Spanish and Portuguese Parental Acceptance of Behavior Management Techniques in Pediatric Dentistry

Aim. To compare acceptance of behavior management techniques used in pediatric dentistry by Spanish and Portuguese parents. Study design. cross-sectional study. A survey of 8 behavior management techniques used in pediatric dentistry was administered to parents whose children were being treated at the Universitat Internacional de Cataluña (Barcelona, Spain) or at the Universidade de Coimbra (Portugal). The techniques evaluated were: tell–show–do (TSD), nitrous oxide sedation, passive restraint using a papoose board, voice control, hand-over-mouth, oral premedication, active restraint and general anaesthesia. The questionnaire also included information on parents’ sex, number and sex of children receiving treatment, parents’ previous dental experience (positive or negative), children’s previous dental experience (positive or negative), and the socioeconomic status of the families. Results. TSD and voice control were rated the most acceptable techniques in both Spain and Portugal, whereas the least accepted techniques in both countries were active and passive restraint. There were no significant differences in the acceptance of each of the techniques, in relation to parents’ sex or their previous dental experience, children’s sex or age, children’s previous dental experience, or families’ socioeconomic status. Conclusion. TSD was the most widely accepted behavior-management technique by Spanish and Portuguese parents, even with the passage of time. Both groups of parents had a low opinion of active and passive restraint techniques.

Parental acceptance of advanced behaviour management techniques in paediatric dentistry in families with different cultural background

Purpose To investigate the differences of parental acceptance of advanced behaviour management techniques (BMT) in different cultural backgrounds (Germany vs. Jordan). Methods A convenience sample of 100 parents each of paediatric patients at the University of Greifswald/Germany and Jordan University/Jordan completed a questionnaire to rate their acceptance of four advanced BMT (passive restraint, active restraint, nitrous oxide sedation, and general anaesthesia) using a five-point Likert scale. Results In both groups, nitrous oxide sedation was the most accepted advanced BMT (mean 3.78 ± 1.34/3.22 ± 1.50, respectively). The least acceptable technique in Germany was passive restraint (2.05 ± 1.18) and in Jordan general anaesthesia (2.11 ± 1.30). The parents in Germany are significantly more accepting of nitrous oxide sedation than are parents in Jordan (p = 0.010), while parents in Jordan are more willing to accept passive restraint (p = 0.001). The acceptance of all advanced BMT increased significantly in both groups when the treatment was urgent. Conclusions Parental cultural background and the urgency of the treatment affect the acceptance of different BMT. Moreover, the parental attitude to the pharmacological technique has changed, as nitrous oxide sedation generally appears to be the most preferred advanced technique in both groups.

Getting a grip: cats respond negatively to scruffing and clips

Use of scruffing and scruffing tools (eg, clipnosis clips) to immobilise cats is contentious, and cat handling guidelines vary in recommendations regarding these techniques. The current study examined whether cats show negative responses to the following restraint methods: (1) scruff (n=17), (2) clip application to the dorsal neck skin (n=16) and (3) full body (a known negative; n=19). Each cat was also handled with passive restraint (control) for comparison. During handling, cats were examined for behavioural (side/back ear positions, vocalisations, lip licking) and physiological (pupil dilation ratio, respiratory rate) responses. Full-body restrained cats showed more negative responses than passively restrained cats (respiratory rate: p=0.006, F3,37=4.31, p=0.01; ear p=0.002, F3,49=6.70, p=0.0007; pupil: p=0.007, F3,95=14.24, p=0.004; vocalisations: p=0.009, F3,49=4.85, p=0.005) and scruff-restrained cats (pupil: p=0.009; vocalisations: p=0.04). Clip restraint resulted in more negative responses than passive (pupil: p=0.01; vocalisations: p=0.007, ear p=0.02) and scruff restraint (pupil p=0.01; vocalisations: p=0.02). No differences were detected between full-body restraint, known to be aversive, and clip restraint. Full-body restraint and clip restraint resulted in the greatest number of negative responses, scruffing resulted in fewer negative responses and passive restraint showed the least number of responses. We therefore recommend against the use of full-body and clip restraint, and suggest that scruff restraint should be avoided when possible.

Acceptance of Behavior Guidance Techniques Used in Pediatric Dentistry by Parents From Diverse Backgrounds

Objective. To investigate if parental background affects acceptance of behavior guidance techniques. Background. Behavior guidance techniques are used for the safe and effective treatment of pediatric patients. Acceptance of these techniques may vary by racial and ethnic background. Methods. A total of 142 parents were recruited and asked to rate videos showing: active restraint/protective stabilization (AR), general anesthesia (GA), nitrous oxide sedation (N2O), oral premedication/sedation (OP), passive restraint/protective stabilization (PR), tell-show-do (TSD), and voice control (VC) techniques. Results. Hispanic parents rated VC most acceptable, followed by TSD, PR, and pharmacologic techniques. Black and white parents rated TSD, followed by N2O, as most acceptable, and AR and PR as least favorable. Hispanics found GA significantly less acceptable than whites or blacks. Hispanics were less accepting of AR than blacks; but more accepting of PR than whites. TSD was highly rated among all 3 cohorts. Parental background affected acceptance of the techniques in this study.

Plaster, splint, brace, tape or functional mobilization after first-time patellar dislocation: what’s the evidence?

With an incidence of 5.8 per 100,000 per year, patellar dislocations are commonly seen in the emergency department. Surprisingly, there are only a few studies available that focus on the results of the different non-surgical treatment options after first-time patellar dislocation. The aim of this review is to provide an overview of the most recent and relevant studies on the rationales and results of the non-surgical treatment for first-time patellar dislocation. Patellar instability mainly affects young and active patients, with a peak incidence of 29 per 100 000 per year in adolescents. The medial patellofemoral ligament, a main passive restraint for lateral translation of the patella, is torn in lateral patellofemoral dislocations. Treatment of first-time patellar dislocation can be either conservative or surgical. There are two options in conservative management of first-time patellar dislocation: immobilization using a cylinder cast or removable splint, or, second, functional mobilization after applying a brace or patellar tape. The current available literature of conservative treatment after a first-time patellar dislocation is little and of low quality of evidence. Conclusions should be drawn with care, new research focussing on non-surgical treatment is therefore strongly needed. Cite this article: EFORT Open Rev 2019;4:110-114. DOI: 10.1302/2058-5241.4.180016