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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 1  |  Issue : 2  |  Page : 45-48

Comparative practice of behavior management techniques in pediatric patients among BDS and MDS practitioners of other specialties


Department of Pedodontic and Preventive Dentistry, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India

Date of Web Publication22-Dec-2016

Correspondence Address:
Sharanya Ravindran
No. 49, 4th Circular Road, Jawahar Nagar, Agaram, Chennai - 600 082, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2468-8932.196478

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  Abstract 

Context: Dentist plays a unique role in treatment plan for the child patient. Without a proper behavior management technique, there would not be a successful treatment outcome. Behavior management techniques among various dentists are studied. Aims: The aim of the present study is to compare the behavior management techniques of pediatric patients among undergraduate and postgraduate practitioners of other specialties. Subjects and Methods: The study was conducted in the Department of Pedodontics and Preventive Dentistry, Thai Moogambigai Dental College and Hospitals, Chennai, Tamil Nadu. A total of 88 dental surgeons were selected randomly by stratifies sampling method, in which 22 were undergraduate dentists and 66 were postgraduate dentists from different specialties. Statistical Analysis Used: Descriptive statistical techniques and bivariate analysis were used. Results: Postgraduate dentists of other specialties were more likely to accept behavior management techniques than undergraduate practitioners. Conclusions: It was concluded that practitioners should recognize that both didactic and clinical educational components may influence on the students. Hence, it is necessary that graduate dentists must be aware of the behavior modification techniques.

Keywords: Behavior management, postgraduate practitioners, techniques, undergraduate practitioners


How to cite this article:
Ravindran S, Moses J, Pari M A, Inbanathan JG. Comparative practice of behavior management techniques in pediatric patients among BDS and MDS practitioners of other specialties. Int J Pedod Rehabil 2016;1:45-8

How to cite this URL:
Ravindran S, Moses J, Pari M A, Inbanathan JG. Comparative practice of behavior management techniques in pediatric patients among BDS and MDS practitioners of other specialties. Int J Pedod Rehabil [serial online] 2016 [cited 2019 Feb 23];1:45-8. Available from: http://www.ijpedor.org/text.asp?2016/1/2/45/196478


  Introduction Top


Children are not young adults, their behavior, attitude, ability to understand, imagination, logical thinking, reasoning, etc., vary considerably from that of adults and also from each other.

Dentistry is a super specialty which primarily depends on the cooperativeness of the patient, without which a dentist will not be able to perform any operatory procedure. One of the most challenging problems faced by dental practitioners and dental students is behavior management. Psychological variables (anxiety and/or stress), sociocultural (individual characteristics, children's maturity, previous dental experience), and legal requirements (parent's consent) are involved in dental treatment interfering with professional performance. [1],[2]

To be successful in pediatric dental treatment, it is necessary to choose adequate strategies based on procedures that stimulate children's cooperative behavior and knowledge which should have been acquired during formal dentistry training. [3]

Apart from these techniques, behavioral management strategies start as soon as the patient arrives in the dental operatory, and also involve attire, voice tone, facial expression, body language, sense of humor of the dentist. For a child who is not capable of cooperate, the dentist has to rely on other behavior management techniques (BMTs) as communication and education. [4]

In general, children used to judge a BMT according to the way it looked; hence, hand over mouth exercise (HOME) was the least acceptable BMT, whereas the most acceptable was tell-show-do (TSD). [5] Interestingly, it was observed the same reaction by parents, which considered HOME an aggressive technique [6],[7] and TSD, the safest of all. [8]

There are many behavior management strategies available in the dental literature. To choose the appropriate protocol and strategies of effective management with the primary goal of installing a positive attitude is the need for the hour. Anticipation of the newer strategies of behavior management and updating them is a vital task for the dentist.

Aim

The aim of the study is to compare the BMTs of pediatric patients among undergraduates and other specialty postgraduates.

Objectives

The objective of the present study was to evaluate the practice of pediatric dental treatment among undergraduate and other specialty postgraduates.


  Subjects and Methods Top


The subjects of this study include patients of undergraduates and other specialty postgraduates of dentistry.

Methods of sample collection

The study was conducted in the Department of Pedodontics and Preventive Dentistry, Thai Moogambigai Dental College and Hospitals, Chennai, Tamil Nadu.

A total of 88 dental surgeons were selected randomly in which 22 were undergraduates and 66 were postgraduates from different specialties such as oral medicine, periodontics, prosthodontics, endodontics, orthodontics, oral and maxillofacial surgery [Table 1] and [Table 2].
Table 1: Total number of practitioners involved


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Table 2: Number of practitioners from different specialities


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Sampling method: Stratified sampling method.

Inclusion criteria

  1. The study included undergraduates and other specialty postgraduates who are designated in various department at Thai Moogambigai Dental College and Hospital
  2. Postgraduate practitioners other than pedodontics and preventive dentistry.


Exclusion criteria

  1. Postgraduate students
  2. Nonclinical dental graduates.
Questionnaire

It is a questionnaire-based study with 15 self-explanatory questions, starting from the attitude of the child when he/she enters the dental clinic and till he/she leaves the premises, and the parental attitude when the child is been treated were included in it. Thus, the questionnaires were given to practitioners individually, and its percentage value was evaluated and scores had been valued and assessed.

Statistical analysis

The absolute and percent frequencies were obtained for data analysis (descriptive statistical techniques). The existence of significant association between undergraduates and postgraduates practitioners was verified by means of bivariate analysis.


  Results Top


90.9% of undergraduate dentists and 87.9% of postgraduate dentists preferred the parents to stand along with the child [Table 3]. 63.6% of undergraduate practitioners and 39.4% postgraduate practitioners say that the child fears but cooperative [Table 4]. Both undergraduate and postgraduate practitioners answered that around 90.9% equally prefer nonpharmacological behavior management [Table 5]. Around 63.6% of undergraduate dentists and 60.6% of postgraduate dentists consider TSD as an effective nonpharmacological BMTs [Table 6]. About 81.8% of undergraduate practitioners and 75.8% of postgraduate practitioners preferred conscious sedation rather than general anesthesia [Table 7].
Table 3: Preference of parental presence during the dental treatment


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Table 4: Preference of patients for dental treatment with various emotional disturbances


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Table 5: Preference for type of dental treatment


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Table 6: Preference for non-pharmacological treatment


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Table 7: Preference for pharmacological treatment


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  Discussion Top


Numerous articles have been published regarding the practice of behavior management among various dentists, but the comparative knowledge of undergraduates and the other specialty postgraduates were not established in the dental literature. The present study is done based on it to assess the comparative BMTs of pediatric patients among undergraduates and other specialty postgraduates.

In the present study, we had found that majority of undergraduate practitioners preferred parent to stay along with the child during the treatment but postgraduate practitioners felt that the child fears but cooperates. Same way, Lewis et al. in 1961 and Shroff et al. in 2015 had conducted a study in which they concluded that more number of undergraduate dentists prefer the parents to be present in the dental operatory during the treatment which is similar to our study. [9]

Whereas there is a specific protocol given by Margaret Mahler in her theory of separation-individualization, where she has classified the relationship between a child and her mother, based on which the presence of mother in the operatory was classified. This should be quoted as a vital tool in behavior management of a child which is to be updated by the dental practitioner. [10]

Both undergraduate and postgraduate dentists preferred nonpharmacological dental treatment rather than pharmacological treatments such as conscious sedation and general anesthesia.

63.6% of undergraduate dentists and 60.6% of postgraduate dentists considered TSD as an effective nonpharmacological BMTs. Similar to our study, Sharath et al. and Adair et al. and Sotto et al. have suggested in their study that TSD is considered as the essential treatment plan for the child in their study. [11],[12],[13]

More number of undergraduate practitioners were involved in conscious sedation than postgraduate practitioners. Similarly, Boynton et al. in 2007 and Brahm et al. in 2013 had concluded in their study that maximum number of undergraduate dentists prefer conscious sedation rather than general anesthesia according to the cooperativeness of the children which was also similar to our study. [14],[15]

This study was made as a questionnaire-based study and the answering options were directly listed, so that we can directly get the dentist's opinion. The advantage of our study is numerical values, statistical evaluation, graphs, and time consumption were all eliminated. Advantages of the study were questions which were direct and self-explanatory.

The results of our study indicated that undergraduate dentists are very much less aware of BMTs and are more toward pharmacological means of treatment planning.

Pediatric dentists who are always in the position and direct exposure to the children so that we can learn all the up-to-date behavior modalities, but it is the need of the general dentists to update the latest behavior management aids to install a positive attitude in child.


  Conclusion Top


It was concluded that postgraduate dentists were more likely to accept and follow the behavior management techniques than the undergraduate practitioners who were not so confident according to our study. However, the undergraduate dental education components have the potential to shape student perceptions of pediatric dental BMTs during their career. Moreover, they should recognize that both didactic and clinical educational components may influence on the students. Hence, it is necessary that undergraduate dentists must be aware of the behavior modification techniques.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Klaassen MA, Veerkamp JS, Hoogstraten J. Dental fear, communication, and behavioural management problems in children referred for dental problems. Int J Paediatr Dent 2007;17:469-77.  Back to cited text no. 1
    
2.
Roberts JF, Curzon ME, Koch G, Martens LC. Review: Behaviour management techniques in paediatric dentistry. Eur Arch Paediatr Dent 2010;11:166-74.  Back to cited text no. 2
    
3.
Batista CG, Nascimento CL, Rolim GS, Rocha RA, Rodrigues AF, Ambrosano GM, et al. Student self-confidence in coping with uncooperative behaviours in paediatric dentistry. Eur J Dent Educ 2011;15:199-204.  Back to cited text no. 3
    
4.
Freeman R. The case for mother in the surgery. Br Dent J 1999;186:610-3.  Back to cited text no. 4
    
5.
Kantaputra PN, Chiewcharnvalijkit K, Wairatpanich K, Malikaew P, Aramrattana A. Children's attitudes toward behavior management techniques used by dentists. J Dent Child (Chic) 2007;74:4-9.  Back to cited text no. 5
    
6.
Luis de León J, Guinot Jimeno F, Bellet Dalmau LJ. Acceptance by Spanish parents of behaviour-management techniques used in paediatric dentistry. Eur Arch Paediatr Dent 2010;11:175-8.  Back to cited text no. 6
    
7.
Elango I, Baweja DK, Shivaprakash PK. Parental acceptance of pediatric behavior management techniques: A comparative study. J Indian Soc Pedod Prev Dent 2012;30:195-200.  Back to cited text no. 7
[PUBMED]  Medknow Journal  
8.
Peretz B, Kharouba J, Blumer S. Pattern of parental acceptance of management techniques used in pediatric dentistry. J Clin Pediatr Dent 2013;38:27-30.  Back to cited text no. 8
    
9.
Shroff S, Hughes C, Mobley C. Attitudes and preferences of parents about being present in the dental operatory. Pediatr Dent 2015;37:51-5.  Back to cited text no. 9
    
10.
Blum HP. Separation-individuation theory and attachment theory. J Am Psychoanal Assoc 2004;52:535-53.  Back to cited text no. 10
    
11.
Sharath A, Rekka P, Muthu MS, Rathna Prabhu V, Sivakumar N. Children's behavior pattern and behavior management techniques used in a structured postgraduate dental program. J Indian Soc Pedod Prev Dent 2009;27:22-6.  Back to cited text no. 11
[PUBMED]  Medknow Journal  
12.
Adair SM, Schafer TE, Rockman RA, Waller JL. Survey of behavior management teaching in predoctoral pediatric dentistry programs. Pediatr Dent 2004;26:143-50.  Back to cited text no. 12
    
13.
Sotto JJ, Azari AF, Riley J 3 rd , Bimstein E. First-year students' perceptions about pediatric dental behavior guidance techniques: The effect of education. J Dent Educ 2008;72:1029-41.  Back to cited text no. 13
    
14.
Boynton JR, Green TG, Johnson LA, Nainar SM, Straffon LH. Portable digital video instruction in predoctoral education of child behavior management. J Dent Educ 2007;71:545-9.  Back to cited text no. 14
    
15.
Brahm CO, Lundgren J, Carlsson SG, Nilsson P, Hultqvist J, Hägglin C. Dentists' skills with fearful patients: Education and treatment. Eur J Oral Sci 2013;121(3 Pt 2):283-91.  Back to cited text no. 15
    


    Figures

  [Table 7]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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  In this article
Abstract
Introduction
Subjects and Methods
Results
Discussion
Conclusion
References
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