Assessment of Parental Preferences Regarding Pediatric Dental Behavior Management Strategies

Nouman Noor; Sadaf Humayoun; Harris Saeed; Varqa Faraid

doi:10.65293/jbkcd.v1i02.16

Authors

Nouman Noor Department of Dental Materials, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
Sadaf Humayoun Professor, Department of Dental Materials, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
Harris Saeed Department of Dental Materials, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
Varqa Faraid Department of Oral Medicine and Oral Diagnostic, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.

DOI:

https://doi.org/10.65293/jbkcd.v1i02.16

Keywords:

Parental Acceptance, Behavior Management Techniques, Pediatric Dentistry, Dental Anxiety, Sedation, Cross-Sectional Study

Abstract

Objective: To assess the parental acceptance of various behaviour management techniques (BMTs) in pediatric dentistry and identify associated influencing factors.

Study Design: Cross-Sectional Study

Place and Duration of the Study: Department of Operative Dentistry and Endodontics, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan, from July 2022 to December 2022.

Materials and Methods: A total of 170 parents participated in this study using a standardized questionnaire. The survey included demographic information, previous dental experiences, and parental perspectives on prevalent behavioural management techniques, such as Tell-Show-Do, positive reinforcement, voice control, passive restraint, sedation, and general anaesthesia. A multiple regression analysis was performed to identify the factors influencing parental acceptability.

Results: Techniques such as Tell-Show-Do (94.1%) and positive reinforcement (88.2%) had the highest acceptance rates, while passive restraint (17.6%) and Hand-Over-Mouth (23.5%) received the lowest acceptance rates. Regression analysis indicated that parental education level (β = 0.22, p = 0.01), socioeconomic status (β = 0.18, p = 0.03), prior bad dental experience (β = -0.30, p = 0.001), and parental anxiety (β = -0.35, p < 0.001) significantly affected acceptance levels. Parents were more likely to obtain information regarding BMTs from dentists (76.5%) and digital platforms (52.9%).

Conclusion: Parental acceptability of BMTs exhibits considerable variability, with a preference for non-invasive methods. Elements such as education, social position, and dental experiences shape these attitudes. Dental practitioners must contemplate these elements while conveying treatment plans and instructing parents regarding BMTs to enhance acceptability and collaboration.

Author Biography

Sadaf Humayoun, Professor, Department of Dental Materials, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.

Corresponding Author: sadaf.humayoun@gmail.com

References

1. Qureshi R, Iqbal A, Khan M, Bader AK, Baig MN, Rao K, et al. Assessment of parental acceptance towards different non-pharmacological behaviour management techniques in pediatric dental care--a cross-sectional study. Journal of Clinical Pediatric Dentistry. 2023;47(4).

2. Nagaveni NB, Muzammil K, Poornima TP. Evaluation of children’s perception of non-pharmacological behaviour management techniques innovative study. Int J Pedo Rehab. 2023;8(1):36–43.

3. Aldhelai TA, Shaman Almodhaibri N, Alsughier Z, Alharbi SA. Parental acceptance of behavior management techniques for pediatric dental visits in Qassim, Saudi Arabia: a cross-sectional study. The Open Dentistry Journal. 2023;17.

4. Boka V, Arapostathis K, Vretos N, Kotsanos N. Parental acceptance of behaviour-management techniques used in paediatric dentistry and its relation to parental dental anxiety and experience. Eur Arch Paediatr Dent [Internet]. 2014;15(5):333–9. Available from: http://dx.doi.org/10.1007/s40368-014-0119-y

5. Kumar MS, Aravinth V, Chenchugopal M, Elangovan A, Thomas A, Aishwarya V, et al. Assessing the attitude of parents towards various Behaviour Management Techniques used during paediatric dental treatment: A cross-sectional study. J Clin Diagn Res [Internet]. 2021; Available from: http://dx.doi.org/10.7860/jcdr/2021/49797.15420

6. Paryab M, Afshar H, Mohammadi R. Informing parents about the pharmacological and invasive behavior management techniques used in pediatric dentistry. J Dent Res Dent Clin Dent Prospects [Internet]. 2014 Spring;8(2):95–100. Available from: http://dx.doi.org/10.5681/joddd.2014.017

7. Shukla H, Kulkarni S, Wasnik MB, Rojekar N, Bhattad D, Kolekar P. Acceptance of parents for behavior management technique concerning previous dental expertise and dental anxiety. International Journal of Clinical Pediatric Dentistry. 2021;14(2).

8. Roberts JF, Curzon M, Koch G, Martens LC. Review: Behaviour management[22]techniques in paediatric dentistry. Eur Arch Paediatr Dent. 2010;11(4):166–74.

9. Ismail N, Isa KAM, Hamzah SH, Mokhtar IW. A randomized cross-over trial of behavior guidance techniques on children with special needs during dental treatment: The caregivers’ perceived mannerisms. J Int Soc Prev Community Dent [Internet]. 2023;13(6):500–8. Available from: http://dx.doi.org/10.4103/jispcd.JISPCD_52_23

10. Kawia HM, Mbawalla HS, Kahabuka FK. Application of behavior management techniques for paediatric dental patients by Tanzanian dental practitioners. Open Dent J [Internet]. 2015;9:455–61. Available from: http://dx.doi.org/10.2174/1874210601509010455

11. Rana K, Saha S, Sarkar S. Dentist’s skills of behavior management: A study of knowledge, attitude, and practice of dentists in managing child patient. Int J Pedod Rehabil [Internet]. 2020;5(2):44. Available from: http://dx.doi.org/10.4103/ijpr.ijpr_28_20

12. Abbas B, Irfan Qureshi A, Waseem M, Talaat A. Effect of parental dental anxiety level on acceptance of non-pharmacological behavior management strategies used in pediatric dentistry. European Journal of Dental and Oral Health [Internet]. 2023;4(1):5–9. Available from: http://dx.doi.org/10.24018/ejdent.2023.4.1.231

13. Peretz B, Kharouba J, Blumer S. Pattern of parental acceptance of management techniques used in pediatric dentistry. J Clin Pediatr Dent [Internet]. 2013 Autumn;38(1):27–30. Available from: http://dx.doi.org/10.17796/jcpd.38.1.8264110prh577428

14. Korenstein KK. Comparing Parental Acceptance of Voice Control as a Behavior Guidance Technique Between Texan Hispanic and Colombian Hispanic Populations in Pediatric Dentistry (Master's thesis, The University of Texas School of Dentistry at Houston).

15. Chalvatzoglou E, Anagnostou F, Arapostathis K, Boka V, Arhakis A. Assessment of Young Mothers’ Oral Hygiene Practices during Pregnancy and Their Knowledge of Children’s Oral Health in Northern Greece. The Journal of Contemporary Dental Practice. 2023;24:202–6.

16. Zoubi A, Schmoeckel L, Ali M, Splieth M. Parental acceptance of advanced behaviour management techniques in paediatric dentistry in families with different cultural background. European Archives of Paediatric Dentistry. 2021;22(4):707–13.

17. Yousaf M, Aslam T, Saeed S, Sarfraz A, Sarfraz Z. Cherrez-Ojeda I. Individual, family, and socioeconomic contributors to dental caries in children from low-and middle-income countries. International journal of environmental research and public health. 2022;19.

18. Ehizele AO, Ayamolowo LB, Ishola A, Foláyan MO. Culture and behaviour management of children in the dental clinic: A scoping review. Dent J [Internet]. 2025;13(5). Available from: http://dx.doi.org/10.3390/dj13050186

19. Boka V, Arapostathis K, Charitoudis G, Veerkamp J, Van Loveren C, Kotsanos N. A study of parental presence/absence technique for child dental behavior management. European Archives of Paediatric Dentistry. 2017;18(6):405–9.

20. Hussain G. Impact of parental education and income on dental knowledge and practices for children: a study in district Khanewal. Education, Behavior, and Law. 2022;1:29–36.

21. Wajahat M, Abbas B, Tariq K, Imran E, Aslam S, Khurshid Z. Parental perception of silver diamine fluoride for the management of dental caries. J Taibah Univ Med Sci [Internet]. 2022;17(3):408–14. Available from: http://dx.doi.org/10.1016/j.jtumed.2021.11.010

22. Wahid M, Yousuf A, Ali Shah PJ, Shah DJA, Bhangar F, Shah M. Knowledge, attitude and practice of Health Care Professionals towards universally applied behavior modification techniques for management of pediatric patients. Pak Armed Force Med J [Internet]. 2022;72(3):921–6. Available from: http://dx.doi.org/10.51253/pafmj.v72i3.4627

23. Khattak O, Chaudhary FA, Alsharari T, Albagami H, Baig MN, Khan FH, et al. Caries status, caries risk assessment and acceptance of behavior management techniques used in dental care for children with special healthcare needs in Saudi Arabia. J ClinPediatr Dent. 2025;49(4):184–91.

24. Lal A, Usman S, Gohil S. The rising epidemic of dental caries in Pakistan: What clinicians need to know. J Islamabad Med Dental Coll [Internet]. 2025;14(2):204–10. Available from: http://dx.doi.org/10.35787/jimdc.v14i2.1150

25. Fahim A, Alam MK, Tariq K, Aileni KR, Emrani R, Ashraf J. Perceptions of Portable Dentistry in Asia Using Machine Learning Models. Available at SSRN 5125467.

26. Mirza A, Zehra FT, Mirza AJ. Awareness of Periodontal Health and Its Systemic Implications: A Study on Dental Patients’ Perception. ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE. 2025;30:144–51.

27. Özen B, Van Strijp AJP, Özer L, Olmus H, Genc A, Cehreli SB. Evaluation of possible associated factors for early childhood caries and Severe early childhood caries: A multicenter cross-sectional survey. J Clin Pediatr Dent [Internet]. 2016;40(2):118–23. Available from: http://dx.doi.org/10.17796/1053-4628-40.2.118

28. Khan ZR, Zaidi SJA, Riaz S, Mahboob U, Mirza S, Khalid F, et al. Rural Pakistan’s smokeless tobacco epidemic: a need for tailored interventions. BMC Oral Health [Internet]. 2025;25(1):818. Available from: http://dx.doi.org/10.1186/s12903-025-06244-3

29. Chaudhary FA, Ahmad B, Khalid MD, Fazal A, Javaid MM, Butt DQ. Factors influencing COVID-19 vaccine hesitancy and acceptance among the Pakistani population. Hum Vaccin Immunother [Internet]. 2021;17(10):3365–70. Available from: http://dx.doi.org/10.1080/21645515.2021.1944743