ABSTRACT
Little is known about implications of temperament for children who receive nitrous oxide inhalation sedation (N2O/O2) for dental care. The aim of this study was to investigate whether child temperament is associated with success in N2O/O2. Child-caregiver dyads were enrolled from patients aged 36-95 months receiving dental care with N2O/O2 at a university-based pediatric dental clinic. To assess child temperament, 48 caregivers completed the Children's Behavior Questionnaire Short Form. Patient behavior was abstracted from Frankl scores recorded in the patient's chart. The overall behavioral failure rate was 15% (n = 7/48). There was no significant difference in sedation outcome associated with sex, health, insurance status, or complexity of treatment provided. Sedation outcome was significantly associated with the broad temperament domain of Effortful Control and its subscales Attentional Focusing and Inhibitory Control. The Negative Affectivity subscales of Frustration, Sadness, and Soothability and the Extraversion/Surgency subscales Activity and Impulsivity were also significantly associated with sedation outcome. The results of this study suggest that Effortful Control is associated with behavior during dental treatment with N2O/O2. The subscales of Attention Focusing, Inhibitory Control, Frustration, Fear, Sadness, Soothability, Activity, and Impulsivity may also be important determinants of child behavior during dental treatment.
Subject(s)
Anesthesia, Dental/methods , Anesthesia, Inhalation/methods , Anesthetics, Inhalation/administration & dosage , Child Behavior , Consciousness/drug effects , Nitrous Oxide/administration & dosage , Temperament , Administration, Inhalation , Age Factors , Child , Child, Preschool , Cooperative Behavior , Dental Clinics , Emotions , Female , Gases , Humans , Male , Pilot Projects , Surveys and Questionnaires , WashingtonABSTRACT
PURPOSE: The purpose of this study was to investigate whether temperament, as measured by the Children's Behavior Questionnaire Short Form (CBQ-SF), was associated with success in oral sedation. METHODS: Child-caregiver dyads were enrolled from patients presenting for midazolam, meperidine, and hydroxyzine oral sedation. Children between 36 and 95 months of age, American Society of Anesthesiology (ASA) classification I or II, with diagnostic radiographs, whose parents believed he/she would swallow oral medications, were enrolled. To assess child temperament, caregivers completed the CBQ-SF. Behavior during sedation and overall sedation results were recorded using the Houpt Behavior Rating Scale. Failure was defined by Houpt overall ratings of fair or worse. The presence of disruptive behavior was also quantified. RESULTS: The sample population consisted of 61 patient-caregiver dyads. The overall sedation success rate was 87 percent (N equals 53). Disruptive behavior was present during 28 percent (N equals 17) of total cases. There was not a significant difference in failure rate or presence of disruptive behavior by age, sex, ASA status, insurance status, reason for sedation, or type of treatment provided. High impulsivity scores were significantly associated with disruptive behavior (P=.04). CONCLUSIONS: Impulsivity may be a determinant of a child's behavior during sedation.
