36553810

Page 1

CLINICAL AND MATERIALS SCIENCES

Children's Response to Sequential Dental Visits L. VENHAM, D. BENGSTON, and M. CIPES

University of Connecticut Health Center, Farmington, Connecticut 06032, USA Behavioral, self-report, and physiological measures were used to study the response of young children to their initial series of dental visits. Their negative response increased from the examination visit through the third treatment visit, then decreased during the fourth treatment visit and the polish visit. Initially, dental experience appeared to sensitize the child to dental procedures. Experience may also allow the child to accurately distinguish between stressful and nonstressful procedures. The effect of sequential dental visits on the young child's response to the dental situation has received limited study. Frankl et a1l studied the cooperative behavior of children 3 to 5 years old durino a dental exam visit and one subsequent dental treatment visit. They concluded that cooperative behavior increased on the second visit. Oppenheim and Frankl2 found no change in cooperative behavior during an exam visit followed by a dental treatment visit. Koenigsberg and Johnson3'4 studied the cooperative behavior of 3- to 7-year-old children during a dental exam and two subsequent dental treatment visits. They did not find a significant difference in the frequency of uncooperative behavior over the three visits. In contrast, Venham5 reported a significant increase in anxiety and a significant decrease in cooperative behavior on the second of two dental treatment visits for children 3 to 8 years old. This "visit" effect was particularly strong in younger children 3 to 5 years of age. Howitt and Stricker6 measured the heart rate of 8 to 14 year olds during a series of dental visits. They reported the highest heart rate during treatment visits, significantly lower heart rate during the exam visit and the lowest heart rate during the This research was supported by Grant No. R23-DE03891 35-009 from the National Institute of Dental Research. Received for publication June 9, 1975. Accepted for publication August 5, 1976.

454

six-month recall exam visit. A comparison of individual treatment visits was not reported. They concluded that the child's arousal level was reduced as he gained experience with the dental environment and procedures. The purpose of the present study was to examine the response of young children to their initial series of dental visits. A combination of meastsres was used to provide a comprehensive assessment of the child's response and to allow a comparison of the results with previous studies which have used either physiological or behavioral rneasures.

Materials and Methods Twenty-nine preschool children 2 to 5 years old (x = 4 years), with no previous dental experience, were studied. The racial distribution was 11 white and 18 black children, with an equal division between boys and girls. The socioeconomic level of the population was lower middle class.7 Each child had six dental visits: an examination visit, four visits involving restorative treatment, and a final visit to polish the restorations, clean the teeth, and apply topical fluoride. The chiJd's response to each visit was assessed using a combination of four measures: heart rate, ratings of clinical anxiety and cooperative behavior and the picture test. The picture test is a projective self-report measure of anxiety consisting of eight items (page 455). The child was asked to choose the little boy in each picture who feels the most like he feels. The child's score represented the number of times the more anxious member of each pair was chosen. Therefore, the scores may range from 0 to 8. Development of the picture test and reliability and validity data have been reported 8 Ratings of clinical anxiety and cooperative behavior were made by three judges independently viewing the video tapes of the visits.


Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.