No 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.

Hovudbodskap Studien kan tyda på at både tannhelsetenesta og brukarane har mykje å vinna på auka fokus på brukarmedverknad i tannhelsetenesta. For å førebyggja tannbehandlingsangst meinte deltakarane at god kommunikasjon og forklaring i forkant og undervegs i behandlingsprosessen er viktig. Deltakarane ynskte å oppleva kontroll, og å bli sett og høyrt i behandlingssituasjonen. Deltakarane opplevde det vanskeleg å sei ifrå til behandlaren når dei opplevde noko ugreitt i tannbehandlingssituasjonen. Fleire av deltakarane meinte at dersom det hadde blitt lagt betre til rette for brukarmedverknad tidlegare, kunne det hindra eller redusert behovet deira for hjelp frå TOO.

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.