Associação de fatores individuais e familiares com o comportamento da criança na sedação odontopediátrica
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2016-12-13
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Universidade Federal de Goiás
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Objectives: Moderate sedation is indicated to control children’s behavior during dental care, reducing anxiety and maintaining the child's well-being. However, some sedated children do not present good behavior making it difficult to perform dental procedures. This study investigated the association of possible individual factors (temperament) and family (parents’ dental anxiety, parents’ pain catastrophizing and coping strategies adopted by parents) with the children’s behavior during dental treatment under moderate sedation. Methods: A total of 110 children/parents (<7 years), referred to sedation at Dental Sedation Center (NESO) of the Faculty of Dentistry of the Federal University of Goiás, for not have cooperated during dental care, and their parents, participated of this observational study of data from two clinical trials. Children had two appointments: clinical examination and tooth restoration, with local anesthesia and rubber dam, under moderate sedation. The restorative session was filmed for further evaluation of the children's behavior by trained and calibrated observers. The behavior was assessed using the Ohio State University Behavioral Rating Scale OSUBRS. Positive behavior was considered when the children presented 80% or more of the sum of the scores 1 and 2 (quiet or crying) during the entire session. The children’s stress was evaluated through the increased cortisol levels present in the saliva, collected in three moments: arrival, 25 min after local anesthesia, and 25 min after the end of the procedure. Children’s temperament was assessed through the Children’s Behavior Questionnaire (CBQ) answered by parents. Factors related to parents’ anxiety were thus evaluated: dental anxiety using Corah Dental Anxiety Scale; level of pain catastrophizing through the Pain-Catastrophizing Scale-parents; coping strategies through Brief COPE. Data were analyzed using descriptive statistics and the Chi-square test, Friedman, Wilcoxon, Mann-Whitney, Kruskal Wallis or t-test for independent samples. Results: More than half of the children displayed negative behavior (n = 60 54.5%). Temperament did not associate with the negative behavior of children. Extroversion/surgency (P = 0.03) and the subscales ‘activity level’ (P = 0.04), ‘impulsivity’ (P = 0.04) and ‘smiling/laughter’ (P = 0.01) differed between behavior groups, where children with positive behavior had higher scores than those who had negative behavior. In a sample of 42 children, 31 (73.8%) were reactive to stress during local anesthesia and temperament was not associated with increased levels of children’s stress. Dental anxiety and pain catastrophizing were not associated with negative children’s behavior. Parents of children with negative behavior had higher scores in maladaptive coping and Venting subscale, and lower scores in the Acceptance subscale. Conclusion: Coping strategies adopted by the parents explained, in part, negative or positive children´s behavior. These results have shown that parental coping strategies may have protective or destructive effects on children's behavior. Temperament was not associated with negative behavior and did not influence the children´s stress during the injection of local anesthesia. However, many children were stressed during this procedure, a fact that should be always considered by the professional who assist children under moderate sedation.
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MACHADO, Geovanna de Castro Morais. Associação de fatores individuais e familiares com o comportamento da criança na sedação odontopediátrica. 2016. 127 f. Tese (Doutorado em Odontologia) - Universidade Federal de Goiás, Goiânia, 2016.