- Email: [email protected]
Parents in the operatory
videos considered duration, ownership, views, age, likes/ dislikes, target audience, and quality of the video and audio. Content was evaluated for coverage of etiology, anatomy, symptoms, procedure, postoperative course, and prognosis. Completeness level was scored. Results.—A total of 253,000 videos were found for root canal, 61,000 for root canal treatment, and 18,400 for endodontics. Eventually 20 videos per search term were selected for evaluation. The mean number of views for all the videos was 70,243, but there were wide variations between videos, with views ranging from a low of 39 to a high of 671,842. The mean number of ‘likes’ was 213 (range 0 to 8328), and the mean number of ‘dislikes’ was 9 (range 0 to 135). Average of age of the video was 788 days (range 70 to 3555 days). Forty-six percent of the videos were posted by a dentist or dental specialist. Seventy percent of those found with the search term endodontics and 20% of those found with the search term root canal treatment were posted by a dentist or specialist. Commercial sources owned 19% of the videos, accounting for 50% of those found by searching root canal treatment and 5% of those found by searching endodontics. Eight percent of the videos were posted by laypersons, but all of these were linked to root canal treatment. The target audience was laypersons for 60% and dental professionals for 40% of the videos. Eighty percent of the videos identified by the endodontics search were directed at dental professionals. Eighty-five percent of the videos identified by the root canal treatment search were directed at the lay audience. The technical procedure was the topic for 76.1% of all videos, followed by anatomy (40%), etiology (36.6%), postoperative period (35%), symptoms (23.3%), and prognosis (21.6%). Videos posted by dental professionals or commercial sources were significantly more complete than those posted by laypersons. Content completeness was
comparable between the dental professional and the dental commercial postings Discussion.—The material related to root canal treatment that has been posted on YouTube is accessible to both laypersons and dental professionals. However, the information is not peer-reviewed, it may not be based on actual evidence, and it does not have to adhere to quality controls. As a result, it is often incomplete or even irrelevant Because a third of all laypersons trust what they read online, dental professionals need to warn them about the shortcomings of this information and provide accurate data and descriptions of the procedures, complications, and other information patients seek.
Clinical Significance.—Laypersons’ use of the internet as an information source is likely to continue to increase, so dental professionals must adapt to this technology and develop strategies for handling information patients want. Most importantly, they should discuss with the patient any procedures that will be undertaken or options for treatment so that the patient understands. Written aids can be invaluable for reminding patients of what they may have missed in this conversation. Dental professionals should also warn patients not to trust everything they read on the internet and point out the limitations of that information source. Endodontic professionals and other dental practitioners need to direct patients to high-quality information sources or develop such sources themselves so that patients can access accurate information online via a credible source.
Nason K, Donnelly A, Duncan HF: YouTube as a patient-information source for root canal treatment. Int Endod J 49:1194-1200, 2016 Reprints available from HF Duncan, Div of Restorative Dentistry and Periodontology, Dublin Dental Univ Hosp, Lincoln Pl Dublin 2, Ireland; e-mail: [email protected]
Pediatric Dentistry Parents in the operatory Background.—Parents have traditionally been kept out of the dental operatory in the belief that their presence causes the child to misbehave. With changes in the attitudes of parents, increased information from behavioral studies,
280
Dental Abstracts
and the development of effective behavior management techniques for handling children in clinical situations, the inclusion of parents’ physical presence in the dental care of their children is being reconsidered.
Parenting Changes.—Parents today are more permissive and use few actions to correct their child’s behavior. Children tend to be less able to handle frustration, have more egocentric thinking, are more impulsive, and can cause more disruptive behavior in classrooms. The society in which families live is more stressful, which can make parents more aware of the need to take an active role on behalf of their children. This includes demanding approval of what are acceptable behavior management techniques. Parents tend to prefer less aggressive and less physical management methods. They are more accepting of pharmacological management, which includes sedation and general anesthesia. In addition, parents want to be present in the operatory for younger children, with the desire diminishing as the child ages. Behavioral Study Results.—Practitioners are slightly more accepting of having parents present in the operatory, with behavioral study results showing the strong desire of parents to be with their child. This desire is especially strong when the child is young, generally up to age 11 years. Parents also want to be present for first visits and during procedures and treatment delivery. Dentists’ preferences tend to be more restrictive than those of parents. Most would allow parents to be present when the child is under age 5 years. Between ages 5 and 9 years, about half of the dentists believe parents may be helpful and just under half see the presence of parents as a hindrance. Many dentists feel more nervous or even threatened by the presence of the parent. They also believe that children can feel more anxious when the parent is present. However, a study in a hospital emergency room setting found that parents were less anxious, clinicians had no increase in anxiety, and the performance or outcome of the procedure was not adversely affected by having parents present during treatment. Parents expressed more satisfaction with the care when they were able to stay with their children. Often it was the parent who recognized the child was in severe or extreme pain. This study invalidates the belief that parents in the operatory cause poorer outcomes. Dentists who see parents as disruptive or a waste of time or a hindrance do not permit parents to stay in the operatory with their children. Those who see the parent as able to comfort the child and improve behavior tend to allow parents in much more often. Behavior Management.—Often the dental practitioner is not trained in the proper behavior management skills to deal with a child patient. Some techniques are effective and some are not. Using a loud voice or coercion is detrimental
and can even increase disruptive behavior. Restraints can also be ineffective in most cases where the child is exhibiting fear-related behavior. Dentists should avoid ‘‘talking down’’ to children or shaming them. Effective methods of handling children include having the chairside assistant gently hold or just touch the patient who is experiencing fear. Dentists will get better cooperation if they are honest and flexible, use age-appropriate vocabulary, help to establish confidence by building a relationship, maintain eye contact, and depend on positive rather than negative methods. Techniques that improve behavior include tell-show-do and anticipatory guidance (AG). AG provides ageappropriate and development-appropriate information on the child’s dental health at each visit. The dentist then explains the anticipated dental milestones and answers questions the parent expresses. It’s a good time to discuss oral hygiene, diet, caries, injury prevention, substance abuse, and speech and language development. For these discussions to be held, the parent must be present.
Clinical Significance.—Parents should be allowed to be present in the operatory regardless of the child’s age or behavior and for every dental procedure. This is the model developed by pediatricians and appears to be working well for these medical practitioners. Children exhibit behavior in response to their perception of what they are enduring. They tend to be highly fearful if they believe the dental visit will be a negative experience. To avoid the development of dental fear in children, which can affect them adversely for many years, the dentist should change the child’s perception, communicate clearly, and include parents in the process for the best results to be obtained. This is a good way to avoid making people fearful of dental care and unwilling to maintain their oral health through regular dental office visits.
Kisby LE: Parental presence in the operatory: An update. Pediatr Dent J 26:109-114, 2016 Reprints available from LE Kisby, Temple Univ, Kornberg School of Dentistry, Dept Pediatric Dentistry, 3223 N Broad St, Philadelphia, PA 19140; e-mail: [email protected]
Volume 62
Issue 5
2017
281
comparable between the dental professional and the dental commercial postings Discussion.—The material related to root canal treatment that has been posted on YouTube is accessible to both laypersons and dental professionals. However, the information is not peer-reviewed, it may not be based on actual evidence, and it does not have to adhere to quality controls. As a result, it is often incomplete or even irrelevant Because a third of all laypersons trust what they read online, dental professionals need to warn them about the shortcomings of this information and provide accurate data and descriptions of the procedures, complications, and other information patients seek.
Clinical Significance.—Laypersons’ use of the internet as an information source is likely to continue to increase, so dental professionals must adapt to this technology and develop strategies for handling information patients want. Most importantly, they should discuss with the patient any procedures that will be undertaken or options for treatment so that the patient understands. Written aids can be invaluable for reminding patients of what they may have missed in this conversation. Dental professionals should also warn patients not to trust everything they read on the internet and point out the limitations of that information source. Endodontic professionals and other dental practitioners need to direct patients to high-quality information sources or develop such sources themselves so that patients can access accurate information online via a credible source.
Nason K, Donnelly A, Duncan HF: YouTube as a patient-information source for root canal treatment. Int Endod J 49:1194-1200, 2016 Reprints available from HF Duncan, Div of Restorative Dentistry and Periodontology, Dublin Dental Univ Hosp, Lincoln Pl Dublin 2, Ireland; e-mail: [email protected]
Pediatric Dentistry Parents in the operatory Background.—Parents have traditionally been kept out of the dental operatory in the belief that their presence causes the child to misbehave. With changes in the attitudes of parents, increased information from behavioral studies,
280
Dental Abstracts
and the development of effective behavior management techniques for handling children in clinical situations, the inclusion of parents’ physical presence in the dental care of their children is being reconsidered.
Parenting Changes.—Parents today are more permissive and use few actions to correct their child’s behavior. Children tend to be less able to handle frustration, have more egocentric thinking, are more impulsive, and can cause more disruptive behavior in classrooms. The society in which families live is more stressful, which can make parents more aware of the need to take an active role on behalf of their children. This includes demanding approval of what are acceptable behavior management techniques. Parents tend to prefer less aggressive and less physical management methods. They are more accepting of pharmacological management, which includes sedation and general anesthesia. In addition, parents want to be present in the operatory for younger children, with the desire diminishing as the child ages. Behavioral Study Results.—Practitioners are slightly more accepting of having parents present in the operatory, with behavioral study results showing the strong desire of parents to be with their child. This desire is especially strong when the child is young, generally up to age 11 years. Parents also want to be present for first visits and during procedures and treatment delivery. Dentists’ preferences tend to be more restrictive than those of parents. Most would allow parents to be present when the child is under age 5 years. Between ages 5 and 9 years, about half of the dentists believe parents may be helpful and just under half see the presence of parents as a hindrance. Many dentists feel more nervous or even threatened by the presence of the parent. They also believe that children can feel more anxious when the parent is present. However, a study in a hospital emergency room setting found that parents were less anxious, clinicians had no increase in anxiety, and the performance or outcome of the procedure was not adversely affected by having parents present during treatment. Parents expressed more satisfaction with the care when they were able to stay with their children. Often it was the parent who recognized the child was in severe or extreme pain. This study invalidates the belief that parents in the operatory cause poorer outcomes. Dentists who see parents as disruptive or a waste of time or a hindrance do not permit parents to stay in the operatory with their children. Those who see the parent as able to comfort the child and improve behavior tend to allow parents in much more often. Behavior Management.—Often the dental practitioner is not trained in the proper behavior management skills to deal with a child patient. Some techniques are effective and some are not. Using a loud voice or coercion is detrimental
and can even increase disruptive behavior. Restraints can also be ineffective in most cases where the child is exhibiting fear-related behavior. Dentists should avoid ‘‘talking down’’ to children or shaming them. Effective methods of handling children include having the chairside assistant gently hold or just touch the patient who is experiencing fear. Dentists will get better cooperation if they are honest and flexible, use age-appropriate vocabulary, help to establish confidence by building a relationship, maintain eye contact, and depend on positive rather than negative methods. Techniques that improve behavior include tell-show-do and anticipatory guidance (AG). AG provides ageappropriate and development-appropriate information on the child’s dental health at each visit. The dentist then explains the anticipated dental milestones and answers questions the parent expresses. It’s a good time to discuss oral hygiene, diet, caries, injury prevention, substance abuse, and speech and language development. For these discussions to be held, the parent must be present.
Clinical Significance.—Parents should be allowed to be present in the operatory regardless of the child’s age or behavior and for every dental procedure. This is the model developed by pediatricians and appears to be working well for these medical practitioners. Children exhibit behavior in response to their perception of what they are enduring. They tend to be highly fearful if they believe the dental visit will be a negative experience. To avoid the development of dental fear in children, which can affect them adversely for many years, the dentist should change the child’s perception, communicate clearly, and include parents in the process for the best results to be obtained. This is a good way to avoid making people fearful of dental care and unwilling to maintain their oral health through regular dental office visits.
Kisby LE: Parental presence in the operatory: An update. Pediatr Dent J 26:109-114, 2016 Reprints available from LE Kisby, Temple Univ, Kornberg School of Dentistry, Dept Pediatric Dentistry, 3223 N Broad St, Philadelphia, PA 19140; e-mail: [email protected]
Volume 62
Issue 5
2017
281