The effect of dentists’ behaviors on fear-related behaviors in children

Author(s): P Weinstein, T Getz, P Ratener, P Domoto
Journal: JADA
Volume (number): 104
Month, Year: January 1982
Major topic: Behavior Management
Minor topic(s: Effect of dentists’ behavior on fear-related behaviors
Type of Article: Behavioral Analysis
Main Purpose: Analyze effect of dentist behavior on fear-related behaviors
Overview of method of research: 25 practitioners (22 G.P.’s, 3 pediatric dentists) were observed treating patients age 3-5 y.o. Each patient was seen for at least two operative appointments for which injections would be needed. 100 total appointments were completed, for which 72 videos from 23 offices were available at completion of the study. No nitrous oxide or premedication was used. Videos were watched independently by two psychologists, a dentist, and a dental student. Behaviors were categorized as fear-related or non-fear-related based on the following criteria: Fear-related = minor and problem movement, crying, screaming, whimpering, protest, hurt, and discomfort. Non-fear-related behaviors are any behavior not listed above.
Findings: Putdowns, and ignoring the patient are likely to produce fear-related behaviors. Specific feedback is better than general feedback (e.g. not just “good job,” but “I like the way you keep your hands in your lap.”) Reassurance was less effective than one would expect (less effective than questioning for feelings), but can be okay when combined with explaining. Physical contact concurrent to explaining works well. Distraction was found to be less than effective in most cases.
Key points/Summary: “In the guidance dimension, the probability of fear-related behaviors is lowest after the use of direction and reinforcement. Findings show that specific feedback resulted in less fear-related behavior than general feedback.” “Questioning for feeling, which attempts to elicit and recognize the child’s feelings, appears to be the most effective empathic behavior.” Physical touch, e.g. patting the childs shoulder as a reassuring gesture was found to be effective as well.
Assessment of article: Very interesting.