Folayan M O, Idehen E
Department of Preventive Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria.
J Clin Pediatr Dent. 2004 Winter;28(2):155-61. doi: 10.17796/jcpd.28.2.18w2v457t8878p69.
Dental anxiety develops from a vicious cycle of bodily arousal from dental stimuli, cognitive interpretation and ineffective coping all working in a runaway feedback loop. Behavioral management strategies (BMT) aim at cognitive reorientation, which results in better compliance with instruction. This paper therefore tried to find out possible factors that influence the effective use of BMT during child dental management during treatment by dental operators in Nigeria. The levels of anxiety pre and post treatment were assessed using the short form of the dental version of the Child Fear Survey Schedule. Also, the type of treatment given to the child, the types and number of behavioral strategies employed during dental management as well as the gender and age of the child were noted. The professional status of the attending dental operator was also noted. Prior to the commencement of the study, the five students in the final year, who were to attend to the children in this study received one week training on the psychological management of dental anxiety in children. Results obtained from the dental operators were compared. The type of treatment received by the child did not significantly affect the dental anxiety score. The number of techniques combined by house officers and senior registrars were significantly higher than would be expected by chance (chi2=16.030, P=0.0001 and chi2=9.000, P=0.0001 respectively). Combination of techniques was also more frequent during invasive procedures and when dental anxiety levels were high. Combining techniques also tended to decrease dental anxiety more significantly than otherwise. Training has a role to play in the basic and efficient use in the management of the child dental patient. The training of dentists should thus entail the full spectrum (content and instructional effectiveness) of all psychological techniques.
牙科焦虑源于牙科刺激引起的身体唤醒、认知解读和无效应对这一恶性循环，它们在一个失控的反馈回路中共同起作用。行为管理策略（BMT）旨在进行认知重新定位，从而使患者更好地遵循医嘱。因此，本文试图找出在尼日利亚，牙科医生在儿童牙科治疗管理过程中影响BMT有效使用的可能因素。使用儿童恐惧调查量表牙科版简表评估治疗前后的焦虑水平。此外，还记录了给儿童的治疗类型、牙科管理过程中采用的行为策略的类型和数量以及儿童的性别和年龄。还记录了主治牙科医生的专业地位。在研究开始前，参与本研究为儿童进行治疗的五名最后一年的学生接受了为期一周的儿童牙科焦虑心理管理培训。对牙科医生获得的结果进行了比较。儿童接受的治疗类型对牙科焦虑评分没有显著影响。住院医生和高级住院医师组合使用的技术数量显著高于随机预期（卡方值分别为16.030，P = 0.0001和卡方值为9.000，P = 0.0001）。在侵入性操作期间以及牙科焦虑水平较高时，技术组合也更频繁。与其他情况相比，组合使用技术往往能更显著地降低牙科焦虑。培训在儿童牙科患者管理的基本和有效使用中发挥着作用。因此，牙医的培训应涵盖所有心理技术的全范围（内容和教学效果）。
