The effect of psychological management on dental anxiety in children

The aim of this study was to determine the effect of using of psychological management techniques on the level of anxiety in Nigerian children during dental management. The Short Form of the Dental Anxiety Survey Schedule was administered to 81 children who were attending a suburban dental clinic for the first time. This schedule was re-administered again two weeks later when they came for a follow up visit. The age of the patients was recorded. The types as well as number of psychological techniques employed during treatment were also noted. The overall mean dental anxiety level of the children decrease from an average of 15.23±5.03 before treatment to 13.40+4.13 after treatment (p < 0.001). However, the mean dental anxiety score in children in whom no psychological technique was employed during treatment increased after treatment. On the other hand, there was also a statistically significant decrease in the mean dental anxiety level of children treated using either a single psycho-logical technique or combined psychological techniques after treatment. Better results were obtained when combined psychological techniques where used than when only a single technique was used. It was concluded that psychological techniques used in the management of dental anxiety in children are highly effective in decreasing dental anxiety levels. Better results are obtained when a number of techniques are combined effectively.

1. Kinirons MJ, Stewart C. Factors affecting levels of untreated caries in a sample of 14-15- year-old adolescents in Northern Ireland. Community Dent Epidemiol 26: 7-11, 1998.

2. Nathan JE. Managing behavior of pre-cooperative children. Dent Clin North Am 39: 789-816, 1995.

3. Milgrom P, Weinstein P. Dental fears in general practice: new guidelines for assessment and treatment. Int Dent J 43: 288-293, 1993.

4. McDonald RE. Behavior guidance in the dental office. In: Dentistry for the child and adolescent. St. Louis, C.V. Mosby Company, pp 26-37, 1974.

5. Baranie JT. Behavior modification techniques. In Ripa, L.W., Barenie, J.T.(eds). Management of dental behavior in children. Littleton Massachusetts: PSG Publishing, pp 61-73, 1979.

6. Boj JR, Davila JA. Differences between normal and develop-mentally disabled children in a first dental visit. J Dent Child 62: 52- 56, 1995.

7. Addelston HK. Child patient training. Fort Rev Dent Soc 38: 7- 9, 27-29, 1959.

8. Pinkham JR. The roles of requests and promises in child patient management. J Dent Child 60: 169-174, 1993.

9. Holst A, Schroder U, Ek L, Hallonsten AL, Crossner CG. Prediction of behavior management problems in children. Scand J Dent Res 96: 457-465, 1988.

10. Klingberg G. Dental fear and behavior management problems in children. Swed Dent J Supplement 103: 1-78, 1995.

11. Machen JB, Johnson R. Desensitisation, model learning and the dental behaviour of children. J Dent Res 53: 83-87, 1974.

12. Melamed BG, Hawes RR, Heiby E, Glick J. Use of filmed modeling to reduce uncooperative behavior of children during dental treatment. J Dent Res 54: 797-901, 1975.

13. Melamed BG, Weinstein D, Hawes R, Katin-Borland M. Reduction of fear-related dental management problems with use of filmed modeling. J A D A 90: 822-826, 1975.

14. Melamed B, Yercheson R, Fleece TL, Hutcherson S, Hawes R. Effects of film modeling on the reduction of anxiety - related behaviors in individuals varying in level of previous experience in the stress. J Consult Clin Psychol 46: 1357-1367, 1978.

15. Klingman A, Melamed BG, Cuthbert Ml, Hormecz DA. Effects of participant modeling on information acquisition and skill utilization. J Consult Clin Psychol 52: 414-422, 1984.

16. Venham LL, Goldstein M, Gaulin-Kremer E, Peteros K, Cohan J, Fairbanks J. Effectiveness of a distraction technique in managing young dental patients. Pediatr Dent 3: 7-11, 1981.

17. Weinstein P, Nathan JE. The challenge of fearful and phobic children. Dent Clin North Am 32: 662-667, 1988.

18. Kuhn BR, Allen KD. Expanding child behavior management technology in pediatric dentistry: a behavioral science perspec-tive. Pediatr Dent 16: 13- 17, 1994.

19. Pinkham JR. Personality development. Managing behavior of the cooperative pre-school child. Dent Clin North Am 39: 771- 787, 1995.

20. Melamed BG, Bennett CG, Jerrell G, Ross SI, Bush JP, Hill C et al. Dentists’ behavioral management as it affects compliance and fear in pediatric patients. J A D A 106: 324-330, 1983.

21. Greenbaum PE, Lumley MA, Turner C, Melamed BG. Dentist’s reassuring touch: effects on children’s behavior. Pediatr Dent 15: 20- 24, 1993.

22. Sussman NM, Rosenfeld HM. Touch, justification violations. J Soc Psychol 106: 215-225, 1978.

23. Raadal M, Milgrom P, Weinstein P. Mancl L, Cauce AM. The prevalence of dental anxiety in children from low income families and its relationship to personality traits. J Dent Res 74: 439, 1995.

24. Murray JJ, Niven N. The child as a dental patient. Curr Opi Dent 2: 59-65, 1992.

25. Carson P, Freeman R. Assessing child dental anxiety: the validity of clinical observations. Int J Paed Dent 7: 171-176, 1997.

26. Wright GZ (1975). Behavioral management in dentistry for children. Cited by Matthewson RJ, Primosch RE and Robertson D. Fundamentals of Paediatric Dentistry. Quintessence Publishing Co Inc pp 144-145, 1987.

27. Thom A, Sartory G, Johren P. Comparison between one-session psychological treatment and benzodiazepine in dental phobia. J Consult Psychol 68: 378-387, 2000.

28. Aartman IH, de Jongh A, Makkes PC, Hoogstraten J. Treatment modalities in a dental fear clinic and the relation with general psychopathology and oral health variables. Br Dent J 186: 467-471, 1999.

29. Alwin N, Murray JJ, Niven N. The effect of children’s dental anxiety on the behavior of a dentist. Int J Paediatr Dent 4: 19-24, 1994.