility of a Tailored Dental Intervention for Children with Autism Spectrum Disorder in the Italian Public Health Service

Children with autism spectrum disorder (ASD) show worse oral health than their peers. Their access to health services is, at present, inadequate: few high-quality interventions have been designed and implemented to improve their care procedures so far. The purpose of this study is to describe an experience of dental care supported by Information and Communication Technologies (ICT), for children with ASD in a public health service. In our study, 59 children (mean age 9.9 years; SD = 5.43) participated in the MyDentist project. It integrates classic dental care techniques with new practices for desensitization and fear control, delivered through an enhanced customized ICT-based intervention aiming at familiarizing the child with ASD with the medical setting and procedures. Two questionnaires were filled out by parents to describe the acceptability of the MyDentist experience for their children. Significant results were shown from T0 (before initiating MyDentist) to T1 (after 6 months of the MyDentist experience) regarding improved oral hygiene and cooperation during dental treatments. Families positively assessed the use of ICT support. In conclusion, the project demonstrated acceptability by parents, suggesting that public health dental care and prevention can be successfully implemented without resorting to costly pharmacological interventions (with potential side effects), taking better care of children's health.

Parenting styles and preschool children's behaviour in a Saudi Arabian postgraduate dental setting

BACKGROUND

The parenting style is shifting universally. Children lack the skills needed to deal with life stressful situations like those present in dental setting. Previous studies showed a correlation between parenting style and the child's dental behaviour. No studies have been performed in the Kingdom of Saudi Arabia (KSA) to relate parenting style to child's dental behaviour. The purpose of this study is to correlate parenting styles with the dental behaviour of their children, in Riyadh, KSA.

METHODOLOGY

Two hundred and eighty-two healthy preschool children aged 3-6 years were recruited in their first dental visit, to a postgraduate Paediatric Dentistry Clinics of the Dental University Hospital at KSU, Riyadh, KSA. The Parenting Styles and Dimensions Questionnaire was completed by the primary caregiver/parents. The behaviour of the children was evaluated after dental prophylaxis and fluoride application in the dental chair using Frankl behavior rating scale. Family and child demographic data were evaluated through a questionnaire.

RESULTS

Two hundred and eighty-two healthy Saudi children participated in the study with their parents. Two parenting styles were identified among Saudi parents including authoritative (94%, n = 265) and permissive parenting styles (6%, n = 17). Most of the children behaved positively (n = 205, 72.7%). Significant correlations were detected between parenting style and parent's dental anxiety (P value 0.02) but not significantly correlated to a child's dental behaviuor.

CONCLUSION

In the KSU sample studied, two parenting styles were identified among Saudi parents, authoritative and permissive parenting styles. Parenting style was correlated to parental dental anxiety and had an influence on a child's dental behaviour. Clinically, interesting correlations were identified regarding factors affecting child/s first dental visit behaviour.