Students’ Perceptions About Pediatric Dental Behavior Guidance in an Undergraduate Four‐Year Dental Curriculum

Abstract

Students' acceptability scores of pediatric dental behavior guidance techniques and clinical situations were measured with visual analog scales in a four-year dental curriculum. At the end of the curriculum, the highest scores were for positive reinforcement (94.7±4.7), use of nitrous oxide (93.1±7.5), stimulating the child's imagination (90.4±11.1), tell-show-do (90.4±10.0), distraction (89.7±11.6), use of euphemisms (88.3±14.4), voice control (86.2±12.4), and promising a toy (83.6±17.7). The lowest scores were for showing a needle (23.1±20.9), treatment without local anesthetic (25.4±24.2), parent talking with the child during treatment (35.3±22.4), hand over mouth (37.1±25.4), dentist/assistant being quiet (38.5±25.3), and not allowing the child to speak (38.6±26.8). Comparison of scores after only didactic education versus after clinical plus didactic education indicated a significant increase in acceptability for general anesthesia and significant decreases for situations involving the parent in the clinic. Ranking of scores before and after the dental curriculum showed the largest change in ranking for general anesthesia (+10), telling that the treatment may involve pain (-9), parent's presence (-8) or talking with the child during treatment (-10), and use of nitrous oxide (+7). Dental education has the potential to shape students' perceptions about pediatric dental behavior guidance.

Saudi dental students’ perceptions of pediatric behavior guidance techniques

“…In general, reinforcement and desensitizing behavior guidance techniques such as positive verbal reinforcement, promising a toy, tell-show-do, using the child’s imagination, and distraction were rated as most acceptable by Saudi fourth-year dental students. Similar findings have been reported by previous studies evaluating the perceptions of first-year dental students towards behavior guidance techniques [ 6 , 7 ]. In another study, third-year dental students used reinforcement and desensitizing techniques in managing pediatric patients more than any other technique being taught in the dental school [ 12 ].…”

“…Although it showed a significant increase in acceptability, the hand-over-mouth technique was not initially accepted by the students, even before they were made aware that this technique was removed from the behavior guidelines of the AAPD. Earlier studies reported comparable results regarding the use of aversive techniques [ 6 , 7 ]. However, a significant positive change was observed in students’ perceptions of voice control, which might be because of the perceived efficacy of this technique by students in controlling patients’ behavior.…”

“…This might be explained by the introductory clinic in which the students were taught to make every effort not to show the needle to the children to gain their cooperation. Previous studies have also reported a lack of acceptance of this technique by dental students [ 6 , 7 ].…”

“…They reported an increase in the acceptability of aversive behavior guidance, sedation, general anesthesia, and modeling among first-year dental students after an educational course. Bimstein et al [ 7 ] also reported that at the end of the dental curriculum, students’ highest acceptability ratings were for positive reinforcement, use of nitrous oxide, stimulating the child’s imagination, and tell-show-do, whereas the lowest scores were for showing the needle to the child, and treatment without a local anesthetic. Additionally, when comparing attitudes after didactic and clinical training with those following didactic education alone, they reported a significant increase in the acceptability of general anesthesia and a significant decrease for situations involving the parent in the clinic [ 7 ].…”

“…Bimstein et al [ 7 ] also reported that at the end of the dental curriculum, students’ highest acceptability ratings were for positive reinforcement, use of nitrous oxide, stimulating the child’s imagination, and tell-show-do, whereas the lowest scores were for showing the needle to the child, and treatment without a local anesthetic. Additionally, when comparing attitudes after didactic and clinical training with those following didactic education alone, they reported a significant increase in the acceptability of general anesthesia and a significant decrease for situations involving the parent in the clinic [ 7 ]. Regarding behavior guidance components in different pre-doctoral pediatric dentistry programs, a survey found that almost all responding programs taught communicative techniques, protective stabilization, and pharmacologic techniques as being acceptable [ 8 ].…”