Physical Constraint in Pediatric Dentistry: The Lived Experience of Parents

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.

Lack of assent to dental examination in children with intellectual disabilities: Dentists' practices in Europe and ethical issues

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.

Necessity and relevance of qualitative research in pediatric dentistry. A literature review

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.

Prevalence and Parental Attitude Toward Nitrous-Oxide and Papoose-Board Use in Two Dental Referral Centers in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Parental preferences and attitudes strongly influence dentists' choices for managing children's behavior in clinics. This study aimed to assess parental attitudes toward two behavior management technique (BMTs)-nitrous oxide (N2O) sedation and/or protective passive stabilization by papoose board (PB)-before and after their children received dental treatment at two referral centers in Jeddah, Saudi Arabia.

METHODS

Participants were parents of healthy children who required dental treatment under N2O and/or PB over an 18-month period. Before and after dental treatment, parents answered a questionnaire on their attitudes toward BMTs used on their children. Parents were divided into three groups: Group 1 (parents of children who received N2O), Group 2 (parents of children who received PB), and Group 3 (parents of children who received both N2O and PB).

RESULTS

Out of the 132 parents who answered the questionnaire, 106 (80.3%) were in Group 1, 10 (7.6%) in Group 2, and 16 (12.1%) in Group 3. More children of parents with low monthly family incomes were in Group 3 than Group 1 compared to other family-incomes.

CONCLUSION

Parental attitudes toward N2O and/or PB improved after their children experienced BMTs. The future use of PB alone with their child's sibling was parents' least preferred BMT (p = 0.001).