Skip to main content

Advertisement

Log in

A study of parental presence/absence technique for child dental behaviour management

  • Original Scientific Article
  • Published:
European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Aim

To examine the effectiveness of parental presence/absence (PPA) technique on the dental behaviour management of children.

Materials and methods

This randomised control study recruited 61 child dental patients with uncooperative behaviour (Frankl 1 or 2) managed with AAPD-endorsed non-pharmacological techniques at a post-graduate university clinic. PPA was only used in the test group (31 children). Using a mini video-tape device, recording commenced at the onset of uncooperative behaviour and this was later rated, minute by minute, by a blinded experienced paediatric dentist.

Statistical analysis

Data were analysed with SPSS v.13.0. The Kolmogorov–Smirnov test was used for normality analysis. The Mann–Whitney U-test and Log Rank analysis were also performed.

Results

The mean point in time, after behavioural problems commenced that PPA or alternatives were applied was 1.82 ± 1.04 min. Behaviour improvement (technique success) was shown by 65.6% of all children. There was no statistically significant difference between the study and control groups in age, gender, mean Frankl score, in Frankl score 2 min before/after technique application or regarding the time point at which the technique was first applied. Behaviour improvement was seen in 17 patients (54.8%) in the PPA group and in 23 patients (76.7%) in the control group.

Conclusion

PPA applied to various dental sessions as a behaviour management technique showed no advantage over other basic, non-pharmacological techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Adair SM, Waller JL, Schafer TE, Rockman RA. A survey of members of the American Academy of Pediatric Dentistry on their use of behavior management techniques. Pediatr Dent. 2004;26:159–66.

    PubMed  Google Scholar 

  • Arathi R, Ashwini R. Parental presence in the dental operatory—parent’s point of view. J Indian Soc Pedod Prev Dent. 1999;17:150–5.

    PubMed  Google Scholar 

  • Arnrup K, Broberg AG, Berggren U, Bodin L. Treatment outcome in subgroups of uncooperative child dental patients: an exploratory study. Int J Paediatr Dent. 2003;13:304–19.

    Article  PubMed  Google Scholar 

  • Boka V, Arapostathis K, Vretos N, Kotsanos N. Parental acceptance of behaviour management techniques used in paediatric dentistry and its relation to parental dental anxiety and experience. Eur Arch Paed Dent. 2014;15(5):333–9.

    Article  Google Scholar 

  • Certo MA, Bernat JE. Parents in the operatory. N Y State Dent J. 1995;61(2):34–8.

    PubMed  Google Scholar 

  • Chundamala J, Wright JG, Kemp SM. An evidence-based review of parental presence during anesthesia induction and parent/child anxiety. Can J Anaesth. 2009;56(1):57–70.

    Article  PubMed  Google Scholar 

  • Cox IC, Krikken JB, Veerkamp JS. Influence of parental presence on the child’s perception of, and behaviour, during dental treatment. Eur Arch Paediatr Dent. 2011;12(4):200–4.

    Article  PubMed  Google Scholar 

  • Crossley ML, Joshi G. An investigation of paediatric dentists’ attitudes towards parent accompaniment and behavioural management techniques in the UK. Br Dent J. 2002;192:517–21.

    Article  PubMed  Google Scholar 

  • Fenlon WL, Dabbs AR, Curzon MEJ. Parental presence during treatment of the child patient: a study with British parents. Br Dent J. 1993;174:23–8.

    Article  PubMed  Google Scholar 

  • Frankl SN, Shiere FR, Fogels HR. Should the parent remain with the child in the dental operatory. J Dent Child. 1962;29(1):150–63.

    Google Scholar 

  • Freeman R. The case for the mother in the surgery. Br Dent J. 1999;186:610–3.

    PubMed  Google Scholar 

  • Gerull FC, Rapee RM. Mother knows best: effects of maternal modelling on the acquisition of fear and avoidance behaviour in toddlers. Behav Res Ther. 2002;40:279–87.

    Article  PubMed  Google Scholar 

  • Goepferd SJ, Garcia-Godoy F. Preventive oral health in early childhood. In: Harris NO, Garcia-Godoy F, editors. Primary preventive dentistry. 6th ed. New Jersey: Pearson; 2004. p. 501–16.

    Google Scholar 

  • Guideline on Behavior Guidance for the Pediatric Dental Patient. Clinical Guidelines, American Academy of Pediatric Dentistry. www.aapd.org. Accessed at 06 Nov 2016.

  • Klingberg G, Berggren U, Noren JG. Dental fear in an urban Swedish population: prevalence and concomitant factors. Commun Dent Health. 1994;11:208–14.

    Google Scholar 

  • Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent. 2007;17(6):391–406.

    Article  PubMed  Google Scholar 

  • Kotsanos N, Arhakis A, Coolidge T. Parental presence versus absence in the dental operatory: a technique to manage the uncooperative child dental patient. Eur J Paed Dent. 2005;3:144–8.

    Google Scholar 

  • Kotsanos N, Coolidge T, Velonis D, Arapostathis KN. A form of ‘parental presence/absence’ (PPA) technique for the child patient with dental behaviour management problems. Eur Arch Paediatr Dent. 2009;10(2):90–2.

    Article  PubMed  Google Scholar 

  • McWhorter AG, Seale NS, King SA. Infant oral health education in US dental school curricula. Pediatr Dent. 2001;23:407–9.

    PubMed  Google Scholar 

  • Peretz B, Zadik D. Attitudes of parents towards their presence in the operatory during dental treatments to their children. J Clin Pediatr Dent. 1998;23:27–30.

    PubMed  Google Scholar 

  • Piira T, Sugiura T, Champion GD, Donnelly N, Cole AS. The role of parental presence in the context of children’s medical procedures: a systematic review. Child Care Health Dev. 2005;31(2):233–43.

    Article  PubMed  Google Scholar 

  • Rayman MS. Parent observation. Calif Dent Assoc J. 1987;15:20–4.

    Google Scholar 

  • Townsend JA. Behavior guidance of the pediatric dental patient. In: Casamassimo PS, Fields HW, McTigue DJ, Nowak AJ, editors. Pediatric dentistry. Infancy through adolescence, Ch. 23. 5th ed. St Louis: Elsevier Saunders; 2013.

    Google Scholar 

  • Varpio M, Wellfelt B. Some characteristics of children with dental behaviour problems. Five-year follow-up of pedodontic treatment. Swed Dent J. 1991;15:85–93.

    PubMed  Google Scholar 

  • Wright GZ, Kupietzky A. Non-pharmacologic approaches in behavior management. In: Wright GZ, Kupietzky A, editors. Behavior management in dentistry for children, Ch. 6. 2nd ed. Hoboken: Wiley; 2014.

    Chapter  Google Scholar 

Download references

Acknowledgements

I would like to thank Dr. Angelos V. Vasiliadis for his contribution to the statistical analysis.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to V. Boka.

Ethics declarations

Funding

This study was not funded.

Conflict of interest

All the authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Aristotle University of Thessaloniki Ethics Committee and with the 1964 Helsinki declaration and its later amendments.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Boka, V., Arapostathis, K., Charitoudis, G. et al. A study of parental presence/absence technique for child dental behaviour management. Eur Arch Paediatr Dent 18, 405–409 (2017). https://doi.org/10.1007/s40368-017-0313-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40368-017-0313-9

Keywords

Navigation