Temperament and acceptance of dental treatment under sedation in preschool children

The major aim of the study was to investigate whether differences concerning acceptance of dental treatment and amnesia after rectal sedation with midazolam can be explained by temperament traits in the child. Fifty children (1.5-4.0 years), consecutively referred for dental extractions because of dental trauma or caries, were sedated with midazolam 0.3 mg kg^-1 rectally. Level of sedation (state of mind) was assessed according to Wilton before and 10 min after administration of the sedative. The children's acceptance of procedures during the oral examination, the administration of the sedative, and the dental treatment were assessed according to Holst. Acceptance of an injection of local anesthesia and tooth extraction was dichotomized as satisfactory (n = 26) or unsatisfactory (n = 24). The parent assessed temperament using the Emotionality Activity Sociability (EAS) Scale of Child Temperament. Amnesia was evaluated by the parent on the following day. The relation between temperament and outcome variables was analyzed using a multiple logistic regression analysis. Children regarded as shy by the parent were at significantly greater risk of unsatisfactory acceptance of the dental treatment (P < 0.05). High scores of negative emotionality were significantly related to less amnesia (P < 0.05). We conclude that parental ratings of their child's temperament are valuable in predicting a child's acceptance of dental treatment under sedation.     

Acceptance of dental care following early extractions under rectal sedation with diazepam in preschool children

The aim of the study was to evaluate the effect of amnesia in preschool children on their later acceptance of dental care. Forty-six 4-6-year-old children, who between 2 and 4 years previously had had primary incisors extracted because of trauma, were reexamined for dental health and acceptance of dental care. The extractions had been performed under rectal sedation with diazepam (0.7 mg/kg body weight). Information about dental treatment and degree of cooperation during the intervening period was obtained from records at the referring clinic. The parents were interviewed about their child's experience of amnesia concerning the extractions, background variables, and experiences of dental care before the follow-up examination. Amnesia concerning the extractions was reported in 85% of the children. Twenty-nine percent had on some occasion exhibited behavior management problems (BMP) during the intervening period. Lack of amnesia was significantly associated with BMP (P &lt; 0.002). Children without amnesia concerning the extractions tended to accept dental care less well at the reexamination. Parents were able to predict their child's acceptance of dental care at the follow-up with a significant degree of success (P = 0.02). In conclusion, amnesia in preschool children concerning extractions seems to be essential to facilitate positive acceptance of future dental care.     

OHRQoL changes among Chinese preschool children following dental treatment under general anesthesia

Clinical Oral Investigations - To assess dental treatment under dental general anesthesia (DGA) among Chinese preschool children by investigating changes in their oral health-related quality of...     

Direct ratings of acceptance of dental treatment in Swedish children

The aim of the present study was to bring forward data of acceptance of dental treatment for 3-16-yr-old children in a population with good dental health and annual dental care, and to evaluate the influence on acceptance of age, sex, residential area, and previous experience and present need of dental treatment. The material consisted of 2773 children. Direct ratings of behavior were made at each of 10 different treatment steps passed during dental appointments. The majority of children needed no more than one dental visit and 79% showed positive acceptance at all steps of treatment passed during dental visits. Eight percent of all children sometimes reacted in such a way that treatment could not be carried out without restraint or undue delay. Dental fear was diagnosed in 3% of all children.     

Dose-responsive characteristics of meperidine sedation in preschool children

Using double-blind conditions, 60 uncooperative and fearful preschool children (24-66 months) received intramuscular injections of meperidine 0.25, 0.50, 1.00 mg/lb or placebo prior to restorative dental treatment. Behavior was assessed by the dentist and an independent observer during five specific treatment procedures. Behavioral ratings found meperidine to be an effective sedative, with 0.50 mg/lb and 1.00 mg/lb being significantly more effective than placebo (P less than 0.05, Kruskal-Wallis). Children receiving 1.0 mg/lb of meperidine had significantly more nausea and vomiting than patients receiving lower doses of the drug (P less than 0.05, Chisquare). Physiologic monitoring demonstrated that the highest dose of meperidine was associated with transient drops in arterial oxygen saturation. Meperidine sedation was found to be more effective for older children (37-66 months) and for children initially rated as being only moderately uncooperative and fearful.     

103例口腔患儿应用笑气镇静的临床效果

目的:观察笑气吸入法在儿童牙科临床治疗效果.方法:选取有牙科焦虑症,行为表现分级为Venham 2 ～4级患儿103例,经患儿家长同意采取笑气吸入,记录每次镇静治疗时患儿的心率、血氧饱和度、呼吸频率,评定笑气吸入在儿童牙科的镇静效果.结果:93例Venham 2～4级患儿笑气吸入后口腔治疗基本顺利进行,10例Venham 4级患儿不能配合治疗,改为束缚下治疗.结论:笑气吸入法能够减轻或缓解患儿对牙科的恐惧和不安,是一种有效的镇静方法.     

学龄前儿童参与治疗在牙科诊疗中的作用研究`

目的　探讨学龄前儿童参与疾病治疗在牙科诊疗中的作用。方法 选取2017年6月~2018年6月来我院口腔门诊首次就诊并需要复诊的3~6岁学龄前儿童90例为研究对象,根据随机数字法分为实验组和对照组,每组各45例。每次就诊对照组给予常规干预,实验组除常规干预措施外,让患儿参与疾病治疗。首诊和复诊治疗结束后采用CFSS-DS量表、Frankl量表和Houpt行为量表对两组患儿牙科畏惧程度、治疗依从性和治疗完成情况进行评定并比较其统计差异。结果 实验组复诊率为93.33%,高于对照组（77.78%）,差异具有统计学意义（?2=4.406,P<0.05）。实施参与疾病治疗的实验组患儿首诊和复诊CFSS-DS评分均低于对照组,Frankl治疗依从性和Houpt治疗完成情况均优于对照组,两组比较均具有统计学差异（P均<0.05）。和首诊比较,复诊后实验组患儿CFSS-DS评分降低,Frankl治疗依从性提高,差异具有统计学意义（P均<0.05）,但Houpt行为量表评定结果没有统计学差异（P>0.05）。结论 实施学龄前儿童参与疾病治疗能缓解患儿牙科畏惧程度,提高就诊率和治疗依从性。     

Traumatic dental injuries in Brazilian preschool children

Abstract  – The purpose of this study was to determine the prevalence and distribution of traumatic injuries to primary anterior teeth in children from zero to 6 years old, all attendees in 28 public nursery schools in Canoas (Brazil). A total of 1545 boys and girls participated in the study. The children were clinically examined for signs of trauma according to Andreasen's classification. Traumatic injuries were identified in 35.5% of children. The largest percentage of injuries was demonstrated by 3–4-year-old child, with no significant difference between boys and girls. The maxillary central incisor was the most vulnerable to injury, without differences between the right and the left side. Single tooth injury was predominant in all age groups. Crown fractures represented 83% of all traumatic injuries. Our findings emphasize the importance of encouraging parents to visit the dentist with their child at an early stage. Furthermore, parents and educators should be advised about prevention of traumatic injuries and actions to be taken in case of an accident.     

Prediction of dental behavior problems in preschool children

Aim of this study was to investigate behavioural and emotional problems in preschool children in relation with behaviour problems during a highly stress provoking dental treatment. Eighty one healthy children between 2 and 4 years referred to the clinic of Special Dental Care (SBT) in Amsterdam were selected, based on dental need (extraction of one or more primary incisors). Each child was sedated with oral midazolam. Their behaviour was rated by registering the degree of acceptance during four consecutive time periods of the dental treatment. Prior to the treatment parents were asked to fill in a questionnaire. No significant correlations between temperament and behaviour were found with the total CBCL profile or its subscales. This confirms the results of earlier studies that the relationship of temperament, dental anxiety and behaviour problems is a complex matter and not yet fully understood. It is also indicated that within the entire treatment a child's behaviour is closely related to its behaviour in the preceded treatment step.     

Effect of systematized "behavior shaping" on acceptance of dental treatment in children

The aim of this study was to compare the acceptance level of children treated by dentists who had participated in a training program of psychologic care and systematized "behavior shaping", with the acceptance level of children treated to a large extent by the same dentists before their training program. The material consisted of 2400 children treated by 149 dentists, to be compared with the material of 2773 children treated by 161 dentists in the "before training" study; 127 dentists took part in both studies. The training program included a video film, a manual, and a case form. Of the children treated before the dentists underwent the training program, 79% showed positive acceptance of all treatment steps encountered during dental visits, 13% reluctant acceptance, and 8% negative or no acceptance. The corresponding figures for children treated after the training program were 92, 6, and 2%. The distributions of overall positive acceptance in the two studies were compared by means of a logistic regression model. The level of overall positive acceptance was significantly increased after the dentists had participated in the training program. The improvement was most pronounced among the youngest children and children in need of restorative treatment or extraction. Of all the background variables studied, age, present need of treatment, and the before/after training variable had the greatest influence. The study shows that dentists can be trained to obtain significantly increased positive acceptance of dental treatment in children, and that the method does not require extra time in the dental chair.     

Traumatic anterior dental injuries in Cuban preschool children

Abstract –  The purpose of this study was to determine the prevalence and distribution of traumatic dental injuries in 2–5 year-old children. It included 543 children of both sexes, all attending five urban nurseries in San José de las Lajas, Cuba. The prevalence of injuries was 34.2%. Type and prevalence of dental injuries was determined using Andreasen's classification. Enamel fracture was the predominant injury (67.1%). The maxillary central incisor was the most vulnerable to injuries. Boys (41.8%) experience more injuries than girls (26.8%).     

Association of diet with dental caries in preschool children

This article updates the evidence linking dietary factors to dental caries in preschool children and recommends dietary approaches to reduce caries risk. Along with nutritional factors, a comprehensive approach to preventing dental caries in preschool children must include good oral hygiene, appropriate use of fluorides, and access to preventive and restorative dental care.