Dental anxiety and behavioural problems: what is their influence on the treatment plan?

Authors:

ABSTRACT

Aim

This was to investigate the influence of emotional and behavioural problems on the choice of treatment type. In addition,
the actual contents of the treatment of dentally fearful children was studied in an attempt to develop dental treatment protocols for
children with such problems.

Methods

The parents of 265 children (144 girls, mean age 88.4 months, SD34.2 months),
referred to a centre for special dental care, were asked to complete the Child Behaviour Check List (CBCL) before their first
appointment. The CBCL was used to assess behavioural problems. All selected children were dentally anxious (score 35 on the
Children's Fear Survey Schedule Dental Subscale, CFSS-DS). After treatment, the children's records were analysed on treatment type
and contents.

Results

The CBCL score was related to the type of treatment. Children treated with the aid of nitrous oxide sedation
scored significantly higher on the CBCL than children treated with behavioural management or under intravenous anaesthesia (IVA). In
the IVA group more surfaces were treated than in the other groups. The CBCL score was not related to the treatment contents (number
of surfaces filled, amount of radiographs, sealants, stainless steel crowns or pulpotomies), the time spent on the child's treatment or the
number of sessions.

Conclusion

Dentally anxious children with behavioural problems as assessed by the CBCL have dental
treatment (contents and length) comparable with that of dentally anxious children without those problems. However, anxious children
with behavioural problems are more often treated with nitrous oxide sedation. Therefore, there seems to be an urgent need for access
to nitrous oxide sedation for dentists working in special dentistry.

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