Survey of Behavior Management Teaching in Pediatric Dentistry Advanced education Programs

Department of Pediatric Dentistry
Lutheran Medical Center

Resident’s Name: Craig Elice Date: 9/11/2009
Article title: Survey of Behavior Management Teaching in Pediatric Dentistry Advanced education Programs
Author(s): Adair SM, Rockman RA, et al
Journal: Pediatric Dentistry
Volume (number): 26:2, 151-8
Major topic: Survey of Behavior Management Techniques
Type of Article: Survey
Main Purpose: This study surveyed advanced Pediatric dentistry programs to determine teaching habits of communicative behavior management techniques as well as pharmacologic techniques.
Materials and Methods: Surveys were mailed to 65 programs. Questions addressed didactic teaching and clinical experience of residents and the answers were expressed as “not taught, “taught as acceptable”, and “taught as unacceptable”. 54 programs responded. Questions also included changes in the past 5 years and proposed changes in the next 3 years. Views on informed consent and presence of parents in the operatory were questioned as well
Findings: Most programs spend more than 20 classroom hours on behavior management with a mean of 13% of the time in didactic hours. TSD, VC, nonverbal, positive reinforcement, and distraction were taught and were acceptable. Only 28% teach HOME as acceptable, 54% teach as unacceptable. Active and passive immobilization, sedation, Nitrous, and general anesthesia were all taught as acceptable by most programs with slightly fewer reporting as acceptable for active immobilization with sedation. Of programs teaching HOME, 50% reported a decrease in time for teaching than they did 5 years ago, and 39% indicated they would spend less time teaching the technique in the future. Parents in operatory were routinely permitted for emergencies and special needs children. It was universally acceptable to have parents in the operatory for children under 3 years of age, while the number diminished as the children became older. Parents were present during routine exams in 56% of programs. Parents are excluded from sedation appointments in 41% of programs. Program directors noted an increase in frequency of parents in the operatory in the last 5 years and 70% of directors indicated no change in the future in their teaching of the acceptability of parents in the operatory. Reasons for the increase include parents request, ease of consultation with parents while treating the child, and concern over legal action. Written informed consent was used by almost all programs for nitrous oxide sedation and in all programs for general anesthesia. However, oral and written informed consent were used equally in conscious sedation
Key points/Summary : In summary, the majority of programs teach communicative and pharmacologic behavior management techniques as acceptable with the exception of HOME. Time spent in the curriculum of programs has not changed in the last 5 years nor is it anticipated that it will change in the next 2-3 years.
Assessment of article: Well presented article yielding expected results. Nothing earth shattering in this article.