Efficacy of behavior management techniques to prevent unnecessary anesthesia in uncooperative children referred to dental hospital of Tabriz University, 1391

Abstract

Background and aims: Despite risks and side effects of general anesthesia (GA), a considerable number of referrals are made due to lack of cooperation in children for dental treatments. The present study aimed at evaluating the efficacy of behavior management techniques to prevent unnecessary GA in uncooperative children referred to a dental hospital. Materials and methods: The study included a total sample of eighty 3-6 year-old uncooperative children referred by general (29 cases) and pediatric dentists (51 cases) to a dental hospital for treatment under GA. Subjects were randomly divided into experimental (E, n = 40) and control (C, n = 40) groups. Behavior management techniques and behavior shaping were used for children in group E, whereas children in group C were solely guided by behavior shaping. The childEs behavior during treatment was assessed according to Frankl behavior scale. Results: In group E, 47.5% of children could be guided by behavior management techniques. In this group, false referrals were significantly higher among the general dentists compared to the pediatric dentists (p < 0.001). In group C, only 16.66% of children could be managed by behavior shaping. Significant differences were seen in the number of manageable children referred by general dentists between groups E and C (p < 0.001); however, this rate was not significant for pediatric dentists (p = 0.61). According to the Mantel-Haenzel test, true referrals among the cases referred by general and pediatric dentists were statistically significant (p = 0.003). Conclusion. Almost half of referrals to the hospital for dental treatments under GA could be successfully guided by behavioral management techniques, and this is especially considerable for children referred by general dentists. It seems that false referrals mostly relate to the practitionersE own fault due to insufficient knowledge, skill and patience