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Perceptions Regarding Protective Stabilization in Pediatric Dentistry
TAKE-HOME MESSAGE
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This qualitative study interviewed 5 parents, 7 psychologists, and 4 pediatric dentists in Brazil regarding the use of active protective stabilization (restraint) of the child under age 3 with an adult holding the child's arms and legs to safely complete dental care. Active restraint was seen as important for safety and generated feelings of emotional discomfort in participants. An atmosphere of trust was seen to be fundamental to utilize the technique.
- Active restraint is common in medical and dental settings when young children are unable to understand and remain still. Honest communication with caregivers and establishment of trust and consent is necessary.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Evidence regarding the feelings evoked, distress caused, and the best way to conduct protective stabilization for the management of young children is lacking.
AIM
Describe the perceptions of mothers, psychologists, and pediatric dentists regarding the use of protective stabilization during the dental care of children up to three years of age attending a University Dental Clinic in southern Brazil.
DESIGN
After watching a video of dental care involving the protective stabilization technique, individualized qualitative interviews were held with three groups [mothers (n = 5), psychologists (n = 7), and pediatric dentists (n = 4)] to investigate four categories of interest: importance of the technique, affective attitude, distress caused to the child, and participation of parents. After the transcription of the recorded comments, qualitative content analysis was performed.
RESULTS
Protective stabilization generated emotional discomfort but was well accepted by all groups. All expressed the need to create a bond between the dentist and caregiver; and the active participation of the caregiver was considered fundamental. The mothers and psychologists rejected other options, such as passive restraint, general anesthesia, and sedation.
CONCLUSION
The three groups admitted having negative feelings, recognized the importance of protective stabilization, and suggested conditions for its use.
Additional Info
Disclosure statements are available on the authors' profiles:
Protective Stabilization in Pediatric Dentistry: A Qualitative Study on the Perceptions of Mothers, Psychologists, and Pediatric Dentists
Int J Paediatr Dent 2021 Sep 01;31(5)647-656, MC Ilha, CA Feldens, J Razera, AG Vivian, EM de Rosa Barros Coelho, PF KramerFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The perception and acceptance of advanced behavior management techniques among parents as well as providers is constantly evolving and often varies among different populations. Per the recent AAPD Best Practices, protective stabilization can be performed by the dentist, staff, or parent with or without the aid of a stabilization device and is generally indicated for the purposes of immediate diagnosis, urgent care, for patients with special healthcare needs exhibiting uncontrolled movements, as an adjunct to treatment completion during sedation, and for completion of procedure on a previously cooperative patient who becomes uncooperative and cannot be managed using basic behavior guidance techniques.
The paper by Ilha et al studies the current perception of mothers, psychologists, and pediatric dentists regarding the use of protective stabilization during child dental care in Brazil. In the current study, 16 participants, including mothers (n=5), child psychologists (n=7), and experienced pediatric dentists (n=4), individually watched a 3-minute video with scenes of routine (non-urgent) dental care for 10 children up to 3 years of age using a protective stabilization technique that involved active restraint by a family member and a staff member without stabilization devices. The responses given by the participants during a structured face-to-face interview conducted by a trained researcher were analyzed qualitatively. Their conclusions reveal that all participants experienced emotional discomfort but, at the same time, recognized the importance of protective stabilization. As the participants did not watch a recorded video on protective stabilization with stabilization device, the basis on which mothers and psychologists rejected the protective stabilization devices and considered them as non-humanized conduct is a bit unclear. It will be interesting to study the acceptance of protective stabilization with or without a stabilization device for providing dental care as indicated by the AAPD Best Practices.