Use of Restraints in Pediatric Dental Patients--A Follow-up Study

Long-term effects of using restraints (Papoose Board®, Pedi-Wrap®) in pediatric dental patients are unknown. Objectives: This study investigates whether restraints used with pediatric dental patients leads to increased fear and behavioral problems during future recall visits. Methods: Data were collected from two groups of children. The experimental group included 80 children with at least one restraint visit longer than one year ago (mean=49.6 months). The control group included 71 children without restraint experience. The children (70 females, 81 males) were on average 8.77 years old (range: 5 to 14 years). Dental fear was assessed with the Dental Subscale of the Children's Fear Survey Schedule (values: "1"=no fear to "5"=high fear). A blind rater evaluated the children's behavior using the Frankl Behavior Rating Scale (values: "1"=definitely negative to "4"=definitely positive). Results: Before the visit, the experimental group reported higher fear about the exam (1.58 vs. 1.21; p=.026), opening their mouth (1.34 vs. 1.04; p=.021), the sight of the dentist drilling (1.95 vs. 1.53; p=.032), white uniforms (1.33 vs. 1.07; p=.042), the nurse cleaning their teeth (1.38 vs. 1.10; p=.028), and having their mouth kept open (1.80 vs. 1.35; p=.025) than the control group. During the visit, the experimental group displayed less positive behavior than the control group (Modified Frankl mean: 3.43 vs. 3.23; p=.041). After the visit, the experimental group reported higher fear concerning the dentist drilling (1.95 vs. 1.51; p=.064), seeing the dentist drilling (1.78 vs. 1.37; p=.06), the noise of the drill (1.88 vs. 1.30 (p=.01), and having an instrument in their mouth (2.03 vs. 1.55; p=.071). Conclusions: Both groups had low dental fear and displayed positive behavior. However, the experimental group showed more dental fear and less positive behavior during the visit than the control group. Further analyses concerning sedation during the use of restraints are currently underway.