What reward does a child prefer for behaving well at the dentist?

Abstract

Background:Paediatric dentists often report using positive reinforcement to encourage their young patients to show co-operative behaviour. For effective reinforcement to take place the reward should be salient to the individual. To date, there is little research into what reward a young patient will choose when attending the dentist.Aim:To identify what reward children between the age of 4–8 years will choose when attending the dentist, and to determine the extent of agreement between children and caregivers in reward choice.Method:Observational study. Fifty-two children from different age groups (4–5 years, 6–7 years and 8 years) attending a primary-care dental clinic were asked to choose between a range of different rewards. The caregiver attending with them was also asked to anticipate the child’s preferred choice.Results:There was no clear favourite reward for children from both genders and different age group. However, no child chose the ‘sticker’ reward that is traditionally given out at the dentist. Overall carers agreed with the child’s choice of toy on 18 occasions (34.6%), but there were significant differences across the age groups with carers of older children showing less agreementConclusion:To ensure that rewards are salient, children should be given a choice of rewards when attending the dental clinic. Parents ability to predict their child’s preferred rewards decreases as the child ages.Clinical relevance:A child’s motivation to co-operate during dental treatment can be increased by offering a range of rewards. Asking children to choose their reward from a limited range will increase the saliency of the reward for the child.

Perceptions of behavioural guidance techniques for paediatric patients amongst students in a Malaysian dental school

“…In order to gain the cooperation of paediatric patients during dental care, it is important for dental practitioners to apply behavioural guidance (BG) techniques, such as those recommended by the American Academy of Pediatric Dentistry 4 . Various non‐pharmacological and pharmacological interventions have been found to be effective in guiding the behaviour of paediatric dental patients, resulting in an improved quality of patient management 5,6 . Dentists who demonstrate competence in communicating with patients and handling their emotional needs were found to have gained improved compliance in personal and professional oral health care 7 …”

Dental Anxiety, Communication and the Dental Team: Responses to Fearful Patients

“…We have progressed studies that have identified dentists' responses to explicit (e.g., crying) or nonexplicit (e.g., repeating words) emotions using an internationally recognized coding system named the Verona (VR) CoDES. 39 Frequently, the patient provides emotional hints -known as cues in the VR CoDES system -that may be explicit or nonexplicit and tend to be more common than overt emotional expressions. Emotional expressions are defined as concerns in the VR CoDES system.…”

“…C-CBT involves computerized psychoeducation, v i r t u a l r e a l i t y t h e r a p y They are asked to rate their level of distress on the Subjective Unit of Distress Score (SUDS) ranging from 0 to 10 where 0 is "no discomfort" and 10 is "the worst distress experienced." 39 Each scenario is repeatedly presented to the patient until an SUDS of ≤ 2 is achieved, after which the next scenario is presented. Patients undergo exposure at their own pace and the duration of VRET is flexible based on the ability of patients to confront all the VR scenarios in a single visit.…”

“…Research from our team 39 suggests that if given the choice of a reward, children tend to choose tangible rewards and that parents are poor at predicting what rewards their children might choose. The use of rewards is appropriate across all age ranges, though the type of reward will vary.…”