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Galdino FF, Bendo CB, Fidalgo TKDS. Acceptability of dental students and professionals concerning child behaviour management techniques: Systematic review. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024. [PMID: 38733094 DOI: 10.1111/eje.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/15/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION During child dental treatment, different behavior management techniques (BMTs) are applied and it is important to understand the possible discomfort in the operator. OBJECTIVE The present systematic review aimed to evaluate the acceptability of dental students and professionals concerning BMTs applied with paediatric dentistry patients. MATERIALS AND METHODS A systematic search was conducted, following the PEOS strategy: Population (P) - dental students/professionals (S); Exposure (E) - BMTs preconized by the American Academy of Paediatric Dentistry, Outcome (O) - proportion of BMT acceptance; and Study design (S) - observational studies based on data from PubMed, Scopus, Web of Science, BVS (Lilacs/BBO), Cochrane, and Open Grey databases up to September 2021. The eligible studies were submitted to data extraction and to the evaluation of methodological quality, using the Joanna Briggs Institute Critical Appraisal Tool. The certainty of evidence was evaluated by GRADE. RESULTS The search retrieved 710 articles; a total of 21 fulfilled the eligibility criteria and were used for qualitative analysis. Among the undergraduate students and dentists, the most accepted techniques were tell-show-do and positive reinforcement, while paediatric dentists preferred the tell-show-do technique and dental professionals with graduate degrees preferred sedation using nitrous oxide and positive reinforcement. The least accepted technique was protective stabilization. Seven students presented a low risk for bias, while 14 presented a high risk. The certainty of evidence was classified as very low. CONCLUSION Although the basis of available certainty of evidence is scarce and with a considerable risk for bias, it is still possible to conclude that the more accepted techniques were based on communication.
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Affiliation(s)
- Fabíola Fontes Galdino
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiane Baccin Bendo
- Departament of Children and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Camoin A, Blanchet I, Dany L, Le Coz P, Saliba-Serre B, Tardieu C. Lack of assent to dental examination in children with intellectual disabilities: Dentists' practices in Europe and ethical issues. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38504403 DOI: 10.1111/scd.12982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/18/2024] [Accepted: 02/15/2024] [Indexed: 03/21/2024]
Abstract
AIM (1) To determine the repartition of criteria which can be considered as marks of lack of assent by the child with intellectual disabilities from the dentist's point of view and whether that influences the decision to examine the patient or not. (2) To explain the decision of practitioners and determine the ethical implications of these practices. METHODS An anonymous and structured questionnaire was distributed online using the scenario of a 9-year-old child with moderate cognitive impairment with eight different oppositional behaviours. The practitioners were asked about their perception of the patient's lack of assent and about their decision to perform the dental examination or not. RESULTS The proportion of them who performed a dental examination despite the patient's refusal represented between 13% and 28.8% of the population of respondents. CONCLUSION There was an ambivalence among the practitioners who carried out a dental consultation when children were uncooperative. They adopted a teleological point of view. It calls for us to reflect on the ethical principles of autonomy and beneficence.
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Affiliation(s)
- Ariane Camoin
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
- Aix Marseille Univ, Faculte de Sciences Médicales et Paramédicales, Marseille, France
- APHM, Timone, Pole Odontologie, Service d'Odontologie Pédiatrique, Marseille, France
| | - Isabelle Blanchet
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
- Aix Marseille Univ, Faculte de Sciences Médicales et Paramédicales, Marseille, France
- APHM, Timone, Pole Odontologie, Service d'Odontologie Pédiatrique, Marseille, France
| | - Lionel Dany
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
- Aix Marseille Univ, LPS, Aix-en-Provence, France
- APHM, Timone, Service d'oncologie médicale Marseille, Marseille, France
| | - Pierr Le Coz
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
- Aix Marseille Univ, Faculte de Sciences Médicales et Paramédicales, Marseille, France
| | | | - Corinne Tardieu
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
- Aix Marseille Univ, Faculte de Sciences Médicales et Paramédicales, Marseille, France
- APHM, Timone, Pole Odontologie, Service d'Odontologie Pédiatrique, Marseille, France
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Baghlaf K. Necessity and relevance of qualitative research in pediatric dentistry. A literature review. Saudi Dent J 2023; 35:31-38. [PMID: 36817030 PMCID: PMC9931522 DOI: 10.1016/j.sdentj.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/15/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives This review aims to understand the essence and relevance of qualitative research in pediatric dentistry and summarizes the most important information needed for a pediatric dentist before conducting a qualitative study. Methods An electronic search was conducted on studies published from December 2019 until December 2021 using PubMed, Scopus, and King Abdulaziz University Digital library. Several keywords were used to identify the studies for this review. Results Thirty-three studies involving qualitative methods in pediatric dentistry have been conducted on parents and dentists. Qualitative studies in pediatric dentistry are used to explore the perceptions of mothers and their children and to understand their behavior in different areas related to pediatric dentistry. Barriers to conducting qualitative studies with children include credibility, the influence of others on children's opinions, and differences that influence children's behavior while conducting the study. Conclusion Qualitative methods in pediatric dentistry have been conducted on parents and dentists; however, little is known about the credibility and trustworthiness of conducting qualitative research with children. Future studies are needed to investigate effective interview techniques with children and more research should be conducted to evaluate the credibility and trustfulness of using children as a source to collect data in qualitative research.
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Affiliation(s)
- Khlood Baghlaf
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Townsend JA, Peng J, McDaniel JC, Casamassimo PS. Acceptability of medical immobilization: Results from a pilot international survey. Int J Paediatr Dent 2022; 32:693-701. [PMID: 34923688 DOI: 10.1111/ipd.12948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Controversy exists on the acceptability of medical immobilization (MI). AIM To identify regulations, professional conventions, and opinions on the acceptability of MI and to identify practice patterns through a pilot study of members of the International Association of Paediatric Dentistry (IAPD) and their colleagues. DESIGN A 22-item questionnaire was developed and electronically distributed to 1191 members of the IAPD. RESULTS Responses were received from 182 dentists in 45 countries. The majority (74.9%) of respondents use MI, and 29.1% use an immobilization device. MI with an immobilization device was reported as professionally acceptable (58.1%) and permitted by medicolegal regulations (70.8%) in their countries of practice. Dentists rated acceptability of MI higher than they perceived parents would overall and perceived MI to be more acceptable by parents for emergency situations and for children with special healthcare needs but 19.8% of respondents found it totally unacceptable in all scenarios. Use and opinions of acceptability varied by geographical location with respondents from North America being more accepting of MI. Most dentists felt that the use of an immobilization device could lead to lasting psychological trauma (72.3%) and violation of the rights of the child (55.4%) but that it improves access to care (58.5%). CONCLUSION The acceptability of MI remains an area of controversy for paediatric dentists internationally.
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Affiliation(s)
- Janice A Townsend
- Department of Dentistry, Nationwide Children's Hospital, Columbus, Ohio, USA.,Division of Pediatric Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Jin Peng
- Research Information Solutions and Innovation, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jodee C McDaniel
- Department of Dentistry, Nationwide Children's Hospital, Columbus, Ohio, USA.,Division of Pediatric Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Paul S Casamassimo
- Department of Dentistry, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Aarvik RS, Svendsen EJ, Agdal ML. Held still or pressured to receive dental treatment: self-reported histories of children and adolescents treated by non-specialist dentists in Hordaland, Norway. Eur Arch Paediatr Dent 2022; 23:609-618. [PMID: 35763246 PMCID: PMC9338127 DOI: 10.1007/s40368-022-00724-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/03/2022] [Indexed: 12/19/2022]
Abstract
Aim This study aimed to estimate the prevalence of a self-reported history of restraint in children and adolescents when receiving dental care by non-specialist dentists and to assess differences in dental fear and anxiety (DFA), intra-oral injection fear, and trust in dentists between patients with and without a self-reported history of restraint. Methods An electronic cross-sectional survey was distributed to all 9 years old (n = 6686) and 17 years old (n = 6327) in the Public Dental Service in Hordaland County, Norway, in 2019. For statistical evaluation, we generated descriptive statistics and Mann–Whitney U tests. Results The response rate ranged between 43.5 and 59.9% for the different questions. The prevalence of a self-reported history of being held still against one’s will during dental treatment and pressured to undergo dental treatment against one’s will was 3.6% and 5.1%, respectively. In general, these patients reported higher DFA, and higher intra-oral injection fear compared with those without such histories of restraint. Patients who had reported being held still against their will during dental treatment had significantly higher distrust in dentists than those who did not report restraint (p < 0.001). Conclusion To feel pressured to receive dental treatment and to be held still against one’s will overlap with the concepts of psychological and physical restraint. Patients with a self-reported history of restraint recorded significant differences in DFA, intra-oral injection fear, and trust in dentists compared to those who did not report restraint. Future studies should explore the role that restraint may play in relation to a patient’s DFA, intra-oral injection fear, and trust in dentists.
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Affiliation(s)
- R S Aarvik
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway. .,Oral Health Centre of Expertise in Western Norway, Bergen, Norway.
| | - E J Svendsen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - M L Agdal
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
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Patient-self-reported history of restraint among 17-year-olds: a retrospective study of records by non-specialist dentists in the public dental service in Hordaland, Norway. Eur Arch Paediatr Dent 2022; 23:475-484. [PMID: 35536447 PMCID: PMC9167190 DOI: 10.1007/s40368-022-00710-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/09/2022] [Indexed: 10/28/2022]
Abstract
PURPOSE The primary purposes were to examine dental records of Norwegian adolescents' with and without self-reported history of restraint for information about oral health (DMFT), total scheduled time in the Public Dental Service (PDS) (dental appointments, cancelled and missed appointments), and reluctant behaviour and/or dental fear and anxiety (DFA). Another purpose was to explore their dental records for information recorded by the dentist concerning the use of restraint. METHODS Data on patient-self-reported history of restraint and DFA were collected in a population-based cross-sectional survey of 17-year-olds in the PDS in Hordaland, Norway, 2019. Patients were divided into two groups: self-reported restraint group (N1 = 26) and self-reported non-restraint group (N2 = 200). Data on oral health and dental treatment, total scheduled time of the PDS, reluctant behaviour or DFA, and information on the use of restraint were extracted from the dental records written by non-specialist dentists using a pre-set protocol covering the period from 2002 to 2019. RESULTS A total of 206 dental records were analysed. Adolescents with self-reported history of restraint (n1 = 18) had higher DMFT and greater descriptions of reluctant behaviour and/or DFA, and total scheduled time compared with the self-reported non-restraint group (n2 = 188). The use of restraint was recorded in the dental records of one patient from the self-reported restraint group and in two patients from the self-reported non-restraint group. CONCLUSIONS The adolescents with self-reported history of restraint had higher DMFT, higher scheduled time attending the PDS, and had more descriptions of reluctant behaviour and/or signs of DFA compared with the self-reported non-restraint group. The patient records contained limited information concerning restraint, and there were significant discrepancies between patient-self-reported history of restraint and the recording of restraint by the dentist in the patients' records.
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