Preventing lack of compliance in children: use of behaviour technique in paediatric dentistry among Italian practictioner

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ABSTRACT

Aim

The purpose of this study was to survey Italian dental practitioners on behaviour guidance techniques (BGTs). Use of tell-show-do (TSD), sedation with nitrous oxide and oxygen according to the Langa technique, audio-visual distraction (AVD) and referral to general anaesthesia (GA) were enquired, particularly focusing on nitrous oxide usage in paediatric dental patients.

Methods

The research was conducted between September 2022 and December 2023. Data from 153 surveys were eligible to be processed using the STATA/BE software program, version18.0. The sample was stratified based on time in practice (≤10 and >10 years in practice), gender, practicing area (northern, central or southern Italy). Descriptive and inferential analysis were conducted comparing groups using X2 test or Fisher’s exact test as appropriate. The level of statistical significance was set at P value <0.05.

Results

One hundred fifty-three complete surveys were analysed. Of the respondents, 79.8% (121) were female and 20.92% (32) were male. Regarding years in practice, 53.59% (82) were in practice for less than or equal to 10 years and 46.41% (71) were in practice for more than 10 years. As for location of the practice, 45.10% (69) worked in northern Italy, 23.53% (36) practiced in central Italy and 31.37% (48) were from southern Italy, Sicily and Sardegna included. Significant difference was found between genders, with 55.37% (67) female practitioners who assessed to have more than 50% of their patients in paediatric age, compared to 28.12% (9) male participants. Statistical significance was also found between years in practice and referral to general anaesthesia: 29.27% (24) respondents in practice for equal or less than 10 years stated to refer no patients to general anaesthesia compared to 9.86% (7) providers in practice for more than 10 years. In the sample stratified by geographical area, statistical significance was noticed among practitioners who do not refer any paediatric patient to GA: 37.50% (18) Southern Italian practitioners versus 27.78% (10) central Italian practitioners and 4.35% (3) northern Italian practitioners. Northern Italy was found to be the territory with the highest referral to GA: the answer category <10% paediatric patients indicated for GA was selected by 71.01% (49) northern practitioners versus 66.67% (24) central respondents and 45.83% (22) southern participants in the survey.

Conclusion

Behaviour guidance technique selection and utilisation among Italian practicing paediatric dentists is influenced by multiple factors, including gender, time in practice and geographic location of practice. The results showed Tell-Show-Do as the preferred behaviour guidance technique among Italian practitioners. GA referral was assessed to be significantly higher among northern practitioners. Responders in practice for more than 10 years referred to GA a statistically higher percentage of paediatric patients, who were more prevalent in female providers’ practices. Sedation with nitrous oxide and oxygen according to the Langa technique was noticed to be the least prevalent among the enquired BGTs; there is a need to implement the use and knowledge of nitrous oxide/oxygen analgesia among Italian practitioners.

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