Behavioural characteristics in externalising children with low and elevated risk for dental caries

Abstract

AimTo compare two groups of children with externalising behaviour problems, having low and elevated caries risk, respectively. Those parameters were assessed in relation to behavioural characteristics and family structure, and to compare the caries risk assessment and gender differences in relation to children in general in the Region of Västra Götaland, Sweden.MethodsFamilies (228) with children, aged 10-13 years, participating in parent training programmes, were recruited. Parents provided information through questionnaires regarding parental knowledge and monitoring, family warmth and conflict and family structure. Children’s behavioural characteristics, based on the Strength and Difficulties Questionnaire and the Disruptive Behaviour Disorder rating scale, were used as outcome. Data about caries risk assessment were obtained from dental records.ResultsChildren in the elevated caries risk group showed higher mean values for conduct problems as well as impulsivity. Parents of the children in the elevated caries risk group reported more parental solicitation and less family conflicts. Children with an elevated caries risk lived more often in households with more than two children and had more often a father from a non-Nordic country.ConclusionThere were statistically significant more children with an elevated caries risk in the study group compared to children in general in the Region of Västra Götaland, both totally and within gender. Differences were observed with regard to behavioural characteristics in externalising children with an elevated risk for caries. Increased knowledge regarding behavioural characteristics in externalising children is an important parameter to be considered in caries risk assessment.

Childhood social, emotional, and behavioural problems and their association with behaviour in the dental setting

“…Externalizing problems are those concerning to impulsivity and conduct problems and refer to behaviour problems manifested in children's outward behaviour and reflect children's negatively acting on the external environment . Such characteristics may interfere with daily routines, such as tooth brushing, directly affecting the oral health . Behavioural problems have also being associated with dental caries, and children who presented with early childhood caries were found to be less sociable, less energetic, highly distractible, and less rhythmic .…”

“…Another article showed that the dental status of children, specifically with traumatic dental injuries, has also been positively correlated with peer relationship problems, and Srilatha et al showed that the presence of caries in adolescents was influenced by emotional and behavioural difficulties. In addition, Staberg et al found that externalizing children with high risk of caries presented more impulsivity and conduct problems (eg, become angry when corrected, act without thinking) than children with low risk of caries.…”

Oral health and oral health risk behaviour in children with and without externalising behaviour problems

“…The study group was comprised of 194 families with children (10–13 years of age), whose parents participated in parent management training (PMT) programs, evaluating early intervention for children with externalising behaviour problems, previously described in detail (Staberg et al 2016 ).…”

“…In children with ADHD, the frequent consumption of sugar can be difficult for the parents to deal with, and sometimes, the oral hygiene/tooth brushing is neglected (Staberg et al 2014b ). Among children with externalising behaviour problems, those with an elevated caries risk have been shown to have more impulsivity and conduct problems, compared to children with low caries risk (Staberg et al 2016 ).…”

Motivation chart as a supporting tool in pediatric dentistry

“…Firstly because children in larger families could be directly or indirectly exposed to information about dental treatment provided to their siblings, and secondly they might have observed their siblings appearing anxious during dental treatment, causing negative thoughts that could have an impact on their anxiety about dental treatment 7 . Pediatric dentists should be aware of the stages of psychological evolution in children and how to build a relationship of trust with their patients, remembering that where children are involved, actions and words may contribute to their personality, lead to greater manual dexterity and performing the correct diagnosis, in order then to achieve successful treatment [8][9] . The professional who can tell the difference between each of these phases and understand the needs of the child, will make the treatment more comfortable and bring more security and tranquility to the parents.…”