Method: The study sample is 65 children <3 years of age and their parents. The children were patients at a university-based clinic and were observed during a preventive dental visit. Dental providers included residents and faculty. The observation period spanned 5 phases of the dental visit: pre-exam, visual inspection, dental cleaning, varnish application and post-exam. Distress in each phase was rated, live, by parents on a 12-point numerical scale that ranged from 0 (no distress) to 11 (distress as bad as it could be). Child characteristics examined included: age, sex, distress pre-exam, and prior experience with preventive dental care (yes/no).
Result: 55% of the children were 9-23 months and 45% were 24-35 months of age. For the majority (57%), this was the first dental visit. Nearly all children were examined in the knee-to-knee position. Most were rated as having no (59%) or mild (28%) distress pre-exam. Distress scores indicating moderate or severe distress were reported for 55-58% of the children in each exam phase (inspection, cleaning, and varnish application). Because these scores were highly correlated, we computed an average score. Intensity of distress pre-exam (none/any) was associated with ratings of distress during the exam (z=2.67; p=.008) and with distress post-exam (z=3.80; p=.001). Distress during the exam was not associated with age, sex or prior preventive dental care.
Conclusion: Strategies to minimize or alleviate pre-exam distress may help infants and young children cope and cooperate with the mildly invasive procedures that comprise a preventive dental visit.