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Purpose: The purpose of this study was to determine provider and practice characteristics influencing usage of behavior guidance techniques (BGTs)., Methods: A 24-item survey was emailed to 4,117 active AAPD members to identify factors influencing pediatric dentists' use of BGTs., Results: A total of 1,081 surveys were returned, for a 26 percent response rate. The mean age of respondents was 44.7 years old, with recent graduates comprising the largest group (30.5 percent). Usage of voice control, nitrous oxide, sedation, and general anesthesia (GA) differed significantly, according to experience. Respondents with at least 30 years of experience reported changes in usage. Tell-show-do, nitrous oxide, oral sedation, and passive restraint were significantly more frequent among female respondents. Parental absence, oral sedation, and GA were significantly more frequent in respondents serving low income populations. Parental absence, pharmacologic techniques, and restraint were significantly different in frequencies among the different geographic regions., Conclusions: Usage of behavior guidance techniques has changed over the past three decades, with more recent graduates and experienced practitioners now emphasizing pharmacologic techniques. More assertive behavior guidance techniques are used more frequently by experienced providers and those in practices in the southwest or serving lower income populations. Pharmacologic techniques are used at a higher prevalence by recent graduates and providers who are female or serving lower income populations.

The purpose of Workshop B was to discuss the implications of this symposium for training of pediatric dental residents and predoctoral dental students, as well as continuing education for general dentists as related to behavior guidance. Participants also considered the implications of the symposium proceedings for practice in terms of informed consent, practice patterns, and provision of information to patients regarding behavior guidance. Workshop B identified a variety of dental educational methodologies used to promote understanding among dentists who provide pediatric dental care to diverse populations. There was a consensus that the indications, use, and documentation of basic behavior guidance techniques need to be defined and clarified by the American Academy of Pediatric Dentistry and disseminated appropriately. Workshop participants called for the development of asynchronous learning activities such as webinars and instructional videos to further educate dental providers treating children and to legitimize the techniques with parents, healthcare providers, and the general public. Major recommendations from the workshop included: 1) solicit, support, and fund research in behavior guidance for diverse populations, 2) clarify best practices for the use and documentation of basic behavior guidance techniques, 3) identify and define new behavior guidance techniques, 4) promote training in motivational interviewing, 5) encourage integration of symposium proceedings throughout dental education curricula, 6) encourage mentorship networks among general dentists treating children and geographically contiguous pediatric dentists, and 7) develop a library of informational videos for parents and the general public about appropriate behavior guidance techniques used when treating children in dental settings.

Behavior management is significant to delivery of dental care to the child. We must be able to elicit cooperation of the child for dental procedures, and of child and parents, for adherence to a preventive home care regimen. However, society has changed, affecting the ability of dentists to influence children and their parents. The purpose of this paper is to review changes in parenting styles that have impacted the nature of oral care in the child.

One of the difficulties of the practice of dentistry is being responsible for the highest quality of care for patients while often having to propose alternate solutions for a variety of reasons, which include financial concerns. Dental practitioners treating young children have the added responsibility of gaining their patient's cooperation to render the best treatment. Determinants that influence the development of a behavioral strategy for a young patient include disease status, the child's physical and mental development, parental characteristics, and provider personality and capabilities. Classic strategies--including a supportive office environment, "tell-show-do," successive approximation, distraction, behavior shaping, and retraining--must be matched to the characteristics of each child and family situation. Current cultural trends suggest that disciplinary forms of behavior management strategies--such as hand-over-mouth, physical restraint, and even voice control--are losing societal acceptance.

Purpose: To assess the effectiveness of nonpharmacological behavior guidance interventions used for children and youth with special health care needs (CYSHCN) during preventive and dental treatment visits. Methods: Databases: Ovid MEDLINE, PsyclNFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmacological techniques rendered during a preventive visit (exam, fluoride application, radiographs, and prophylaxis) or a treatment visit (simple surgical treatment, sealants, restorative care with or with local anesthesia) with control or other interventions. The primary outcome measures for the studied interventions were reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included Randomized Controlled Trials (RCTs), performed data extraction, and assessed the risk of bias (ROB). Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done. Results: Eleven articles qualified for analysis from 219 screened articles. Included studies evaluate the effectiveness of in office strategies such as modeling, audio-visual distraction, sensory adapted dental environment, and picture exchange communication system. The certainty of evidence ranged from Very low to Low and the magnitude of effect varied from trivial to large change in the desired outcomes. Conclusions: Most basic non-pharmacological behavior guidance techniques showed some trivial to small reduction in self-reported anxiety and/ or improvement in behavior, with audiovisual distraction, Sensory Adopted Dental Environment, and Picture Exchange Communication System showing large reduction in anxiety based on some rating scales. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness of nonpharmocological behavior guidance interventions used for children undergoing dental treatment visits. Methods: Databases: Ovid MEDLINE, PsycINFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmocological techniques rendered during a dental . treatment visit including sealants, restorative core, dental local anesthesia, and simple surgical procedures. The primary outcome measures were reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included RCTs, performed data extraction, and assessed the risk of bios (ROB). Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done. Results: Forty articles qualified for analysis from 219 screened articles. Included studies evaluated the effectiveness of pre-visit preparation and in office strategies rendered pre-/post- or during treatment such as positive imagery, direct observation/modeling, desensitization, tell-show-do and its modifications, voice control, positive reinforcement, memory restructuring, bio-feedback and breathing relaxation, animal assisted therapy, combined therapies, and cognitive behavior therapy. The certainty of evidence ranged from Very low to high and the magnitude of effect varied from trivial to large change in the desired outcomes. Conclusions: Most of the basic non-pharmacological behavior guidance techniques showed trivial to small reduction in self-reported anxiety and/or improvement in behavior, with modeling, positive reinforcement, biofeedback relaxation, breathing relaxation, animal assisted therapy, combined tell-show-do and audiovisual distraction, and cognitive behavior therapy showing large effects in reduction of anxiety based on some scales. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness of nonpharmacological behavior guidance interventions used for a child undergoing preventive dental visits. Methods: Databases: Ovid MEDLINE, PsyclNFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmacological techniques rendered during a preventive visit including examination, prophylaxis, fluoride application and radiographs. Workgroup (WG) identified moderate-to-high quality systematic reviews (SRs) published on hypnosis, audiovisual distraction, and parental presence/absence; and decided to exclude these interventions from current SR to avoid duplication. The primary outcome measures for the studied interventions included reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included RCTs, performed data extraction, and assessed the risk of bias. Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done. Results: Fifteen articles qualified for analysis from 219 screened articles. WG found studies evaluating effectiveness of pre-visit preparation and in-office strategies rendered pre- or during treatment such as positive imagery, communication, modeling, tell-show-do, magic tricks, mobile applications, positive reinforcement, and sensory adapted dental environment. The certainty of evidence ranged from Very low to Moderate and the magnitude of effect varied from trivial to a large change in the desired outcomes. Conclusions: Most basic nonpharmacological behavior guidance techniques showed trivial to small reduction in self-reported anxiety and/or improvement in behavior, with mobile application and modeling showing large effects in reduction of anxiety based on some rating scales. [ABSTRACT FROM AUTHOR]