Frankl Behaviour Rating Scale Research Articles

Effectiveness and Safety of Elevated Dosages of Nitrous Oxide on Behavior Management in Pediatric Dentistry

To determine if administering a higher dosage of nitrous oxide (>50%), with a nasal hood in pediatric dental restorative procedures, can allow for a safe and more cooperative experience for the pediatric patient as measured by observable adverse reactions and the Frankl Behavior Rating Scale. A retrospective chart review was completed of 200 patients total, 100 for each nitrous oxide (N2O) dosage group (≤50% vs >50%). Adverse reactions and The Frankl Behavior Rating Scale during pediatric restorative procedures with N2O were compared between the two dosage groups. There were few adverse reactions for both nitrous oxide groups (≤50% vs >50%) and there was no statistical difference in the Frankl Behavior Rating Scale for each group. Patients given more than 50% of nitrous oxide were not found to have an increase in adverse events. Higher concentrations of nitrous oxide (>50%) were not found to be associated with a better behavior score when completing pediatric restorative procedures.

Efficacy of an Innovative Device in Reducing Discomfort during Local Anesthesia Administration in Children: A Clinical Study.

Aim and objectiveTo assess the efficacy of an innovative vibrating device and compare it with the conventional method in reducing discomfort during the administration of local anesthesia.Materials and methodsForty children in the age-group of 4–8 years requiring local anesthesia for routine dental procedures were allocated to either a control or experimental group, with 20 children in each group. The preoperative assessment of behavior was carried out using the Frankl Behavior Rating Scale. Both groups received local anesthesia using the intraoral conventional approach. However, in the experimental group, a vibrating device was simultaneously placed over the cheek during local anesthesia administration. The SEM (sounds, eyes, motor) scale was used to assess the level of comfort or pain during the administration of local anesthesia. Data were subjected to statistical analysis and the level of significance was considered at 5%.ResultsThe mean SEM score in the control group was 6.65 ± 21.95 which was significantly higher than 3.80 ± 1.15 in the experimental group (p < 0.001).ConclusionThe vibrating device was useful and effective in reducing pain and discomfort during intraoral local anesthesia administration.How to cite this articleSubramaniam P, Ghai SK. Efficacy of an Innovative Device in Reducing Discomfort during Local Anesthesia Administration in Children: A Clinical Study. Int J Clin Pediatr Dent 2021;14(3):353–356.

Application of virtual reality on non-drug behavioral management of short-term dental procedure in children

BackgroundDue to the inherent characteristics of immersion, imagination, and interactivity in virtual reality (VR), it might be suitable for non-drug behavior management of children in dental clinics. The purpose of this trial was to measure the role of VR distraction on behavior management in short-term dental procedures in children.MethodsA randomized clinical trial design was carried out on 120 children aged between 4 and 8 years to identify the comparative efficacy of VR and tell-show-do (TSD) to improve behavioral management during dental procedures. The primary outcomes were evaluated anxiety, pain, and compliance scores in perioperative children. The levels of operative anxiety and pain were assessed using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Wong Baker FACES Pain Rating Scale (WBFS), respectively. The Frankl Behavior Rating Scale (FBRS) was tested before and during dental procedures. The length of the dental procedure was compared between both groups after treatment.ResultsThe average anxiety and behavioral scores of the VR group significantly reduced compared with the control. The decreased anxiety score for the VR group and control group were 8 (7, 11) and 5 (5, 7), p < 0.05. The compliance scores of the control group during treatment were 3 (2, 3), and the same in the VR intervention were 3 (3, 4), p = 0.02. A significant reduction in pain was observed when using VR distraction (p < 0.05). Comparing the length of the dental procedure, the VR group (19.0 2 ± 5.32 min) had a shorter treatment time than the control group (27.80 ± 10.40 min).ConclusionThe use of VR significantly reduced the anxiety and pain of children and the length of the dental procedure and improved the compliance of children that underwent short-term dental procedures without an adverse reaction.Trial registrationChinese Clinical Trial Registry, ChiCTR2000029802. Registered on February 14, 2020

Gagging and cooperation in 4-12-year-old children over a series of dental appointments.

The purposes were to evaluate if gagging can affect children's cooperation with treatment, investigate possible changes in gagging and study factors that can predict children's behaviour over dental treatment. 255 children aged 4-12years, needing at least three consecutive dental appointments, completed the Children's Fear Survey Schedule-Dental Subscale before examination. The Gagging Problem Assessment was performed before the initial examination and after the third/final appointment. Frankl's Behaviour Rating Scale (FBRS) was used to rate children's behaviour. Multivariate Mixed Linear and Logistic Regression Models were used. Children with definitely positive behaviour were significantly older, less fearful and less likely to gag before treatment. Girls and older children had lower odds of gagging over time, while fearful children had higher odds. There were no statistically significant associations between gagging over time, FBRS and the type of dental treatment at the third appointment. The percentage of children who gagged after the third appointment (27.05%) was significantly lower as compared to the percentage found at the initial appointment (32.54%; p = 0.004). Among the variables studied, age, dental fear, initial GPA and type of treatment were good predictors of children's behaviour during dental treatment.

Cheiloscopy and Dactyloscopy as Behavior Assessment Tool in Dental Settings: A Cross-sectional Study.

PurposeAssessment of children's behavior in the dental setting and its correlation with thumb print and lip print.Materials and methodsThe behavior pattern, lip print pattern, and thumb print pattern of 518 children aged 5–12 years were recorded in their first dental visit. The behavior pattern, lip print pattern, and thumb print pattern were determined using Frankl's Behavior Rating Scale, Tsuchihashi's classification, and Cummin's classification, respectively. The data were tabulated according to the classified criteria and statistically analyzed.ResultsIt was observed that positive and definitely positive Frankl Behavior was associated with the children bearing an arch pattern of thumb print, whereas their lip pattern had no association with their behavior pattern, particularly in dental sittings.ConclusionThumb print pattern can aid as a behavior marker before a child's first dental appointment and this can prove beneficial for both the child and the clinician in providing a high quality of dental care and modify behavior for future dental appointments.How to cite this articleNavit S, Pramanik S, Khan SA, et al. Cheiloscopy and Dactyloscopy as Behavior Assessment Tool in Dental Settings: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(2):238–242.

Prevalence and risk factors of children’s dental anxiety in China: a longitudinal study

ObjectivesDental anxiety remains widespread among children, may continue into adulthood and affect their oral health-related quality of life and clinical management. The aim of the study was to explore the...

Evaluation of children's pain expression and behavior using audio visual distraction.

ObjectivesDental anxiety distresses children and their families with consequent poor oral health and costly pediatric dental services. Children's behaviors could be modified using a distraction technique for improved dental treatment. The study evaluates the effects of an audio‐visual distraction on children's behaviors and pain expressions during dental treatment.Material and MethodsOne hundred healthy children, between 4 and 6 years of age, were randomly assigned to one of two groups: audio visual distraction (AVD, N = 61) group and control (CTR, N = 39) group. The pre and post pain expression was collected using a faces pain rating scale from the participated children. Children's behavior was evaluated using the Frankl behavior rating scale by the assigned dentist. Data was analyzed using chi‐squared tests and analysis of variance.ResultsThe AVD group demonstrated more “definitely positive” behavior (91.8%) compared to the CTR group (35.9%) based on the Frankl scale evaluation from pre‐ and post‐treatment (p < 0.0001). The pain rating scale did not demonstrate a significant difference in post‐treatment pain scales (p = 0.2073) or changes in pain (p = 0.1532) between the AVD group and CTR group.ConclusionsThe AVD is an effective distraction tool for young children during dental treatment regardless of child's subjective pain expression.

Impact of lockdown on children's lifestyle and their collaboration during dental sessions.

To analyse lifestyle of Italian families during lockdown, evaluating its possible impact on the collaboration of children with the paediatric dentist and associated predictive factors. Only patients aged between 3 and 16 years, who had started treatment before the lockdown and had spent this periodwith both parents were included in the study. The interviews were carried out using an anonymous questionnaire that assessed school and play activities, the type of diet, the time dedicated to home oral hygiene and the activities carried out with parents. Parents' work situation during lockdown was included to correlate it with time spent at home. The Frankl Behavior Rating Scale was used to determine the degree of cooperation during dental sessions pre- and post-lockdown. Chi-square test and Fisher's Exact tests were used to identify statistical associations of improvement with each categorical variable. Student's t-test was used to highlight the differences in mean values of continuous variables between subjects considered more cooperative and unimproved subjects. Hosmer-Lemeshow test was used to assess the goodness-of-fit of the model. Assumption of linearity of independent variables and log-odds were assessed by Box-Tidwell transformation. Final selection was carried out using the Akaike criterion and all statistical analyses were carried out using the STATA statistical software package. The sample consisted of 212 patients (103F; 109M). The age ranged between 3 and 16 years with an average age of 9.03 years; 82.08% (95% CI 76.24-86.99) of the subjects showed an improvement in collaboration compared to pre-lockdown. Logistic analysis reveals a statistically significant increase of the odds of improvement in patients with a lower pre-lockdown collaboration (OR: 6.05, p = 0.001), in children with a parental presence at home (jobless, OR : 30.55, p <0.001; in "smart working", OR: 23.06, p <0.001) when compared to children whose parents work away from home. From a further exploratory analysis, time dedicated to home oral hygiene was increased if associated with an increased presence of the parents at home (p = 0.015). Changes in family routines and increased parental presence at home, during the COVID-19 pandemic lockdown, are associated with improved collaboration of children during dental sessions. A statistical association between the increase in time spent on oral hygiene and the increased presence of parents at home was found.

Robotic approach to the reduction of dental anxiety in children

Objective We introduced a humanoid robot for the use of techno-psychological distraction techniques in children aged 4–10 to reduce their anxiety and improve their behaviour during dental treatment.Materials and methods Two hundred children (98 boys, 102 girls; mean age: 6.5 ± 1.66 years) appointed for first time for dental caries were included and randomly divided into two groups [N = 100 for each group; RG: Robot Group (accompanied by the robot), CG: Control Group (without robot accompaniment)]. Half of the children were treated under local anaesthesia (infiltration anaesthesia) (n = 50 within each group) and half of the children were treated without any local anaesthesia (n = 50 within each group) within each group. The success rate of the new robotic distraction technique was evaluated by using Parental Corah Dental Anxiety Scale, Facial Image Scale (FIS), physiological pulse rate and Frankl Behaviour Rating Scale (FBRS).Result Pulse rates, which measured during treatment and after treatment, were statistically higher in CG than in RG (p < .05). After dental treatment, the FIS score was significantly higher in CG than RG (p < .05). 88.3% of the children in RG stated that they wanted the robot to be with them at the next treatment session.Conclusions Robotic technology can successfully help in coping with dental anxiety and stress, and helps children to behave better in dental office.

Articaine efficacy and safety in young children below the age of four years: An equivalent parallel randomized control trial.

Pain control is a mandatory aspect in pediatric dentistry office through local anesthesia. To assess the safety and efficacy of 4% articaine local anesthetic in young children below four years old. An equivalent randomized control trial with two parallel arms included 184 young children (92 per group) aged from 36 to 47months seeking pulpotomy of mandibular primary molars which performed after buccal infiltration injection. The control group received lidocaine hydrochloride 2% with epinephrine 1:100000. The intervention was articaine hydrochloride 4% with epinephrine 1:100000. Children's behavior during injection and treatment have assessed using Faces, Legs, Activity, Cry, and Consolability (FLACC) and child's behavior using Frankl Behavior Rating Scale (FBRS). In addition, post-operative complications have been addressed. Both anesthetic agents were equivalent during the injection phase. During the treatment phase, the absolute risk difference (ARR) between the two groups was 0.120 (95% CI: -0.003; 0.243). The maximum limit of 95% CI surpassed the margin of equivalence, indicating that less pain has been expressed during pulpotomy among children delivered articaine when compared to their counterparts in the lidocaine group. Concerning post-operative complications, no statistically significant difference was detected between the two anesthetic drugs. The findings supported the efficient and secure use of articaine hydrochloride 4% with epinephrine 1:100000 to treat children between the ages of 3 and below 4years old.

Dental Fear and Anxiety of Kindergarten Children in Hong Kong: A Cross-Sectional Study.

Objectives: The objectives of this cross-sectional study were to investigate the fear level of kindergarten children in the general population during dental outreach in a familiar kindergarten setting, and to explore the factors associated with the dental fear of kindergarten children. Method: Consecutive sampling method was used to select kindergarten children aged 3 to 5 to participate in a questionnaire survey and an outreach service. A behavioural observation type of instrument for dental fear and anxiety assessment—Frankl Behaviour Rating Scale (FBRS)—was chosen to investigate the fear level of the children. Bivariate analyses between various factors and children’s dental fear and anxiety were carried out using Chi-square test. Results: A total of 498 children participated in this study. Almost half (46%) of the children have had caries experience, and the mean dmft score was 2.1 ± 3.4. The prevalence of dental caries was 32%, 43%, and 64% in the 3-, 4- and 5-year-olds, respectively. Only 4% of the children scored negatively for dental fear and anxiety (95% CI 2.3%–5.7%). Children at three years of age displayed more dental fear and anxiety than children of older ages, but the difference in dental fear and anxiety among the genders and caries status was not statistically significant. Most of the children (92%) brushed daily, but only 20% of them used toothpaste. Most (85%) of them had never visited the dentist, and over 70% of them were mainly taken care by their parents. High levels of positive and cooperative behaviour and low levels of fear were found in this population. No statistical significance was found between the child’s dental fear and any factors except age. Conclusion: Children generally displayed low fear or anxiety levels in a dental outreach consisting of a non-invasive oral examination and preventive treatment in a familiar kindergarten setting. Conducting regular outreach dental services to kindergartens by providing oral examination and simple remineralisation therapies could be a promising strategy to not only control childhood caries, but also manage and reduce dental fear and encourage long term dental attendance in line with the medical model.

Children's dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital.

Child dental anxiety (CDA) and uncooperative dental behaviour are common. We aimed to assess the prevalence of CDA (self- and proxy- reported) in the United Arab Emirates (UAE) children related to their dental behaviour. Data were collected from 312 questionnaires obtained from 156 parent/child (mean age 9.95 ± 2.17years) pairs attending a postgraduate dental hospital. Demographics, self/proxy- reported CDA scores via a six-question, five-point Likert scale, of the Modified CDA Scale-faces version (MCDAS-f: where ≥ 19 was severe CDA) and Frankl Behaviour Rating Scale (FBRS) scores were compared and analysed. Chi-square test, Pearson's correlation, Kappa- coefficient, one-way ANOVA and independent t test statistical analysis were used (p < 0.05). The prevalence of self and proxy severe CDA was 22.4% (n = 35) and 33.3% (n = 52) respectively, with 9% (n = 14) being dentally- uncooperative. In both groups, extractions caused the highest CDA followed by injections and fillings (p < 0.001). The mean scores for self-reported/proxy-reported CDA were 15.02 (± 4.90)/15.70 (± 6.07) respectively. There was a positive linear correlation between self- and proxy- reported CDA scores and a negative linear correlation between self/proxy- reported CDA scores and the FBRS (p < 0.001). Self/proxy concordance of severe anxiety/none-to-moderate- anxiety was fair (68.6%, kappa = 0.23, p = 0.003). Both self/FBRS and proxy/FBRS concordance of severe anxiety/none-to-moderate- anxiety/behaviour was fair (78.8%, kappa = 0.23, p = 0.001) and (71.8%, kappa = 0.22, p < 0.001) respectively. Considering the limitations of the present study in a UAE child population sample, the prevalence of CDA from extractions, injections and fillings was 22.4% (self- reported) and 33% (proxy reported). There was fair agreement between child- self and parent- proxy- reported CDA. Increased CDA led to uncooperative dental behaviour.

Assessing the behavior management problems during the first dental visit of preschool children using a doll placement test

Assessing dental anxiety as a predictor of the likely behavior of the child in the dental operatory is of paramount importance for a clinician to render quality care. This study aims to correlate the dental anxiety of preschool children as shown during the doll placement test with that of their behavioral patterns during the first dental visit. This cross-sectional study was conducted between the ages of 3-7 years. During their first dental visit, the background variables were elicited from parent/guardian at the reception desk. Later at the play area, the child was given a set of dolls representing dentist, child, and mother to place them in a model dental office having a dental chair. The child was then taken for the initial oral examination, during which the behavior of the child was rated using Frankl's Behavior Rating Scale. The data collected were analyzed using Chi-square test and binary regression analysis. The observed association between the doll placement pattern and the behavior of the patient during dental treatment was statistically significant (P < 0.001). The binary regression analysis showed that the child's unpleasant previous medical and parent's unpleasant dental experiences had higher odds favoring uncooperative behavior (46.63 and 41.93, respectively). The child's behavior on the dental chair is associated with the doll placement pattern, which is also influenced by experiences of the child during his/her encounter with the medical doctor and previous dental experiences of their parents.

Effectiveness and Safety of Oral Midazolam Combined Nitrous Oxide Sedation in Treating Children with Dental Fear

Objective To evaluate the safety and effectiveness of oral midazolam sedation combined nitrous oxide sedation for reducing dental fear in children.Methods Totally 77 children with a Frankl's Behavior Rating Scale score of 1 were included in this study,among whom 41 received a total of 78 person-times of oral midazolam sedation (0.50-0.75 mg·kg -1) (midazolam group) and 36 children were treated with the combination of 0.4 mg/kg oral midazolam with 30%-40% nitrous oxide (totally 73 person-times)(combination group). At each visit,heart rate,arterial oxygen saturation,and treatments were recorded. The behaviors of children during the treatment were assessed by Frankl's Behavior Rating Scale,the completion of treatment was assessed by Houpt Scale,and the sedation status was assessed by Ramsay Scale. Telephone follow-up was performed to record the side effects 24 hours after treatment. Results The vital signs were stable among all the 77 subjects,with a Ramsay score of 2 or 3. In the midazolam group, the behaviors were cooperative in 52 person-times (66.7%) and not cooperative in 26 person-times (33.3%);the planned treatments were completed in 62 person-times (79.5%) and partially completed in 16 person-times(20.5%). In the combination group,the behaviors were cooperative in 56 person-times (76.7%) and not cooperative in 17 person-times (23.3%);64 person-times (87.7%) completed the planned treatments and 9 person-times (12.3%) partially completed the treatments. The success rates of sedation (χ 2=1.87,P= 0.17) and treatment (χ 2=1.83,P= 0.18) were not significantly different between these two groups. The median Frankl scale score was significantly higher in the combination group [3 (3,4)] than in the midazolam group [3 (2,4)] (Z=2.647,P=0.008]. The median score of Houpt scale in the combination group [5(4,6)] was also significantly higher than in midazolam group [5(3,5)] (Z=2.236,P=0.026]. In midazolam group,there were 7 person-times of dysphoria,3 person-times of diplopia,and 2 person-times of hiccough among 78 person-times;in the combination group,there were 5 person-times of dysphoria,5 person-times of diplopia,1 person-time of hiccough,and 2 person-times of vomit among 73 person-times of treatment. Thus,there was no significant difference in the incidence of side effects (15.4% vs.17.8%,χ 2=0.160,P=0.689). Logistic regression analysis showed that the success rate of treatment was not associated with sex (OR=1.704,P=0.174),dose (OR=1.289,P=0.516),and treatment types (OR=0.555,P=0.143). Children over 3 years old had a significantly high success rate than those under 3 years old (OR=3.372,P=0.011). Conclusions Oral midazolam is safe and effective for reducing dental fear in children. The combination of oral midazolam with 30%-40% nitrous oxide can improve the behaviors of children during the dental treatment,especially in children over 3 years old.

The prevalence of dental anxiety and fear among 4-13-year-old Nepalese children.

The aim of the study was to assess the prevalence of dental fear and anxiety among children aged 4-13 years using three fear scales, i.e., facial image scale (FIS), Nepalese version of Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Modified Child Dental Anxiety Scale (MCDAS). The study was conducted on 300 children (4-13 years) who visited the Department of Pedodontics and Preventive Dentistry. The fear and anxiety levels were measured using three fear measurement scales, i.e., FIS, Nepalese version of CFSS-DS, and MCDAS. The dental behavior observed was rated according to the Frankl's Behavior Rating Scale (FBRS). The prevalence of dental fear according to FIS was 11.9% as evident from children having FIS 4 and 5 scores. Dental fear with CFSS-DS ≥38 was identified in 49 children (21 [12.5%] male and 28 [21.21%] female). In assessment of the behavior of children in the clinics through FBRS, it was observed that the maximum number of respondents (70.6%) showed Frankl's rating 3, i.e., positive. The Nepalese versions of the CFSS-DS and the MCDAS are both reliable and valid scales for evaluating dental anxiety and fear in young children. Assessing dental anxiety and fear is useful, as behavior management can be designed accordingly for child patients.

Effect of visual distraction on children's anxiety during dental treatment: a crossover randomized clinical trial.

This was to evaluate the effect of visual distraction on anxiety of children during dental treatment. This randomized, crossover clinical trial study was conducted on 28 children (aged 4-5years) randomly divided into two groups of 14 each. Group 1, treatment procedure in the first visit was completed while the patients were watching a cartoon as a visual distraction tool, at the second visit, the procedure was carried out with conventional tell-show-do. Group 2, had visual distraction in their second visit and conventional tell-show-do during the first visit. Treatment procedures were similar in both groups during two sessions. The anxiety level was determined using Venham picture test and pulse rate (PR) at the beginning and the end of each appointment. Patient behaviour was also scored using Frankl behaviour rating scale (FBRS). Self-reported dental anxiety was reduced significantly by visual distraction (p-value < 0.001) compared to conventional tell-show-do, but it did not change FBRS scores significantly (p-value = 0.24). Use of visual distraction improves self-reported anxiety and decreases PR of children but does not change their behaviour.

Effects of child characteristics and dental history on dental fear: cross-sectional study

BackgroundDental fear (DF) is a challenging problem in dentistry. It is multifactorial in origin and many contributing factors have been identified. The aim of the study was to assess dental fear among 12–15 years old Arabic speaking children in Jeddah, Saudi Arabia and its relation to demographic variables, previous dental experience, and child behaviour.MethodsIn this cross-sectional study, a total of 1522 boys and girls from middle schools in Jeddah, Saudi Arabia participated in this study during the period of 2014 to 2016. The Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS) was used to assess DF. A parental questionnaire was used to record the children’s previous dental experience. Children were examined for caries and the children’s behaviour was assessed during dental examination using Frankl Behaviour Rating Scale. The associations between different variables and the CFSS-DS scores were analysed using t-tests, ANOVA, and multiple linear regression analysis.ResultsThe response rate of the questionnaires was 78.6%. The mean CFSS-DS score was 25.99 ± 9.3 out of a maximum of 75. Bivariate analysis showed that younger children, girls, and public-school students were significantly more fearful than older children, boys, and private school children, respectively (P < 0.001). Children who showed poor behaviour during dental examination were significantly more fearful than those with good behaviour (P < 0.001). Regression analysis showed that children who had significantly higher scores of dental fear were the children who did not visit the dentist in the past year due to dental fear; who never visited the dentist or those who only visited the dentist on pain; who were reported by parents as crying, screaming, or resistant during their previous dental visit; and those who were described to be in pain during previous dental treatment. Dental caries showed no significant association with DF.ConclusionsThis study confirms that DF is low among 12–15 years old Arabic speaking children in Jeddah, Saudi Arabia. DF is associated with age, gender, school type, irregular patterns of dental visits, painful experiences during previous dental visits and negative behaviours during dental examinations.

An In Vivo Comparative Evaluation of Dental Anxiety Level and Clinical Success Rate of Composite and Multicolored Compomers in 6 to 12 years of Children.

ABSTRACTBackgroundPediatric dentistry is not just about treating the tooth, but it also involves giving an overall comprehensive treatment to the child. Children like different colors and when the child is allowed to select the color of the restoration, it will positively motivate the child to accept dental treatment.AimThe aim of our study was to evaluate and compare the clinical success rate of composite and multicolored compomer restorations and dental anxiety level in children.Materials and methodsA total of 60 samples equally divided into two study groups by of split-mouth design. In the control group, subjects received composites and in experimental group, they received colored compomers. The dental behavior was assessed using the Frankl behavior rating scale for both the groups. Dental anxiety was checked in the patients using visual analogue scale (VAS) before and after the treatment for both the groups. Children were recalled for follow up at 1, 3 and 6 months to evaluate clinical success rate amongst control and experimental group and results were subjected to statistical analysis.ResultsColored compomer proved to reduce the anxiety in the child and had a better behavioral response and positive attitude. Both restorative materials had comparable clinical success rates.ConclusionAt 6 months follow-up evaluation colored compomer restorative material showing promising with similar properties like that of composites with the added advantage of multicolors and can be considered as the new restorative material in the child dentistry.Clinical significanceColored compomers are known to be excellent alternative restorative materials for restoration of teeth in children as they aid in behavior modification and good compliance from the patient.How to cite this articleHugar SM, Kohli D, Badakar CM, Gokhale NS, Thakkar PJ, Mundada MV. An In Vivo Comparative Evaluation of Dental Anxiety Level and Clinical Success Rate of Composite and Multicolored Compomers in 6 to 12 years of Children. International Journal of Clinical Pediatric Dentistry, 2018;11(6):483-489.

The Influence of Parenting Style towards Cooperative Levels in Children Aged 3-5 Years during Dental Treatment

AbstractObjective: Children’s behaviour management problems is considered to be the most frequent problems in paediatric dentistry. One of factors that affect response behaviour of children towards dental treatment is parenting style. The purpose of this study was to evaluate the influence of parenting style towards cooperative levels in children aged 3-5 years during dental treatment.Material and Methods: The study was an observational analitical research with cross sectional research design. To obtain data in the field conducted by distributing Parenting Style and Dimention Questionare (PSDQ) and Frankl Behaviour Rating Scale to 130 respondents who currently make use of dental treatment in Hasanuddin University Dental Collage and Hospital.Results: Results showed that there are simultaneous effects of independent variables on the dependent variable with a sig &lt; α (0,05), while the partial variables that most influence on patient cooperative variable is authoritarian with B Exponen of 8,370.Conclusion: There is a significant influence of parenting style towards cooperative levels in children aged 3-5 years during dental treatment. Parents with authoritative parenting style would made children cooperative eight times highest compared with other parenting style.

Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale.

AimTo develop a simple method to assess the level of anxiety by using children’s drawings and correlating them with Frankl’s behavior rating scale.Materials and methodsA total of 178 patients aged of 3 to 14 years were handed out two-page forms which contained three sections on coloring and drawing, along with general information, and Frankl’s behavior rating scale for the visit. The three types of drawing exercises given to the patients were geometric copy drawings, coloring a nonthreatening figure, and an empty sheet for freehand drawing.ResultsOut of 178 patients, 60 showed definitely positive behavior, 73 exhibited positive behavior, 37 showed negative behavior, and 8 were definitely negative on Frankl’s behavior rating scale; 133 children had none or, 1 stress marker and 45 exhibited 2 or 3 stress markers in their drawings. Chi-square (χ2) analysis was done with a 2 × 2 contingency table. Observed χ2 value was 46.166, which at 1 degree of freedom was much greater than that at 0.995 percentile. Therefore, the result was highly significant.ConclusionChildren requiring specialized behavioral techniques can be identified by the presence of stress markers in their drawings. This nonverbal activity by itself can have an overall positive effect on the behavior displayed in the dental clinic.How to cite this articleMathur J, Diwanji A, Sarvaiya B, Sharma D. Identifying Dental Anxiety in Children’s Drawings and correlating It with Frankl’s Behavior Rating Scale. Int J Clin Pediatr Dent 2017;10(1):24-28.