Pharmacological behaviour management: a survey of Thai paediatric dentists

To investigate training experiences, current practices following paediatric dentistry training, and challenges related to pharmacological behaviour management (PBM) among Thai paediatric dentists, focussing on inhalation sedation (N₂O/O₂), oral sedation (OS) and general anaesthesia (GA).

A nationwide cross-sectional survey using convenience sampling was conducted between March and May 2024. A validated web-based questionnaire, reviewed by the Pediatric Dentistry Training Subcommittee of the Royal College of Dental Surgeons of Thailand, was distributed through paediatric dentistry alumni networks and the official platforms of the Thai Association of Pediatric Dentistry. The questionnaire assessed training experiences, current practices, practitioner confidence, and barriers. Data were analysed using descriptive statistics, Chi-squared, and independent t tests (p < 0.05).

A total of 273 paediatric dentists participated (48% response rate). More than half received didactic and clinical PBM training. Clinical exposure to N₂O/O₂ and OS was limited, with 53.6% and 48.6% of respondents, respectively, treating fewer than three cases during training, whereas 79.7% treated three or more GA cases. Following training, 56.8% reported using PBM, predominantly GA. Annual case volumes were low across all modalities (< 5 cases). PBM utilisation was significantly associated with training duration, board certification, and practice setting, with higher use in dental schools and provincial/central public hospitals (p < 0.05). Reported barriers included inadequate facilities, staff shortages, and insufficient emergency preparedness.

Over half of Thai paediatric dentists used PBM, mainly GA, whereas sedation was rarely used. Strengthening postgraduate training, improving infrastructure, and developing national guidelines could support safer, more accessible PBM for children.