Relationship between attachment style of 4-7-year-old children and their behavior during dental visit.

Background: The general health and quality of life are directly correlated with oral health. Oral health is one of the unique health concerns that apply to all children. Pediatric dentistry is built on effective communication with children, which is also a requirement for providing pediatric dental care. Many pediatric dentists find it difficult to anticipate children's behavior and how they will respond to therapeutic procedures. The purpose of this study was to evaluate children's attachment types in order to forecast their behavior during a dentist appointment. Materials and Methods: The participants were 120 children between the ages of 4 and 7 who were reported to the Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Bareilly. The youngsters were evaluated by a dental graduate student. While they waited in the waiting area, the parents were asked to complete the Kinship Center Attachment Questionnaire regarding their kids. In the second visit, dental work was scheduled for the kids who had met the requirements for inclusion in the first visit. Another pediatric dentistry postgraduate student evaluated the children's conduct during the dental procedure using a predefined questionnaire and the Frankl scale. The Chi-squared test, t-test, Pearson's correlation coefficient, and linear regression were used to examine the data. Results: According to the findings, 55.8% of the total children were cooperative, among which 59.1% were female and 52.0% were males. The average age of the kids was 6.2 ± 0.95. Moreover, 21.3% of kids had insecure attachment styles and 78.7% of kids had secure attachment types. The child-dentist communication and the insecure ambivalent attachment pattern were significantly correlated. As a result, our study demonstrated that children's safe attachment styles varied with age. Our results showed that there is an inverse relationship between children's collaboration and age, with cooperation rising as age increases. Conclusions: According to the findings of this study and considering its limitations, in young ages, the attachment style of the mother plays an important role in behavior of children. The significant correlations existed between the insecure ambivalent attachment style and child-dentist communication, as well as the secure attachment type and mother-child separation.

Reliability and Validity of the Dental Anxiety Question Used With Children.

OBJECTIVE: Dental fear screening is an important part of providing a positive pediatric dental experience. To improve efficiency, the development of a single-item dental fear assessment tool for children has been desired. In this psychometric analysis, the reliability and validity of the Dental Anxiety Question (DAQ) is studied when used in children aged 7 to 18 years. METHODS: Participants completed the DAQ (pre-tx-DAQ), the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and a demographic information questionnaire before treatment. Participants repeated the DAQ after treatment (post-tx-DAQ) and once more at least 2 weeks later (follow-up-DAQ). Stability reliability within the DAQ scores and criterion validity with the CFSS-DS were evaluated. RESULTS: Stability reliability analyses between pre-tx-DAQ/post-tx-DAQ and post-tx-DAQ/follow-up-DAQ demonstrated significant positive correlations: Spearman rank correlation coefficient (rs) = 0.420, rs2 = 0.18, P < .001, and rs = 0.563, rs2 = 0.32, P < .001, respectively. Criterion validity analysis between the pre-tx-DAQ and CFSS-DS also demonstrated a significant correlation: Pearson correlation coefficient (r) = 0.584, r2 = 0.34, P < .001. CONCLUSION: The stability reliability and criterion validity of the DAQ was proved among children.

The effect of parental presence and dental anxiety on children's fear during dental procedures: A randomized trial.

Objective: To evaluate the effect of anxiety of parent accompanying child on child's anxiety during treatment. Methods: The study included two groups: one group with 80 children whose parents were anxious, and the other group with 80 children with non-anxious parents, totaling 160 children. Each group was further randomized into subgroups, with and without parents accompanying their children. The children's heart rates were measured using a portable pulse oximeter during the treatment. The child's perception was measured using the Wong-Baker Faces Rating Scale, and another pediatric dentist rated child's behavior using the Frankl scale based on the treatment video that was limited to the child's appearance. Results: The highest pulse rates were observed in children accompanied by an anxious parent (p < .001). Values on the Wong-Baker scale did not differ according to parental anxiety and parental presence (p > .05). According to the dentist, the presence of parents negatively affected the anxiety of the child (p = .025), while the effect of parents' anxiety was not statistically significant (p = .514). Conclusions: The anxiety of parent accompanying the child affects child's anxiety. Parents with high anxiety appeared to negatively affect their children's behavior.

Role of attachment style in prediction of behavior of 3 to 6-year-old children.

PURPOSE: Efficient communication with children is the basis of pediatric dentistry and is a prerequisite for provision of pediatric dental care. Prediction of the behavior of children and their reaction to therapeutic procedures is a challenge for many pediatric dentists. This study aimed to assess the attachment styles of children to predict their behavior during a dental visit. METHODS: The participants included 117 healthy children aged 3 to 6 years presented to the Department of Pediatric Dentistry, Tehran University of Medical Sciences, in 2017-2018. A postgraduate dental student examined the children. The parents were requested to fill out the Kinship Center attachment questionnaire (KCAQ) regarding their children, while waiting in the waiting room. The children who met the inclusion criteria in the first visit were scheduled for a dental procedure in the second visit. Another postgraduate student of pediatric dentistry assessed the behavior of children during the dental procedure according to the designed questionnaire and based on the Frankl scale. A third examiner along with the second examiner evaluated the behavior of children on a random basis to determine the inter-examiner agreement. Data were analyzed using the Chi-squared test, t test, Pearson's correlation coefficient, and linear regression. RESULTS: The results showed that 67.5% of the children were cooperative, including 54.7% of boys. The mean age of children was 5.1 ± 0.95 years. Also, 80.3% of children had secure and 19.7% had insecure attachment styles (11.97% insecure avoidant and 7.69% insecure ambivalent). A significant association existed between the insecure ambivalent attachment style and child-dentist communication. A significant inverse correlation was also noted between the total score of the questionnaire and parent-child separation in dental office. CONCLUSIONS: The current findings revealed no significant difference in the attachment styles of cooperative and uncooperative children. Significant associations only existed between the insecure ambivalent attachment style and child-dentist communication, and also between mother-child separation and secure attachment style. Thus, the children's behavior in dental office cannot be predicted based on their attachment style.

O sistema cvdentus® e o comportamento infantil / CVdentus® system and child's behavior

Procurando favorecer um comportamento infantil colaborador no consultório odontológico, o odontopediatra deve buscar técnicas preventivas e equipamentos avançados que proporcionem tratamentos rápidos, conservadores e, acima de tudo, mais confortáveis para o paciente. Desta forma, novos métodos de preparo cavitário são utilizados na odontologia, como laser microabrasão a ar, remoção químico-mecânica da cárie dentária e a ponta de diamante-CVD. Este estudo teve como objetivo avaliar o comportamento infantil frente ao uso do sistema CVDentus® (brocas de diamante-CVD acopladas ao aparelho de ultra-som). Participaram do estudo 27 pacientes com idade entre 4 e 12 anos (média de 7,6 ± 2,56 anos), sendo 16 (59,3%) do genêro masculino e 11 (40,7%) do genêro fminino. As crianças tiveram seu comportamento avaliado durante o tratamento odontológico com o uso do sistema CVDentus® através das Escalas de Frankl e Houpt. Na análise dos resultados foi utilizado o software Epiinfo 6.04. De acordo com os resultados obtidos, foi possível concluir que houve uma boa aceitação do sistema CVDentus® pelas crianças, as quais apresentaram um menor percentual de choro e de movimentos bruscos, bem como uma maior cooperação. Observou-se associação entre as duas escalas em relação aos ítens cooperação (p=0,003) choro (p=0,001) e apreensão (p=0,02) indicando confiabilidade e validade das mesmas.

Trying to have a collaborating child behavior in dentist's office, the pediatric dentist should look for preventive techniques and advanced equipment that provide quickly, and conservatives treatments and, above all, more comfort for the patient. Thus, new methods of cavity preparation are being used in dentistry, such as laser, abrasive air, chemo-mechanical removal of dental caries and the CVD-diamond burs. This study aimed to evaluate the children's behavior towards the use of the CVDentus® system (CVD-diamond burs coupled to an ultrasound device). The study had 27 patients aged between 4 and 12 years (mean 7.6± 2.56 years), 16 (59.3%) were males and 11 (40.7%) were females. The children had their behavior observed during dental treatment using the system CVDentus® through Frankl and Houpt scales. The Epiinfo 6.4d software were used to analyze the results. According to results, it was possible to conclude that there was a good acceptance of the CVDentus® system from the children, which had a lower percentage of cryng, sudden movements and lack of cooperation. There was association between the two scales in relation to cooperation (p=0,003), crying (p=0,001) and apprehension (p=0,02) indicating reliability and validity of them.