Strategies used by dentists in Victoria, Australia, to manage children with anxiety or behavior problems

Two hundred and sixty-seven Australian dentists from the State of Victoria, representing members of the Australian Society of Dentistry for Children (AusSDC) and randomly selected practitioners, responded to a survey on attitudes and practices in the management of anxious children or children with behavior problems. The most common strategies used by dentists in this study were: permitting the child to exercise some form of control over terminating the treatment, if they were experiencing difficulties; furnishing waiting areas with play materials; and using a Tell-Show-Do approach to the provision of dental care. Members of the Australian Society of Dentistry for Children differed from general dentists by more frequently teaching anxious children a technique of relaxation and also by more frequently using a mouth prop or rubber dam during the delivery of care. Younger dentists tended to use behavioral strategies more frequently than older practitioners. Women dentists more frequently than male dentists, used strategies including: spending more time with the child before entering the operatory; setting shorter appointment sessions; and permitting the child to hold a toy or a mirror during dental treatment. In contrast to North American studies, few of the Australian dentists used the Hand-Over-Mouth technique to control hysteria. Australian dentists appeared to rely more frequently than their North American colleagues on setting shorter appointment sessions as a major strategy in managing children with anxiety or other behavioral difficulties.