Labels and descriptions of dental behaviour support techniques: A scoping review of clinical practice guidelines

Inclusive Dentistry? Mapping the Landscape of Autism and Dentistry Research through Bibliometric Analysis

Conduct a bibliometric analysis of articles related to dentistry and autism. A search strategy was constructed and conducted at the Web of Science database. The following information was extracted from each paper: title, authorship, year of publication, title of the journal, study subject dental care, oral health status, dental behavior support), study design, and number of citations. A total of 2,637 articles were obtained from the WoS-CC search. After selection, 422 papers were included, published from 1996 to 2024, and had 6,728 citations. Observational studies constituted most publications (214 papers). Among the focus of published articles, "oral health status" emerged as the predominant subject followed by "dental behavior support". More than half of the included papers were published in the last five years, accounting for 70.6% of the total. There has been a notable increase in research publications on autism and dentistry over time, primarily comprising observational studies. The predominant themes revolved around oral health status and dental behavior support.

Experiences of dental behaviour support techniques: A qualitative systematic review

BACKGROUND

Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can provide unique insight into these experiences.

AIM

To explore and synthesize qualitative literature related to patient experience of dental behaviour support.

METHODS

A PROSPERO-registered systematic review of qualitative articles was undertaken. Studies were identified through MEDLINE, Embase and PsycINFO. Abstracts were screened by two reviewers and data were extracted to summarize the qualitative findings included within them. A thematic summary approach was used to synthesize the qualitative data identified.

RESULTS

Twenty-three studies were included. Studies primarily explored experiences of dental care of children by speaking to their parents (n = 16), particularly regarding paediatric dental general anaesthesia (DGA) (n = 8). Studies of adults' experiences of DBS (n = 7) covered a range of techniques. Nine studies explored broader dental care experiences and did not study specific DBS approaches. A thematic synthesis identified five themes applicable across the studies identified: Trust and the therapeutic alliance supporting effective care delivery; considered information sharing often alleviated anticipatory anxiety; control and autonomy-reduced anxieties; variations in the perceived treatment successes and failures of DBS techniques; and DBS techniques produced longer positive and negative impacts on patients beyond direct care provision.

CONCLUSION

Qualitative research has been under-utilized in research on DBS techniques. Care experiences of most DBS techniques outside of paediatric DGA are poorly understood. Building trust with patients and enabling autonomy appear to support positive patient-reported experiences of care.

Dental behaviour support: can we improve qualitative research on patient experience?

DATA SOURCES

Databases included Embase, Medline (via OVID) and PsycINFO (via EBSCO). Studies referenced within included review articles were additionally screened for relevance.

STUDY SELECTION

This review focused upon qualitative research studies and their use of dental behaviour support (DBS) tools to support dental care. Included studies were restricted to those in English and published since 1997. Screening of studies involved several authors according to pre-agreed inclusion and exclusion criteria. In the event of disagreement, a third author mediated the collaborative discussion.

DATA EXTRACTION AND SYNTHESIS

Included studies first provided baseline study information including the type of qualitative research, the population studied and details of the type(s) of DBS under investigation. Then the qualitative data generated by each study, together with any interpretation provided by the authors, was entered onto bespoke data collection forms. A thematic synthesis approach was adopted. The authors generated new themes supported by selected quotations. The methodological quality of each included study was explored through a recognised tool and the level of confidence provided by each study was informed by the GRADE-CERQual assessment process.

RESULTS

Twenty-three studies were included. Most studies used semi-structured interviews, followed by focus groups and a small number of video diaries. For most studies, the focus was upon the dental care of children with a good proportion of these exploring dental general anaesthesia (DGA). Indeed, DGA was the most studied DBS technique. Whilst some studies explored adults' experiences of DBS, none of the included studies centred upon medically compromised or older adults. The review authors identified five themes following data synthesis. These themes included the following areas (abridged and modified from the review paper): trust; information sharing; control and autonomy; perceived treatment success and failure of DBS techniques; and the longer-term impact of DBS techniques upon patients.

CONCLUSIONS

Qualitative research has more to offer our understanding of DBS techniques and the impact they have upon patient care experience. There is a need for research to explore a wider range of DBS techniques used in isolation or in combination. Patient reported experiences of care should be considered in the development of outcome measures and any related DBS Core Outcome Set.

The effect of a cognitive behavioural intervention package on peripheral venous cannulation pain, fear and anxiety in Paediatric patients: A randomised controlled trial

PURPOSE

This study investigated the effect of a cognitive behavioural intervention package (CBIP) on peripheral venous cannulation (PVC) pain, fear and anxiety in paediatric patients aged 7-12 years.

DESIGN AND METHODS

This randomised controlled trial included 77 paediatric patients (intervention: n = 39 and control: n = 38). The control group underwent a routine PVC procedure, whereas the intervention group attended the CBIP while undergoing a PVC procedure. Data were collected using a sociodemographic form, the Visual Analogue Scale (VAS), the Wong-Baker FACES (WB-FACES) Pain Rating Scale, the Children's Fear Scale (CFS) and the State-Trait Anxiety Inventory for Children-State Form (STAIC-State). The participants, their caregivers and the researcher scored PVC pain, fear and anxiety levels. The study was approved by an ethics committee. Informed consent was obtained from caregivers, and verbal consent was obtained from children.

RESULTS

No significant difference in pre-procedural CFS scores were noted between the CBIP and control groups (p > 0.05). However, the CBIP group had significantly lower mean procedural pain (VAS and WB-FACES), fear (CFS) and anxiety (STAIC-State) scores than the control group (p < 0.05).

CONCLUSIONS

The CBIP helped children experience less PVC pain, fear and anxiety.

PRACTICE IMPLICATIONS

Nurses can use the CBIP to help reduce PVC pain, fear and anxiety in children.

CLINICAL TRIALS REGISTRATION

The study was registered at Clinical-Trials.gov (NCT06018909).

A scoping review of interventions and outcome measures in trials of dental behavior support

BACKGROUND

Dental behavior support (DBS) describes all techniques used by dental professionals to ensure that dental care is safe, effective, and acceptable. There is a need to standardize outcome measures across DBS techniques to reduce heterogeneity, limit selective reporting, promote consistency, and optimize outcomes across DBS research. A comprehensive review of existing measures is a prerequisite to understanding potential outcomes related to the area of interest.

AIM

This review had three aims: first, to identify the outcome measures (OMs) reported in trials of dental behavior support; second, to categorize the component DBS techniques reported within interventions according to emerging agreed terminology; and, third, to map outcome measures to intervention type.

METHODS

A scoping review of trials evaluating DBS techniques was undertaken from 2012 to 2022. The review was prospectively registered. Studies were identified through Medline, Embase, and PsycINFO. Study abstracts were screened by two reviewers. Data were extracted by single selector. Outcome measures were sorted according to measurement domains (physiological, behavioral, psychological, and treatment). Responses were assimilated and summed to produce a refined list of distinguishable outcome measures. Intervention types were categorized according to accepted descriptors. Frequencies were presented; associations between outcome domain and DBS type were also reported (Chi-square test of independence).

RESULTS

A total of 344 trials were included in the review from an initial 14,793 titles / title and abstracts screened. Most involved children (n = 215), most were from India (n = 104), involving basic dental care (n = 117). The median number of outcome measures per trial was four (range = 1-12); 1,317 individual outcomes were reported, categorized as: psychological (n = 501, 38.0%); physiological (n = 491, 37.3%), behavioral (n = 123, 9.3%) or, treatment-related (n = 202, 15.3%). DBS interventions were split between 239 (45.7%) pharmacological and 283 (54.1%) non-pharmacological; 96.6% of interventions mapped to accepted descriptors. A significant relationship was noted between the type of intervention and the outcome domain reported.

CONCLUSION

The findings demonstrate massive variation in outcome measures of DBS interventions that likely lead to unnecessary heterogeneity, selective reporting, and questionable relevance in the literature. A large range of DBS interventions were mapped according to BeSiDe list. There is a need for consensus on a core outcome set across the spectrum of DBS techniques.