Dentists' Use of Pediatric Behavior Guidance Techniques

Objectives:  To explore Illinois dentists’ use of basic and advanced behavioral guidance techniques (BGTs) in children.

Methods:  A survey was mailed to a random sample of 400 general and all 194 pediatric dentists in Illinois who were members of the Illinois State Dental Society and the Illinois Academy of Pediatric Dentists. The survey was designed to repeat Adair’s from 2004. Subjects were asked to report their use/non use of 11 behavioral guidance techniques in children of various age ranges, and to rate whether they were likely to use the technique more or less in the future.

Results:  98 pediatric and 173 general dentists responded for adjusted response rates of 51% and 44%. Pediatric dentists were younger and more likely to be female than general dentists. Except for positive reinforcement (universally endorsed), voice control, equally reported (89%-82%), and hand over mouth, equally reported (1%-4%), pediatric dentists were more likely than general dentists to report use of any basic or advanced BGT, especially among younger children (chi squares, p<.001).  The greatest differences were in use of nitrous oxide (36% among general dentists vs 86%, p<.001), protective stabilization, sedation and general anesthesia. Both general and pediatric dentists were likely to allow parents in the operatory, and both tended to restrict parent presence more with older children, but pediatric dentists started of more permissive at younger ages, and ended up less permissive at older ages. The majority of both groups reported no change in usage of basic and advanced techniques compared to 5 years prior and did not anticipate changes in use over the next 2-3 years. 

Conclusions: In Illinois, with some exceptions, general dentists do not use basic behavioral guidance techniques, especially nitrous oxide sedation, when treating children as much as pediatric dentists, which might inhibit their willingness and success with treating children.