Influence of active versus passive parental presence on the behavior of preschoolers with different intelligence levels in the dental operatory: a randomized controlled clinical trial

Abstract

Background Dental fear and anxiety still pose the most common factors proposed for the child’s negative behavior in the dental operatory. Intelligence has an impact on the children’s communication, feelings, and responsiveness to dental situations. The benefits of parental presence on reinforcing the child’s behavior during dental treatment are still debatable. This study aimed to assess the effect of parental active versus parental passive presence techniques on the overall behavior of preschool children with different intelligence levels. Methods This randomized controlled trial was conducted from December 2017 to August 2019. It recruited 150 healthy children, 3–6-year-old, with no history of previous dental pain/treatment, and intelligence quotient level of 70– ≤ 110 stratified into 3 equal groups (high, average, low). In the first visit, each IQ group was randomly divided into test (PAP) and control (PPP) groups. In the second visit, dental fear was assessed before preventive intervention, the test groups were then managed using parental active presence technique, while the control groups were managed using parental passive presence technique. The overall behavior was assessed at the end of the visit. Data was analyzed using Chi-square test and logistic regression analysis. Results The parental active presence technique had significant effect on children with high and low intelligence quotients. There were significantly higher odds of positive behavior in high than low intelligence quotient children, (OR 4.08, 95% CI 1.43, 11.67, P = 0.01). The parental active presence technique had significantly higher odds of positive behavior than the parental passive presence technique, (OR 4.08, 95% CI 1.71, 9.76, P = 0.002). Conclusions The parental active presence technique had positively influenced the children’s overall behavior irrespective of their intelligence levels. This trial was retrospectively registered, trial identifier number: NCT04580316, 8/11/2020.

The effect of parental presence on the anxiety during first dental treatment in children

“…the fact that a systemic review published in 2021 reported that the parental presence in the operatory room did not affect the behavior, fear and anxiety of children during dental treatment supports our findings [15]. in contrast, some studies in the literature have mentioned that parental presence reduces the level of anxiety in children during dental treatments [13,30,31].…”

“…Behavior management techniques aim to alleviate the anxiety in the child and to promote the child's positive attitude toward oral health care. it is recommended that the child is fully evaluated and that different methods are applied in different processes customized for each child [13].…”

“…in psychological techniques, it is aimed to obtain information about the severity of fear and anxiety by making measurements such as blood pressure, pulse and oxygen saturation level by using special equipments [11,12]. children's responses in the presence of parents in the treatment environment can have different results, from very useful to extremely challenging [13]. the purpose of determining the effect of parental presence or absence is to improve the child's cooperation, to prevent negative or avoidant behaviors, to establish proper dentist patient roles, to strengthen effective communication between the dentist, the child and the parents, to reduce anxiety and to achieve a positive treatment experience [14,15].…”

Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis

“…There were 3 studies published during or before the 1990s [ 57 , 58 , 59 ], 4 studies published in the 2000s [ 60 , 61 , 62 , 63 ], and the majority of the included studies were published in the 2010s ( n = 30) [ 31 , 35 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 ] and 2020s ( n = 29) [ 50 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , ...…”

<strong>The relationship of the formation of dental fear between mothers and their 7 to 9 year-old children</strong>

“…Fear in patients still poses a significant problem for dentistry, so detecting and assessing the prevalence of dental fear among child patients with some valid measurement method is necessary. 18 The social situation of the child is likely to be of importance. Children live under different circumstances in modern society, sometimes also on the margins of society in one aspect or the other.…”