IMPACT OF PARENTING STYLE ON CHILD BEHAVIOR AND GUIDANCE STRATEGIES DURING THE DENTAL TREATMENT
Behaviour guidance could be challenge in modern paediatric dentistry. A child’s behaviour towards dental treatment varies according to different parenting styles. Authoritative parenting utilizes warmth and nurturance, while at the same time maintaining firm control of the child’s behavior. The authoritarian category is a harsh parenting style in which power-assertive techniques are utilized, including physical punishment, commands and yelling, while lacking warmth and communication. Permissive parents are characterized as having little control over their children while exhibiting great warmth toward them. Behavior guidance techniques are used to alleviate anxiety, nurture a positive dental attitude, and perform quality oral health care safely and efficiently for children. The aim of this paper was to study the influence of parenting style on the child`s behaviour and some factors influenced guidance strategies during the dental treatment.
Forty-nine children aged between 3 and 6 years with caries and its complications were examined during this study. These subjects presented to the Community paediatric dental clinic in Poltava. The Primary Caregivers’ Practices Report (PCPR) used in this study to assess the level of parenting style (authoritarian, permissive, and authoritative). The parent was asked to rank each behaviour on a Likert scale of 1-5 (1=Never and 5=Always) as to how often they and their spouse/significant other (if applicable) exhibited each behaviour. The scoring key of the PCPR used to classify parents into one of the three specific parenting styles. Also a child`s behaviour was investigated based on Frankle`s scale.
Behaviour guidance strategies during the dental treatment based on recommendations of AAPD. Impact of parenting style on a child`s positive behaviour is evaluated with the Chi-square test months. The level of significance was p<0.05.
The dominant authoritarian style was not observed in parents; rate of forty-three parents (87,75%) categorized as predominantly authoritative was higher than rate of six permissive parents (22,25%) (p<0,0001). A half of children of permissive parents showed positive behaviour during dental treatment. Majority of children of authoritative parents demonstrated positive behaviour (67,44%), followed by permissive (32,56%). There was statistically significant difference (р<0,05) between parenting styles in positive behaviour.
Strategies used for all children were «tell-show-do», distraction, enhancing control, positive reinforcement (gifts and toys). Voice control used in a case of local anaesthesia. Techniques used for children with negative behaviour were desensitization, parental absence, protective stabilization, and sedation. Enhancing control used to allow the patient with positive behaviour (3 score) to assume an active role in the dental experience; the dentist provides the patient a signal to use if he becomes uncomfortable.
Parenting style and kind of dental aid (emergency or planned) have impact on choice of guidance strategy for children with negative behaviour. Authors started management of children of permissive parents with negative behaviour from parent absence, this strategy was successful in one case; desensitisation used if strategy was unsuccessful. 7 children with negative behaviour during the first visit got planned dental aid after psychological desensitisation next visit. Children exposed gradually through a series of sessions to components of the dental appointment: parents examined them at home and children made dental treatment with «Play-Doh Doctor drill and fill». This technique was effective in 6 children of authoritative parents and 1 patient of permissive parents.
One child of permissive children and three children of authoritative children got emergency dental aid under sedation. Two children of authoritative parents who need emergency dental aid, have contraindications to general anaesthesia, therefore, protective stabilisation of the patients performed.
Planned dental aid under sedation (3 children of authoritative parents), which is one of the methods of positive motivation for treatment, performed if other guidance strategies were unsuccessful.
Thus, children of authoritative parents more often showed positive behaviour, whereas permissive parenting style had no impact on child`s behaviour during dental treatment. Choice of guidance strategy depends on the kind of dental aid (planned and emergency), parenting style and child`s behaviour during dental treatment.
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